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Klapproth H, Stroucken B, Helbig D, Tantcheva-Poór I, Fabri M. Adult-onset Still's disease: Switch to atypical skin manifestations under anakinra therapy. JAAD Case Rep 2023; 41:60-63. [PMID: 37869367 PMCID: PMC10587671 DOI: 10.1016/j.jdcr.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Affiliation(s)
- Henning Klapproth
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, University Hospital of Cologne, Cologne, Germany
| | - Birte Stroucken
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, University Hospital of Cologne, Cologne, Germany
| | - Doris Helbig
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, University Hospital of Cologne, Cologne, Germany
| | - Iliana Tantcheva-Poór
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, University Hospital of Cologne, Cologne, Germany
| | - Mario Fabri
- Department of Dermatology and Venereology, Faculty of Medicine, University of Cologne, University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, Cologne, Germany
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2
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Yang J, Hu X, Niu M, Zheng X. Prurigo Pigmentosa Successfully Treated with Oral Minocycline: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:1073-1077. [PMID: 37123623 PMCID: PMC10145459 DOI: 10.2147/ccid.s404859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023]
Abstract
Purpose We aimed to report a case of prurigo pigmentosa (PP) with blisters. Patients and Methods A 21-year-old male patient presented to our hospital with erythema, papules, and blisters all over the front chest and back. Densely distributed round and oval edematous erythema was noted on the neck, front chest, and back of the patient. Histopathologic examination of the skin lesions (blisters) on the chest revealed epidermal cell hyperkeratosis. He was diagnosed with PP and was treated with oral minocycline. Results After 1-week minocycline administration, the patient's itching was relieved, and the blisters dried up. His skin lesions recurred following self-withdrawal from the medication; subsequently, the patient was administered oral minocycline treatment again. After 1-month continuous oral treatment, the drug was discontinued. No recurrence of symptoms was noted. Conclusion Oral minocycline is effective for the treatment of PP.
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Affiliation(s)
- Jie Yang
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
| | - Xiaohuan Hu
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
| | - Mu Niu
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
- Correspondence: Mu Niu; Xiaole Zheng, Department of Dermatology, The Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou City, Hainan Province, 570206, People’s Republic of China, Email ;
| | - Xiaole Zheng
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
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Wang HF, Zhou XF, Deng XF, Li YC, Zhang L, Gu HZ, Zhai ZF. Dermoscopy and reflection confocal microscope features of pigmented prurigo. Skin Res Technol 2023; 29:e13258. [PMID: 36704889 PMCID: PMC9838776 DOI: 10.1111/srt.13258] [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: 11/12/2022] [Accepted: 12/05/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Pigmented prurigo (PP) is a chronic and recurrent inflammatory skin disease. PP is not common clinically, but it is easily misdiagnosed because of its diversified clinical manifestations in different stages. MATERIALS AND METHODS We retrospectively analyzed the clinical, histopathological, dermoscopy, and reflectance confocal microscopy (RCM) features of 20 patients diagnosed as PP. RESULTS The female predominance ratio was revealed with male to female of 1:4. Seven female patients were on a diet (without staple food) and one patient had a history of diabetes. Eight cases were suffered in spring, six cases in winter, three cases in summer, and three cases in autumn. Multiple sites were involved in 13 cases. Four patients had urticarial papules and plaques. Nineteen patients had erythematous papules with reticular distribution, of which 14 cases accompanied reticulate hyperpigmentation, four cases with papulovesicle, and two cases accompanied with pustules. One patient only showed reticulate hyperpigmentation. In the early lesions, dermatoscopy showed pink oval lesions, punctate or linear vessels, and pale yellow rings around the skin lesions. RCM is characterized by spongiosis, spongy vesicle, neutrophils scattered in the epidermis, which was consistent with epidermis spongiosis, neutrophils infiltrating into the upper epidermis and necrotic keratinocytes in histopathology. In the fully developed lesions, dermatoscopy showed pink lesions with brown pigment granules in the center and linear vessels in the edge. RCM showed that demarcation of epidermis and dermis is not clear, and inflammatory cells can be seen in the upper dermis and histopathologically lesions assumed a patchy lichenoid pattern, and the inflammatory cells infiltrating the dermis were dominated by lymphocytes. In the late lesions, dermatoscopy showed grainy grayish-brown or yellowish-brown pigmentation surrounding the hair follicle merging with each other. RCM showed that pigment granules were increased on the ring of basal cells, inflammatory cells were sparsely infiltrated in the dermal papilla and superficial layer, and epidermis slightly hyperplastic, with melanophages and a few lymphocytes infiltrating the superficial dermis in histopathology. CONCLUSION PP is easily misdiagnosed and not always occurs in those on a restrictive diet. A combination of dermatoscopy and RCM is helpful for its diagnosis of PP.
