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Forbes S, Bettenay S, Meertens NM, Wildermuth BE, Wildermuth K, Mueller RS. Diascopy and histopathological evaluation of nonblanching erythematous dermatoses in dogs. Vet Dermatol 2024; 35:255-262. [PMID: 38111018 DOI: 10.1111/vde.13230] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 09/19/2023] [Accepted: 12/06/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Diascopy is a point-of-care diagnostic test used to differentiate skin erythema due to vascular dilation from haemorrhage. In the veterinary literature, only a handful of diseases have been described to be associated with a negative (nonblanching) diascopy result, and histological investigation of haemorrhage has been inconsistent. OBJECTIVES Retrospective study to undertake a histopathological investigation of canine, nonblanching erythematous dermatoses for the presence or absence of haemorrhage and vascular changes. MATERIALS AND METHODS Skin biopsies from dogs presented with moderate-to-severe nonblanching erythema were evaluated histologically. Additionally, clinical data about each patient were analysed. RESULTS Twenty cases were identified with nonblanching erythema. Diagnoses included vasculopathy (n = 6), canine eosinophilic dermatitis (n = 3), cutaneous epitheliotropic T-cell lymphoma (n = 2), and one case each of sterile granuloma and pyogranuloma syndrome, German shepherd dog pyoderma, multiple mast cell tumours, haemangiosarcoma, exfoliative cutaneous lupus erythematosus, canine leishmaniosis with sebaceous adenitis, sebaceous adenitis with concurrent dermatophytosis, calcinosis cutis and canine atopic dermatitis with insect-bite reaction. One or more vascular changes were present in all 20 cases and included perivascular oedema, endothelial swelling and neutrophilic infiltration of vessel walls. Haemorrhage was identified in 17 of 20 cases (85%). Three cases without dermal haemorrhage were calcinosis cutis, sebaceous adenitis with dermatophytosis and canine atopic dermatitis with insect-bite reaction. CONCLUSIONS AND CLINICAL RELEVANCE Negative diascopy was associated with haemorrhage and vascular pathological findings in the majority of cases, yet not all. Haemorrhage was identified histologically in all diseases previously reported as nonblanching as well as in a few additional diseases.
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Affiliation(s)
| | - Sonya Bettenay
- Centre for Clinical Veterinary Medicine, University of Munich, Munich, Germany
| | | | | | | | - Ralf S Mueller
- Centre for Clinical Veterinary Medicine, University of Munich, Munich, Germany
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2
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Mendoza-Kuznetsova E, Lokianskiene V, Matise-VanHoutan I, Fiskovich O, Olivry T. Figurate erythema in 11 Eastern European sphynx cats. Vet Dermatol 2024; 35:346-353. [PMID: 38284278 DOI: 10.1111/vde.13240] [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: 02/26/2023] [Revised: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND In humans, figurate erythema (FE) represents a heterogenous group of dermatoses with circular or serpiginous erythematous skin lesions; FE has not been reported in cats. OBJECTIVES To report clinical and histological characteristics and outcomes of FE in sphynx cats from Baltic sea-bordering countries. ANIMALS Eleven client-owned sphynx cats with FE. MATERIALS AND METHODS We recruited cases meeting the following criteria: (i) a sphynx breed, (ii) FE with or without scaling, (iii) a chronic, waxing-and-waning course lasting longer than a month and (iv) an absence of other skin diseases. RESULTS Of 11 cats, there were seven Donskoys, one Peterbald, one Ukrainian Levkoy and two presumed Canadian sphynxes; all except one were males, and the age of onset was <12 months in eight cats. Skin lesions lasted between 1.2 and 56 months, and they consisted of erythematous plaques with a linear-to-serpiginous, annular, gyrate or iris configuration predominating on the trunk and extremities. Scaling was often seen trailing the edge of the centrifugally expanding erythema. All cats were otherwise asymptomatic or mildly pruritic. Dermatophytosis was ruled out by special stains and/or fungal cultures in eight cats. Microscopic lesions revealed focal, mild-to-moderate epidermal hyperplasia and hyperkeratosis, minimal-to-mild dysplasia and subepidermal collagen smudging. Special stains were negative for dermatophytes. The clinical remission of FE was not achieved with diet changes or medical interventions; yet, a spontaneous, transient, partial or complete improvement occurred in most cats. CONCLUSION AND CLINICAL RELEVANCE This is the first report of FE in sphynx cats from Eastern Europe.
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Affiliation(s)
| | | | | | | | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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3
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Aquino JMRM, Guevara BEK. Erythematous, annular lesions on the extremities of a female patient. Int J Dermatol 2024; 63:588-589. [PMID: 38044561 DOI: 10.1111/ijd.16956] [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: 09/12/2023] [Revised: 11/09/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Jay M R M Aquino
- Department of Dermatology, Southern Philippines Medical Center, Davao City, Philippines
| | - Bryan E K Guevara
- Department of Dermatology, Southern Philippines Medical Center, Davao City, Philippines
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Williams SF, Wan H, Chittock J, Brown K, Wigley A, Cork MJ, Danby SG. Characterization of skin barrier defects using infrared spectroscopy in patients with atopic dermatitis. Clin Exp Dermatol 2024; 49:466-477. [PMID: 38011533 DOI: 10.1093/ced/llad416] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/30/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is characterized by skin barrier defects that are often measured by biophysical tools that observe the functional properties of the stratum corneum (SC). OBJECTIVES To employ in vivo infrared spectroscopy alongside biophysical measurements to analyse changes in the chemical composition of the SC in relation to AD severity. METHODS We conducted an observational cross-sectional cohort study where attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy measurements were collected on the forearm alongside surface pH, capacitance, erythema and transepidermal water loss (TEWL), combined with tape stripping, in a cohort of 75 participants (55 patients with AD stratified by phenotypic severity and 20 healthy controls). Common FLG variant alleles were genotyped. RESULTS Reduced hydration, elevated TEWL and redness were all associated with greater AD severity. Spectral analysis showed a reduction in 1465 cm-1 (full width half maximum) and 1340 cm-1 peak areas, indicative of less orthorhombic lipid ordering and reduced carboxylate functional groups, which correlated with clinical severity (lipid structure r = -0.59, carboxylate peak area r = -0.50). CONCLUSIONS ATR-FTIR spectroscopy is a suitable tool for the characterization of structural skin barrier defects in AD and has potential as a clinical tool for directing individual treatment based on chemical structural deficiencies.
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Affiliation(s)
- Samuel F Williams
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
| | - Helen Wan
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
| | - John Chittock
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
| | - Kirsty Brown
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
| | - Andrew Wigley
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
| | - Michael J Cork
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
- Sheffield Children's NHS Foundation Trust, Sheffield Children's Hospital, Western Bank, Sheffield, UK
- Sheffield Teaching Hospitals NHS Foundation Trust, The Royal Hallamshire Hospital, Sheffield, UK
| | - Simon G Danby
- Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
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Viedma-Martinez M, Gallo-Pineda G, Recio-Monescillo M, Jimenez-Gallo D, Lopez-Sanz P, Drake-Monfort M, Urigoitia-Ugalde P, Martínez-Signes V, Llorca-Juan D, Fuertes-Vega L, Ríos-Viñuela E, Escario-Travesedo E, Ríos-Martín JJ, Requena-Caballero L, Linares-Barrios M. Retrospective Case Series of Cocaine-Associated Plasma Cell Orificial Mucositis. JAMA Dermatol 2024; 160:320-327. [PMID: 38265770 PMCID: PMC10809139 DOI: 10.1001/jamadermatol.2023.5692] [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: 08/22/2023] [Accepted: 11/15/2023] [Indexed: 01/25/2024]
Abstract
Importance Plasma cell orificial mucositis (PCOM) associated with cocaine use is an emerging, rare condition that has become a concern in Spain in recent years. Limited knowledge exists regarding this novel condition. Objectives To delineate the clinicopathologic characteristics of this emerging entity and establish a novel approach in the differential diagnosis of cocaine-associated lesions. Design, Setting, and Participants A descriptive, retrospective, multicenter case series of 10 patients diagnosed with cocaine-associated PCOM was conducted in Spain from April 2020 to March 2023. Main Outcomes and Measures Patient demographic, clinical, histopathologic, and treatment data were collected. Results A total of 10 patients (6 [60%] male; median [range] age, 45.5 [36-66] years) presenting with exudative ulcerated plaques were identified for this study. The lesions had raised and erythematous edges over the nostril and a median (range) evolution time of 9 (2-24) months. Septal or palate perforations were observed in 4 (40%) of the patients. Biopsies revealed a dense inflammatory infiltrate of plasma cells in the dermis without atypia and with eosinophils. All patients reported recent cocaine use. Three urine tests detected cocaine but found no presence of amphetamines or opiates. Six patients improved with corticosteroid therapy. Up to 60% of patients were lost to follow-up. Conclusions and Relevance This case series describes the clinicopathologic characteristics of PCOM, an emerging entity associated with cocaine use in Spain, and demonstrates a novel approach in the differential diagnosis of cocaine-associated lesions. To date, cocaine-associated skin lesions have been reported as neutrophilic dermatoses and vasculitis. The appearance of a plasma cell infiltrate changes what has been described in the medical literature so far. PCOM is a benign condition of unknown cause characterized by a proliferative polyclonal plasma cell infiltrate. A comprehensive differential diagnosis workup is required to reach this exclusionary diagnosis. Several irritants have been documented in cases of PCOM, and a hypersensitivity mechanism has been proposed. Since the initial report of cocaine-associated PCOM in Spain, its incidence has experienced a surge in the country. The cause of this phenomenon may be attributed to newly unidentified adulterants. The administration of corticosteroids and discontinuation of cocaine use are the sole treatments that have demonstrated efficacy. Clinicians should be vigilant regarding this emerging condition and conduct inquiries into cocaine use. Additional research is required to clarify the pathophysiology of this emerging condition.
