1
|
Scabies in infants and children - a narrative review. Eur J Pediatr 2024; 183:2527-2536. [PMID: 38536458 DOI: 10.1007/s00431-024-05535-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024]
Abstract
Scabies is a human ectoparasitosis caused by Sarcoptes scabei var. hominis. World-wide around 300 million patients are affected. Infants and children have the highest incidence rates. Poverty and overcrowding are social factors contributing to a higher risk of transmission and treatment failure. The leading symptom of the infestation is itch. Complications are bacterial infections that are responsible for mortality. Diagnosis is clinical. Non-invasive imaging technologies like dermoscopy can be used. Polymerase chain reaction (PCR) is less sensitive and specific than microscopy of skin scrapings. Treatment of choice is topical permethrin 5%. Ivermectin is the only oral drug FDA-approved for scabies. It should be used in cases non-responsive to topical therapy and in case of high number of infested patients in addition to topical therapy. Pseudo-resistance to treatment is not uncommon. New drugs are on the horizon. What is Known: • Pruritus is the leading symptom causing sleep disturbances and scratching with the risk of secondary bacterial infections. • Treatment failure is related to inappropriate application of topical drugs and asymptomatic family members. What is New: • COVID-19 pandemic and migration are contributing to an increased incidence of scabies. • New compounds to treat scabies are on the horizon.
Collapse
|
2
|
Correction to: Scabies in infants and children - a narrative review. Eur J Pediatr 2024:10.1007/s00431-024-05563-x. [PMID: 38642104 DOI: 10.1007/s00431-024-05563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
|
3
|
Angular cheilitis-an oral disease with many facets. Wien Med Wochenschr 2024:10.1007/s10354-024-01037-9. [PMID: 38517608 DOI: 10.1007/s10354-024-01037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/14/2024] [Indexed: 03/24/2024]
Abstract
Cheilitis is a common inflammatory disorder of the vermillion and adjacent skin of the lips. A special type is angular cheilitis. The disease has a mixed etiology, mostly with bacterial and fungal components. Angular cheilitis may be a clinical sign of an underlying disease. It has two age peaks: one during childhood and another in adults. It becomes more frequent with aging. Clinical presentation, differential diagnoses, and treatment are discussed. Angular cheilitis is of importance in primary care of patients, in geriatrics, dentistry, pediatrics, internal medicine, and in dermatology.
Collapse
|
4
|
Cutaneous borreliosis in children - a challenging problem. Eur J Dermatol 2024; 34:18-25. [PMID: 38557454 DOI: 10.1684/ejd.2024.4611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Borreliosis, also known as Lyme disease, is a vector-borne disease caused by different species of the Borrelia burgdorferi complex. It is frequent in Europe and Northern America. The major vectors are ixodoid ticks. Paediatric borreliosis is common and peaks in children between five to nine years. In Europe, the leading symptom of early infection is erythema migrans, in contrast to Northern America where arthritis is the dominating clinical finding. In this review, we focus on Europe, where cutaneous borreliosis is mainly caused by infection with B. afzelii. The cutaneous symptoms include erythema migrans, lymphocytoma, chronic atrophic dermatitis and juxta-articular nodules. In children, lymphocytoma is very common but chronic atrophic dermatitis is rare. Clinical symptoms, diagnosis, peculiarities of childhood disease and treatment are also reviewed. It is important to note that after haematogeneic spread, signs of infection may be non-specific, and this is a challenge for diagnosis.
Collapse
|
5
|
Kerion Celsi in infants and children-A narrative review 2010-2023. Mycoses 2024; 67:e13675. [PMID: 37983862 DOI: 10.1111/myc.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
Kerion Celsi is an inflammatory, deep fungal infection of the scalp. It is rare in neonates but gets more common in children about 3 years and older. It represents with swelling, boggy lesions, pain, alopecia and purulent secretions. Secondary bacterial infection is not unusual after maceration. Extracutaneous manifestations include regional lymphadenopathy, fever and very rare fungemia. Id-reactions can occur. Diagnosis is based on clinical suspicion, clinical examination and medical history. Diagnosis should be confirmed by microscopy, fungal culture and molecular procedures. The most common isolated fungal species are anthropophilic Trichophyton (T.) tonsurans and zoophilic Microsporum (M.) canis, while geophilic species and moulds rarely cause Kerion Celsi. Treatment is medical with systemic and topical antifungals supplemented by systemic antibiotics when necessary, while surgery needs to be avoided. Early and sufficient treatment prevents scarring alopecia. The most important differential diagnosis is bacterial skin and soft tissue infections.