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Affiliation(s)
- Hui-Fen Wang
- Department of Dermatology, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xiao-Fang Zhou
- Department of Dermatology, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xiang-Fen Deng
- Department of Dermatology, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yuan-Chao Li
- Department of Dermatology, Rheumatology and Immunology, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Lian Zhang
- Department of Dermatology, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Hong-Zhi Gu
- Department of Dermatology, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zhi-Fang Zhai
- Department of Dermatology, The First Affiliated Hospital of Army Medical University, Chongqing, China
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4
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Föhr J, Gschnell M, Cunha T, Hertl M, Didona D. Complete remission of prurigo pigmentosa after oral doxycycline. Dermatol Ther 2022; 35:e15908. [PMID: 36205101 DOI: 10.1111/dth.15908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Julia Föhr
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Martin Gschnell
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Tomas Cunha
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - Dario Didona
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
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5
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Xu M, Wu N, Du Q, Zhou Z, Deng D, Liu Y. Crisaborole: an emerging therapy for prurigo pigmentosa. J Eur Acad Dermatol Venereol 2022; 36:e441-e443. [PMID: 35037315 DOI: 10.1111/jdv.17938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/06/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mingyuan Xu
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Bao'de Road, Shanghai, 200443, China
| | - Nanhui Wu
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Bao'de Road, Shanghai, 200443, China
| | - Qian Du
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Bao'de Road, Shanghai, 200443, China
| | - Zhiyu Zhou
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Bao'de Road, Shanghai, 200443, China
| | - Dan Deng
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Yeqiang Liu
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Bao'de Road, Shanghai, 200443, China
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6
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Oku A, Nakai K, Tsuruta D. A case of prurigo pigmentosa occurring in a patient with psoriasis vulgaris following a ketogenic diet during the COVID-19 pandemic. Int J Dermatol 2021; 60:1437-1438. [PMID: 34363697 PMCID: PMC8444721 DOI: 10.1111/ijd.15833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Aoi Oku
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kozo Nakai
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Mufti A, Mirali S, Abduelmula A, McDonald KA, Alabdulrazzaq S, Sachdeva M, Yeung J. Clinical manifestations and treatment outcomes in prurigo pigmentosa (Nagashima disease): A systematic review of the literature. JAAD Int 2021; 3:79-87. [PMID: 34409375 PMCID: PMC8362297 DOI: 10.1016/j.jdin.2021.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Prurigo pigmentosa (PP) is a rare inflammatory dermatosis characterized by pruritic erythematous papules that coalesce to form a reticulate pattern. PP is often misdiagnosed, and patients are treated with ineffective therapies. Although the majority of reports about PP are from East Asia, patients of all backgrounds can be affected. OBJECTIVES To perform a systematic review of reported PP cases with the purpose of summarizing the clinical presentation and treatment of PP. METHODS MEDLINE and Embase were searched for original articles describing PP. We identified 115 studies from 24 countries representing 369 patients to include in the analysis. RESULTS Of the 369 patients included in the analysis, the mean age was 25.6 years (range: 13-72 years) with 72.1% (266 of 369) female. Risk factors or aggravating factors were described in 52.3% (193 of 369) of patients and included dietary changes (25.5%, 94 of 369), friction (8.4%, 31 of 369), sweat (7.6%, 28 of 369), and ketonuria (5.1%, 19 of 369). Of those patients who experienced PP following dietary changes, 40.4% (38 of 94) started a ketogenic diet. Minocycline monotherapy was the most frequently prescribed treatment for PP (20.9%, 77 of 369), achieving complete resolution in 48.1% (37 of 77) of patients. CONCLUSIONS PP is sometimes associated with ketogenic diets and can be effectively managed with oral tetracyclines.