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Affiliation(s)
- Myriam Viedma-Martinez
- Department of Dermatology, Hospital Universitario Puerta del Mar, Cádiz, Andalucía, Spain
| | - Gonzalo Gallo-Pineda
- Department of Dermatology, Hospital Universitario Puerta del Mar, Cádiz, Andalucía, Spain
| | - Miguel Recio-Monescillo
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Madrid, Spain
| | - David Jimenez-Gallo
- Department of Dermatology, Hospital Universitario Puerta del Mar, Cádiz, Andalucía, Spain
| | - Pablo Lopez-Sanz
- Department of Dermatology, Hospital General Universitario De Albacete, Albacete, Castilla La Mancha, Spain
| | - Marta Drake-Monfort
- Department of Dermatology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | | | | | - David Llorca-Juan
- Department of Dermatology, Hospital Universitario De La Ribera, Alzira, Valencia, Spain
| | - Laura Fuertes-Vega
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Madrid, Spain
| | - Elisa Ríos-Viñuela
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Madrid, Spain
| | - Eduardo Escario-Travesedo
- Department of Dermatology, Hospital General Universitario De Albacete, Albacete, Castilla La Mancha, Spain
| | - Juan José Ríos-Martín
- Pathology Department, Hospital Universitario Virgen Macarena, Sevilla, Andalucía, Spain
| | - Luis Requena-Caballero
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Madrid, Spain
| | - Mario Linares-Barrios
- Department of Dermatology, Hospital Universitario Puerta del Mar, Cádiz, Andalucía, Spain
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Hacınecipoğlu F, Çevirgen Cemil B, Kartal SP, Arslankoz S. A rare case of cutaneous lupus erythematosus presenting with periorbital erythema and edema. Lupus 2024; 33:183-186. [PMID: 38148123 DOI: 10.1177/09612033231224767] [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: 12/28/2023]
Abstract
Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can manifest itself with a variety of skin symptoms. Periorbital erythema, a rare variant of CLE, presents challenges in terms of diagnosis and treatment. Here, we report a case of CLE presenting with periorbital erythema and edema. A 42-year-old female patient presented with complaints of erythema, edema, and scaling on the right eyelid that started four months ago. A skin biopsy was performed on the lesioned skin of the eyelid to differentiate dermatomyositis, cutaneous lupus erythematosus, sarcoidosis, lupus vulgaris, and cutaneous lymphoma. Histopathological examination revealed focal hyperkeratosis and parakeratosis on the surface of the epidermis, vacuolar degeneration in the basal layer of the epidermis, lymphocyte exocytosis with necrotic keratinocytes, edema in the dermis, melanophages, and perivascular, periadnexal lymphocytic reaction. Laboratory tests showed negative antinuclear antibody and anti-dsDNA, but positivity for anti-Ro-52. In the absence of any other complaints, the patient was diagnosed with cutaneous lupus erythematosus presenting with periorbital erythema based on clinical, histopathological, and laboratory findings. Hydroxychloroquine 200 mg/day, topical corticosteroid, and topical tacrolimus were administered. Two months later, significant improvement in the lesions was observed. In conclusion, it should be kept in mind that periorbital erythema can develop as a rare variant of CLE and can be misdiagnosed as contact dermatitis, dermatomyositis, sarcoidosis, or cutaneous lymphoma. Additionally, the ANA and anti-dsDNA antibodies are often found to be negative in these cases. In establishing the diagnosis, firstly considering the disease, followed by histopathological examinations and laboratory tests, is crucial.
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Affiliation(s)
- Fatmanur Hacınecipoğlu
- Department of Dermatology, University of Health Sciences Ankara Etlik City Hospital, Ankara, Turkey
| | - Bengü Çevirgen Cemil
- Department of Dermatology, University of Health Sciences Ankara Etlik City Hospital, Ankara, Turkey
| | - Selda Pelin Kartal
- Department of Dermatology, University of Health Sciences Ankara Etlik City Hospital, Ankara, Turkey
| | - Sehbal Arslankoz
- Department of Pathology, University of Health Sciences Ankara Etlik City Hospital, Ankara, Turkey
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Zhu J, Sun J. A Case of Uncommon S100-Negative CD1a-Positive Histiocytosis in a 9-Year-Old Boy: Clinical Presentation, Histopathologic Features, and Successful Treatment Approach. Am J Dermatopathol 2024; 46:121-125. [PMID: 38055958 DOI: 10.1097/dad.0000000000002602] [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: 12/08/2023]
Abstract
ABSTRACT Immunohistochemically, histiocytosis differentiating into Langerhans cells is typically characterized by the expression of CD1a, S100, and varying degrees of Langerin. However, CD1a-positive but S100-negative histiocytosis is extremely rare in clinical practice. We present a case of a 9-year-old boy with multiple erythematous to brown dome-shaped nodules. Histopathologic examination revealed dermal infiltrates of histiocytic cells, exhibiting a distinctive immunohistochemical profile of CD68+, S100-, CD1a+, and Langerin-. This exceptional case may contribute to our understanding of the etiology and differentiation processes of histiocytic proliferative disorders.
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Affiliation(s)
- Jiaping Zhu
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
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8
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Yao L, Cai X, Du X, Ma Y. Adalimumab induced exacerbation of psoriasis in patients with combined pemphigus: A case report. Medicine (Baltimore) 2024; 103:e36988. [PMID: 38277534 PMCID: PMC10817017 DOI: 10.1097/md.0000000000036988] [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: 08/11/2023] [Accepted: 12/26/2023] [Indexed: 01/28/2024] Open
Abstract
RATIONALE Psoriasis is an immune-related disease caused by genetic factors, abnormalities in the immune system and environmental factors, while pemphigus is an autoimmune disease caused by the autoimmune system attacking the skin and mucosal tissues. Herein, we aimed to report a rare case of adalimumab induced exacerbation of psoriasis patients with pemphigus. The rare disease causes considerable challenges for clinical diagnosis and treatment. PATIENT CONCERNS The patient was a 43-year-old man with intermittent erythema and scaling all over the body for more than 20 years, and blisters and vesicles on the trunk and limbs for 1 month. Half a year ago, the patient had blisters on the limbs, and was diagnosed with deciduous pemphigus in a hospital, and the blisters subsided after being given traditional Chinese medicine orally. Half a month ago, the erythema area was enlarged, and adalimumab 80 mg intramuscular injection was given for 1 time after consultation in the hospital. On the following day, the area of erythema and scales was suddenly enlarged obviously compared with the previous 1, and obvious blisters and vesicles appeared on the limbs, neck, and trunk, which were aggravated progressively and accompanied by obvious itching and pain. DIAGNOSES The patient was diagnosed with psoriasis in patients with combined pemphigus. INTERVENTION After combined treatment with methylprednisolone and cyclosporine, the skin lesions have basically recovered. OUTCOMES The skin lesions have basically healed. Follow up for 6 months without recurrence. LESSONS Methylprednisolone combined with cyclosporine may be an option in treating patients with psoriasis patients with pemphigus.
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Affiliation(s)
- Limin Yao
- Department of Dermatology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China
| | - Xiaoli Cai
- Department of Pathology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China
| | - Xiaoqing Du
- Department of Dermatology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China
| | - Yuxin Ma
- Department of Dermatology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China
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Goswami DG, Singh SK, Okoyeocha EOM, Roney AK, Madadgar O, Tuttle R, Sosna W, Anantharam P, Croutch CR, Agarwal R, Tewari-Singh N. Dermal Exposure to Vesicating Nettle Agent Phosgene Oxime: Clinically Relevant Biomarkers and Skin Injury Progression in Murine Models. J Pharmacol Exp Ther 2024; 388:536-545. [PMID: 37652710 PMCID: PMC10801780 DOI: 10.1124/jpet.123.001718] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 09/02/2023] Open
Abstract
Phosgene oxime (CX), categorized as a vesicating chemical threat agent, causes effects that resemble an urticant or nettle agent. CX is an emerging potential threat agent that can be deployed alone or with other chemical threat agents to enhance their toxic effects. Studies on CX-induced skin toxicity, injury progression, and related biomarkers are largely unknown. To study the physiologic changes, skin clinical lesions and their progression, skin exposure of SKH-1 and C57BL/6 mice was carried out with vapor from 10 μl CX for 0.5-minute or 1.0-minute durations using a designed exposure system for consistent CX vapor exposure. One-minute exposure caused sharp (SKH-1) or sustained (C57BL/6) decrease in respiratory and heart rate, leading to mortality in both mouse strains. Both exposures caused immediate blanching, erythema with erythematous ring (wheel) and edema, and an increase in skin bifold thickness. Necrosis was also observed in the 0.5-minute CX exposure group. Both mouse strains showed comparative skin clinical lesions upon CX exposure; however, skin bifold thickness and erythema remained elevated up to 14 days postexposure in SKH-1 mice but not in C57BL/6 mice. Our data suggest that CX causes immediate changes in the physiologic parameters and gross skin lesions resembling urticaria, which could involve mast cell activation and intense systemic toxicity. This novel study recorded and compared the progression of skin injury to establish clinical biomarkers of CX dermal exposure in both the sexes of two murine strains relevant for skin and systemic injury studies and therapeutic target identification. SIGNIFICANCE STATEMENT: Phosgene oxime (CX), categorized as a vesicating agent, is considered as a potent chemical weapon and is of high military and terrorist threat interest since it produces rapid onset of severe injury as an urticant. However, biomarkers of clinical relevance related to its toxicity and injury progression are not studied. Data from this study provide useful clinical markers of CX skin toxicity in mouse models using a reliable CX exposure system for future mechanistic and efficacy studies.
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Affiliation(s)
- Dinesh G Goswami
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Satyendra K Singh
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Ebenezar O M Okoyeocha
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Andrew K Roney
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Omid Madadgar
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Rick Tuttle
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - William Sosna
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Poojya Anantharam
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Claire R Croutch
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Rajesh Agarwal
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
| | - Neera Tewari-Singh
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine (D.G.G., E.O.M.O., A.K.R., O.M., N.T.-S.) and Department of Biomedical Engineering (S.K.S.), Michigan State University, East Lansing, Michigan; MRIGlobal, Kansas City, Missouri (R.T., W.S., P.A., C.R.C.); and Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado (R.A.)
