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Bayramgürler D, Demirbaş A, Durdu M, Aslankoç GE, Eruyar T, Demirkesen C. Granulomatous Dermatitis Characterized by the Manifestation of Tumor and Plaque Lesions Subsequent to Herpes Zoster: A Case Series. Dermatol Pract Concept 2024; 14:dpc.1402a129. [PMID: 38810031 PMCID: PMC11135929 DOI: 10.5826/dpc.1402a129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 05/31/2024] Open
Affiliation(s)
- Dilek Bayramgürler
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Abdullah Demirbaş
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Murat Durdu
- Department of Dermatology, Faculty of Medicine, Başkent University, Adana, Turkey
| | - Göktuğ Eren Aslankoç
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Tuğrul Eruyar
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Cüyan Demirkesen
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
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2
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Chien WC, Tsai TF. Pressure and Skin: A Review of Disease Entities Driven or Influenced by Mechanical Pressure. Am J Clin Dermatol 2024; 25:261-280. [PMID: 38159214 DOI: 10.1007/s40257-023-00833-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
Skin perceives and reacts to external mechanical forces to create resistance against the external environment. Excessive or inappropriate stimuli of pressure may lead to cellular alterations of the skin and the development of both benign and malignant skin disorders. We conducted a comprehensive literature review to delve into the pressure-induced and aggravated skin disorders and their underlying pressure-related mechanisms. Dysregulated mechanical responses of the skin give rise to local inflammation, ischemia, necrosis, proliferation, hyperkeratosis, impaired regeneration, atrophy, or other injurious reactions, resulting in various disease entities. The use of personal devices, activities, occupations, weight bearing, and even unintentional object contact and postures are potential scenarios that account for the development of pressure-related skin disorders. The spectrum of these skin disorders may involve the epidermis (keratinocytes and melanocytes), hair follicles, eccrine glands, nail apparatuses, dermis (fibroblasts, mast cells, and vasculature), subcutis, and fascia. Clarifying the clinical context of each patient and recognizing how pressure at the cellular and tissue levels leads to skin lesions can enhance our comprehension of pressure-related skin disorders to attain better management.
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Affiliation(s)
- Wei-Chen Chien
- Department of Medical Education, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan.
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3
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R M K, Sekar M. Arriving at SKINTED (Surgery of the Knee, Injury to the Infrapatellar Branch of the Saphenous Nerve, Traumatic Eczematous Dermatitis): A Case Report. Cureus 2024; 16:e54307. [PMID: 38496181 PMCID: PMC10944648 DOI: 10.7759/cureus.54307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/19/2024] Open
Abstract
Surgery of the knee, injury to the infrapatellar branch of the saphenous nerve, traumatic eczematous dermatitis (SKINTED) is a postsurgical localized dermatitis specifically linked to total knee arthroplasty (TKA). It is due to autonomic denervation following surgically inflicted nerve injury. It develops several months to years following a surgical trauma. It is being referred to by various names in the literature. Locoregional immune dysfunction due to lymphatic injury after surgery is the currently accepted theory. It must be distinguished from atopic dermatitis, allergic contact dermatitis/sensitization induced by topical medications or implanted metal hypersensitivity dermatitis, and post-traumatic eczema/dermatitis. We present a case of an elderly female patient in her 50s with dry eczematous lesions over the lateral aspect of the surgical incision over both knees developed three months following bilateral total knee replacement (TKR) done in view of osteoarthritis. The patient responded well to topical corticosteroid and emollient treatment. We have also reviewed the literature to provide an overview of potential concepts of etiopathogenesis described in the literature and to clear up any ambiguity surrounding various labels given to this entity.
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Affiliation(s)
- KavyaDeepu R M
- Dermatology, Chettinad Hospital and Research Institute, Chennai, IND
| | - Mohnish Sekar
- Dermatology, Venereology and Leprosy, Karpaga Vinayaga Institiute of Medical Sciences and Research Centre, Chengalpattu, IND
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4
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Singh S, Narang T, Dogra S. Reverse Koebner phenomenon in erythema nodosum leprosum. Trans R Soc Trop Med Hyg 2024; 118:77-79. [PMID: 37632458 DOI: 10.1093/trstmh/trad066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/19/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Erythema nodosum leprosum (ENL) is an immunologically mediated phenomenon complicating the course of leprosy. Reverse Koebner phenomenon is the term used to describe the sparing of previously injured or diseased skin by new skin lesions of the disease. METHODS A middle-aged woman with a known case of lepromatous leprosy for the past year presented with an eruption of reddish painful nodules over her body. The lesions were found to characteristically spare the sites of previous scars. RESULTS This sparing phenomenon of previous scar sites has been termed reverse Koebner phenomenon, a site of the body that offers greater resistance than the rest of the body to the onset of the disease, seen in various diseases, but it has never been described in ENL. CONCLUSION This sparing of scar sites in ENL can be attributed to reverse Koebner phenomenon.
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Affiliation(s)
- Sukhdeep Singh
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India160012
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India160012
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India160012
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5
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Meyer AM, Macdonald C, Fornadley JM, Taylor KF. Cutaneous Sarcoidosis in Bilateral Carpal Tunnel Release Scars: A Case Report. JBJS Case Connect 2023; 13:01709767-202312000-00001. [PMID: 37797175 DOI: 10.2106/jbjs.cc.23.00143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
CASE A 58-year-old woman with a history of systemic sarcoidosis, 2 years in remission, presented 6 years after bilateral carpal tunnel release with a 3-month history of nodularity, erythema, and tenderness to her bilateral incisions. Histopathology demonstrated noncaseating granulomas without evidence of foreign material or organisms, consistent with infiltrative scar sarcoidosis. Treatment included 4 intralesional corticosteroid injections over 5 months, with progressive resolution of symptoms and no evidence of systemic sarcoidosis reoccurrence. CONCLUSION Sarcoidosis should be considered when presented with a cutaneous lesion in association with an incisional scar, either as primary presentation or as disease recurrence.
