1
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Liu Y, Cai L, Zhou Y. A blood blister-like aneurysm occurring on an intracranial dissecting aneurysm: A case report. Asian J Surg 2024; 47:2449-2450. [PMID: 38302355 DOI: 10.1016/j.asjsur.2024.01.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Yongsheng Liu
- Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lize Cai
- Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Youxin Zhou
- Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
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2
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Bastien AJ, Amin L, Moses J, Sacks W, Ho AS. Cutaneous fistula formation after thyroid nodule rupture: A rare complication after radiofrequency ablation. Head Neck 2024; 46:E40-E43. [PMID: 38270507 DOI: 10.1002/hed.27654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND With innovative treatment options such as radiofrequency ablation (RFA) for thyroid nodules, new complications are being identified. It is important to define and delineate complications in order to counsel patients appropriately about treatment options and their associated risks and benefits. METHODS A 46-year-old male presented with a left thyroid nodule (6.5 cm). Fine needle aspiration results were benign. He started to develop intermittent dyspnea and underwent one RFA procedure. Approximately 6 days post-RFA, the neck area was raised and red with blister. The skin overlying the blister underwent eventual dehiscence with fluid spillage. Several months later, MRI imaging showed substernal extension with tracheal deviation. RESULTS A left thyroid lobectomy was performed with cutaneous excision and successful closure of a fistula. CONCLUSIONS This is the first reported case of a thyroid nodule rupture following RFA which manifested into a thyro-cutaneous fistula and required surgical intervention.
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Affiliation(s)
- Amanda J Bastien
- Division of Otolaryngology - Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Luv Amin
- Division of Otolaryngology - Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jeffrey Moses
- Division of Otolaryngology - Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Wendy Sacks
- Division of Endocrinology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Allen S Ho
- Division of Otolaryngology - Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
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3
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Antoniadis J, Gomes De Pinho Q, Koubi M, Macagno N, Benyamine A, Granel B. [A bullous eruption]. Rev Med Interne 2024; 45:253-254. [PMID: 38705594 DOI: 10.1016/j.revmed.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 05/07/2024]
Affiliation(s)
- J Antoniadis
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France
| | - Q Gomes De Pinho
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France
| | - M Koubi
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France
| | - N Macagno
- Service d'anatomie pathologique et de neuropathologie, hôpital Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - A Benyamine
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France
| | - B Granel
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France.
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4
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Saoji V, Madke B, Saoji S, Talasila SR. Non-inflammatory blisters in the case of chikungunya. BMJ Case Rep 2024; 17:e259817. [PMID: 38458765 DOI: 10.1136/bcr-2024-259817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Affiliation(s)
- Vikrant Saoji
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| | - Bhushan Madke
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| | - Sampada Saoji
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
| | - Sree Ramya Talasila
- Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, India
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5
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López Sanz P, Rodríguez de Vera Guardiola C, Escario Travesedo E. Annular Erythematous Plaques With Overlying Blisters in a Cluster of Jewels Pattern. JAMA Dermatol 2024; 160:356-357. [PMID: 38265771 DOI: 10.1001/jamadermatol.2023.4461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
A woman in her 80s presented with erythematous, nondesquamative, annular plaques in a cluster of jewels pattern on her wrists and legs. What is your diagnosis?
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Affiliation(s)
- Pablo López Sanz
- Department of Dermatology, Hospital General Universitario de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | | | - Eduardo Escario Travesedo
- Department of Dermatology, Hospital General Universitario de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
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6
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Dang H, Radunzel N, Pouw A. Subepithelial Corneal Bullae after Posttrabeculectomy Ocular Digital Massage. Ophthalmol Glaucoma 2024; 7:205. [PMID: 38519248 DOI: 10.1016/j.ogla.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/12/2024] [Accepted: 01/25/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Hansen Dang
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa
| | - Nicole Radunzel
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa
| | - Andrew Pouw
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa
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7
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Wang PY, Niu H, Yin YK, Yin GW. Multiple blisters in a 6-month old infant. Pediatr Dermatol 2024; 41:331-333. [PMID: 37872651 DOI: 10.1111/pde.15457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023]
Affiliation(s)
- Pei-Yu Wang
- Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hao Niu
- Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ya-Kun Yin
- Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guang-Wen Yin
- Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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8
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Gherghel N, Technau-Hafsi K, Mockenhaupt M, Eyerich K, Schempp CM. [Urticarial dermatitis with blister formation]. Dermatologie (Heidelb) 2024; 75:268-270. [PMID: 38214726 DOI: 10.1007/s00105-023-05279-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Nicole Gherghel
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Kristin Technau-Hafsi
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Maja Mockenhaupt
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland
| | - Christoph M Schempp
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.
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9
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Tovar Vetencourt A, Sayed-Ahmed I, Gomez J, Chen H, Agostini B, Carroll K, Parry T, Krishnan S, Sabater AL. Ocular Gene Therapy in a Patient with Dystrophic Epidermolysis Bullosa. N Engl J Med 2024; 390:530-535. [PMID: 38324486 DOI: 10.1056/nejmoa2301244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Dystrophic epidermolysis bullosa is a rare genetic disease caused by damaging variants in COL7A1, which encodes type VII collagen. Blistering and scarring of the ocular surface develop, potentially leading to blindness. Beremagene geperpavec (B-VEC) is a replication-deficient herpes simplex virus type 1-based gene therapy engineered to deliver functional human type VII collagen. Here, we report the case of a patient with cicatrizing conjunctivitis in both eyes caused by dystrophic epidermolysis bullosa who received ophthalmic administration of B-VEC, which was associated with improved visual acuity after surgery.
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Affiliation(s)
- Arianna Tovar Vetencourt
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Ibrahim Sayed-Ahmed
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Jennifer Gomez
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Hubert Chen
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Brittani Agostini
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Kate Carroll
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Trevor Parry
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Suma Krishnan
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
| | - Alfonso L Sabater
- From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (A.T., I.S.-A., J.G., A.L.S.); and Krystal Biotech, Pittsburgh (H.C., B.A., K.C., T.P., S.K.)