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Shah S, Baskaran N, Vinay K, Bishnoi A, Parsad D, Kumaran MS. Acquired dermal macular hyperpigmentation: an overview of the recent updates. Int J Dermatol 2023; 62:1447-1457. [PMID: 37767951 DOI: 10.1111/ijd.16859] [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] [Received: 08/02/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Acquired dermal macular hyperpigmentation (ADMH), previously known as macular pigmentation of uncertain etiology (MPUE), is an umbrella concept that unifies the distinct but overlapping acquired dermal pigmentary disorders like lichen planus pigmentosus, ashy dermatosis, erythema dyschromicum perstans, Riehl's melanosis and pigmented contact dermatitis. All of these disorders usually lack a clinically apparent inflammatory phase, are characterised by dermal pigmentation clinically and histologically, and have a variable protracted disease course. Recently, a proposal has been made to classify these disorders into those with and without contact sensitisation. Dermoscopy is essentially similar across the spectrum of these disorders, and is useful for diagnosis and therapeutic response monitoring. Scoring system has been validated for the same. The treatment of ADMH remains challenging, with multiple topicals, oral therapies including mycophenolate mofetil, and lasers tried. Need of the hour is randomised controlled trials to enhance the therapeutic armamentarium.
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Affiliation(s)
- Shikha Shah
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Narayanan Baskaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu S Kumaran
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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11
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Allali S, Carton M, Everhard S, Rivera S, Ghannam Y, Peignaux K, Guilbert P, De La Lande B, Chara-Brunaud C, Blanchecotte J, Pasquier D, Racadot S, Bourgier C, Cottu P, André F, Kirova Y. CANTO skin: Evaluation of skin toxicity risk factors in patients treated for breast cancer. Int J Cancer 2023; 153:1797-1808. [PMID: 37572223 DOI: 10.1002/ijc.34664] [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: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 08/14/2023]
Abstract
Skin reaction is a common toxicity during oncology management, especially followed during the radiotherapy. Its assessment and understanding of the factors influencing its occurrence, is a major issue in the management of patients treated for an early breast cancer (BC). We evaluated 8561 patients during their overall management for a BC. We focus on specific skin toxicities: erythema, fibrosis, telangiectasia and changes of skin colour. These toxicities were assessed at the baseline defined as 0-3-6 (M0), 12 (M12), 36 (M36) and 60 (M60) months. The prevalence of toxicities of interest varied over time, so at M0, 30.4% of patients had erythema while 17.7% of patients had fibrosis. At M60, the prevalence of erythema was 2%, while fibrosis remained stable at about 19%. After adjustments, at M0, there was a significant association between the onset of cutaneous erythema and obesity, the presence of axillary dissection, the type of surgery and the tumour phenotype RH+/HER2+. Concerning fibrosis, a significant association was found, at M12, with the age of the patient, obesity, Charlson score and type of surgery. Concerning the modification of skin colour at M12, we find a link between the age of the patient, obesity, tobacco consumption and alcohol consumption. The prevention of this toxicity is a major issue for the quality of life. Our results allow us to understand the risk of developing skin toxicity in a patient, depending on her intrinsic, tumour or therapeutic characteristics and to implement adapted means of prevention and monitoring.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - David Pasquier
- Centre Oscar Lambret, Academic Department of Radiation Oncology, Lille, France
- Université de Lille, CHU Lille, CNRS, Centrale Lille, Lille, France
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12
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España AG, Pimentel MIF, Lyra JPDM, Valete-Rosalino CM, Lyra MR. Description of the dermatoscopic features observed in sporotrichosis and American cutaneous leishmaniasis in a reference center in Rio de Janeiro, Brazil. An Bras Dermatol 2023; 98:764-773. [PMID: 37481377 PMCID: PMC10589486 DOI: 10.1016/j.abd.2022.09.015] [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: 06/29/2022] [Revised: 08/14/2022] [Accepted: 09/05/2022] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND The evaluation of American cutaneous leishmaniasis (CL) and sporotrichosis (SP) with dermoscopy may improve the diagnosis accuracy and clinical monitoring. OBJECTIVES To describe the dermoscopic findings and patterns of skin lesions of patients with CL and SP followed up at the Laboratory of Clinical Research and Surveillance in Leishmaniasis (LaPClinVigiLeish), Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. METHODS The authors included patients with a diagnosis of CL or SP, who attended at INI/ Fiocruz, between 2019‒2021. All patients had 3 dermoscopic examinations (DermLite DL4): before treatment (T0), during treatment (T1), and after healing (T2). Up to three lesions per patient were evaluated. RESULTS The authors studied 47 patients with CL (74 lesions), and 19 patients with SP (24 lesions). The authors described dermoscopic structures such as rosettes, white lines, white dots, brown focal structureless areas, brown lines and dots, white perilesional circles, perilesional hyperchromic circles, microulcerations and the rainbow patterns. The authors created specific patterns; in CL: CL-T0 "central yellow scales with a white perilesional circle pattern", CL-T1 "diffuse structureless white area pattern" and CL-T2 "white and brown focal structureless areas pattern". In SP: SP-T0 the "pustule with erythema pattern"; SP-T1 the "focal structureless white areas with erythema pattern" and SP-T2 the "white linear pattern". STUDY LIMITATIONS This study does not correlate dermoscopic findings with time of disease evolution at the first medical examination. CONCLUSIONS The recognition of CL and SP dermoscopy patterns may be helpful tool for the differential diagnosis and monitoring of disease evolution.
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Affiliation(s)
- Alejandra Galeano España
- Laboratory of Clinical Research and Surveillance in Leishmaniasis, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
| | - Maria Inês Fernandes Pimentel
- Laboratory of Clinical Research and Surveillance in Leishmaniasis, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Cláudia Maria Valete-Rosalino
- Laboratory of Clinical Research and Surveillance in Leishmaniasis, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil; Otolaryngology Department and Ophthalmology, Faculty of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcelo Rosandiski Lyra
- Laboratory of Clinical Research and Surveillance in Leishmaniasis, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Poddighe D, Assylbekova M, Almukhamedova Z, Aman A, Mukusheva Z. Pediatric erythema ab igne: clinical aspects and diagnostic issues. Eur J Pediatr 2023; 182:4807-4832. [PMID: 37661206 DOI: 10.1007/s00431-023-05155-1] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023]
Abstract
Erythema ab igne is a dermatological condition resulting from repeated low-grade heat exposure (below the burning point), which can variably manifest with reticulated erythema and skin hyperpigmentation. Not infrequently, the cause of such a skin disorder is not immediately evident or reported by patients, especially if these are children. Compared to adults, erythema ab igne is rare in children and, if the general practitioners and pediatricians are not aware of this disorder, pediatric patients are often addressed to rheumatologists and/or undergo useless immunological investigations. Here, we performed a systematic case-based review, which finally included 32 cases of pediatric erythema ab igne (in addition to our new clinical report), and discussed the main clinical aspects and issues of this clinical entity in children. In detail, similarities of erythema ab igne with livedo reticularis and/or vasculitis-related rashes sometimes can lead to perform a panel of immunological investigations, which could be avoided. Indeed, our analysis emphasizes the importance of a careful and complete patient's anamnesis, including active questioning about the potential exposure to any physical agents (including heat sources) that may cause dermatological lesions. We also highlight some peculiarities in terms of location and heat injury in children developing erythema ab igne, based on the presence or absence of comorbidities. CONCLUSION The occurrence of erythema ab igne in children (and especially in adolescents) is likely to increase in the next years because of the greater and sometimes inappropriate use of technological devices. Physicians should be aware of this condition in order to prevent patients from useless investigations, especially in the differential diagnosis of rheumatic disorders. A careful and complete patient's history with active questioning about the potential exposure to heating source is often decisive to diagnose erythema ab igne. WHAT IS KNOWN • Erythema ab igne is a dermatological condition which is mainly described in adults exposed to heating source at the workplace. WHAT IS NEW • The occurrence of erythema ab igne in children is likely to increase in the next years because of the greater and sometimes inappropriate use of technological devices. • Erythema ab igne in children can be classified in two main categories, based on the presence or absence of comorbidity. • A careful and complete anamnesis (including the active questioning about potential exposure to any heating source) is the mainstay for diagnosing erythema ab igne in children.
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Affiliation(s)
- Dimitri Poddighe
- Department of Medicine, Nazarbayev University School of Medicine, Kerei-Zhanibek Str. 5/1, Astana, 010000, Kazakhstan.
- Clinical Academic Department of Pediatrics, National Research Center of Mother and Child Health, University Medical Center, Astana, 010000, Kazakhstan.
| | - Maykesh Assylbekova
- Program of Pediatric Rheumatology, Clinical Academic Department of Pediatrics, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
| | - Zhaina Almukhamedova
- Program of Pediatric Rheumatology, Clinical Academic Department of Pediatrics, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
| | - Akbota Aman
- Department of Medicine, Nazarbayev University School of Medicine, Kerei-Zhanibek Str. 5/1, Astana, 010000, Kazakhstan
| | - Zaure Mukusheva
- Program of Pediatric Rheumatology, Clinical Academic Department of Pediatrics, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
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14
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Mayur O, Martinez R, McNichol MC, McGee JS. Clinical and histological features and treatment outcomes of patients with Morbihan disease: a systematic review. Arch Dermatol Res 2023; 315:2427-2429. [PMID: 37062777 DOI: 10.1007/s00403-023-02621-6] [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: 12/23/2022] [Revised: 03/15/2023] [Accepted: 03/30/2023] [Indexed: 04/18/2023]
Abstract
Morbihan disease (MD) is considered a rare complication of rosacea, which is difficult to diagnose and challenging to treat. Here, we performed a systematic review of available case reports and case series to summarize key clinical and pathologic features of and successful treatment regimens for MD. We conducted a search of the PubMed/MEDLINE, EMBASE, and Cochrane electronic databases from their inception to the date of search on March 6, 2023. We found that MD affects patients in the fifth decade of life on average, more commonly reported in male than female (69% vs 31%). Clinically, MD affects the eyelids, cheeks, and forehead most commonly, presenting as non-pitting, erythematous edema or an edematous plaque. On biopsy, the pathologic features, such as dermal edema, sebaceous hyperplasia, perivascular and periadnexal inflammatory infiltrate, and granulomatous reaction, are frequently reported. Out of 55 patients who were able to achieve complete response without recurrence, 35% of patients were treated with isotretinoin and 22% were treated with tetracycline antibiotics with a daily dosage range of 20-80 mg and 40-200 mg, respectively. Out of those 55 patients, 22% and 7% were treated successfully with surgical intervention and intralesional injection of steroids, respectively. Additionally, lymphatic drainage has been shown to be an effective adjunctive therapeutic tool. More studies are necessary to understand the disease mechanism to improve the diagnosis of and develop evidence-based therapies for MD.