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Affiliation(s)
- Andrea M Meyer
- The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Collin Macdonald
- The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
- Penn State Milton S. Hershey Medical Center, Department of Surgery, Division of Plastic and Reconstructive Surgery, Hershey, Pennsylvania
| | - Jeffrey M Fornadley
- The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
- Penn State Milton S. Hershey Medical Center, Department of Surgery, Division of Plastic and Reconstructive Surgery, Hershey, Pennsylvania
| | - Kenneth F Taylor
- The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
- Penn State Milton S. Hershey Medical Center, Department of Orthopedics and Rehabilitation, Division of Hand Surgery, Hershey, Pennsylvania
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6
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Kulkarni S, Adya KA, Inamadar A. Post skin graft eczematous dermatitis at the donor and recipient sites: a case of Ruocco's immunocompromised district. BMJ Case Rep 2023; 16:e255883. [PMID: 37524508 PMCID: PMC10391823 DOI: 10.1136/bcr-2023-255883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Affiliation(s)
- Shruti Kulkarni
- Dermatology Venereology and Leprosy, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Keshavmurthy A Adya
- Dermatology Venereology and Leprosy, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Arun Inamadar
- Dermatology Venereology and Leprosy, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
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7
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Liang Z, Zhang M, Hao Y, Shan M, Liu H, Xia Y, Chen Q, Chang G, Wang Y. Risk factors associated with keloid infections: A five-year retrospective study. Int Wound J 2023. [PMID: 36746767 DOI: 10.1111/iwj.14099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/09/2023] [Indexed: 02/08/2023] Open
Abstract
Keloid infections reduce patient-reported quality of life greatly. Characteristics and risk factors of keloid infections have not been thoroughly studied. So, a retrospective cohort study was conducted focusing on the potential risk factors, microbiologic cultures and histological findings. Keloid patients consulting for surgical interventions were included in this study. Data were collected from their electronic medical records. 564 patients were recruited with the keloid infection rate being 22.4%. For adult patients, age above 40 years (OR, 2.84; P = .000), disease duration of 12 years or more (OR, 3.03; P = .000), the number of keloids over 3 (OR, 1.59; P = .050) and the presence of family history (OR, 1.91; P = .027) were significantly associated with keloid infections. Suppurative keloids were located mostly in thorax (61.79%). For the under-age subgroup(n = 25), family history was frequently seen in patients with infections. Microbiologic cultures revealed a mixed spectrum of bacteria including Staphylococcus (25%), Actinomyces (30%) and Prevotella (10%). The rate of epidermoid cysts was 19.7% in histological examination. Age > 40 years, disease duration ≥12 years, the number of keloids >3 and the presence of family history are risk factors for keloid infections.
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Affiliation(s)
- Zhengyun Liang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingzi Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yan Hao
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mengjie Shan
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hao Liu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yijun Xia
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qiao Chen
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Guojing Chang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Youbin Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
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8
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Ammar H, Ben Fredj N, Ben Romdhane H, Chaabane A, Chadli Z, Ben Fadhel N, Aouam K. Cross-reactivity between nonsteroidal anti-inflammatory drugs in fixed drug eruption: Two unusual cases and a literature review. Br J Clin Pharmacol 2023; 89:561-573. [PMID: 36223303 DOI: 10.1111/bcp.15565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/22/2022] [Accepted: 10/05/2022] [Indexed: 01/18/2023] Open
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the main causes of fixed drug eruption (FDE). Cross-sensitivity between chemically unrelated NSAIDs has been rarely described in FDE. We report herein two cases of NSAID-induced FDE confirmed by oral provocation test (OPT) with a literature review. Case 1 is a 49-year-old woman who took mefenamic, naproxen and acetaminophen for lumbago. On the second day, she noticed three erythematous plaques, located in the upper lip, chin and the right hand, which faded spontaneously, leaving residual patches. Three months later, she took mefenamic acid with reactivation of the same plaques. She received naproxen. On the same day, she exhibited a reactivation of lesions with the development of a new one. These lesions have disappeared leaving hyperpigmented sequelae. After negative patch test to naproxen, an OPT was performed with positive reaction, observed on the third day. To establish the cross-reactivity, she underwent OPTs, which gave positive results to indomethacin, ketoprofen and tiaprofenic acid. Case 2 is a 52-year-old woman who presented painful dusky-red macules, located in the right and left wrists, 24 hours after taking mefenamic acid. She described two similar events that occurred in the past with an undefined drug and piroxicam. Patch tests to lysine acetylsalicylate, mefenamic acid, piroxicam, naproxen and celecoxib were negative. OPTs to the same NSAIDs gave positive results to lysine acetylsalicylate, piroxicam and mefenamic acid. Thirteen case reports, seven case series and one retrospective analysis, including cases with confirmed cross-reactivity between NSAIDs, were reported in literature. Clinicians should be aware of such phenomenon.
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Affiliation(s)
- Helmi Ammar
- Department of Pharmacology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Nadia Ben Fredj
- Department of Pharmacology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Haifa Ben Romdhane
- Department of Pharmacology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Amel Chaabane
- Department of Pharmacology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Zohra Chadli
- Department of Pharmacology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Najah Ben Fadhel
- Department of Pharmacology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Karim Aouam
- Department of Pharmacology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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9
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Tabka M, Gammoudi R, Frioui R, Fetoui N, Mokni S, Ounallah A, Belajouza C, Denguezli M. Unilateral Rosacea in a Patient With Multiple Sclerosis. Dermatol Pract Concept 2022; 12:e2022187. [PMID: 36534579 PMCID: PMC9681237 DOI: 10.5826/dpc.1204a187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Mariem Tabka
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
| | - Rima Gammoudi
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
| | - Refka Frioui
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
| | - Nadia Fetoui
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
| | - Sana Mokni
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
| | - Amina Ounallah
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
| | - Colondane Belajouza
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
| | - Mohamed Denguezli
- Department of Dermatology, Farhad Hachad Hospital of Sousse, Sousse, Tunisia
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10
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Abstract
PURPOSE OF REVIEW Coronavirus disease 2019 (COVID-19) is a well established respiratory tract illness. Recent studies in adults and children have shown an increasing number of patients reporting polymorphic cutaneous manifestations during COVID-19, including different types of rashes, from maculopapular, vascular, vesicular to atypical forms. RECENT FINDINGS Although pathogenesis of skin manifestations is still not fully understood, it has been proposed that cutaneous involvement during COVID-19 may be the results of the activation of the immune response against severe acute respiratory syndrome coronavirus-2, the reactivation or co-infection of herpesviruses or drug hypersensitivity. SUMMARY According to available literature, skin manifestations in patients with COVID-19 may be categorized on the basis of their clinical presentations as follows: erythematous rashes, lesions of vascular origin, vesicular rash, urticarial rash and acute generalized exanthematous pustulosis (AGEP), erythema multiforme and other polymorphic erythema/atypical reactions. Prompt recognition of these cutaneous manifestations represents a crucial point to facilitate diagnosis and management of COVID-19 patients.