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10
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Wang J, Xu J. Newborn Girl Presenting With Erythema and Blisters. JAMA Dermatol 2024; 160:222-223. [PMID: 38090992 DOI: 10.1001/jamadermatol.2023.4221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
A female child presents for 3-year follow-up with erythema, vesicles, and bullae present since birth and an increasing number of annular hyperkeratotic plaques and palmoplantar hyperkeratosis. What is your diagnosis?
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Affiliation(s)
- Jiayue Wang
- Department of Dermatology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
- Department of Dermatology, Capital Medical University, Beijing Children's Hospital, Beijing, China
| | - Jiaosheng Xu
- Department of Dermatology, Capital Medical University, Beijing Children's Hospital, Beijing, China
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11
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Rushton R, Richie D. Friction Blisters of the Feet: A Critical Assessment of Current Prevention Strategies. J Athl Train 2024; 59:8-21. [PMID: 36701678 PMCID: PMC10783476 DOI: 10.4085/1062-6050-0341.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Friction blisters are a common injury of the feet sustained by individuals participating in sporting, recreational, and military activities. The high incidence of friction blisters brings into question the effectiveness of common prevention strategies. The purpose of this article was to review current evidence for established blister-prevention strategies and to explore how these interventions address the factors that cause friction blisters. Preventive strategies, focusing on previously overlooked elements of the blister-causing mechanism, are proposed. Areas of future research that are much needed to reduce this common skin injury in active individuals are outlined.
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Affiliation(s)
- Rebecca Rushton
- Esperance Podiatry and BlisterPod, Esperance, Western Australia, Australia
| | - Douglas Richie
- California School of Podiatric Medicine at Samuel Merritt University, Oakland
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12
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Korrapati A, Ta CN, Mitchell BC, Wall PV, Gurusamy P, Dwight K, Girard PJ, Schwartz AK, Kent WT. Fracture blisters: predictors for time to definitive fixation in pilon fractures. Eur J Orthop Surg Traumatol 2024; 34:161-166. [PMID: 37386191 PMCID: PMC10771370 DOI: 10.1007/s00590-023-03623-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/17/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE Fracture blisters, a common soft-tissue complication of pilon fractures, are associated with post-operative wound infections, delays in definitive fixation, and alterations in surgical plan. The purpose of this study was to (1) identify the delay in surgery attributable to the presence fracture blisters and (2) investigate the relationship of fracture blisters to comorbidities and fracture severity. METHODS Patients with pilon fractures at an urban level 1 Trauma center from 2010 to 2021 were identified. The presence or absence of fracture blisters was noted, along with location. Demographic information, time from injury to external fixator placement, and time to definitive open reduction internal fixation (ORIF) were collected. Pilon fractures were classified according to AO/OTA guidelines using CT imaging and plain radiographs. RESULTS 314 patients with pilon fractures were available for analysis, eighty (25%) of whom were found to have fracture blisters. Patients with fracture blisters had longer time to surgery compared to those without fracture blisters (14.2 days vs 7.9 days, p < 0.001). A greater proportion of patients with fracture blisters had AO/OTA 43C fracture patterns, compared with those without fracture blisters (71.3% vs 53.8%, p = 0.03). Fractures blisters were less likely to be localized over the posterior ankle (12%, p = 0.007). CONCLUSION The presence of fracture blisters in pilon fractures are associated with significant delays in time to definitive fixation and higher energy fracture patterns. Fracture blisters are less commonly located over the posterior ankle which may support the implementation of a staged posterolateral approach when managing these injures.
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Affiliation(s)
- Avinaash Korrapati
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - Canhnghi N Ta
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - Brendon C Mitchell
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - Pelle V Wall
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - Pradyumna Gurusamy
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - Kathryn Dwight
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - Paul J Girard
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - Alexandra K Schwartz
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA
| | - William T Kent
- Department of Orthopaedic Surgery, University of California San Diego, 200 W Arbor Drive, MC 8894, San Diego, CA, 92103, USA.
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13
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Codina Barbosa J, Benavent Puiggené A, Álvarez Vukov M, Baselga Torres E, Fernández Santervás Y. Annular grouped blisters on an infant. An Pediatr (Barc) 2024; 100:77-78. [PMID: 38185572 DOI: 10.1016/j.anpede.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/24/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Jana Codina Barbosa
- Servicio de Pediatría, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.
| | - Ares Benavent Puiggené
- Servicio de Pediatría, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain
| | - Mariana Álvarez Vukov
- Servicio de Anatomía Patológica, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain
| | - Eulàlia Baselga Torres
- Servicio de Dermatología Pediátrica, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain
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Abstract
Friction blisters on the feet commonly occur when individuals engage in active pursuits such as running, hiking, and military training. The high prevalence of blisters in active individuals underscores the fact that the pathomechanics of this condition are not fully understood. The traditional blister causation paradigm revolves around heat, moisture, and friction. In reality, foot friction blisters are caused by repetitive shear deformation. The 3 fundamental elements of blister-inducing shear deformation are (1) motion of bone, (2) high friction force, and (3) repetition of the resulting shear events. Rubbing at the skin surface is not a mechanism for friction blister formation. To that end, prevention of the friction blister continues to be an elusive quest for both the patient and the treating clinician. In this article, we aimed to highlight the limitations of the long-held blister-causation paradigm and offer a new explanation.