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Affiliation(s)
- Asfandyar Mufti
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sara Mirali
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Abrahim Abduelmula
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Katherine Ann McDonald
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shaikhah Alabdulrazzaq
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Muskaan Sachdeva
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jensen Yeung
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
- Probity Medical Research Inc, Waterloo, Ontario, Canada
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8
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Promyelocytic Differentiation in Infiltrates of Prurigo Pigmentosa: An Analogy to Histiocytoid Sweet Syndrome. Am J Dermatopathol 2020; 42:86-91. [PMID: 31995545 DOI: 10.1097/dad.0000000000001449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Prurigo pigmentosa (PP) is a rare inflammatory dermatosis of unknown etiology. Young women are affected most commonly. Clinically, heavily itchy papules erupt mainly on the trunk healing with residual reticulate pigmentation. Histopathologic descriptions of PP are somewhat controversial. First, PP was reported as lichenoid-interface dermatitis, and later, neutrophils were recognized as the characteristic feature, and the variation in histopathologic patterns was interpreted as a time-dependent phenomenon. Immunohistochemical studies on PP are rare. Biopsies of 5 patients with clinically typical PP were examined histopathologically, and infiltrates were characterized immunohistochemically: myeloperoxidase, CD11c, CD68, CD4, CD8, tryptase, and langerin. In all cases, myeloperoxidase-positive cells with band forms of nuclei and with histiocytoid cytomorphology were identified. They were seen in the epidermis (4/5) and in the dermal infiltrate (5/5). On staining with CD11c, myeloid dendritic cells could be demonstrated in the infiltrate (5/5). In conclusion, myeloid progenitor cells are part of the infiltrate in PP, and they may sometimes be more numerous than mature neutrophils, akin to the situation in histiocytoid Sweet syndrome. This supports the classification of PP as a "neutrophilic dermatosis." In biopsies of suspected PP in which mature neutrophils are sparse, the section should be searched for neutrophilic band forms and histiocytoid promyelocytic cells. Immunohistochemical staining with myeloperoxidase helps to identify such cells and may enable a diagnosis of PP even when mature neutrophils are few.
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9
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Affiliation(s)
- Justin Gabriel Schlager
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland.
| | - Kinan Maurice Hayani
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Matthias Betke
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Hans Wolff
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
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10
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Seol JE, Cho GJ, Park SH, Kim H. Prurigo pigmentosa: An institutional retrospective study of 24 patients. Australas J Dermatol 2020; 62:70-72. [PMID: 32965705 DOI: 10.1111/ajd.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Jung Eun Seol
- Department of Dermatology, Busan Paik Hospital, Inje University, Busan, Korea.,Cardiovascular and Metabolic Disease Center, Inje University, Busan, Korea
| | - Gyeong Je Cho
- Department of Dermatology, Busan Paik Hospital, Inje University, Busan, Korea
| | - So Hee Park
- Department of Dermatology, Busan Paik Hospital, Inje University, Busan, Korea
| | - Hyojin Kim
- Department of Dermatology, Busan Paik Hospital, Inje University, Busan, Korea
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11
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Navarro-Triviño FJ, Pérez-López I, Ruíz-Villaverde R. Doxycycline, an antibiotic or an anti-inflammatory agent? The Most Common uses in dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2019.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Navarro-Triviño FJ, Pérez-López I, Ruiz-Villaverde R. Doxycycline, an Antibiotic or an Anti-Inflammatory Agent? The Most Common Uses in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:561-566. [PMID: 32401726 DOI: 10.1016/j.ad.2019.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/28/2019] [Accepted: 12/18/2019] [Indexed: 10/24/2022] Open
Abstract
Doxycycline is a synthetic tetracycline that was approved in 1967. This wide-spectrum antibiotic has been shown to also have useful anti-inflammatory properties that make it suitable for the treatment of a number of noninfectious conditions. Tetracyclines are probably the most commonly prescribed antibiotics in dermatology, where they are usually used at doses lower than those effective against infections. They also have an excellent efficacy and safety profile. Because of doxycycline's ability to inhibit the molecular pathways associated with certain processes, this antibiotic can be used to treat hair follicle diseases, granulomatous diseases, and vascular proliferation, among other conditions. The main properties of doxycycline and its many applications in dermatology make this drug one that specialists should become familiar with.