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Affiliation(s)
- Omkar Mayur
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Rebeca Martinez
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Megan C McNichol
- Information Systems Knowledge Services, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jean S McGee
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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15
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Kowe P, Behera B, Sethy M, Dash S, Sarkar N, Garg S. Clinico-dermoscopic and pathological features of a rare presentation of erythema elevatum diutinum. Indian J Dermatol Venereol Leprol 2023; 89:738-741. [PMID: 37067117 DOI: 10.25259/ijdvl_933_2021] [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: 09/19/2021] [Accepted: 12/05/2022] [Indexed: 03/31/2023]
Affiliation(s)
- Priyanka Kowe
- Department of Dermatology, and Venereology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Biswanath Behera
- Department of Dermatology, and Venereology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Madhusmita Sethy
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Siddharth Dash
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Namrata Sarkar
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Sonika Garg
- Department of Dermatology, and Venereology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
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16
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Kordeva S, Broshtilova V, Batashki I, Tchernev G. BULGARIAN PATIENT WITH ATROPHODERMA OF PASINI AND PIERINI- DESCRIPTION OF A CASE AND SHORT UPDATE. Georgian Med News 2023:227-231. [PMID: 37805902] [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: 10/09/2023]
Abstract
Atrophoderma of Pasini and Pierini is a rare, considered benign, skin disease characterized by single or multiple asymptomatic atrophic plaques. Lesions can occur everywhere on the body with the trunk being the most often reported affected site. It appears in the second or third decade of life and affects mostly the female population, with male to female ratio of 1:6, commonly of white European descent. Different risk factors were described in the literature - genetic predisposition, infections with Epstein-Barr virus, varicella zoster and Borrelia burgdorferi, vaccinations, local trauma and more. Since the pandemic with COVID-19, skin manifestations after the viral infection with COVID-19 were reported. After a thorough search of the existing medical literature, we believe, we present the first case of a rapid progression of Atrophoderma of Pasini and Pierini after COVID-19 infection. Due to its similarity to morphea in some aspects, the condition is often misdiagnosed, and the proper treatment is often delayed. Sometimes the dilemma "Is it atrophoderma Pasini-Pierini or is it in fact morphea?" stays, but the exact histopathological verification and the "diagnostic clues" which can be used during the examination stage, are usually enough to diagnose the condition. We present a 63-year-old female with a rapid progression of atrophoderma of Pasini and Pierini after a COVID-19 infection. The lesion that she presented with was single, asymptomatic, with central hypopigmentation and slight atrophy, with a smooth, shiny surface and ivory color, and peripheral hyperpigmentation, measured 18x5cm, without the presence of perilesional erythema. The patient was initially diagnosed clinically with localized scleroderma (morphea) and treated with hydroxychloroquine 200 mg once daily for a 5-year period without improvement. Years later two biopsies from different lesional sites were taken, resulting in absence of sclerosis and dermal atrophy, but - reduction in the thickness of the dermis with fragmentation and hyalinization of collagen fibers forming a parallel orientation, dilated vascular vessels of small caliber and reduced number of skin appendages, confirming the diagnosis of atrophoderma Pasini-Pierini. The patient's therapy was switched to methotrexate with good therapeutic response. Often, the two conditions - morphea and atrophoderma of Pasini and Pierini can be mistaken due to its clinical similarity and sometimes coexistence. Therefore, we will shortly review the existing literature with key points on the similarities and differences.
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Affiliation(s)
- S Kordeva
- 1Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
| | - V Broshtilova
- 2Department of Dermatology and Venereology, Military Medical Academy, Sofia, Bulgaria
| | - I Batashki
- 3Medical Institute of Ministry of Interior, Department of Common, Abdominal and Vascular Surgery, Sofia, Bulgaria
| | - G Tchernev
- 1Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria; 4Department of Dermatology and Venereology, Medical Institute of Ministry of Interior, Sofia, Bulgaria
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17
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Kim T, Lee YE, Han Y, Baek JH, Ko MJ, Ahn H, Shin MK. Analysis of facial vascular pattern characteristics in the Korean population. Skin Res Technol 2023; 29:e13344. [PMID: 37357648 PMCID: PMC10240184 DOI: 10.1111/srt.13344] [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: 01/27/2023] [Accepted: 04/26/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Facial erythema is a common problem among patients visiting dermatologists. However, data on the clinical characteristics of facial erythema in healthy people are lacking. We aimed to compare and analyze the severity and pattern of facial vascularity in healthy subjects based on their age and gender. MATERIALS AND METHODS This study included 198 Korean volunteers (126 females and 72 males) with Fitzpatrick skin types II, III, or IV. Fourteen different anatomical areas on the face were divided into facial erythema units. Each unit was scored from one (least erythematous) to five (most erythematous) according to the observed level of erythema on the red images implemented as hemoglobin content. We also evaluated the presence of facial telangiectatic macules. RESULTS On average, the perinasal, nasal, and cheek units were the most hypervascular regions. In contrast, the degree of facial erythema was lowest in the labial (perioral), neck, and temporal regions. The average value of erythema was higher in males than in females. Additionally, the severity of erythema tended to increase with age. In both males and females, the number of telangiectatic macules increased with age. CONCLUSIONS We analyzed the clinical characteristics of erythema in healthy subjects with Fitzpatrick skin types II, III, or IV in the Korean population. This study is expected to be used to identify the neurovascular pathogenesis of the most common regions of facial dermatosis in the future.
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Affiliation(s)
- Tae‐Eun Kim
- Department of DermatologyKyung Hee University College of MedicineKyung Hee University HospitalSeoulRepublic of Korea
| | | | - Young‐Min Han
- Department of DermatologyKyung Hee University College of MedicineKyung Hee University HospitalSeoulRepublic of Korea
| | | | | | - Hye‐Jin Ahn
- Department of DermatologyKyung Hee University College of MedicineKyung Hee University HospitalSeoulRepublic of Korea
| | - Min Kyung Shin
- Department of DermatologyKyung Hee University College of MedicineKyung Hee University HospitalSeoulRepublic of Korea
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18
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Al-Dhalimi MA, Jasim SH. Dermoscopic evaluation of cutaneous leishmaniasis. Arch Dermatol Res 2023; 315:531-540. [PMID: 36163392 DOI: 10.1007/s00403-022-02387-3] [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: 03/24/2022] [Revised: 07/17/2022] [Accepted: 09/07/2022] [Indexed: 11/02/2022]
Abstract
Cutaneous leishmaniasis (CL) is an endemic disease in Iraq that is caused by protozoan infection. Dermoscopy has been applied to help in the diagnosis of multiple skin disease, including infestations. To evaluate the dermoscopic characteristics of CL lesions and their relationship with the disease duration, site, and pattern. Dermoscopic examination using (3 Gen Dermlite DL 100) at tenfold magnification of 91 lesions in 67 patients was elicited. This study was done from December 2019 to December 2020. The main dermoscopic features were generalized erythema (100%), hyperkeratosis with central erosion or ulceration (53.8%), white scar-like patch (41.8%), yellow tears (35.2%), white starburst sign (34.1%), and milia-like cyst (2.2%). We also observed vascular structures, including linear irregular (63.1%), dotted (57.1%), glomerular (38.1%), hairpin (22.6%), and comma-shaped vessels (16.7%). Linear irregular vessels were more commonly demonstrated on the face and upper limbs; while on the lower limbs, hyperkeratosis with erosion and ulceration were the most common finding. Hyperkeratosis with erosions/ulcerations (43.8%) was the most common finding in the papular pattern, linear irregular vessels (56.7%) in the nodular pattern, glomerular vessels (64.3%) was the most common finding in noduloulcerative pattern and linear irregular vessels (71%) was the most common finding in plaque pattern. The dermoscopic features would help in the diagnosis of CL lesions by dermoscopy, especially in endemic areas. There is a good relationship between the dermoscopic features and type of CL lesions.
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Affiliation(s)
- Muhsin A Al-Dhalimi
- Department of Dermatology, Faculty of Medicine, University of Kufa, Kufa Post Office, P.O. Box 21, Najaf, Iraq.
| | - Shadan Hussein Jasim
- Department of Dermatology, Alsader Teaching Hospital, AlNajaf Health Directorate, Najaf, Iraq
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19
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Abstract
Many skin diseases show circular red lesions on the skin, called erythema. Erythema is characterized by the expansion of its circular area solely from local stimulation. A pathological inflammatory response caused by the stimulation persistently increases inflammatory mediators in the dermis, whereas a normal inflammatory response transiently increases mediators, resulting in the shrinkage of the erythema. Although the diffusion of mediators theoretically reproduces the expansion, how the inflammatory response expands or shrinks the erythema remains unknown. A possibility is positive feedback, which affects mediator production and can generate two distinct stable states (i.e., inflamed and noninflamed), referred to as bistability. Bistability causes a state transition either from the noninflamed to inflamed state or the reverse direction by suprathreshold stimulation. Additionally, the diffusion selectively causes state transition in either direction, resulting in spatial spread of the transited state, known as the traveling wave. Therefore, we hypothesize that the traveling wave of the inflammatory response can account for both the expansion and shrinkage. Using a reaction-diffusion model with bistability, we theoretically show a possible mechanism in which the circular inflamed area expands via the traveling wave from the noninflamed to the inflamed state. During the expansion, the boundary between the inflamed and noninflamed areas moves at a constant velocity while maintaining its concentration gradient. Moreover, when the positive feedback is weak, the traveling wave selectively occurs from the inflamed to noninflamed state, shrinking the inflamed area. Whether the inflamed area expands or shrinks is mainly controlled by the balance of mediator concentration between the noninflamed and inflamed states, relative to the threshold. The traveling wave of the inflammatory response provides an experimentally testable framework for erythema expansion and shrinkage, thereby contributing to the development of effective treatments, including probiotics.