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11
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Pearlman R, Badon H, Whittington A, Brodell RT, Ward KH. The Isooncotopic Response:
Immunotherapy‐Associated
Bullous Pemphigoid in Tumor Footprints. Clin Exp Dermatol 2022; 47:1379-1381. [DOI: 10.1111/ced.15177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/12/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Ross Pearlman
- University of Mississippi Medical Center Jackson Mississippi USA
| | - Hannah Badon
- University of Mississippi Medical Center Jackson Mississippi USA
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12
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Mizuta T, Kato M. Anastrozole-related dermatitis with mainly unilateral distribution. Australas J Dermatol 2022; 63:e173-e175. [PMID: 35196401 DOI: 10.1111/ajd.13813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Takahiro Mizuta
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Miyuki Kato
- Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
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13
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The sparing phenomenon of cutaneous amyloidosis. Postepy Dermatol Alergol 2021; 38:694-695. [PMID: 34658715 PMCID: PMC8501440 DOI: 10.5114/ada.2021.108928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/22/2019] [Indexed: 11/29/2022] Open
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14
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Choi B, Tan MG, Gooderham MJ, Beecker J. Reverse koebnerization of primary cutaneous follicle center lymphoma following skin biopsy. JAAD Case Rep 2021; 16:149-151. [PMID: 34621940 PMCID: PMC8484730 DOI: 10.1016/j.jdcr.2021.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Bohmyi Choi
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Marcus G Tan
- Division of Dermatology, University of Ottawa, and The Ottawa Hospital, Ottawa, Canada
| | | | - Jennifer Beecker
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Division of Dermatology, University of Ottawa, and The Ottawa Hospital, Ottawa, Canada.,The Ottawa Hospital Research Institute, Ottawa, Canada
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15
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Piccolo V, Mazzatenta C, Bassi A, Argenziano G, Cutrone M, Grimalt R, Russo T. COVID vaccine-induced lichen planus on areas previously affected by vitiligo. J Eur Acad Dermatol Venereol 2021; 36:e28-e30. [PMID: 34547122 PMCID: PMC8657361 DOI: 10.1111/jdv.17687] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/15/2021] [Indexed: 12/22/2022]
Affiliation(s)
- V Piccolo
- Dermatology Unit University of Campania, Naples, Italy
| | - C Mazzatenta
- UO Dermatology- Azienda USL Toscana Nord Ovest, Lucca, Italy
| | - A Bassi
- UO Dermatology- Azienda USL Toscana Nord Ovest, Lucca, Italy
| | - G Argenziano
- Dermatology Unit University of Campania, Naples, Italy
| | - M Cutrone
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza, venezia, Italy
| | - R Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - T Russo
- Dermatology Unit University of Campania, Naples, Italy
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16
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Fixed Drug Eruption Induced by Pristinamycin and Amoxicillin-Clavulanic Acid: An Unusual Case of Cosensitization. Dermatitis 2021; 32:e158-e159. [PMID: 34405827 DOI: 10.1097/der.0000000000000775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Farinazzo E, Dianzani C, Zalaudek I, Conforti C, Grabbe S, Goldust M. Synthesis of the Data on COVID-19 Skin Manifestations: Underlying Mechanisms and Potential Outcomes. Clin Cosmet Investig Dermatol 2021; 14:991-997. [PMID: 34385830 PMCID: PMC8354337 DOI: 10.2147/ccid.s325552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 07/24/2021] [Indexed: 01/01/2023]
Abstract
The incidence of coronavirus disease 2019 (COVID-19)-related skin manifestations has progressively grown, in parallel with the global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreading. The available evidence indicates that cutaneous signs are heterogeneous and can be divided as follows: a) erythematous rashes, b) lesions of vascular origin, c) vesicular rashes, d) urticarial rashes, and e) acute generalized exanthematous pustulosis (AGEP), erythema multiforme (EM) and other polymorphic/atypical reactions. Most cutaneous manifestations appear simultaneously or after respiratory and/or systemic symptoms such as fever, even if rarely urticaria has been reported as the first sign of the disease. It has been proposed that erythematous and vesicular rashes, as well as urticaria, are the result of immunological activation against Sars-CoV-2, similarly to other viral exanthems; alternatively, reactivation or co-infection of herpesviruses and drug hypersensitivity represent possible etiologic diagnosis that has to be considered. Regarding lesions of vascular origin, ischemic ones are the result of systemic hypercoagulability established in severe infections, whereas chilblains seem to be linked to the type I-interferon massively produced to halt virus replication. AGEP is triggered by drugs, whereas EM could represent a delayed immune response to the virus or a hypersensitivity reaction to drugs elicited by the inflammatory process built to fight the infection. A further pathogenic hypothesis is that the virus, or its particles detected in the skin (particularly in endothelium and eccrine glands), could be responsible for certain skin reactions, including chilblains and EM. From the available data, it appears that chilblains are correlated with younger age and less severe disease, while ischemic manifestations occur in the elderly with severe infection. In conclusion, larger studies are needed to confirm the suggested pathogenetic mechanisms of COVID-19-related skin reactions and to determine the potential prognostic significance of each one.
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Affiliation(s)
- Eleonora Farinazzo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Caterina Dianzani
- Dermatology Section, Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Biomedico University Hospital, Rome, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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18
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Kapoor P, Bansal S, Boparai AS, Kaur N, Brar AK, Khera U. Molluscum contagiosum localised to sites of superficial dermatophytosis. Indian J Dermatol Venereol Leprol 2021; 87:748. [PMID: 34379965 DOI: 10.25259/ijdvl_1412_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Priya Kapoor
- Department of Dermatology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Shivani Bansal
- Department of Dermatology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Amarbir Singh Boparai
- Department of Dermatology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Narvinderjeet Kaur
- Department of Dermatology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Arwinder Kaur Brar
- Department of Dermatology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Utkarshni Khera
- Department of Pathology, All India Institute of Medical Sciences, Bathinda, Punjab, India
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19
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Ozbagcivan O, Ayozcan DF, Lebe B. Lichen sclerosus et atrophicus on dimples: a striking example of immunocompromised cutaneous district. J Eur Acad Dermatol Venereol 2021; 35:e817-e819. [PMID: 34242434 DOI: 10.1111/jdv.17509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/11/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Affiliation(s)
- O Ozbagcivan
- Faculty of Medicine, Department of Dermatology, Dokuz Eylul University, Izmir, Turkey
| | - D F Ayozcan
- Faculty of Medicine, Department of Dermatology, Dokuz Eylul University, Izmir, Turkey
| | - B Lebe
- Faculty of Medicine, Department of Pathology, Dokuz Eylul University, Izmir, Turkey
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20
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A Review of Acquired Autoimmune Blistering Diseases in Inherited Epidermolysis Bullosa: Implications for the Future of Gene Therapy. Antibodies (Basel) 2021; 10:antib10020019. [PMID: 34067512 PMCID: PMC8161452 DOI: 10.3390/antib10020019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/24/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Gene therapy serves as a promising therapy in the pipeline for treatment of epidermolysis bullosa (EB). However, with great promise, the risk of autoimmunity must be considered. While EB is a group of inherited blistering disorders caused by mutations in various skin proteins, autoimmune blistering diseases (AIBD) have a similar clinical phenotype and are caused by autoantibodies targeting skin antigens. Often, AIBD and EB have the same protein targeted through antibody or mutation, respectively. Moreover, EB patients are also reported to carry anti-skin antibodies of questionable pathogenicity. It has been speculated that activation of autoimmunity is both a consequence and cause of further skin deterioration in EB due to a state of chronic inflammation. Herein, we review the factors that facilitate the initiation of autoimmune and inflammatory responses to help understand the pathogenesis and therapeutic implications of the overlap between EB and AIBD. These may also help explain whether corrections of highly immunogenic portions of protein through gene therapy confers a greater risk towards developing AIBD.