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Affiliation(s)
- Rebecca Rushton
- Esperance Podiatry and BlisterPod, Esperance, Western Australia, Australia
| | - Douglas Richie
- California School of Podiatric Medicine at Samuel Merritt University, Seal Beach
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15
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Shimada Y, Ohtomo R, Hayashi H, Suyama Y. Hemorrhagic Blisters in the Lower Extremities. Intern Med 2023; 62:3719-3720. [PMID: 37164673 PMCID: PMC10781544 DOI: 10.2169/internalmedicine.1608-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/27/2023] [Indexed: 05/12/2023] Open
Affiliation(s)
- Yusuke Shimada
- Department of General Medicine, Nerima Hikarigaoka Hospital, Japan
| | - Rie Ohtomo
- Department of Pathology, JR Tokyo General Hospital, Japan
| | - Hiroaki Hayashi
- Department of International Healthcare, NTT Medical Center Tokyo, Japan
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16
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Smith KN, Maddy AJ, Motaparthi K. Lupus erythematosus-specific bullous lesions. Dermatol Online J 2023; 29. [PMID: 38478668 DOI: 10.5070/d329662997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 05/01/2024] Open
Abstract
Lupus erythematosus (LE)-specific bullous lesions are often difficult to distinguish from other bullous diseases presenting in patients with systemic lupus erythematosus. Herein, we describe a 49-year-old woman with systemic lupus erythematosus with recurrent tense bullae on the forearms. Clinical, histopathologic, and serologic findings led to the diagnosis of LE-specific bullous lesions. We also summarize the diagnostic clues for distinguishing LE-specific bullous lesions, bullous systemic lupus erythematosus, and erythema multiforme-like lesions in LE (Rowell syndrome).
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Affiliation(s)
| | | | - Kiran Motaparthi
- Department of Dermatology, University of Florida, Gainesville, Florida, USA.
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17
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Kano Y, Kato M. Periumbilical blisters: pemphigus vulgaris during pregnancy. Am J Obstet Gynecol 2023; 229:688-689. [PMID: 37271432 DOI: 10.1016/j.ajog.2023.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Affiliation(s)
- Yasuhiro Kano
- Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan; 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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18
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Morris AJ, Rueckeis CA. Sap and Sun: A Case of Phytophotodermatitis. Wilderness Environ Med 2023; 34:532-535. [PMID: 37802751 DOI: 10.1016/j.wem.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 05/04/2023] [Accepted: 06/07/2023] [Indexed: 10/08/2023]
Abstract
We report a case of phytophotodermatitis caused by cow parsnip (Heracleum maximum) exposure affecting a hiker in Colorado. Phytophotodermatitis is a phototoxic skin reaction to UV-A rays after contact with photosensitizing plant substances that presents as a burning, painful rash, often with blisters. Treatment is supportive, including wound hygiene, analgesia, and anti-inflammatories. Avoiding offending plants, protecting the skin from sun, and immediate washing with soap and water after plant contact are the primary means of prevention. We have included a table and photos of plants found in the United States that can cause phytophotodermatitis. Medical providers should include phytophotodermatitis in the differential diagnosis of blistering rashes in patients who have been outdoors with possible exposure to offending plants.
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Affiliation(s)
- Andrew J Morris
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC; Mountain Area Health Education Center, Hendersonville Family Medicine Residency Program, Hendersonville, NC.
| | - Cathleen A Rueckeis
- University of Washington, Seattle, Washington; Full Circle Health Family Medicine Residency Program, Boise, ID.
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López-Vera E, López-Riquelme I, García-Hirschfeld JM, Godoy-Díaz DJ. Asymptomatic wide erosive, erythematous, and bullous lesions in an elder woman. Int J Dermatol 2023; 62:1345-1346. [PMID: 37828781 DOI: 10.1111/ijd.16681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/15/2023] [Accepted: 04/01/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Eduardo López-Vera
- Dermatology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Irene López-Riquelme
- Dermatology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - Daniel J Godoy-Díaz
- Dermatology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
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20
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Dong XS, Shi JQ, Wang HP, Zhang LL, Liu ZH. Boy with blister on face. J Paediatr Child Health 2023; 59:1096. [PMID: 35962991 DOI: 10.1111/jpc.16169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Xiao-Shuang Dong
- Section of Pediatric Dermatology, Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jun-Qi Shi
- Section of Pediatric Dermatology, Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hai-Peng Wang
- Section of Cardiovascular Medicine, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lan-Lan Zhang
- Section of Pediatric Dermatology, Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ze-Hu Liu
- Section of Pediatric Dermatology, Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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21
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Boy with blister on face. J Paediatr Child Health 2023; 59:1098-9. [PMID: 37728043 DOI: 10.1111/jpc.1_16169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/02/2022] [Indexed: 09/21/2023]
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22
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Yamawaki M, Katayama K, Fujimoto M, Goto H, Yuasa H, Kozuka Y, Mori M, Takahashi D, Saiki R, Hirabayashi Y, Murata T, Yamanaka K, Dohi K. Bullous Pemphigoid in X-linked Alport Syndrome. Intern Med 2023; 62:2375-2379. [PMID: 36543213 PMCID: PMC10484771 DOI: 10.2169/internalmedicine.0972-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022] Open
Abstract
Skin lesions in X-linked Alport syndrome (XLAS) are rarely observed. Bullous pemphigoid (BP) is caused by autoantibodies against BP180, also called α1 (XVII) chain, in the basement membrane zone (BMZ). A 48-year-old man with XLAS developed tense blisters. A skin biopsy showed a cleft between the basal cell layer and dermis, with the infiltration of neutrophils and eosinophils. α1 (XVII) staining was positive on the epidermal side of α2/5 (IV) staining. Oral prednisolone improved his symptoms gradually. Abundant tense blisters on the palms and soles might suggest an important role of the α5 (IV) chain in the integrity of BMZ.