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Affiliation(s)
- Maki Sudo
- Department of Biological Sciences, Graduate School of Science, Osaka University, Machikaneyama-cho, Toyonaka, Japan
| | - Koichi Fujimoto
- Department of Biological Sciences, Graduate School of Science, Osaka University, Machikaneyama-cho, Toyonaka, Japan
- * E-mail:
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20
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Labadie JG, Compres E, Sunshine JC, Alam M, Gerami P, Harikumar V, Poon E, Arndt KA, Dover JS. Actinic Keratosis Color and Its Associations: A Retrospective Photographic, Dermoscopic, and Histologic Evaluation. Dermatol Surg 2022; 48:57-60. [PMID: 34812188 DOI: 10.1097/dss.0000000000003281] [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: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Actinic keratoses (AKs) have been described with varying color and morphology; however, no reports have demonstrated associations between color, vasculature, and inflammation. In this retrospective study, we analyze the clinical, dermoscopic, and histopathologic features of AKs to elucidate this relationship. METHODS A retrospective search for patients diagnosed with AK between January 2018 and October 2019 was performed. Clinical and dermoscopic photographs and pathology slides for all included subjects were reviewed. RESULTS Forty-nine images and histopathology slides were analyzed. Dermoscopy of white AKs demonstrated scale and absence of erythema with corresponding absence of inflammation on histopathology. Dermoscopy of brown AKs revealed pseudonetwork, absent scale, and a variable vessel pattern with pigment incontinence and absence of inflammation on histopathology. Red AKs had a distinct polymorphous vessel pattern and presence of erythema on dermoscopy. On histopathology, about half of samples showed increased vascularity and variable inflammation. Pink AK dermoscopy revealed a presence of erythema with corresponding presence of inflammation on histopathology. CONCLUSION This report adds to our understanding of AKs and confirms that, in general, the pinker or redder the AK, the more prominent the inflammatory infiltrate and vasculature, respectively. Dermatologists should continue to use their diagnostic skills to successfully diagnose and triage AKs.
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Affiliation(s)
- Jessica G Labadie
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Elsy Compres
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joel C Sunshine
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Dermatopathology, Northwestern University, Chicago, Illinois
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Department of Dermatopathology, Northwestern University, Chicago, Illinois
| | - Vishnu Harikumar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kenneth A Arndt
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jeffrey S Dover
- SkinCare Physicians, Chestnut Hill, Massachusetts
- Yale University School of Medicine, New Haven, Connecticut
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
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21
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Strong JA, Hoegler KM, Reznikova A, Driscoll MS. A Histologic Timeline of a Delayed Hypersensitivity Reaction after the COVID-19 Pfizer Booster. Skinmed 2022; 20:387-389. [PMID: 36314709] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
A 54-year-old man presented with worsening bilateral rashes on legs and arms 7 days after receiving his BNT162b2 mRNA COVID-19 (Pfizer) vaccine booster. He developed burning on his palms about 5 days after receiving the booster. On day 6, he observed significant edema on his fingers and palms in addition to thin erythematous papules on his forearms. On day 7, he developed edema on his bilateral dorsal feet, and thin erythematous plaques on his shins. He stated that the rashes were pruritic. He had no rashes following the first two doses of the Pfizer vaccine. He denied having any history of skin disease, autoimmune disease, or allergies. Physical examination revealed multiple thin erythematous papules coalescing into thin plaques on his flexor forearms, and thin erythematous plaques on his dorsal feet (Figure 1). Three 4-mm punch biopsies were performed on his left flexor forearm. The biopsies were carried out at papules present for different lengths of time. Papules at biopsy sites "A," "B," and "C" were present for approximately 24-36 hours, 12-18 hours, and 3-6 hours, respectively (Figure 1).
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Affiliation(s)
- Jennifer A Strong
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD
| | - Karl M Hoegler
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD
| | - Anna Reznikova
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD
| | - Marcia S Driscoll
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD;
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22
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Noguchi K, Nishimura R, Ikawa Y, Mase S, Fujiki T, Kuroda R, Araki R, Maeba H, Yachie A, Wada T. High-dose Methotrexate-induced Acral Erythema in Two Pediatric Patients With Acute Lymphoblastic Leukemia: A 17 Pediatric Case Series of Methotrexate-induced Acral Erythema. J Pediatr Hematol Oncol 2021; 43:e1259-e1261. [PMID: 34486565 DOI: 10.1097/mph.0000000000002326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/26/2022]
Affiliation(s)
- Kazuhiro Noguchi
- Department of Pediatrics, School of Medicine, Institute of Medical Pharmaceutical and Health Sciences Kanazawa University, Kanazawa, Japan
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23
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Affiliation(s)
- Sooyie Choi
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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24
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Dumbuya H, Yan X, Chen Y, Wangari-Olivero J, Lynch S, Brieva P, Zheng Q, Bouez C. ARTICLE: Efficacy of Ceramide-Containing Formulations on UV-Induced Skin Surface Barrier Alterations. J Drugs Dermatol 2021; 20:s29-s35. [PMID: 33852258 DOI: 10.36849/jdd.2021.589e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The human skin, particularly the stratum corneum, serves as a protective barrier against exogenous factors, including ultraviolet radiation (UVR) and pathogen invasions. The impact of UVR on skin cancer and photoaging has been extensively studied. However, the direct impact of UVR on skin barrier integrity under clinical settings remains poorly explored. Due to their benefits in reducing inflammation and promoting skin barrier repair, ceramide-containing formulations can provide added photoprotection benefits. In this study, the efficacy of a ceramide-containing sunscreen and moisturizer were evaluated in preventing UV-induced skin surface barrier changes. Expert grading, instrumental, and tape-stripping assessments demonstrated that UVR induced erythema and hyperpigmentation and caused changes in skin cells surface morphological organization and maturation. Treatment with a ceramide-containing sunscreen and moisturizing cream routine reduced erythema and hyperpigmentation, improved skin hydration, and maintained normal superficial skin cells morphology and turnover after UVR. Our results indicate that barrier-enforcing lipids formulations can provide additional benefits in patient’s daily routine by strengthening the barrier and improving skin health overall against chronic sun exposure. J Drugs Dermatol. 20(4 Suppl):s29-35. doi:10.36849/JDD.S589E.
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25
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Abstract
Cellulitis is a common skin infection resulting in increasing hospitalizations and health care costs. There is no gold standard diagnostic test, making cellulitis a potentially challenging condition to distinguish from other mimickers. Physical examination typically demonstrates poorly demarcated unilateral erythema with warmth and tenderness. Thorough history and clinical examination can narrow the differential diagnosis of cellulitis and minimize unnecessary hospitalization. Antibiotic selection is determined by patient history and risk factors, severity of clinical presentation, and the most likely microbial culprit.
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Affiliation(s)
- Renajd Rrapi
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, 2nd Floor, Boston, MA 02114, USA
| | - Sidharth Chand
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, 2nd Floor, Boston, MA 02114, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, 2nd Floor, Boston, MA 02114, USA.
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26
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Cazzato G, Mazzia G, Cimmino A, Colagrande A, Sablone S, Lettini T, Rossi R, Santarella N, Elia R, Nacchiero E, Maruccia M, Marzullo A, Maiorano E, Giudice G, Ingravallo G, Resta L. SARS-CoV-2 and Skin: The Pathologist's Point of View. Biomolecules 2021; 11:biom11060838. [PMID: 34200112 PMCID: PMC8227624 DOI: 10.3390/biom11060838] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 05/15/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 02/05/2023] Open
Abstract
The SARS-CoV-2 pandemic has dramatically changed our lives and habits. In just a few months, the most advanced and efficient health systems in the world have been overwhelmed by an infectious disease that has caused 3.26 million deaths and more than 156 million cases worldwide. Although the lung is the most frequently affected organ, the skin has also resulted in being a target body district, so much so as to suggest it may be a real "sentinel" of COVID-19 disease. Here we present 17 cases of skin manifestations studied and analyzed in recent months in our Department; immunohistochemical investigations were carried out on samples for the S1 spike-protein of SARS-CoV-2, as well as electron microscopy investigations showing evidence of virions within the constituent cells of the eccrine sweat glands and the endothelium of small blood vessels. Finally, we conduct a brief review of the COVID-related skin manifestations, confirmed by immunohistochemistry and/or electron microscopy, described in the literature.
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Affiliation(s)
- Gerardo Cazzato
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
- Correspondence:
| | - Giulia Mazzia
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Antonietta Cimmino
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Anna Colagrande
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Sara Sablone
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Policlinico di Bari Hospital, University of Bari, 70124 Bari, Italy; (S.S.); (G.G.)
| | - Teresa Lettini
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Roberta Rossi
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Nadia Santarella
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Rossella Elia
- Department of Emergency and Organ Transplantation, Section of Plastic and Reconstructive Surgery, University of Bari, 70124 Bari, Italy; (R.E.); (E.N.); (M.M.)
| | - Eleonora Nacchiero
- Department of Emergency and Organ Transplantation, Section of Plastic and Reconstructive Surgery, University of Bari, 70124 Bari, Italy; (R.E.); (E.N.); (M.M.)
| | - Michele Maruccia
- Department of Emergency and Organ Transplantation, Section of Plastic and Reconstructive Surgery, University of Bari, 70124 Bari, Italy; (R.E.); (E.N.); (M.M.)
| | - Andrea Marzullo
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Giuseppe Giudice
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Policlinico di Bari Hospital, University of Bari, 70124 Bari, Italy; (S.S.); (G.G.)
| | - Giuseppe Ingravallo
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Leonardo Resta
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
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Sun J, Yang X, Zhu X, Wang Y. Hemifacial erythema: an unusual manifestation of lupus erythematosus tumidus. Rheumatology (Oxford) 2021; 60:476. [PMID: 32772087 DOI: 10.1093/rheumatology/keaa409] [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: 05/23/2020] [Accepted: 06/13/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jingru Sun
- Department of Dermatology and Venerology, Peking University First Hospital
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - Xiaojing Yang
- Department of Dermatology and Venerology, Peking University First Hospital
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - Xuejun Zhu
- Department of Dermatology and Venerology, Peking University First Hospital
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - Yang Wang
- Department of Dermatology and Venerology, Peking University First Hospital
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
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28
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Hattori N, Kuroda M, Katano H, Takuma T, Ito T, Arai N, Yanai R, Sekizuka T, Ishii S, Miura Y, Tokunaga T, Watanabe H, Nomura N, Eguchi J, Hasegawa H, Nakamaki T, Wakita T, Niki Y. Candidatus Mycoplasma haemohominis in Human, Japan. Emerg Infect Dis 2021; 26:11-19. [PMID: 31855136 PMCID: PMC6924906 DOI: 10.3201/eid2601.190983] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Hemotropic mycoplasmas are common pathogens in animals, but it remains unclear what role these pathogens play in human infections. We report clinical and biologic characterization of Candidatus Mycoplasma haemohominis infection in a 42-year-old man in Japan. The patient had severe hemophagocytic syndrome 1 month after an accidental needlestick injury. Metagenomic deep sequencing identified Candidatus M. haemohominis and determined its draft genome for an isolate from serum of the patient. A high copy number of the Candidatus M. haemohominis genome was detected in serum and bone marrow samples. Electron microscopy examination showed morphologic characteristics of Candidatus M. haemohominis. Levofloxacin monotherapy induced resistance caused by a gyrase A gene mutation in the quinolone resistance–determining region, but a combination treatment with moxifloxacin and minocycline was effective. We identified Candidatus M. haemohominis in a patient who had life-threatening symptoms related to multiple organ infection. Human infection with this mycoplasma might occur more frequently than has been generally recognized.