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21
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Lowy DB, Makker PGS, Moalem-Taylor G. Cutaneous Neuroimmune Interactions in Peripheral Neuropathic Pain States. Front Immunol 2021; 12:660203. [PMID: 33912189 PMCID: PMC8071857 DOI: 10.3389/fimmu.2021.660203] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/17/2021] [Indexed: 12/14/2022] Open
Abstract
Bidirectional interplay between the peripheral immune and nervous systems plays a crucial role in maintaining homeostasis and responding to noxious stimuli. This crosstalk is facilitated by a variety of cytokines, inflammatory mediators and neuropeptides. Dysregulation of this delicate physiological balance is implicated in the pathological mechanisms of various skin disorders and peripheral neuropathies. The skin is a highly complex biological structure within which peripheral sensory nerve terminals and immune cells colocalise. Herein, we provide an overview of the sensory innervation of the skin and immune cells resident to the skin. We discuss modulation of cutaneous immune response by sensory neurons and their mediators (e.g., nociceptor-derived neuropeptides), and sensory neuron regulation by cutaneous immune cells (e.g., nociceptor sensitization by immune-derived mediators). In particular, we discuss recent findings concerning neuroimmune communication in skin infections, psoriasis, allergic contact dermatitis and atopic dermatitis. We then summarize evidence of neuroimmune mechanisms in the skin in the context of peripheral neuropathic pain states, including chemotherapy-induced peripheral neuropathy, diabetic polyneuropathy, post-herpetic neuralgia, HIV-induced neuropathy, as well as entrapment and traumatic neuropathies. Finally, we highlight the future promise of emerging therapies associated with skin neuroimmune crosstalk in neuropathic pain.
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Affiliation(s)
- Daniel B Lowy
- School of Medical Sciences, The University of New South Wales, UNSW Sydney, Sydney, NSW, Australia
| | - Preet G S Makker
- School of Medical Sciences, The University of New South Wales, UNSW Sydney, Sydney, NSW, Australia
| | - Gila Moalem-Taylor
- School of Medical Sciences, The University of New South Wales, UNSW Sydney, Sydney, NSW, Australia
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22
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Verma SB, Panda S, Nenoff P, Singal A, Rudramuruthy SM, Uhrlass S, Das A, Bisherwal K, Shaw D, Vasani R. The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features. Indian J Dermatol Venereol Leprol 2021; 87:154-175. [PMID: 33769736 DOI: 10.25259/ijdvl_301_20] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/01/2020] [Indexed: 12/21/2022]
Abstract
Dermatophytosis has attained unprecedented dimensions in recent years in India. Its clinical presentation is now multifarious, often with atypical morphology, severe forms and unusually extensive disease in all age groups. We hesitate to call it an epidemic owing to the lack of population-based prevalence surveys. In this part of the review, we discuss the epidemiology and clinical features of this contemporary problem. While the epidemiology is marked by a stark increase in the number of chronic, relapsing and recurrent cases, the clinical distribution is marked by a disproportionate rise in the number of cases with tinea corporis and cruris, cases presenting with the involvement of extensive areas, and tinea faciei.
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Affiliation(s)
| | - Saumya Panda
- Department of Dermatology, Belle Vue Clinic, Kolkata, West Bengal, India,
| | - Pietro Nenoff
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India,
| | - Shivprakash M. Rudramuruthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Silke Uhrlass
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India,
| | - Kavita Bisherwal
- Department of Dermatology, Venereology and Leprosy, Lady Hardinge Medical College and SSK Hospital, Delhi, India,
| | - Dipika Shaw
- Department of Medical Microbiology, PGI, Chandigarh, India,
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23
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Bishnoi A, Chatterjee D, Patel S, Vinay K. Classical Cutaneous Lichen Planus Exhibiting Locus Minoris Resistentiae. Indian Dermatol Online J 2020; 11:1019-1021. [PMID: 33344365 PMCID: PMC7734977 DOI: 10.4103/idoj.idoj_197_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/23/2020] [Accepted: 06/28/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Patel
- Department of Orthopedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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24
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Cohen PR, Erickson CP, Uebelhoer NS, Calame A. Tattoo-Associated Basal Cell Carcinoma: Coincident or Coincidence. Biomed Hub 2020; 5:2055-2062. [PMID: 32884932 DOI: 10.1159/000508208] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/25/2020] [Indexed: 12/13/2022] Open
Abstract
Tattoos may be associated with medical complications including, albeit rarely, skin cancer. The features of a 46-year-old man who developed a basal cell carcinoma within a tattoo on his left scapula are described and the characteristics of the other 13 patients (7 men and 6 women) with tattoo-associated basal cell carcinoma are reviewed. The tumor usually occurs on the sun-exposed skin of individuals aged 60 years and older whose tattoo has often been present for 20 years or more. The pathogenesis of a basal cell carcinoma developing within a tattoo may merely be a coincidence. However, there is supporting evidence that the tattoo and the subsequent basal cell carcinoma may be coincident events whereby either tattoo injection-associated trauma or the tattoo pigments and dyes (in their native state or after ultraviolet radiation alteration) or both have a carcinogenic impact on the development of the basal cell carcinoma at that location.
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Affiliation(s)
- Philip R Cohen
- San Diego Family Dermatology, National City, California, USA.,Department of Dermatology, Touro University California College of Osteopathic Medicine, Vallejo, California, USA
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25
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Tabosa GVBS, Stelini RF, Souza EM, Velho PENF, Cintra ML, Florence MEB. Immunocompromised cutaneous district, isotopic, and isopathic phenomena-Systematic review. J Cosmet Dermatol 2020; 20:410-416. [PMID: 32629542 DOI: 10.1111/jocd.13592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the development of lesions in skin areas that have undergone injury has long been known, understanding of its pathogenesis is limited. Depending on their peculiarities, those events have been described as isomorphic, reverse isomorphic, pseudoisomorphic, isotopic, and isopathic phenomena. Ruocco's immunocompromised cutaneous district (ICD) concept was proposed to include all those phenomena. AIMS We performed a systematic review and critically evaluated the current understanding about ICD and its relationship with the isotopic and isopathic phenomena. METHODS To illustrate the complexity of the theme, we present a case of subclinical leprosy, whose manifestation was brisk in an old tattoo. The possible interaction between the approached phenomena, acting in the genesis of the disease, made this a pertinent study. The research was conducted under the PRISMA-P guidelines, in seven biomedical databases between 1996 and 2018. The eligibility criteria were systematic reviews, meta-analyses, clinical studies, and case series, written in English, French, Italian, Portuguese, or Spanish. RESULTS Using standardized keywords, 1220 articles were identified. After applying the eligibility criteria, 53 studies were selected. CONCLUSION This review ratifies that all these phenomena are aspects of one single condition. They can be integrated into the ICD concept with the pathogenesis including: (a) neural damage (peripheral or central) and (b) chronic lymphedema. Both may change the local neuroimmune interaction. The identification of these phenomena and the understanding of their pathogenesis are of paramount importance, to define the diagnosis and choose the therapeutic strategy.