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Affiliation(s)
- F J Navarro-Triviño
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario San Cecilio, Granada, España.
| | - I Pérez-López
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario San Cecilio, Granada, España
| | - R Ruiz-Villaverde
- Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario San Cecilio, Granada, España
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Goh SW, Adawiyah J, Md Nor N, Yap F, Ch'ng P, Chang CC. Skin eruption induced by dieting - an underdiagnosed skin disease in Malaysia. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2019; 14:42-46. [PMID: 31289632 PMCID: PMC6612274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prurigo pigmentosa is an inflammatory dermatosis characterized by a pruritic, symmetrically distributed erythematous papular or papulo-vesicular eruption on the trunk arranged in a reticulated pattern that resolves with hyperpigmentation. It is typically non-responsive to topical or systemic steroid therapy. The exact etiology is unknown, but it is more commonly described in the Far East countries. Dietary change is one of the predisposing factors. We report on nine young adult patients with prurigo pigmentosa, among whom five were on ketogenic diets prior to the onset of the eruptions. All cases resolved with oral doxycycline with no recurrence. We hope to improve the awareness of this uncommon skin condition among general practitioners and physicians so that disfiguring hyperpigmentation due to delayed diagnosis and treatment can be avoided.
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Affiliation(s)
- S W Goh
- MB BCh (Soton), MRCP (UK) Medical Department, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur Malaysia.,
| | - J Adawiyah
- MB BCh BAO, MMed (UKM) AdvMDerm (UKM), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur Malaysia.,
| | - N Md Nor
- MBBCH (Cardiff), MRCP (UK), AdvMDerm (UKM), Medical Department, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
| | - Fbb Yap
- MD (UNIMAS), MRCP (UK), AdvMDerm (UKM), Universiti Tunku Abdul Rahman, Selangor, Malaysia,
| | - Pwb Ch'ng
- MD (UKM), MRCP (UK), AdvMDerm (UKM), Gleneagles Kuala Lumpur Kuala Lumpur, Malaysia,
| | - C C Chang
- MBBS (Malaya), MRCP (UK), AdvMDerm (UKM), Gleneagles Kuala Lumpur, Kuala Lumpur, Malaysia
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Sanchez J, Durlach A, Bernard P, Cribier B, Viguier M. Prurigo pigmentosa in a fair-skinned European woman: Dramatic improvement with doxycycline. Ann Dermatol Venereol 2019; 146:219-222. [PMID: 30777290 DOI: 10.1016/j.annder.2018.12.006] [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] [Received: 04/30/2018] [Revised: 07/30/2018] [Accepted: 12/03/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Prurigo pigmentosa is a rare inflammatory, pruriginous skin disease seen predominantly in young Asian women, with average age of onset in the mid-20s. OBSERVATION A 25-year-old fair-skinned European woman presented with a two-year history of pruriginous skin lesions recurring fortnightly. The initial lesions were inflammatory papules, which first emerged on the back of the neck before spreading to the shoulders, below the breasts and the back. The papules resolved leaving a reticular hyperpigmented network that gradually worsened after each episode. The clinical presentation and histopathological findings were consistent with a diagnosis of prurigo pigmentosa. Doxycycline 200mg/day was initiated, with rapid resolution, absence of any further flare-ups and gradual regression of the reticular pigmentation. DISCUSSION Prurigo pigmentosa is a skin disease of stereotypical presentation marked by frequent inflammatory flare-ups involving the trunk that are followed by periods of remission with residual hyperpigmentation. Herein we report a case observed in a fair-skinned French female subject. It is important that dermatologists are able to recognize it and distinguish it from other forms of pruriginous papular dermatosis, owing to the dramatic efficacy of tetracyclines in controlling the inflammatory flares and in reducing the adverse aesthetic impact of hyperpigmentation.