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29
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Relvas M, Calvão J, Oliveira R, Cardoso JC, Gonçalo M. [Cutaneous Manifestations Associated with COVID-19: A Narrative Review]. ACTA MEDICA PORT 2021; 34:128-136. [PMID: 33315008 DOI: 10.20344/amp.14574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/15/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION COVID-19 is an infectious disease caused by the new coronavirus, SARS-CoV-2, that has spread rapidly throughout the world. This has resulted in an urgent need to obtain information regarding its pathogenesis, diagnosis and clinical manifestations. More specifically, skin manifestations, seldom reported initially, have been increasingly described. MATERIAL AND METHODS We performed a literature search in the PubMed database, regarding cutaneous manifestations associated with COVID-19. This article describes the clinical and histological findings of the main skin lesions observed in the context of SARS-CoV-2 infection. DISCUSSION Cutaneous manifestations associated with COVID-19 have been described in multiple retrospective and prospective studies, case series and case reports. The reported incidence reached 20.4%. Although there was substantial heterogeneity in terms of clinical patterns, the main ones include: erythematous/maculopapular, urticarial, papulovesicular, and purpuric/petechial eruptions, chilblain-like lesions and livedoid/acro-ischemic lesions. In the vast majority, the underlying pathophysiologic mechanisms are not fully understood, although histopathological findings and biomolecular studies can add relevant data. CONCLUSION The recognition of cutaneous manifestations associated with COVID-19 is of utmost importance. They may help establishing an early diagnosis, namely in oligosymptomatic patients or when confirmatory tests are impossible to perform. Moreover, chilblain-like lesions and acro-ischemia, also seem to play an important role in terms of prognosis.
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Affiliation(s)
- Maria Relvas
- Serviço de Dermatologia e Venereologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Joana Calvão
- Serviço de Dermatologia e Venereologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Raquel Oliveira
- Serviço de Medicina Interna. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - José Carlos Cardoso
- Serviço de Dermatologia e Venereologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Margarida Gonçalo
- Serviço de Dermatologia e Venereologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Departamento de Dermatologia. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
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30
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Sandoval-Clavijo A, Castillo P, Toll A. Erythematous papules on the penis as first manifestation of metastatic prostate adenocarcinoma. Dermatol Online J 2021; 27:13030/qt1059k69c. [PMID: 33560795] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023] Open
Abstract
We report a 70-year-old man with asymptomatic reddish papules on the glans penis that histologically showed metastases of prostate adenocarcinoma. He had a medical history of a stage IV undifferentiated prostate adenocarcinoma that was currently being treated with chemotherapy. The medical history of advanced stage prostate adenocarcinoma associated with the clinical and pathological findings confirmed the diagnosis of penile metastatic prostate adenocarcinoma. This is an example of the relevance of a thorough history combined with histopathological and immunohistochemical correlation which allowed the diagnosis of a penile lesion that may be the first manifestation of prostate metastatic progression and should therefore be included among the differential diagnoses of penile tumors.
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31
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Officer K, Pruvot M, Horwood P, Denk D, Warren K, Hul V, Thy N, Broadis N, Dussart P, Jackson B. Epidemiology and pathological progression of erythematous lip lesions in captive sun bears (Helarctos malayanus). PLoS One 2020; 15:e0243180. [PMID: 33259561 PMCID: PMC7707555 DOI: 10.1371/journal.pone.0243180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/25/2020] [Accepted: 11/16/2020] [Indexed: 01/15/2023] Open
Abstract
This study investigates the occurrence of erythematous lip lesions in a captive sun bear population in Cambodia, including the progression of cheilitis to squamous cell carcinoma, and the presence of Ursid gammaherpesvirus 1. Visual assessment conducted in 2015 and 2016 recorded the prevalence and severity of lesions. Opportunistic sampling for disease testing was conducted on a subset of 39 sun bears, with histopathological examination of lip and tongue biopsies and PCR testing of oral swabs and tissue biopsies collected during health examinations. Lip lesions were similarly prevalent in 2015 (66.0%) and 2016 (68.3%). Degradation of lip lesion severity was seen between 2015 and 2016, and the odds of having lip lesions, having more severe lip lesions, and having lip lesion degradation over time, all increased with age. Cheilitis was found in all lip lesion biopsies, with histological confirmation of squamous cell carcinoma in 64.5% of cases. Single biopsies frequently showed progression from dysplasia to neoplasia. Eighteen of 31 sun bears (58.1%) had at least one sample positive for Ursid gammaherpesvirus 1. The virus was detected in sun bears with and without lip lesions, however due to case selection being strongly biased towards those showing lip lesions it was not possible to test for association between Ursid gammaherpesvirus 1 and lip squamous cell carcinoma. Given gammaherpesviruses can play a role in cancer development under certain conditions in other species, we believe further investigation into Ursid gammaherpesvirus 1 as one of a number of possible co-factors in the progression of lip lesions to squamous cell carcinoma is warranted. This study highlights the progressively neoplastic nature of this lip lesion syndrome in sun bears which has consequences for captive and re-release management. Similarly, the detection of Ursid gammaherpesvirus 1 should be considered in pre-release risk analyses, at least until data is available on the prevalence of the virus in wild sun bears.
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Affiliation(s)
- Kirsty Officer
- Free the Bears, Phnom Penh, Cambodia
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
- * E-mail:
| | - Mathieu Pruvot
- Health Program, Wildlife Conservation Society, Bronx, New York, United States of America
| | - Paul Horwood
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Daniela Denk
- International Zoo Veterinary Group, Keighley, United Kingdom
| | - Kris Warren
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - Vibol Hul
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Nhim Thy
- Forestry Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia
| | | | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Bethany Jackson
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
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32
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Szep Z, Majtan J. Annular erythema as a cutaneous sign of recurrent ductal breast carcinoma, misdiagnosed as erythema chronicum migrans. Dermatol Online J 2020; 26:13030/qt4bq4t7tm. [PMID: 33054939] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023] Open
Abstract
Annular erythema as a clinical manifestation of locoregional recurrence of breast cancer is extremely rare. Only three papers with the description of five cases have been published in the current literature to our knowledge. Herein, we describe two additional cases of annular erythema as a cutaneous sign of recurrent ductal breast carcinoma; both were misdiagnosed as erythema chronicum migrans.
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Affiliation(s)
| | - Juraj Majtan
- Institute of Molecular Biology, Slovak Academy of Sciences, Bratislava.
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Abstract
RATIONALE The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which quickly spread throughout the world, has been putting medical workers all over the world in difficulty because of the high number of cases combined with the lack of information about the disease. Although pediatric cases are rare, the group age under 12 months has been in general more susceptible to develop severe forms of the disease compared with the patients in the age interval of 1 to 18 years. PATIENT CONCERNS Three newborns have been tested positive for SARS-CoV-2 infection. One of them presented bilateral decreased air entry, while the other 2 had no respiratory symptomatology. All 3 developed diaper erythema and oral candidiasis. DIAGNOSIS For building up the report, newborns that were positive for coronavirus disease 2019 (COVID-19) infection were included in the case series. The chest X-ray of the symptomatic patient revealed a medium degree of hilar parenchymal infiltration and a slight infiltration of the visceral pleura. INTERVENTIONS The patients were admitted in our isolated neonatology ward. All of them received antifungal treatment for the oral candidiasis and topic cream for diaper erythema. The symptomatic patient also received prophylactic antibiotherapy, human immunoglobulins, aminophylline, and parenteral nutrition. OUTCOMES All 3 neonates were discharged after 2 consecutive negative tests for SARS-CoV-2. Patients 1 and 2 fully recovered, whereas the condition of patient 3 improved. LESSONS Even if there are only a few reported cases of neonates infected with COVID-19 and most of them present mild manifestations, newborns need a more careful insight because of the nonspecific symptomatology.