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Affiliation(s)
| | - Rafael F Stelini
- Department of Pathology, Medical Sciences School, Unicamp, Campinas, Brazil
| | - Elemir M Souza
- Department of Dermatology, Medical Sciences School, Unicamp, Campinas, Brazil
| | - Paulo E N F Velho
- Department of Dermatology, Medical Sciences School, Unicamp, Campinas, Brazil
| | - Maria L Cintra
- Department of Pathology, Medical Sciences School, Unicamp, Campinas, Brazil
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26
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Yoshida S, Fujimura T, Ohuchi K, Kambayashi Y, Segawa Y, Yamazaki E, Tono H, Takahashi T, Tsuchiyama K, Aiba S. IL-23 Expression in Stewart-Treves Syndrome: Two Case Reports and Immunohistochemical Investigation. Case Rep Oncol 2020; 13:462-467. [PMID: 32508617 PMCID: PMC7250377 DOI: 10.1159/000506975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 12/18/2022] Open
Abstract
Stewart-Treves syndrome (STS) is a rare cutaneous lymphangiosarcoma developing from chronic lymph edema as a consequence of radical mastectomy or surgical invasion of the groin for the treatment of cervical or penile cancer. Previous reports suggested possible mechanisms in the development of lymphangiosarcoma that correlate with the immunological background of STS patients. In this report, we described two cases of STS developing in patients who underwent radical dissection for cervical cancer, we employed immunohistochemical staining of IL-23 and IL-17.
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Affiliation(s)
- Saaya Yoshida
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kentaro Ohuchi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yuichiro Segawa
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Emi Yamazaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hisayuki Tono
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toshiya Takahashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenichiro Tsuchiyama
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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27
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Sala ACA, Crespo ACF, Stelini RF, Leite O, Moraes AM, Velho PENF, Souza EM, Cintra ML. Chronic Venous Insufficiency as a Predisposing Factor for Basal Cell Carcinoma on Legs. Ann Vasc Surg 2020; 68:185-191. [PMID: 32422291 DOI: 10.1016/j.avsg.2020.04.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/17/2020] [Accepted: 04/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The main risk factor associated with basal cell carcinomas (BCCs) is believed to be exposure to ultraviolet radiation (UVR). In the case of lower limb BCC, the frequency is higher in women, possibly because of greater exposure of the leg to UVR. Chronic venous insufficiency (CVI), also more common in women, may have some association with leg BCCs. METHODS We retrospectively evaluated the histopathological features of leg BCCs removed between 1993 and 2017 in a tertiary referral center. The patients' clinical data were obtained from medical records, considering, in particular, CVI. RESULTS We selected 149 patients with leg BCCs, predominately occurring in elderly Caucasian women. Of those, 71 had a clinical diagnosis of CVI in whom the clinical tumor size and frequency of recurrences were significantly higher than patients without CVI. There was an association between clinical diagnosis of CVI and histological findings of (1) follicular induction in epidermis and (2) distal sweat duct hyperplasia. CONCLUSIONS CVI, besides the already known UVR exposure, is probably associated with leg BCCs and may determine a worse BCC course.
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Affiliation(s)
| | | | | | - Oriete Leite
- Department of Dermatology, Medical School, Unicamp, Campinas, SP, Brazil
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28
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Shimizuguchi T, Sekiya N, Hara K, Taguchi A, Nakajima Y, Miyake Y, Shibata Y, Taguchi K, Ogawa H, Ito K, Karasawa K. Radiation therapy and the risk of herpes zoster in patients with cancer. Cancer 2020; 126:3552-3559. [PMID: 32412661 DOI: 10.1002/cncr.32926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 02/23/2020] [Accepted: 04/02/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND The role and impact of radiation therapy (RT) on the development of herpes zoster (HZ) has not been well studied. The objective of this study was to investigate the association between RT and HZ. METHODS A propensity score-matched, retrospective cohort study was conducted using institutional cancer registry data and medical records from 2011 to 2015. The risk of developing HZ in the RT and non-RT groups was compared using a Cox proportional hazards model. Associations also were explored between the RT field and the anatomic location of HZ in patients who developed HZ after RT. The expected number of HZ events within the radiation field was calculated according to the RT received by each patient; then, this number was compared with the observed number of in-field events. RESULTS Of 17,655 patients, propensity score matching yielded 4350 pairs; of these, 3891 pairs were eligible for comparison. The cumulative incidence of HZ in the RT group (vs the non-RT group) during the first 5 years after the index date was 2.1% (vs 0.7%) at 1 year, 3.0% (vs 1.0%) at 2 years, 3.4% (vs 1.3%) at 3 years, 4.1% vs 1.7% at 4 years, and 4.4% vs 1.8% at 5 years. The RT group showed a significantly higher risk of HZ than the non-RT group (hazard ratio, 2.59, 95% CI, 1.84-3.66). In the 120 patients who developed HZ after RT, HZ events were observed significantly more frequently within the RT field than expected (74 vs 43.8 events; P < .001). CONCLUSIONS Patients with cancer who received RT showed a significantly higher risk of HZ, which was commonly observed within the radiation field.