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Affiliation(s)
- J Sanchez
- Department of Dermatology, Hôpital Robert-Debré, avenue du Général Koenig, 51092 Reims cedex, France
| | - A Durlach
- Department of Histopathology, Hôpital Maison Blanche, 51092 Reims, France
| | - P Bernard
- Department of Dermatology, Hôpital Robert-Debré, avenue du Général Koenig, 51092 Reims cedex, France
| | - B Cribier
- Department of Dermatology, Centre Hospitalo Universitaire de Strasbourg, 67091 Strasbourg, France
| | - M Viguier
- Department of Dermatology, Hôpital Robert-Debré, avenue du Général Koenig, 51092 Reims cedex, France.
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Gómez-Zubiaur A, Pericet-Fernández L, Vélez-Velázquez MD, Knöpfel N, Trasobares-Marugán L. Pruritic reticulated eruption. Pediatr Dermatol 2018; 35:239-241. [PMID: 29575070 DOI: 10.1111/pde.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alba Gómez-Zubiaur
- Department of Dermatology, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Laura Pericet-Fernández
- Department of Dermatology, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Maria Dolores Vélez-Velázquez
- Department of Pathology, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Nicole Knöpfel
- Department of Dermatology, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Lidia Trasobares-Marugán
- Department of Dermatology, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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16
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Abstract
Prurigo pigmentosa is a rare inflammatory skin disease of unknown origin, mostly described in the ethnic Japanese population. Etiology and pathogenesis are not completely known. Tetracyclines or dapsone are the therapy of choice. A 17-year-old Swiss patient with Turkish parents presented with pruritic rash on the neck and trunk, which started after a diet. Under therapy with doxycycline over 5 weeks, complete healing with slight reticular hyperpigmentation was observed.
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17
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Satter E, Rozelle C, Sperling L. Prurigo Pigmentosa: An under‐recognized inflammatory dermatosis characterized by an evolution of distinctive clinicopathological features. J Cutan Pathol 2016; 43:809-14. [DOI: 10.1111/cup.12763] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 04/07/2016] [Accepted: 06/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Elizabeth Satter
- Departments of Dermatology and PathologyUniformed Services University of the Health Sciences Bethesda MD 20814
| | - Christopher Rozelle
- Department of PathologyUniformed Services University of the Health Sciences Bethesda MD 20814
| | - Leonard Sperling
- Departments of Dermatology and PathologyUniformed Services University of the Health Sciences Bethesda MD 20814
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18
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Abstract
Prurigo pigmentosa, also referred to as Nagashima's disease, is a rare inflammatory skin condition of unknown etiology. It typically presents as pruritic erythematous papules, papulovesicles, and vesicles appearing in a reticular pattern on the back, chest, or neck. The histological features of prurigo pigmentosa vary according to the stage of the disease. Early-stage disease is characterized by a superficial perivascular infiltrate of neutrophils; spongiosis and necrotic keratinocytes commonly appear in later stages. The etiology of prurigo pigmentosa has yet to be determined. Oral minocycline is usually the first-line therapy for prurigo pigmentosa. However, doxycycline, macrolide antibiotics, and/or dapsone (diaminodiphenyl sulfone) may be indicated for some patients. We describe the key features of prurigo pigmentosa, including the epidemiology, clinical and histologic presentation, differential diagnosis, postulated pathogenesis, and treatment options for this condition.