Collapse
|
6
|
Achenbach Syndrome - Case Report and Discussion on the Interdisciplinary Approach of a Patient. MAEDICA 2022; 17:740-742. [PMID: 36540598 PMCID: PMC9720656 DOI: 10.26574/maedica.2022.17.3.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
We present a case of Achenbach syndrome, which is an alarming disease for both patients and physicians, although it is a rare, benign and self-limiting disorder. It is also reported as "paroxysmal finger haematoma", but the majority of cases are misdiagnosed, and unnecessarily investigated and treated.
Collapse
|
7
|
Raman Spectroscopy, X-ray Diffraction, and Scanning Electron Microscopy as Noninvasive Methods for Microstructural Alterations in Psoriatic Nails. Molecules 2021; 26:molecules26020280. [PMID: 33429943 PMCID: PMC7826832 DOI: 10.3390/molecules26020280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 11/16/2022] Open
Abstract
Psoriasis is a chronic inflammatory disease associated with immune system dysfunction that can affect nails, with a negative impact on patient life quality. Usually, nail psoriasis is associated with skin psoriasis and is therefore relatively simple to diagnose. However, up to 10% of nail psoriasis occurs isolated and may be difficult to diagnose by means of current methods (nail biopsy, dermoscopy, video dermoscopy, capillaroscopy, ultrasound of the nails, etc.). Since the nail is a complex biological tissue, mainly composes of hard α-keratins, the structural and morphological techniques can be used to analyze the human fingernails. The aim of this study was to corroborate the information obtained using Raman spectroscopy with those obtained by scanning electron microscopy (SEM) and X-ray diffractometry and to assess the potential of these techniques as non-invasive dermatologic diagnostic tools and an alternative to current methods.
Collapse
|
8
|
Koebner Phenomenon Induced by Face Mask Ear Loops. MAEDICA 2020; 15:561-562. [PMID: 33603919 PMCID: PMC7879359 DOI: 10.26574/maedica.2020.15.4.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We present a case of Koebner phenomenon induced by friction due to tightness of ear loops attached to the face mask used as protective measure against spreading COVID-19 infection.
Collapse
|
9
|
Chloronychia in Healthcare Workers in COVID-19 Times. Skin Appendage Disord 2020; 7:80-81. [PMID: 33614727 PMCID: PMC7705944 DOI: 10.1159/000511193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/28/2020] [Indexed: 11/25/2022] Open
|
10
|
Malignant Degeneration of Scars. Cancer Manag Res 2020; 12:10297-10302. [PMID: 33116884 PMCID: PMC7585506 DOI: 10.2147/cmar.s274470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/19/2020] [Indexed: 11/23/2022] Open
Abstract
”Marjolin’s ulcer” is known as malignant degeneration of ancient burn scars, but both words can induce misdiagnosis. Malignant degeneration of scarring tissue can occur and can vary in its clinical, histological manifestations and its pre-existing skin lesions. We present several cases to substantiate our observations. ”Marjolin’s ulcer” is not synonym to an ulceration appeared on an old burn scar, transformed into squamous cell carcinoma.