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Affiliation(s)
- Masahiro Yamawaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Kan Katayama
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Mika Fujimoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Hiroyuki Goto
- Department of Dermatology, Mie University Graduate School of Medicine, Japan
| | - Hiroto Yuasa
- Department of Pathology, Mie University Hospital, Japan
| | - Yuji Kozuka
- Department of Pathology, Mie University Hospital, Japan
| | - Mutsuki Mori
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Daisuke Takahashi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Ryosuke Saiki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Yosuke Hirabayashi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Tomohiro Murata
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Keiichi Yamanaka
- Department of Dermatology, Mie University Graduate School of Medicine, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
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23
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Urushidani S. Angina Bullosa Hemorrhagica Mimicking Upper Airway Obstruction. J Emerg Med 2023; 65:e132-e134. [PMID: 37442666 DOI: 10.1016/j.jemermed.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/14/2023] [Accepted: 04/10/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Seigo Urushidani
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan
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24
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Mounsey SJ, Oluwole E, Semkova K, Abdelrahman W. Blistering rash in a child. Clin Exp Dermatol 2023; 48:831-833. [PMID: 37012702 DOI: 10.1093/ced/llad123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023]
Abstract
A 5-year-old child was brought to the dermatology department with a blistering rash on the lower limbs. Indirect and direct immunofluorescence, in conjunction with haematoxylin and eosin showed a rare blistering disorder.
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Affiliation(s)
- Stephen J Mounsey
- St John's Institute of Dermatology, Guy's and St Thomas' Hospitals, London, UK
| | - Ebunoluwa Oluwole
- St John's Institute of Dermatology, Guy's and St Thomas' Hospitals, London, UK
| | - Kristina Semkova
- St John's Institute of Dermatology, Guy's and St Thomas' Hospitals, London, UK
| | - Wedad Abdelrahman
- St John's Institute of Dermatology, Guy's and St Thomas' Hospitals, London, UK
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25
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Li Y, Su C, Yan Y, Wang Z, Wei X, Wang Z. A 75-Year-Old Man With Irregular Solid Components Within an Emphysematous Bulla. Chest 2023; 163:e265-e273. [PMID: 37295885 DOI: 10.1016/j.chest.2022.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/13/2022] [Accepted: 12/18/2022] [Indexed: 06/12/2023] Open
Abstract
CASE PRESENTATION A 75-year-old man presented to our hospital with cough and sputum for more than a year. Eight months previously, the patient was admitted to a local hospital, and his symptoms were relieved after symptomatic treatment (expectorants and antitussives). Three months ago, he was admitted to our hospital, and his symptoms improved with antiinflammatory therapy. He had a 30-pack-years history of smoking (20 cigarettes/day) and a history of drinking (200 g liquor per day). The patient had no history of genetic disorders or cancer. He did not present with fever, dyspnea, hemoptysis or chest distress, and there was no history of weight loss since onset.
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Affiliation(s)
- Yanhua Li
- NanKai University, School of Medicine, Tianjin, China; Department of Radiology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China; Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Caili Su
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying Yan
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zheng Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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26
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Chang ZL, Bazarbashi AN. Esophageal Bulla in Epidermolysis Bullosa. Am J Gastroenterol 2023; 118:925. [PMID: 36634221 DOI: 10.14309/ajg.0000000000002109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/15/2022] [Indexed: 01/14/2023]
Affiliation(s)
- ZeNan Li Chang
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA
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27
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Long Y, Li Y, Wang T, Ni A, Guo J, Dong Q, Yang S, Guo J, Wang L, Hou Z. Inflammation-related proteomics demonstrate landscape of fracture blister fluid in patients with acute compartment syndrome. Front Immunol 2023; 14:1161479. [PMID: 37090725 PMCID: PMC10115951 DOI: 10.3389/fimmu.2023.1161479] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundBlisters are tense vesicles or bullae that arise on swollen skin and are found in a wide range of injuries. As a complication of fracture, fracture blisters are considered soft tissue injuries, which often lead to adverse effects such as prolonged preoperative waiting time and increased risk of surgical site infection. However, our previous study found that in patients with acute compartment syndrome, fracture blisters may be a form of compartment pressure release, but the specific mechanism has not been revealed. Here, we mapped out the proteomic landscape of fracture blister fluid for the first time and compared its expression profile to cupping and burn blisters.MethodsFirst, fluid samples were collected from 15 patients with fracture blisters, 7 patients with cupping blisters, and 9 patients with burn blisters. Then, the expression levels of 92 inflammatory proteins were measured using the Olink Target 96 Inflammation panel. Protein profiles were compared across the three groups using Differential Protein Expression Analysis and Principal Component Analysis (PCA).ResultsFracture blisters had significantly higher levels of 50 proteins in comparison to cupping and 26 proteins in comparison to burn blisters. Notably, PCA showed fracture blisters closely resembled the protein expression profile of burn blisters but were distinct from the protein expression profile of cupping blisters.ConclusionOur study provides the first characterization of fracture blister fluid using proteomics, which provides a valuable reference for further analysis of the difference between blisters caused by fractures and those caused by other pathogenic factors. This compendium of proteomic data provides valuable insights and a rich resource to better understand fracture blisters.
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Affiliation(s)
- Yubin Long
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- Country Department of Orthopaedic Surgery, Baoding No. 1 Central Hospital, Baoding, China
| | - Yiran Li
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tao Wang
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Andrew Ni
- Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Jialiang Guo
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- The School of Medicine, Nankai University, Tianjin, China
| | - Qi Dong
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shuo Yang
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Junfei Guo
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Zhiyong Hou, ; Ling Wang, ; Junfei Guo,
| | - Ling Wang
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Zhiyong Hou, ; Ling Wang, ; Junfei Guo,
| | - Zhiyong Hou
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Zhiyong Hou, ; Ling Wang, ; Junfei Guo,
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28
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Recurrent blistering in an infant! J Paediatr Child Health 2023; 59:702-3. [PMID: 37052328 DOI: 10.1111/jpc.1_16044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 04/14/2023]
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29
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Rouatbi J, Rejeb MB, Denguezli M. sQUIZ your knowledge! Blistering verrucous lesions on the feet. Eur J Dermatol 2023; 33:197-198. [PMID: 37431140 DOI: 10.1684/ejd.2023.4471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
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30
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Meneguzzo A, Mazzetto R, Lazzarotto A, Piaserico S. Painless Plaques Evolving to Bullae and Painful Erosions on the Penis: A Quiz. Acta Derm Venereol 2023; 103:adv00871. [PMID: 36794893 PMCID: PMC9949219 DOI: 10.2340/actadv.v103.4845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/29/2022] [Indexed: 02/17/2023] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Alberto Meneguzzo
- Department of Dermatology, University of Padua, Via Vincenzo Gallucci 4, IT-35121, Padova, Italy.