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Affiliation(s)
- Takuya Shimizuguchi
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Noritaka Sekiya
- Department of Infection Prevention and Control, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.,Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Konan Hara
- Graduate School of Economics, The University of Tokyo, Tokyo, Japan.,Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Ayumi Taguchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yujiro Nakajima
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.,Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan
| | - Yu Miyake
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yukiko Shibata
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kentaro Taguchi
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroaki Ogawa
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kei Ito
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Katsuyuki Karasawa
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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29
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Verma SB, Gupta S, Yadav A, Ruocco E. Varicella and herpes zoster appearing over sites of tinea corporis, hitherto unreported examples of immunocompromised districts: a case series. Int J Dermatol 2020; 59:758-759. [DOI: 10.1111/ijd.14810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/12/2020] [Indexed: 01/22/2023]
Affiliation(s)
| | - Sanjeev Gupta
- Department of Dermatology Maharishi Markandeshwar Institute of Medical Sciences and Research MMDU Mullana Ambala India
| | - Anuradha Yadav
- Department of Dermatology Maharishi Markandeshwar Institute of Medical Sciences and Research MMDU Mullana Ambala India
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30
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Verma SB. What's in a name? Surgical incision sites are potential immunocompromised districts. Int J Dermatol 2020; 59:e23-e24. [PMID: 31483489 DOI: 10.1111/ijd.14621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 08/09/2019] [Indexed: 01/24/2023]
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31
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Fergus KB, Lee AW, Baradaran N, Cohen AJ, Stohr BA, Erickson BA, Mmonu NA, Breyer BN. Pathophysiology, Clinical Manifestations, and Treatment of Lichen Sclerosus: A Systematic Review. Urology 2020; 135:11-19. [DOI: 10.1016/j.urology.2019.09.034] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 11/25/2022]
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32
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Carlesimo M, Pigliacelli F, D'Arino A, Caro G, Magri F, De Vincentiis L, Soda G, Fortuna MC, Rossi A. Isoradiotopic response of discoid lupus after radiotherapy: A case report and review of the literature. Dermatol Ther 2019; 33:e13183. [DOI: 10.1111/dth.13183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/09/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Marta Carlesimo
- Department of Internal Medicine and Medical Specialties, UOC DermatologySapienza University of Rome Rome Italy
| | - Flavia Pigliacelli
- Department of Internal Medicine and Medical Specialties, UOC DermatologySapienza University of Rome Rome Italy
| | - Andrea D'Arino
- Department of Internal Medicine and Medical Specialties, UOC DermatologySapienza University of Rome Rome Italy
| | - Gemma Caro
- Department of Internal Medicine and Medical Specialties, UOC DermatologySapienza University of Rome Rome Italy
| | - Francesca Magri
- Department of Internal Medicine and Medical Specialties, UOC DermatologySapienza University of Rome Rome Italy
| | | | - Giuseppe Soda
- Department of Molecular MedicineSapienza University of Rome Rome Italy
| | - Maria C. Fortuna
- Department of Internal Medicine and Medical Specialties, UOC DermatologySapienza University of Rome Rome Italy
| | - Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, UOC DermatologySapienza University of Rome Rome Italy
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33
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Mohapatra L, Samal K, Mohanty P, Dash S. Reverse Koebner Phenomenon in Bullous Pemphigoid - A Case Report. Indian Dermatol Online J 2019; 10:692-694. [PMID: 31807450 PMCID: PMC6859752 DOI: 10.4103/idoj.idoj_512_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Reverse Koebner response is the nonappearance or disappearance of the lesions of particular dermatoses at the site of injury. Herein we report a case of the reverse Koebner phenomenon in bullous pemphigoid in a 35-year-old male patient with sparing of the waist area which could probably be because of the phenomenon of locus majoris resistentiae. The histopathology of the lesion showed subepidermal split with a mixed inflammatory infiltrate, which was composed of predominantly eosinophils, neutrophils, and lymphocytes, but the histopathology of the spared skin showed no abnormalities. However, the direct immunofluorescence from the perilesional area showed linear deposits of immunoglobulin G and C3 in the dermoepidermal junction, but there were no deposits in direct immunofluorescence from the spared skin. This case is being reported for its originality and one of its kind.
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Affiliation(s)
- Liza Mohapatra
- Department of Skin and VD, SCB Medical College and Hospital, Cuttack, Odisha, India
| | - Kallolinee Samal
- Department of Skin and VD, SCB Medical College and Hospital, Cuttack, Odisha, India
| | - Prasenjeet Mohanty
- Department of Skin and VD, SCB Medical College and Hospital, Cuttack, Odisha, India
| | - Siddhartha Dash
- Department of Skin and VD, SCB Medical College and Hospital, Cuttack, Odisha, India
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34
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Verma SB. Tinea Confined to Tattoo Sites - An Example of Ruocco's Immunocompromised District. Indian Dermatol Online J 2019; 10:739-740. [PMID: 31807466 PMCID: PMC6859758 DOI: 10.4103/idoj.idoj_343_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shyam B Verma
- In Skin Clinic, Diwali Pura Race Course, Akota, Vadodara, Gujarat, India
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35
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Abudu B, Erickson CP, Calame A, Cohen PR. Basal Cell Carcinoma Originating in a Tattoo: Case Report and Review of an Uncommon Complication in Tattoo Recipients. Dermatol Pract Concept 2019; 9:265-270. [PMID: 31723458 DOI: 10.5826/dpc.0904a03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2019] [Indexed: 10/31/2022] Open
Abstract
Background The placement of a tattoo is a common event. Basal cell carcinoma arising from a tattoo is rare despite this neoplasm being the most common form of skin cancer. Objective We describe a 41-year-old man who developed a basal cell carcinoma in his tattoo and review the literature of basal cell carcinomas originating in a tattoo. Methods A literature search using PubMed was performed. The following terms were searched: "basal," "carcinoma," "cell," and "tattoo." The characteristics of individuals with a basal cell carcinoma originating in a tattoo were analyzed and summarized. Results A total of 13 patients (6 women and 7 men) with a basal cell carcinoma arising in a tattoo have been reported. The majority of the tumors were located on the head (6 cases, 46.2%) followed by either an upper extremity (4 cases, 30.7%) or the trunk (3 cases, 23.1%). Most of the carcinomas were asymptomatic; however, 2 patients reported pruritus associated with their tumor. Nodular basal cell carcinoma was the most common subtype diagnosed (5 tumors), followed by superficial basal cell carcinoma (2 tumors). One patient had either a pagetoid or a mixed (nodular and sclerosing) histology. The pathological variant was not described for 4 patients. Conclusions Basal cell carcinoma arising in a tattoo is a rare occurrence. Although this occurrence may be coincidental, emerging evidence of carcinogenesis associated with tattoo pigment may suggest a causal link. Elucidating this important relationship warrants further investigation.
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Affiliation(s)
- Boya Abudu
- University of California San Diego School of Medicine, La Jolla, CA, USA
| | | | | | - Philip R Cohen
- San Diego Family Dermatology, National City, CA, USA.,Touro University California College of Osteopathic Medicine, Vallejo, CA, USA
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36
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Vojvodic A, Tirant M, Nardo VD, Lotti T, Wollina U. Immunocompromised Districts of Skin: A Case Series and a Literature Review. Open Access Maced J Med Sci 2019; 7:2969-2975. [PMID: 31850101 PMCID: PMC6910813 DOI: 10.3889/oamjms.2019.680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/07/2019] [Accepted: 09/08/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The concept of immunocompromised districts of skin has been developed by Ruocco and helps to explain certain aspects of the macromorphology of skin diseases. This concept unites the isomorphic response of Koebner and the isotopic response of Wolf. CASE REPORTS We present different cutaneous conditions which can lead to immunocompromised districts of skin such as scars, radiodermatitis, lymphedema, disturbed innervation or mechanical friction etc. Typical and rarer skin disorders associated with them are discussed and illustrated by their observations. CONCLUSION At this moment, we wish to inform dermatologists and non-dermatologists about Ruocco's concept and its implications.