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Affiliation(s)
| | | | | | | | - Emil Radu Iacob
- Department of Pediatric Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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34
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Campolo M, Casili G, Paterniti I, Filippone A, Lanza M, Ardizzone A, Scuderi SA, Cuzzocrea S, Esposito E. Effect of a Product Containing Xyloglucan and Pea Protein on a Murine Model of Atopic Dermatitis. Int J Mol Sci 2020; 21:ijms21103596. [PMID: 32438777 PMCID: PMC7279434 DOI: 10.3390/ijms21103596] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/13/2020] [Revised: 04/23/2020] [Accepted: 05/17/2020] [Indexed: 12/12/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease of the skin, characterized by dryness and more or less severe itching. The etiology of AD is complex and has not been fully clarified, involving genetic susceptibility, immunological abnormalities, epidermal barrier dysfunction, and environmental factors. Xyloglucan (XG) and pea protein (PP) are two compounds of natural origin characterized by the ability to create a physical barrier that protects mucosae membranes, reducing inflammation. The aim of the present study was to evaluate the potential beneficial effects of XG + PP in both a mouse model of AD and Staphylococcus aureus (S. aureus) infection- associated AD. Mice were topically treated with 200 μL of 0.5% oxazolone on the dorsal skin three times a week for AD induction. Mice received XG and PP by topical administration 1 h before oxazolone treatment. In S. aureus infection-associated AD, to induce a superficial superinfection of the skin, mice were also treated with 5 μL of 108 of a culture of S. aureus for 2 weeks; mice superinfected received XG and PP by topical administration 1 h before oxazolone + S. aureus. Four weeks later, the skin was removed for histological and biochemical analysis. Our results demonstrated the protective barrier effects of XG and PP characterized by a reduction in histological tissue changes, mastocyte degranulation, and tight junction permeability in the skin following oxazolone treatment. Moreover, XG + PP was able to preserve filaggrin expression, a hallmark of AD. Our data also support the effectiveness of XG + PP to reduce the damage by superinfection post AD induced by S. aureus. In conclusion, a future product containing XG and PP could be considered as a potentially interesting approach for the treatment of AD.
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35
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Abstract
The aims of this study were to compare diagnostic value of anti-ribosomal P protein antibody (anti-P), anti-Smith antibody (anti-Sm), anti-double-stranded DNA antibody (anti-dsDNA), anti-nucleosome antibody (ANuA), and anti-histone antibody (AHA) for systemic lupus erythematosus (SLE) as well as explore the correlation between anti-P and SLE.A retrospective study was performed with 487 SLE patients, 235 non-SLE rheumatic diseases, and 124 healthy subjects from January 2015 to December 2018. Clinical manifestations, laboratory results and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 scores were analyzed between anti-P/+/ and anti-P/-/ patients. SPSS19.0 statistical software was used for data analysis.The sensitivities of anti-P, anti-Sm, anti-dsDNA, ANuA, and AHA in SLE were 31.6%, 20.7%, 45.0%, 27.9%, and 14.6%, and the specificities were 99.2%, 99.4%, 98.9%, 98.3%, and 96.7%, respectively. Only 27.9% of SLE had a single positive anti-P while the other 4 antibodies were all negative. There were significant differences in the age of onset, skin erythema, urinary protein, creatinine and serum IgG, IgM, C3, C4 between anti-P/+/ and anti-P/-/ patients (P < .05). When anti-Sjogren syndrome A antibody, anti-P were positive and anti-dsDNA was negative, the incidence of skin erythema was the highest (35.1%). Compared with anti-P/-/ patients, anti-P/+/ patients had higher SLEDAI scores (P < .001).Anti-P, anti-Sm, anti-dsDNA, ANuA, and AHA have high specificity but poor sensitivity in the diagnosis of SLE; combined detection can greatly improve the detection rate. Anti-P is more valuable in the diagnosis of SLE when other specific autoantibodies are negative. SLE patients with positive anti-P have an earlier onset age and are more prone to skin erythema, lupus nephritis as well as higher disease activity.
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GIANOTTI R, VERALDI S, RECALCATI S, CUSINI M, GHISLANZONI M, BOGGIO F, FOX LP. Cutaneous Clinico-Pathological Findings in three COVID-19-Positive Patients Observed in the Metropolitan Area of Milan, Italy. Acta Derm Venereol 2020; 100:adv00124. [PMID: 32315073 PMCID: PMC9128952 DOI: 10.2340/00015555-3490] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [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] [Accepted: 04/21/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Raffaele GIANOTTI
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan
| | - Stefano VERALDI
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan
| | | | - Marco CUSINI
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan
| | - Massimo GHISLANZONI
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan
| | - Francesca BOGGIO
- Division of Pathology, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lindy P. FOX
- Department of Dermatology, University of California, San Francisco, USA
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Didona D, Fania L, Didona B, Eming R, Hertl M, Di Zenzo G. Paraneoplastic Dermatoses: A Brief General Review and an Extensive Analysis of Paraneoplastic Pemphigus and Paraneoplastic Dermatomyositis. Int J Mol Sci 2020; 21:ijms21062178. [PMID: 32245283 PMCID: PMC7139382 DOI: 10.3390/ijms21062178] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 11/17/2019] [Revised: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 02/06/2023] Open
Abstract
Skin manifestations of systemic disease and malignancy are extremely polymorphous. Clinicians should be familiarized with paraneoplastic dermatoses in order to perform an early diagnosis of the underlying neoplasm. Lack of familiarity with cutaneous clues of internal malignancy may delay diagnosis and treatment of cancer. In this review, we described several paraneoplastic dermatoses and discussed extensively two paradigmatic ones, namely paraneoplastic pemphigus and paraneoplastic dermatomyositis.
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Affiliation(s)
- Dario Didona
- Department of Dermatology and Allergology, Philipps University, 35043 Marburg, Germany; (R.E.); (M.H.)
- Correspondence: ; Tel.: +49-(6421)-58-64882; Fax: +49-(6421)-58-62902
| | - Luca Fania
- First Dermatology Division, IDI-IRCCS, 00167 Rome, Italy;
| | | | - Rüdiger Eming
- Department of Dermatology and Allergology, Philipps University, 35043 Marburg, Germany; (R.E.); (M.H.)
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps University, 35043 Marburg, Germany; (R.E.); (M.H.)
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, IDI-IRCCS, 00167 Rome, Italy;
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Esteves M, Nogueira A, Mota A, Portugal R, Azevedo F. Ulcerated Nodule in a Young Girl's Thigh. Skinmed 2020; 18:120-121. [PMID: 32501797] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 9-year-old girl with no relevant past medical history presented to our department due to a painless solitary nodule on the anterior aspect of the left thigh. The lesion had appeared 18 months before and showed a gradual significant growth, along with recent ulceration. Examination revealed a 20-mm firm, well-circumscribed pink-violaceous nodule but a yellow hue and an ulcerated erythematous center.
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Affiliation(s)
- Mariana Esteves
- Department of Dermatology and Venereology, University of Porto, Porto, Portugal;
| | - Ana Nogueira
- Department of Dermatology and Venereology, University of Porto, Porto, Portugal
| | - Alberto Mota
- Department of Dermatology and Venereology, University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Raquel Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Pathology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Filomena Azevedo
- Department of Dermatology and Venereology, University of Porto, Porto, Portugal
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Johnson O, Pouncey AL, Gardiner S, Ross D. A woman with spreading erythema after caesarean section. BMJ 2020; 368:m445. [PMID: 32107271 DOI: 10.1136/bmj.m445] [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: 11/03/2022]
Affiliation(s)
| | | | | | - David Ross
- Guy's and St Thomas' Hospital, London, UK
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40
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Santana AP, Cardoso AEC, Passos RT, Ferreira ÍSC. Case for diagnosis. Erythematous and pruritic papules on forearms. An Bras Dermatol 2020; 95:250-251. [PMID: 32171542 PMCID: PMC7175029 DOI: 10.1016/j.abd.2019.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/22/2018] [Accepted: 06/18/2019] [Indexed: 11/18/2022] Open
Abstract
Gamasoidosis is a poorly known and underdiagnosed mite infestation. It is characterized by the presence of erythematous and flattened papules that are quite pruritic, and can affect any region of the body, with preference for areas of folds. This article reports a case of the disease caused by mites of the species Dermanyssus gallinae. Increasingly, the agents that cause this disease are found in urban environments, increasing the incidence of people affected by the disease. This dermatosis has a self-limiting clinical picture and the treatment is done with the use of topical corticosteroids and oral antihistamines.
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Affiliation(s)
- Aline Palitot Santana
- Dermatology Clinic, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brazil.
| | - Alberto Eduardo Cox Cardoso
- Dermatology Clinic, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brazil
| | - Rafaela Tenório Passos
- Dermatology Clinic, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brazil
| | - Íris Sampaio Costa Ferreira
- Dermatology Clinic, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brazil
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Olsavszky V, Géraud C. Slowly Growing Annular Erythematous Lesions on Lightly Pigmented Skin: A Quiz. Acta Derm Venereol 2020; 100:adv00011. [PMID: 31663603 PMCID: PMC9128933 DOI: 10.2340/00015555-3365] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Victor Olsavszky
- Department of Dermatology, Venereology and Allergy, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, DE-68167 Mannheim, Germany
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42
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Bittencourt MDJS, dos Anjos AB, Brito FCDOCA, Unger DAA. Cutaneous sarcoidosis with livedo-like manifestation. An Bras Dermatol 2019; 94:493-494. [PMID: 31644635 PMCID: PMC7007037 DOI: 10.1590/abd1806-4841.20198173] [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] [Received: 02/08/2018] [Accepted: 08/27/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Deborah Aben Athar Unger
- Discipline of Dermatology, Universidade Federal do Pará, Belém, PA, Brazil
- Dermatology Service, Universidade Federal do Pará, Belém, PA, Brazil
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Xue R, Elbendary A, Wu T. Necrolytic acral erythema in a Chinese patient with hepatitis C and hepatitis B virus coinfection. An Bras Dermatol 2019; 94:446-448. [PMID: 31644618 PMCID: PMC7007027 DOI: 10.1590/abd1806-4841.20197257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/05/2017] [Accepted: 02/02/2018] [Indexed: 12/27/2022] Open
Abstract
Necrolytic acral erythema is a distinct erythema that has been described as an extrahepatic manifestation of hepatitis C virus infection. Most reported cases have been in Africa, especially Egypt. We report the first case (to the best of our knowledge) of necrolytic acral erythema in a Chinese patient with HCV and HBV coinfection. We aim to increase awareness for recognizing this condition in the Chinese population.