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Affiliation(s)
- Bryce D Beutler
- University of Nevada School of Medicine, 1060 Wiegand Road, Encinitas, CA, 92024, USA.
| | - Philip R Cohen
- Department of Dermatology, University of California San Diego, San Diego, CA, USA.
| | - Robert A Lee
- Department of Dermatology, University of California San Diego, San Diego, CA, USA.
- Dermatopathology, University of California San Diego, San Diego, CA, USA.
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Abstract
Prurigo pigmentosa (PP) is a rare inflammatory dermatosis originally reported in Japan. Since then, most reports have originated from Asia, and to a lesser extent from Europe. Although the pathogenesis remains unclear, it is now established that PP is linked to ketoacidotic states. Four patients diagnosed with PP were identified from the dermatopathology database at the American University of Beirut Medical Center between January 2009 and December 2013. Clinicopathologic findings in the 4 patients were similar to those previously reported in the literature. The patients were all female with a mean age of 23.5 years. They all presented with itchy erythematous reticulated papulovesicles/plaques leaving variable reticulated brownish patches. Two patients had, in addition, annular lesions arranged en cocarde and pustules, respectively. In 3 patients, the rash was associated with fasting or dieting. The rash had a predilection to the trunk and proximal part of the upper extremities. One patient had intergluteal area involvement. Two biopsy specimens revealed psoriasiform hyperplasia and neutrophilic exocytosis mimicking psoriasis or an impetiginized spongiotic dermatitis. One biopsy specimen exhibited a mild superficial perivascular lymphocytic infiltrate with ballooning and reticular degeneration, a picture mimicking a viral exanthema. Another biopsy specimen exhibited a picture similar to chronic spongiotic dermatitis. Although mostly described in Japan, PP has been described much less frequently in the Middle East region likely due to mis/underdiagnosis. Therefore, increased awareness is necessary especially because fasting is a common religious practice among Arab countries. Further investigations are necessary to better understand the etiopathogenesis of this rare entity.
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Abstract
Prurigo pigmentosa (PP) is a rare inflammatory dermatosis of unknown cause characterized by a predominantly truncal eruption of pruritic erythematous papules in a reticular pattern, resolving with hyperpigmentation. PP is twice as common in girls and women, and the mean age at onset is 25 years. Diagnosis of PP is challenging and is aided by characteristic histopathologic findings. We report a case of PP in a 17-year-old white boy. The eruption arose during strict adherence to a ketogenic diet.
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Chao LL, Lu CF, Shih CM. Molecular detection and genetic identification of Borrelia garinii and Borrelia afzelii from patients presenting with a rare skin manifestation of prurigo pigmentosa in Taiwan. Int J Infect Dis 2013; 17:e1141-7. [DOI: 10.1016/j.ijid.2013.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/07/2013] [Accepted: 08/07/2013] [Indexed: 11/29/2022] Open
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22
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Muthalaly AS, Bradish J, Sampson R, Hugenberg ST, Ang DC, Warren S, Muthalaly A. Prurigo pigmentosa as an atypical persistent plaque-like skin rash in adult-onset Still’s disease: case report and literature review. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/ijr.13.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Neuman MG, McKinney KK, Nanau RM, Kong V, Malkiewicz I, Mazulli T, Moussa G, Cohen LB. Drug-induced severe adverse reaction enhanced by human herpes virus-6 reactivation. Transl Res 2013; 161:430-40. [PMID: 23333110 DOI: 10.1016/j.trsl.2012.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 12/17/2012] [Accepted: 12/20/2012] [Indexed: 01/20/2023]
Abstract
Reactivation of certain latent viruses has been linked with a more severe course of drug-induced hypersensitivity reaction (HSR). For example, reactivation of human herpes virus (HHV)-6 is associated with severe organ involvement and a prolonged course of disease. The present study discusses an HSR developed in a previously healthy male exposed to ceftriaxone, doxycycline, vancomycin, and trimethoprim/sulfamethoxazole (co-trimoxazole; TMP/SMX). Initially, the patient presented clinical manifestations of HSR, as well as clinical and laboratory measurements compatible with liver and renal failure. Moreover, the patient presented skin desquamation compatible with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis. During the reaction, it was observed HHV-6 reactivation. The severity of clinical symptoms is correlated with HHV-6 titer, as well as with results of the in vitro lymphocyte toxicity assay (LTA). Serum levels of a large panel of cytokines are compared between the patient, a large population of SJS patients, and a cohort of healthy controls, using data collected by our laboratory over the years. HHV-6 was measured in the cell culture media from lymphocytes incubated with each of the 4 drugs. Moreover, we describe a new assay using cytokines released by patient lymphocytes following in vitro exposure to the incriminated drugs as biomarkers of HSR. Based on LTA results, HHV-6 reactivation and cytokine measurements, we establish that only doxycycline and TMP/SMX were involved in the HSR. As result of this analysis, the patient could continue to use the other 2 antibiotics safely.