| | - Roberto Mazzetto
- Department of Dermatology, University of Padua, Via Vincenzo Gallucci 4, IT-35121, Padova, Italy
| | - Annalisa Lazzarotto
- Department of Dermatology, University of Padua, Via Vincenzo Gallucci 4, IT-35121, Padova, Italy
| | - Stefano Piaserico
- Department of Dermatology, University of Padua, Via Vincenzo Gallucci 4, IT-35121, Padova, Italy
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31
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Bornstein MM, von Arx T, Baumhoer D. [Not Available]. Swiss Dent J 2023; 133:34-35. [PMID: 36606468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Michael M Bornstein
- Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel UZB, Universität Basel, Basel, Schweiz
| | - Thomas von Arx
- Klinik für Oralchirurgie und Stomatologie, Zahnmedizinische Kliniken der Universität Bern, Bern, Schweiz
| | - Daniel Baumhoer
- Knochentumor-Referenzzentrum und DÖSAK, Referenzregister am Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Universität Basel, Schweiz
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32
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Mizuno Y, Shibata S, Ito Y, Taira H, Sugimoto E, Awaji K, Sato S. Interleukin-26–DNA complexes promote inflammation and dermal-epidermal separation in a modified human cryosection model of bullous pemphigoid. Front Immunol 2022; 13:1013382. [PMID: 36311716 PMCID: PMC9599390 DOI: 10.3389/fimmu.2022.1013382] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Bullous pemphigoid (BP) is an autoimmune disease characterized by autoantibody-mediated activation of immune cells and subepidermal blister formation. Excess amounts of extracellular DNA are produced in BP, however, it remains unclear how extracellular DNA contributes to BP pathogenesis. Here we show a possible mechanism by which interleukin (IL)-26 binds to extracellular DNA released from neutrophils and eosinophils to support DNA sensing. Patients with BP exhibited high circulating levels of IL-26, forming IL-26–DNA complexes in the upper dermis and inside the blisters. IL-26–DNA complexes played a dual role in regulating local immunity and blister formation. First, they enhanced the production of inflammatory cytokines in monocytes and neutrophils. Second, and importantly, the complexes augmented the production and activity of proteases from co-cultured monocytes and neutrophils, which induced BP180 cleavage in keratinocytes and dermal-epidermal separation in a modified human cryosection model. Collectively, we propose a model in which IL-26 and extracellular DNA synergistically act on immune cells to enhance autoantibody-driven local immune responses and protease-mediated fragility of dermal-epidermal junction in BP.
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33
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Kinderwater KS, Ferderber ML. 57-year-old man • type 2 diabetes • neuropathy • bilateral foot blisters • Dx? J Fam Pract 2022; 71:E19-E21. [PMID: 36179140 DOI: 10.12788/jfp.0472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
► Type 2 diabetes ► Neuropathy ► Bilateral foot blisters.
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Affiliation(s)
- Kathleen S Kinderwater
- Department of Family Medicine, East Carolina University Brody School of Medicine, Greenville, NC
| | - Megan L Ferderber
- Department of Family Medicine, East Carolina University Brody School of Medicine, Greenville, NC
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Taton O, Heinen V, Bondue B, Slebos DJ, Shah PL, Carron K, Moens O, Leduc D. Long-Term Follow-Up of Intralobar Bullae After Endobronchial Valve Treatment for Emphysema. Int J Chron Obstruct Pulmon Dis 2022; 17:1735-1742. [PMID: 35941900 PMCID: PMC9356607 DOI: 10.2147/copd.s363490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Endoscopic lung volume reduction using unidirectional endobronchial valves is a new technique in the treatment of patients with severe emphysema. However, the movements of the thoracic structures after endobronchial valves insertion are still unpredictable We report the unusual outcome of six patients after valves insertion in the left upper lobe. They all developed a complete atelectasis of the target lobe, a pneumothorax and sequential genuine bullae in the treated left lung of unknown etiology. The chest CT scan prior to the valves insertion was unremarkable. Three patients developed an air–liquid level in the bullae the day before a bacterial infection of their left lower lobe. The three other patients had an uneventful spontaneous resolution of their bullae at long-term follow-up. Therefore, a conservative attitude should be followed in this particular setting.
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Affiliation(s)
- Olivier Taton
- Department of Pneumology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Correspondence: Olivier Taton, Department of Pneumology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik, 808, Brussels, 1070, Belgium, Tel +3225553943, Email
| | - Vincent Heinen
- Department of Pneumology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Benjamin Bondue
- Department of Pneumology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Dirk-Jan Slebos
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- The Netherlands and GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Pallav L Shah
- Royal Brompton Hospital, London, UK
- National Heart & Lung Institute, Imperial College, London, UK
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Kris Carron
- Department of Pneumology, AZ Delta, Menen, Belgium
| | - Olivia Moens
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Dimitri Leduc
- Department of Pneumology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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35
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Pathania YS, Budania A, Didel S. Multiple clear fluid-filled blisters over body in an unconscious female. J Accid Emerg Med 2022; 39:520-539. [PMID: 35732303 DOI: 10.1136/emermed-2021-211202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Yashdeep Singh Pathania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Anil Budania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Siyaram Didel
- Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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36
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Kurosaki Y, Ishitsuka Y, Kato Y, Arase N, Fujimoto M. Blistering Papulosquamous Erythema with Arthralgia: A Quiz. Acta Derm Venereol 2022; 102:adv00690. [PMID: 35356998 PMCID: PMC9631277 DOI: 10.2340/actadv.v102.936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Yosuke Ishitsuka
- Department of Dermatology, Faculty of Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.