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Affiliation(s)
- Ruzeng Xue
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Amira Elbendary
- Department of Dermatology, Kasralainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tieqiang Wu
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangdong Provincial Dermatology Hospital, Guangzhou, China
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44
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Maruta CW, Miyamoto D, Aoki V, de Carvalho RGR, Cunha BM, Santi CG. Paraneoplastic pemphigus: a clinical, laboratorial, and therapeutic overview. An Bras Dermatol 2019; 94:388-398. [PMID: 31644609 PMCID: PMC7007015 DOI: 10.1590/abd1806-4841.20199165] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 04/21/2019] [Accepted: 06/17/2019] [Indexed: 12/27/2022] Open
Abstract
Paraneoplastic pemphigus is a rare and severe autoimmune blistering disease characterized by mucocutaneous lesions associated with benign and malignant neoplasms. Diagnostic criteria include the presence of chronic mucositis and polymorphic cutaneous lesions with occult or confirmed neoplasia; histopathological analysis exhibiting intraepidermal acantholysis, necrotic keratinocytes, and vacuolar interface dermatitis; direct immunofluorescence with intercellular deposits (IgG and C3) and at the basement membrane zone (IgG); indirect immunofluorescence with intercellular deposition of IgG (substrates: monkey esophagus and simple, columnar, and transitional epithelium); and, autoreactivity to desmogleins 1 and 3, desmocollins 1, 2, and 3, desmoplakins I and II, envoplakin, periplakin, epiplakin, plectin, BP230, and α-2-macroglobulin-like protein 1. Neoplasias frequently related to paraneoplastic pemphigus include chronic lymphocytic leukemia, non-Hodgkin lymphoma, carcinomas, Castleman disease, thymoma, and others. Currently, there is no standardized treatment for paraneoplastic pemphigus. Systemic corticosteroids, azathioprine, mycophenolate mofetil, cyclosporine, rituximab, cyclophosphamide, plasmapheresis, and intravenous immunoglobulin have been used, with variable outcomes. Reported survival rates in 1, 2, and 5 years are 49%, 41%, and 38%, respectively.
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Affiliation(s)
- Celina Wakisaka Maruta
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Denise Miyamoto
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Valeria Aoki
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Breno Medeiros Cunha
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Claudia Giuli Santi
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Affiliation(s)
- Thadeu Santos Silva
- Dermatology Outpatient Clinic, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Luciana Rebouças de Araujo
- Dermatology Outpatient Clinic, Hospital Santa Izabel, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
| | - Gustavo Baptista de Almeida Faro
- Dermatology Outpatient Clinic, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Geise Rezende Paiva
- Anatomical Pathology Laboratory, Hospital Santa Izabel, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
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46
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Patrone CC, Nelson C, Gaddis KJ, Lubin D, Xu X, Kim EJ, Micheletti RG. Erythematous plaques and nodules on the abdomen and groin. Cutis 2019; 104:E24-E26. [PMID: 31774901] [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] [Indexed: 06/10/2023]
Affiliation(s)
- Christina C Patrone
- Columbia University College of Physicians and Surgeons, New York, New Yor, USA
| | - Caroline Nelson
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Kevin J Gaddis
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Daniel Lubin
- Department of Pathology and Laboratory Medicine, Department of Dermatology, Perelman SchoDepartment of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.ol of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Xiaowei Xu
- Department of Pathology and Laboratory Medicine, Department of Dermatology, Perelman SchoDepartment of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.ol of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Ellen J Kim
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Robert G Micheletti
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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47
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Nogueira CP, Torres T. Erythematous, Concentric Rash Resembling Wood Grain. ACTA MEDICA PORT 2019; 32:621. [PMID: 31493368 DOI: 10.20344/amp.11075] [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: 07/15/2018] [Accepted: 11/27/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Catarina Pinto Nogueira
- Unidade de Saúde Familiar Fânzeres. Agrupamento de Centros de Saúde de Gondomar. Gondomar. Portugal
| | - Tiago Torres
- Department of Dermatology and Dermatology Research Unit. Centro Hospitalar do Porto. Porto. Instituto de Ciências Biomédicas Abel Salazar. University of Porto. Porto. Portugal
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48
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Cheng MW, Goldbach H, Young LC. Rash on the thigh. J Fam Pract 2019; 68:415-416. [PMID: 31532818] [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: 06/10/2023]
Abstract
The patient's study habits led to the diagnosis in this case.
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Affiliation(s)
- Michelle W Cheng
- Division of Dermatology, University of California, Los Angeles, USA
| | - Hayley Goldbach
- Division of Dermatology, University of California, Los Angeles, USA
| | - Lorraine C Young
- Division of Dermatology, University of California, Los Angeles, USA.
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49
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Geffrier C, de Parades V, Abramowitz L, Benfredj P, Bonnaud G, Bord C, Bouchard D, Bouguen G, Devulder F, Didelot JM, Fathallah N, Higuero T, Lesage X, Nouts A, Petit P, Pigot F, Pommaret E, Roumeguere P, Siproudhis L, Staumont G, Zeitoun JD, Marteau P. Online training on how to diagnose anoperineal lesions of Crohn's disease: Do pictures matter? A nationwide randomized study. Clin Res Hepatol Gastroenterol 2019; 43:483-496. [PMID: 30935906 DOI: 10.1016/j.clinre.2018.12.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/03/2018] [Indexed: 02/04/2023]
Abstract
UNLABELLED Any gastroenterologist must be trained to properly diagnose anoperineal lesions in patients with Crohn's disease (APLOC). The aim of this study was to establish whether adding pictures would improve teaching effectiveness of the diagnosis of APLOC to French gastroenterology trainees. METHOD Trainees were asked to answer a first web-based survey consisting of evaluating 12 pictures of APLOC with a closed answer questionnaire. They were then randomized in 2 groups. Group A received an online teaching with typical pictures and APLOC definitions and group B definitions only. Trainees were asked again seven days later to answer a second survey with 12 other pictures of APLOC and 14 experts also answered this survey. Diagnostic scores were expressed in %. The primary endpoint was the comparison of the score of survey 2 between the two groups of trainees. Secondary endpoints were to compare results of survey 2 between trainees of both groups and experts, and assess diagnosis of each lesion. RESULTS Two hundred fourty eight trainees among 465 answered survey 1, and 195 survey 2. The diagnostic score was 71.9% for groups A and B and 74.6% for experts (differences NS). After training diagnosis of ulceration was 72% for group A and 72.9% for group B, fistulae 85.2% versus 85.8%, erythema 44.1% vs. 55.6%, anoperineal scars 67.5% vs. 65.6%, and abscess 100% (differences NS). CONCLUSION There was no difference between the two teaching methods. Further research should be performed aiming at improving teaching material and quotation baremes.
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Affiliation(s)
- C Geffrier
- Department of digestive diseases, CHU de Louis-Mourier, AP-HP, 92700 Colombes, France
| | - V de Parades
- Department of proctology, groupe hospitalier Paris Saint Joseph, institut Léopold-Bellan, Paris, France
| | - L Abramowitz
- Department of proctology and digestive diseases, CHU de Bichat, AP-HP, Paris, France
| | - P Benfredj
- Department of proctology, groupe hospitalier Paris Saint Joseph, institut Léopold-Bellan, Paris, France
| | - G Bonnaud
- Department of digestive diseases, clinique des Cèdres, 31700 Cornebarrieu, France
| | - C Bord
- Department of proctology, clinique Beau Soleil, 34070 Montpellier, France
| | - D Bouchard
- Department of proctology, hôpital Bagatelle, 33401 Talence, France
| | - G Bouguen
- Department of digestive diseases, CHU de Pontchaillou, Rennes, France
| | - F Devulder
- Department of digestive diseases and proctology, polyclinique de Courlancy, 51100 Reims, France
| | - J M Didelot
- Department of proctology, Clinique Clementville, 34070 Montpellier, France
| | - N Fathallah
- Department of proctology, Clinique St Antoine, 06004 Nice, France
| | - T Higuero
- Department of proctology, 59280 Armentieres, France
| | - X Lesage
- Department of proctology, 94120 Fontenay-sous-Bois, France
| | - A Nouts
- Department of proctology, clinique Saint Augustin, 44000 Nantes, France
| | - P Petit
- Department of proctology, clinique Tivoli, 33000 Bordeaux, France
| | - F Pigot
- Department of proctology, clinique St Jean-Languedoc, 31400 Toulouse, France
| | - E Pommaret
- Department of proctology, groupe hospitalier Paris Saint Joseph, institut Léopold-Bellan, Paris, France
| | - P Roumeguere
- Department of proctology, clinique Tivoli, 33000 Bordeaux, France
| | - L Siproudhis
- Department of digestive diseases, CHU de Pontchaillou, Rennes, France
| | - G Staumont
- Department of proctology, clinique St Jean-Languedoc, 31400 Toulouse, France
| | - J D Zeitoun
- Department of digestive diseases and proctology, CHU de Saint Antoine, AP-HP, 75012 Paris, France
| | - P Marteau
- Philippe-Marteau, université Paris Sorbonne, AP-HP, pole digestif, hôpital Saint Antoine 75012 Paris, France.
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50
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Abstract
Cutaneous vasculitides present with typical clinical signs depending on the size and distribution of the affected vessels. Since there are no large vessels in the skin, giant cell arteritis and Takayasu's arteritis only rarely lead to cutaneous symptoms. The classical systemic polyarteritis nodosa (PAN) is very rare. More frequent is cutaneous PAN presenting with a typical localized livedo racemosa and palpable subcutaneous nodules. The ANCA-associated vasculitides, which belong to the small vessel vasculitides, usually show systemic involvement and manifest on the skin with a diverse picture. Immune complex vasculitides are characterized by deposition of immunoglobulins on the walls of small vessels. The most common form is IgA vasculitis with the cardinal symptoms of palpable, round or oval and partially branched (retiform) purpura and a clear predilection for the legs. Serum disease is a príme example of systemic immune complex diseases due to large circulating immune complexes. Cryoglobulinemic vasculitis primarily involves small as well as medium sized vessels. Simultaneous involvement of vessels of different sizes is characteristic for vasculitis in systemic lupus erythematosus (SLE), Sjögren's syndrome, rheumatoid arthritis and sarcoidosis. Recurrent macular vasculitis in hypergammaglobulinemia is an episodic macular vasculitis of the small blood vessels. Bacteremic vasculitis of the small vessels (without direct microbial infection of the vessel wall) can typically also affect capillaries of dermal papillae and is usually accompanied by a disseminated intravascular coagulation (DIC). In some cases more than one distinct cutaneous vasculitis can occur in the same patient.
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Affiliation(s)
- Cord Sunderkötter
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
| | - Christiane Michl
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
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