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Affiliation(s)
- Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
| | - Michael Tirant
- Department of Dermatology, University of Rome "G. Marconi", Rome, Italy.,Hanoi Medical University, Hanoi, Vietnam
| | - Veronica di Nardo
- Department of Dermatology, University of Rome "G. Marconi", Rome, Italy
| | - Torello Lotti
- Department of Dermatology, University of Rome "G. Marconi", Rome, Italy
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
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37
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Verma SB. Adding 'SKINTED' to the list of immunocompromised districts. Clin Exp Dermatol 2019; 45:346-347. [PMID: 31437872 DOI: 10.1111/ced.14082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2019] [Indexed: 11/28/2022]
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38
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Tanaka A, Yamashita C, Hinogami H, Shirai H, Yamamura J, Ito R. Localized Cutaneous Adverse Event Induced by Anastrozole as Adjuvant Treatment for Breast Cancer: A Case Report. Case Rep Dermatol 2019; 11:57-63. [PMID: 31011314 PMCID: PMC6465706 DOI: 10.1159/000497469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/28/2019] [Indexed: 11/19/2022] Open
Abstract
Cutaneous adverse events caused by aromatase inhibitors have been reported to be rare. We describe a rare case of a cutaneous adverse event that developed in a cancer-affected breast after aromatase inhibitor treatment. A 72-year-old postmenopausal female patient who was diagnosed with stage IA breast cancer received anastrozole as adjuvant treatment. Six months after the initiation of anastrozole, she developed an irregularly shaped purpuric plaque with several purpuric papules surrounding the postoperative scar on her left breast. Histological findings revealed capillary vessel proliferation and expansion, with hemorrhage in the superficial dermis. Immunohistochemistry of the skin biopsy specimen revealed hormone receptor expression limited to the vascular endothelial cells of the proliferating and expanding vessels. We believe that anastrozole induced a change in the local estrogen level, which affected the hormone receptor-positive endothelial cells in the dermis near the primary lesion of the breast cancer and caused a cutaneous adverse event only in the aforementioned area.
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Affiliation(s)
- Aya Tanaka
- Department of Dermatology, Sakai City Medical Center, Sakai-shi, Japan
| | - Chigusa Yamashita
- Department of Dermatology, Sakai City Medical Center, Sakai-shi, Japan
| | - Haruna Hinogami
- Department of Dermatology, Sakai City Medical Center, Sakai-shi, Japan
| | - Hirohiko Shirai
- Department of Dermatology, Sakai City Medical Center, Sakai-shi, Japan
| | - Jun Yamamura
- Department of Surgery, Breast Oncology, Sakai City Medical Center, Sakai-shi, Japan
| | - Ryota Ito
- Department of Pathology, Sakai City Medical Center, Sakai-shi, Japan
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39
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Truss A, Papalexandris S, Gardner S, Harvey R. Localised bullous pemphigoid overlying knee arthroplasty: a diagnostic challenge. BMJ Case Rep 2019; 12:12/4/e227440. [PMID: 30954955 DOI: 10.1136/bcr-2018-227440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An elderly Caucasian woman developed bullous pemphigoid (BP) overlying the site of total knee arthroplasty for osteoarthritis 2 days after surgery. The clinical findings were consistent with blistering due to soft tissue swelling, bullous impetigo or allergic contact dermatitis. The blistering spread over weeks to months down the ipsilateral leg and then to the other leg and hips. A biopsy for H&E and direct immunofluorescence established the diagnosis of BP. A concomitantly occurring wound infection was identified and treated. The blistering responded well to superpotent topical steroids and local care.
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Affiliation(s)
- Adam Truss
- Department of Surgery, Arrowe Park Hospital, Wirral, UK
| | | | - Susan Gardner
- Department of Surgery, Arrowe Park Hospital, Wirral, UK
| | - Robert Harvey
- Department of Surgery, Arrowe Park Hospital, Wirral, UK
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40
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De Vita V, Ruocco E. Isomorphic and isotopic responses after radiation therapy. Cancer Radiother 2019; 23:73-74. [PMID: 30639378 DOI: 10.1016/j.canrad.2017.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/12/2017] [Indexed: 10/27/2022]
Affiliation(s)
- V De Vita
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - E Ruocco
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
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41
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Ranugha PSS, Betkerur JB, Veeranna S, Basavaraj V. Appearance of Verruca Over Linear Verrucous Epidermal Nevus - An Example of Locus Minoris Resistentiae: A Report of Three Cases. Indian Dermatol Online J 2018; 9:334-337. [PMID: 30258804 PMCID: PMC6137671 DOI: 10.4103/idoj.idoj_337_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Locus minoris resistentiae (LMR) is a site of the body that offers lesser resistance than the rest of the body to the onset of disease. It can be congenital or acquired. Areas of cutaneous mosaicism such as epidermal nevi can act as congenital LMR, leading to the development of inflammatory skin conditions or skin tumors on these. The occurrence of an infectious condition such as warts over nevi is rare. We report three cases of verrucous epidermal nevi (VENs) with the development of verrruca overlying the nevus later in life. The three patients had VEN on forehead, preauricular, and presternal area, respectively, since birth, with development of a warty lesion overlying these a few months before presenting to us. Skin biopsy and histopathological examination of the linear verrucous lesion were suggestive of VEN with hyperkeratosis, thickened epidermis, and papillomatosis. There was no evidence of epidermolytic hyperkeratosis or increased sebaceous glands in the dermis. Biopsy of the new warty lesion showed findings of verruca in all the patients. With the above findings, a diagnosis of verruca superimposed on linear VEN was made in all the three cases. The warts were removed by electrofulguration. Several acquired skin disorders, including inflammatory dermatoses, adnexal disorders, and neoplasms, have been shown to occur superimposed on epidermal or sebaceous nevus. Ours is probably the first ever description of a wart occurring on VEN.
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Affiliation(s)
- P S S Ranugha
- Department of Dermatology and STD, JSS Medical College and Hospital, JSS University, Mysuru, Karnataka, India
| | - Jayadev B Betkerur
- Department of Dermatology and STD, JSS Medical College and Hospital, JSS University, Mysuru, Karnataka, India
| | - S Veeranna
- Department of Dermatology and STD, JSS Medical College and Hospital, JSS University, Mysuru, Karnataka, India
| | - Vijaya Basavaraj
- Department of Pathology, JSS Medical College and Hospital, JSS University, Mysuru, Karnataka, India
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42
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Prurigo Nodularis after Radiotherapy: An Isoradiotopic Response? Case Rep Dermatol Med 2018; 2018:9186745. [PMID: 30245894 PMCID: PMC6139234 DOI: 10.1155/2018/9186745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 08/02/2018] [Indexed: 11/17/2022] Open
Abstract
Prurigo nodularis is a rare and chronic skin disorder with multiple, pruritic, and firm nodules. The exact pathophysiology is still unknown. Skin disorders appearing at sites of radiation can be defined as isoradiotopic. A 35-year-old male had developed a skin lesion in the left submandibular area on a base of irradiated skin which was initially suspected as a skin malignancy. The patient had a history of undifferentiated nasopharyngeal cancer with lymph node involvement which was treated by radiochemotherapy thirteen years previously. Histological examination confirmed that it was a case of prurigo nodularis which subsequently evolved at distant sites. This presentation may suggest a case of an isoradiotopic response.