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Affiliation(s)
- Manuela G Neuman
- In Vitro Drug Safety and Biotechnology, Toronto, Ontario, Canada.
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24
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Abstract
A 23-year-old Chinese man presented with a 3-year history of a pruritic eruption. On examination, pink urticarial papules associated with hyperpigmented reticulated patches were noted on his neck, back, and upper chest. Histopathology revealed vacuolar interface dermatitis and numerous gram-negative rods within a dilated hair follicle. The organisms were reactive with anti-Helicobacter pylori immunohistochemisty. The histologic findings and clinical presentation support the diagnosis of prurigo pigmentosa. Additional testing demonstrated a positive urease breath test and serum H. pylori IgG antibodies. The patient was referred to gastroenterology and treated with appropriate antibiotics. After treatment, esophagogastroduodenoscopy revealed chronic gastritis without evidence of H. pylori infection and his skin showed reticulated hyperpigmented patches without evidence of active inflammatory papules. Although previous reports have associated prurigo pigmentosa to H. Pylori gastritis, this is the first report of H. pylori organisms identified in a skin biopsy of prurigo pigmentosa.
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Kim JK, Chung WK, Chang SE, Ko JY, Lee JH, Won CH, Lee MW, Choi JH, Moon KC. Prurigo pigmentosa: Clinicopathological study and analysis of 50 cases in Korea. J Dermatol 2012; 39:891-7. [DOI: 10.1111/j.1346-8138.2012.01640.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 06/26/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Jae Kyung Kim
- Department of Dermatology; University of Ulsan College of Medicine, Asan Medical Center; Seoul; Korea
| | - Woon Kyong Chung
- Department of Dermatology; University of Ulsan College of Medicine, Asan Medical Center; Seoul; Korea
| | - Sung Eun Chang
- Department of Dermatology; University of Ulsan College of Medicine, Asan Medical Center; Seoul; Korea
| | - Joo Yeon Ko
- Department of Dermatology; Hanyang University College of Medicine; Seoul; Korea
| | - Jong Hee Lee
- Department of Dermatology; Seoul National University, Boramae Medical Center; Seoul; Korea
| | - Chong Hyun Won
- Department of Dermatology; University of Ulsan College of Medicine, Asan Medical Center; Seoul; Korea
| | - Mi Woo Lee
- Department of Dermatology; University of Ulsan College of Medicine, Asan Medical Center; Seoul; Korea
| | - Jee Ho Choi
- Department of Dermatology; University of Ulsan College of Medicine, Asan Medical Center; Seoul; Korea
| | - Kee Chan Moon
- Department of Dermatology; University of Ulsan College of Medicine, Asan Medical Center; Seoul; Korea
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Kokol R, Miljković J, El Shabrawi-Caelen L. Prurigo pigmentosa. J Dtsch Dermatol Ges 2011; 9:867-8. [PMID: 21801307 DOI: 10.1111/j.1610-0387.2011.07757.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rok Kokol
- Department of Dermatology, Medical University of Graz, Austria.
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27
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Mok Y, Lim K, Tey H. Doxycycline - an emerging therapy for prurigo pigmentosa. J Eur Acad Dermatol Venereol 2011; 26:526-7. [DOI: 10.1111/j.1468-3083.2011.04090.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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