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Ashton R. Not all that blisters is infectious. Can Fam Physician 2022; 68:266-268. [PMID: 35418391 PMCID: PMC9007117 DOI: 10.46747/cfp.6804266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Rosalind Ashton
- Family physician in the Rideau Friel Medical Centre in Ottawa, Ont
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38
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Murciano M, Laterza C, Attolini E, Storelli S, Dipietro G, Rubino A, Annicchiarico G. Procedural analgesia with nitrous oxide at home for epidermolysis bullosa: A case report. Medicine (Baltimore) 2022; 101:e28474. [PMID: 35029895 PMCID: PMC8735711 DOI: 10.1097/md.0000000000028474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 12/15/2022] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Epidermolysis bullosa (EB) is an inherited disease characterized by fragile skin with painful blistering, which requires lifelong skin and wound care. This case report describes the use of inhaled nitrous oxide (N2O) for procedural pain control at home during wound care in a young man with severe dystrophic EB. To our knowledge, only 1 case was reported by Ingelmo et al in 2017 regarding the use of N2O at home in a 4-year-old-child. To date, no such attempt has been made in adult patients. PATIENT CONCERNS Our patient was a 28-year-old man. Frequent blisters appear spontaneously, and are often preceded by erythema and itching. Patient required daily treatment daily consisting of lancing blisters with a needle and emptying them by compression. DIAGNOSES Severe recessive dystrophic EB diagnosed at the time of delivery. INTERVENTIONS Procedural pain control was managed by the auto-administration of an inhaled N2O and air gas mixture. OUTCOMES Conscious sedation with N2O leads to beneficial effects, such as reduction in dressing duration, acute procedural pain, local antibiotic needing, medication memory, anxiety, anticipatory pain, and fatigue after the dressing session. LESSONS N2O analgesia is safe and effective, resulting in a significant reduction in procedural pain and an improvement in the quality of life of patients and their caregivers.
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Affiliation(s)
- Manuel Murciano
- Regional Coordination of Rare Diseases (CoReMaR), Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy
- Emergency and General Pediatrics Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Claudia Laterza
- Regional Coordination of Rare Diseases (CoReMaR), Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy
| | - Ettore Attolini
- Health System Innovation and Quality Area at Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy
| | - Sonia Storelli
- Regional Coordination of Rare Diseases (CoReMaR), Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy
| | - Giovanni Dipietro
- Regional Coordination of Rare Diseases (CoReMaR), Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy
| | - Antonio Rubino
- Department of Anesthesia and Resuscitation, Valle D’Itria Hospital Martina Franca, Taranto, Italy
| | - Giuseppina Annicchiarico
- Regional Coordination of Rare Diseases (CoReMaR), Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy
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Corrà A, Bonciolini V, Quintarelli L, Verdelli A, Caproni M. Linear IGA bullous dermatosis potentially triggered by vaccination. Int J Immunopathol Pharmacol 2022; 36:20587384211021218. [PMID: 35001680 PMCID: PMC8753231 DOI: 10.1177/20587384211021218] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Linear IgA bullous dermatosis (LABD) is a mucocutaneous autoimmune blistering disease affecting both adults and children. It is caused by IgA antibodies targeting multiple antigens along the basement membrane zone, leading to disruption of dermoepidermal junction and development of bullous lesions which often presents in characteristic arrangement. Although most LABD cases have been reported to be idiopathic, different triggers have been described, including several drugs and infection. However, the occurrence of vaccine-induced cases of LABD is not widely known and accepted due to the few reports available. We present two cases of LABD occurred following different triggers, rising the suspicion for a possible pathogenetic role of vaccines.
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Affiliation(s)
- Alberto Corrà
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Veronica Bonciolini
- Dermatology Unit, Versilia Hospital, USL Toscana Nord-Ovest, Lido di Camaiore, Lucca, Italy
| | - Lavinia Quintarelli
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Alice Verdelli
- Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Florence, Italy
| | - Marzia Caproni
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
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40
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West L, Cho SK, Thomas C. Erythematous Papules and Hemorrhagic Vesicles in a Woman With Arthralgias and Eye Pain. JAMA 2021; 326:2314-2315. [PMID: 34757376 DOI: 10.1001/jama.2021.18708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lindsey West
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
| | - Sung Kyung Cho
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
| | - Cristina Thomas
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
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41
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Tayem R, Niemann C, Pesch M, Morgner J, Niessen CM, Wickström SA, Aumailley M. Laminin 332 Is Indispensable for Homeostatic Epidermal Differentiation Programs. J Invest Dermatol 2021; 141:2602-2610.e3. [PMID: 33965403 DOI: 10.1016/j.jid.2021.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/24/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022]
Abstract
The skin epidermis is attached to the underlying dermis by a laminin 332 (Lm332)-rich basement membrane. Consequently, loss of Lm332 leads to the severe blistering disorder epidermolysis bullosa junctionalis in humans and animals. Owing to the indispensable role of Lm332 in keratinocyte adhesion in vivo, the severity of the disease has limited research into other functions of the protein. We have conditionally disrupted Lm332 expression in basal keratinocytes of adult mice. Although blisters develop along the interfollicular epidermis, hair follicle basal cells provide sufficient anchorage of the epidermis to the dermis, making inducible deletion of the Lama3 gene compatible with life. Loss of Lm332 promoted the thickening of the epidermis and exaggerated desquamation. Global RNA expression analysis revealed major changes in the expression of keratins, cornified envelope proteins, and cellular stress markers. These modifications of the keratinocyte genetic program are accompanied by changes in cell shape and disorganization of the actin cytoskeleton. These data indicate that loss of Lm332-mediated progenitor cell adhesion alters cell fate and disturbs epidermal homeostasis.
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Affiliation(s)
- Raneem Tayem
- Center for Biochemistry, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Catherin Niemann
- Center for Biochemistry, Faculty of Medicine, University of Cologne, Cologne, Germany; Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Monika Pesch
- Center for Biochemistry, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Jessica Morgner
- Paul Gerson Unna Group 'Skin Homeostasis and Ageing', Max Planck Institute for Biology of Ageing, Cologne, Germany; Division of Molecular Pathology, Oncode Institute, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Carien M Niessen
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany; Medical Faculty, Department of Cell Biology of the Skin, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Sara A Wickström
- Paul Gerson Unna Group 'Skin Homeostasis and Ageing', Max Planck Institute for Biology of Ageing, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Wihuri Research Institute, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland
| | - Monique Aumailley
- Center for Biochemistry, Faculty of Medicine, University of Cologne, Cologne, Germany.