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43
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[Bullous pemphigoid localised to a strip of skin]. Ann Dermatol Venereol 2018; 145:636-637. [PMID: 30097211 DOI: 10.1016/j.annder.2018.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/19/2018] [Accepted: 06/29/2018] [Indexed: 11/23/2022]
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44
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A Rare Extraskeletal Osteosarcoma Appearing After 55 Years on a Large Stage 3 Burn Scar. Case Rep Dermatol Med 2018; 2018:5185604. [PMID: 29971170 PMCID: PMC6008689 DOI: 10.1155/2018/5185604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/22/2018] [Indexed: 12/14/2022] Open
Abstract
It is widely accepted that chronic burn wounds may lead to the development of various malignant skin tumors. Deep stage 3 burned areas may facilitate deeper carcinogenesis. Deep tissues are probably less subject to severe insult than is the epithelial layer during physical insult, suggesting that soft tissues transform to a lesser extent during the late stages of tumoral development as in an immunocompromised district with altered local immune defense with both cellular and humoral defense affected. Most authors claim that tumors are almost squamous cell carcinomas, although other types of malignancies such as basal cell carcinoma and, to a lesser extent, melanoma can also be seen. However, malignant transformation of cutaneous soft tissue in a burn insult area has rarely been described. Similarly, burn-induced tumors of histiocytic origin have been reported in few cases and osteosarcoma only in two case reports. Here, we report a patient case suffering from severe large stage 3 burn after-effects on the leg. Fifty-five years after the injury, this patient developed a large extraosseous osteosarcoma on the scar.
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45
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Reverse Koebner phenomenon induced by the Mantoux test in erythrodermic psoriasis: A case report and literature review. JAAD Case Rep 2018; 4:586-589. [PMID: 29942829 PMCID: PMC6010968 DOI: 10.1016/j.jdcr.2018.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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46
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Atypical Cutaneous Presentations of Sarcoidosis: Two Case Reports and Review of the Literature. Curr Allergy Asthma Rep 2018; 18:40. [PMID: 29904803 DOI: 10.1007/s11882-018-0794-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW The goal of this review is to provide the reader with an updated summary of the cutaneous manifestations of systemic sarcoidosis, with a particular emphasis on the predilection of sarcoidosis for scars, tattoos, and other areas of traumatized skin. RECENT FINDINGS While the mechanism underlying the propensity for traumatized skin to develop sarcoidosis lesions remains unclear, several theories have been proposed including the idea that cutaneous sarcoidosis represents an exuberant, antigen-driven foreign-body response, as well as the theory that traumatized skin represents an immunocompromised district with altered local immune trafficking and neural signaling. In this review, we present two cases in which the development of cutaneous lesions in scars and tattoos was integral to the diagnosis of systemic sarcoidosis. We then review the various cutaneous manifestations of systemic sarcoidosis, the clinical characteristics and differential diagnosis of scar and tattoo sarcoidosis, the proposed mechanism by which traumatized skin is prone to developing sarcoidosis lesions, and current treatments for cutaneous sarcoidosis.
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48
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An unusual swelling of the supraorbital region. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:98-101. [PMID: 29373259 DOI: 10.1016/j.oooo.2017.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 10/29/2017] [Accepted: 11/06/2017] [Indexed: 11/20/2022]
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49
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Wollina U, Schönlebe J, Heinig B, Tchernev G, França K, Lotti T. Segmental Erythema Multiforme-Like Drug Eruption by Aromatase Inhibitor Anastrozole - First Case Report and another Example of an Immunocompromised District. Open Access Maced J Med Sci 2018; 6:79-81. [PMID: 29483990 PMCID: PMC5816324 DOI: 10.3889/oamjms.2018.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 09/07/2017] [Accepted: 09/29/2017] [Indexed: 12/22/2022] Open
Abstract
Anastrozole is a non-selective aromatase inhibitor for adjuvant breast cancer therapy in postmenopausal women. Cutaneous adverse events have been reported. We observed a 64-year-old female patient with a medical history of locally advanced breast cancer of her right breast that was treated with radiotherapy and adjuvant drug therapy with anastrozole. She developed a segmental bullous eruption limited to the cancer-affected breast. Cessation of the aromatase inhibitor and systemic therapy with prednisolone cleared the lesions completely. This is the first report of a segmental erythema multiforme like drug eruption by anastrozole and another example of the concept of the immunocompromised district of skin.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Friedrichstrasse 41, 01067 Dresden, Germany
| | - Jacqueline Schönlebe
- Städtisches Klinikum Dresden - Institute of Pathology "Georg Schmorl", Dresden, Germany
| | - Birgit Heinig
- Städtisches Klinikum Dresden - Center of Physical and Rehabilitative Medicine, Dresden, Germany
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, Sofia, Bulgaria.,Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
| | - Katlein França
- Department of Dermatology and Cutaneous Surgery, Department of Psychiatry & Behavioral Sciences; Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL, USA
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50
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Wollina U, Nowak A, Tchernev G, Lotti T. Chronic Scalp Ulcer 35 Years after Skull Trepanation Surgery and Radiotherapy for Oligodendroglioma: A Further Example of Immunocompromised Cutaneous Districts. Open Access Maced J Med Sci 2018; 6:55-57. [PMID: 29483982 PMCID: PMC5816315 DOI: 10.3889/oamjms.2018.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/17/2017] [Accepted: 08/19/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND: Chronic ulcers of the scalp have a variety of underlying pathologies. In case of cancer patients, a second malignancy must be excluded. CASE REPORT: A 78-year-old female patient presented to our department with a large soft tissue defect on the frontotemporal left side. The lesion was about 3 cm in diameter with exposed bone and inflammatory soft tissue on the edges of the defect. About 35 years ago, she had undergone a combined neurosurgery with skull trepanation and radiotherapy for an oligodendroglioma. Three years ago, sandwich transplantation with the dermal template and meshed skin graft failed. Now she re-presented with inflammatory ulcer borders. A complex defect repair was performed after exclusion of a second malignancy. CONCLUSION: Chronic scalp ulcers may be the result immunocompromised cutaneous districts and need a complex reconstruction.
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Affiliation(s)
- Uwe Wollina
- Städtisches Klinikum Dresden, Dresden, Sachsen, Germany; Academic Teaching Hospital Dresden-Friedrichstadt, Germany
| | - Andreas Nowak
- Department of Anesthesiology & Intensive Care Medicine, Emergency Medicine & Pain Management, Dresden, Germany
| | - Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.,Onkoderma - Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
| | - Torello Lotti
- Università Degli Studi "G. Marconi", Rome, Italy, Facoltà di Medicina e Chirurgia - Chair of Dermatology, University of Rome, Rome, Italy
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