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42
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Alonso de la Hoz J, Martínez Antequera CE, Fernández Manso B, Llorente Otones L, de Inocencio Arocena J. Hemorrhagic bullous IgA vasculitis (Schönlein-Henoch purpura), does it have a worse prognosis? Reumatol Clin (Engl Ed) 2021; 17:549-551. [PMID: 34756318 DOI: 10.1016/j.reumae.2020.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/08/2020] [Indexed: 06/13/2023]
Abstract
Haemorrhagic bullous form of IgA vasculitis (IgAV), or Schönlein-Henoch purpura, is an unusual presentation of the disease in paediatric patients (<2%). Blistering eruptions can sometimes be very striking, leading to hospital admissions and administration of high-dose steroids and even immunosuppressants. Review of the literature, however, does not suggest that this clinical form carries a worse prognosis than the other forms of IgAV. In fact, the prognosis of the disease depends on the organic involvement. We present the case of a 5-year-old girl that is very representative. She developed palpable purpura and four days later the skin lesions evolved into blistering lesions. She did not receive any anti-inflammatory nor immunosuppressive treatment and the lesions spontaneously subsided within 14 days. She did not develop any extracutaneous nor systemic involvement.
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Affiliation(s)
- Julia Alonso de la Hoz
- Servicio de Pediatría, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain.
| | | | | | - Lucía Llorente Otones
- Servicio de Pediatría, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Jaime de Inocencio Arocena
- Unidad de Reumatología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain; Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, Madrid, Spain
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43
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Guda A, Usatine RP. Painful lumps in the axilla. J Fam Pract 2021; 70:409-411. [PMID: 34818179 DOI: 10.12788/jfp.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The location of these lesions and the odorous fluid that drained from them pointed to the diagnosis. The acne on the patient's back was another clue.
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44
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Tomayko MM, Damsky W, Fathy R, McMahon DE, Turner N, Valentin MN, Rallis T, Aivaz O, Fox LP, Freeman EE. Subepidermal blistering eruptions, including bullous pemphigoid, following COVID-19 vaccination. J Allergy Clin Immunol 2021; 148:750-751. [PMID: 34275656 PMCID: PMC8280592 DOI: 10.1016/j.jaci.2021.06.026] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/04/2021] [Accepted: 06/24/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Mary M Tomayko
- Department of Dermatology, Yale University School of Medicine, New Haven, Conn; Department of Pathology, Yale University School of Medicine, New Haven, Conn.
| | - William Damsky
- Department of Dermatology, Yale University School of Medicine, New Haven, Conn; Department of Pathology, Yale University School of Medicine, New Haven, Conn
| | - Ramie Fathy
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa
| | - Devon E McMahon
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Noel Turner
- Department of Dermatology, Yale University School of Medicine, New Haven, Conn
| | | | | | - Ohara Aivaz
- Cedars-Sinai Medical Group, Department of Dermatology, Beverly Hills, Calif
| | - Lindy P Fox
- Department of Dermatology, University of California, San Francisco, Calif
| | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
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Abstract
Coronavirus disease 2019 (COVID-19) is a novel infectious disease affecting the general population worldwide. A fever and cough are the common clinical presentations of COVID-19. In most of these patients, computed tomography (CT) shows bilateral peripheral ground-glass opacities. We herein report a case of hemoptysis and lung bulla in the convalescent phase of COVID-19. Based on the clinical observations, alveolar destruction was likely associated with hemoptysis and bulla formation. Therefore, we suggest the follow-up of COVID-19 patients whose clinical parameters indicate alveolar damage, even after their symptoms improve.
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Affiliation(s)
- Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
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46
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Lin CT, Shyur SD, Fang LC, Huang HH, Shih YY. Unusual presentation of linear wrist blisters associated with hereditary angioedema: The first case report in Taiwan. J Formos Med Assoc 2021; 120:1642-1646. [PMID: 33640192 DOI: 10.1016/j.jfma.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/09/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
Abstract
Hereditary angioedema (HAE) is an autosomal dominant disease characterized clinically by recurrent episodes of swelling in the tissues of the extremities, face, abdomen, and respiratory tract. It is most often caused by C1 esterase inhibitor (C1 INH) gene mutation. This swelling may lead to bradykinin release, resulting in recurrent, paroxysmal, painful angioedema. Blister formation is an uncommon cutaneous manifestation of HAE. Herein, we report a case of a patient with HAE who developed linear wrist blisters on her skin, with swelling, as a rare complication of HAE. She was treated with attenuated androgens (Danazol) for two weeks at our clinic, after which the blisters showed dramatic improvement. To date, only a few HAE cases have been reported across the world. Therefore, it is important to focus on and recognize the development of edema blisters as a flare of HAE, which could consequently avoid unnecessary dermatological diagnostic workup and treatment.
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Affiliation(s)
- Cheng-Tung Lin
- Department of Allergy, Immunology and Rheumatology, Mackay Children's Hospital, Taipei, Taiwan; Department of Pediatrics, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan.
| | - Shyh-Dar Shyur
- Department of Allergy, Immunology and Rheumatology, Mackay Children's Hospital, Taipei, Taiwan; Mackay Medical College, New Taipei City, Taiwan.
| | - Li-Ching Fang
- Department of Allergy, Immunology and Rheumatology, Mackay Children's Hospital, Taipei, Taiwan.
| | - Hao-Hsuan Huang
- Department of Allergy, Immunology and Rheumatology, Mackay Children's Hospital, Taipei, Taiwan.
| | - Yi-Yang Shih
- Department of Allergy, Immunology and Rheumatology, Mackay Children's Hospital, Taipei, Taiwan.
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47
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Affiliation(s)
- Ji-Hyun Moon
- Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Julie Huynh
- Children's Hospital at Westmead, Westmead, NSW, Australia
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48
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Tuuli MG, Liu J, Tita ATN, Longo S, Trudell A, Carter EB, Shanks A, Woolfolk C, Caughey AB, Warren DK, Odibo AO, Colditz G, Macones GA, Harper L. Effect of Prophylactic Negative Pressure Wound Therapy vs Standard Wound Dressing on Surgical-Site Infection in Obese Women After Cesarean Delivery: A Randomized Clinical Trial. JAMA 2020; 324:1180-1189. [PMID: 32960242 PMCID: PMC7509615 DOI: 10.1001/jama.2020.13361] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Obesity increases the risk of both cesarean delivery and surgical-site infection. Despite widespread use, it is unclear whether prophylactic negative pressure wound therapy reduces surgical-site infection after cesarean delivery in obese women. OBJECTIVE To evaluate whether prophylactic negative pressure wound therapy, initiated immediately after cesarean delivery, lowers the risk of surgical-site infections compared with standard wound dressing in obese women. DESIGN, SETTING, AND PARTICIPANTS Multicenter randomized trial conducted from February 8, 2017, through November 13, 2019, at 4 academic and 2 community hospitals across the United States. Obese women undergoing planned or unplanned cesarean delivery were eligible. The study was terminated after 1624 of 2850 participants were recruited when a planned interim analysis showed increased adverse events in the negative pressure group and futility for the primary outcome. Final follow-up was December 18, 2019. INTERVENTIONS Participants were randomly assigned to either undergo prophylactic negative pressure wound therapy, with application of the negative pressure device immediately after repair of the surgical incision (n = 816), or receive standard wound dressing (n = 808). MAIN OUTCOMES AND MEASURES The primary outcome was superficial or deep surgical-site infection according to the Centers for Disease Control and Prevention definitions. Secondary outcomes included other wound complications, composite of surgical-site infections and other wound complications, and adverse skin reactions. RESULTS Of the 1624 women randomized (mean age, 30.4 years, mean body mass index, 39.5), 1608 (99%) completed the study: 806 in the negative pressure group (median duration of negative pressure, 4 days) and 802 in the standard dressing group. Superficial or deep surgical-site infection was diagnosed in 29 participants (3.6%) in the negative pressure group and 27 (3.4%) in the standard dressing group (difference, 0.36%; 95% CI, -1.46% to 2.19%, P = .70). Of 30 prespecified secondary end points, 25 showed no significant differences, including other wound complications (2.6% vs 3.1%; difference, -0.53%; 95% CI, -1.93% to 0.88%; P = .46) and composite of surgical-site infections and other wound complications (6.5% vs 6.7%; difference, -0.27%; 95% CI, -2.71% to 2.25%; P = .83). Adverse skin reactions were significantly more frequent in the negative pressure group (7.0% vs 0.6%; difference, 6.95%; 95% CI, 1.86% to 12.03%; P < .001). CONCLUSIONS AND RELEVANCE Among obese women undergoing cesarean delivery, prophylactic negative pressure wound therapy, compared with standard wound dressing, did not significantly reduce the risk of surgical-site infection. These findings do not support routine use of prophylactic negative pressure wound therapy in obese women after cesarean delivery. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03009110.
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Affiliation(s)
- Methodius G Tuuli
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis
| | - Jingxia Liu
- Department of Surgery, Washington University School of Medicine in St Louis, Missouri
| | - Alan T N Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham
- Center for Women's Reproductive Health, University of Alabama at Birmingham
| | - Sherri Longo
- Department of Obstetrics and Gynecology, Ochsner Health, New Orleans, Louisiana
| | - Amanda Trudell
- Division of Maternal Fetal Medicine, BJC Medical Group St Louis, Missouri
| | - Ebony B Carter
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Anthony Shanks
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis
| | - Candice Woolfolk
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Aaron B Caughey
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland
| | - David K Warren
- Department of Medicine, Washington University School of Medicine in St Louis, Missouri
| | - Anthony O Odibo
- Department of Obstetrics and Gynecology, University of South Florida School of Medicine, Tampa
| | - Graham Colditz
- Department of Surgery, Washington University School of Medicine in St Louis, Missouri
| | - George A Macones
- Department of Obstetrics and Gynecology, Dell School of Medicine, University of Texas at Austin
| | - Lorie Harper
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham
- Center for Women's Reproductive Health, University of Alabama at Birmingham
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49
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Jain S, Patra S, Choudhary S, Kaur M. An easy way to make blisters in suction blister grafting of vitiligo with Hijama therapy cups. J Am Acad Dermatol 2020; 86:e149-e150. [PMID: 32454099 DOI: 10.1016/j.jaad.2020.04.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Saurabh Jain
- Atal Bihari Vajpayee Government Medical College, Vidisha, India
| | - Suman Patra
- Department of Dermatology, All India Institute of Medical Sciences, Bhopal, India.
| | - Sanjeev Choudhary
- Department of Dermatology, All India Institute of Medical Sciences, Nagpur, India
| | - Maninder Kaur
- Department of Dermatology, All India Institute of Medical Sciences, Bhopal, India
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50
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Bemelmans YFL, Heitink MV, Hendrickx RPM. [A man with blisters after a knee replacement]. Ned Tijdschr Geneeskd 2020; 164:D4876. [PMID: 32406640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 62-year old male patient was seen four days after total knee arthroplasty with pain, itchy erythema and blistering surrounding the wound. European Standard Series and wound dressing patch testing was performed. This confirmed the diagnosis allergic contact dermatitis, with the wound dressing as the offending allergen.
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Affiliation(s)
- Yoeri F L Bemelmans
- Zuyderland Medisch Centrum, Sittard-Geleen. Afd. Orthopedie
- Contact: Yoeri F.L. Bemelmans
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