Collapse
|
11
|
Disseminated cutaneous herpes zoster-A frequently misdiagnosed entity. Int Wound J 2020; 17:1089-1091. [PMID: 32297463 DOI: 10.1111/iwj.13370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 12/01/2022] Open
|
12
|
New insights into human hair: SAXS, SEM, TEM and EDX for Alopecia Areata investigations. PeerJ 2020; 8:e8376. [PMID: 31976181 PMCID: PMC6968496 DOI: 10.7717/peerj.8376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/09/2019] [Indexed: 12/16/2022] Open
Abstract
Background Alopecia areata (AA) is a T-cell-mediated autoimmune disease and affects up to 2% of the population. There is a need for a more profound and rigorous understanding of the structure and composition of human hair affected by AA in order to manage this disease. The aim of this article is to understand the effects of AA on the structure and composition of human hair. Methods Several physico-chemical investigation methods, such as Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Energy-Dispersive X-ray Spectroscopy (EDX), and microbeam Small Angle X-ray Scattering (SAXS), were used to analyze human hair samples obtained from healthy donors and patients with AA. Results SEM revealed more severe hair surface defects for the white regrown hair (W-AA) samples. TEM showed the presence of air-like vesicles located in the endocuticle of regrown hair. Analysis of ultrathin sections of W-AA showed the existence of empty vesicles and smaller melanin granules compared to control samples. SAXS demonstrated that unaffected hair of patients with AA (B-AA) and W-AA melanin aggregates are different in their sizes and shapes compared to the control samples. EDX data showed that W-AA elemental composition was significantly different from the other sample groups. Our study showcases promising non-invasive techniques for a better and more accurate understanding of changes in the internal structure and composition of hair affected by AA.
Collapse
|
13
|
Abstract
Herpes zoster usually affects the thoracic and lumbar vertebra (T3-L3), while sacral herpes zoster has been very rarely reported. We present a very rare case of herpes zoster involving S1 dermatome in a 35-year-old healthy man who presented aching pain and typical herpes zoster eruption on the lateral aspect of the calcaneus, lateral plantar area and dorsal aspect of digits III and IV.
Collapse
|
14
|
“Chemical” surgery in treating basal cell carcinoma in elderly. Dermatol Ther 2018; 32:e12753. [DOI: 10.1111/dth.12753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 06/08/2018] [Accepted: 09/16/2018] [Indexed: 11/27/2022]
|
15
|
Home remedies for skin tags: Not recommended! Int J Clin Pract 2018; 72:e13209. [PMID: 29920870 DOI: 10.1111/ijcp.13209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
16
|
Self-medication garlic-induced irritant skin lesions - case series. Int Wound J 2017; 14:1407-1408. [PMID: 28945003 DOI: 10.1111/iwj.12818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 08/18/2017] [Indexed: 11/27/2022] Open
|
17
|
First Report of Pachyonychia Congenita Type PC-K6a in the Romanian Population. MAEDICA 2017; 12:123-126. [PMID: 29090033 PMCID: PMC5649033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pachyonychia congenita (PC) is a rare autosomal dominant skin disorder, with unknown prevalence, although it is estimated there are between 2,000 and 10,000 cases of PC worldwide. The International PC Research Registry (IPCRR) has currently identified (as of November 2016) 746 individuals (in 403 families) with genetically confirmed PC. Heterozygous mutations, predominantly missense mutations, in any one of five keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17 cause PC. The predominant clinical findings include plantar keratoderma, plantar pain and variable dystrophy of some or all toenails and/ or fingernails. Oral leukokeratosis, follicular hyperkeratosis, cysts of various types and natal teeth may also be present. We report the first case of genetically confirmed PC from Romania due to a mutation in KRT6A, p.Arg466Pro.
Collapse
|
18
|
Pragmatic management of (suspected allergic) diaper dermatitis. Contact Dermatitis 2017; 76:129-130. [PMID: 28095634 DOI: 10.1111/cod.12663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 11/30/2022]
|
19
|
Romanian Questionnaire to Assess the Prevalence of Occupational Hand Eczema among Healthcare Providers. JOURNAL OF INTERDISCIPLINARY MEDICINE 2016. [DOI: 10.1515/jim-2016-0061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Occupational skin diseases have an unknown prevalence in Romania, although they are considered the most frequent occupational diseases reported in Western European countries. Self-reported hand eczema among healthcare providers by questionnaire aims to estimate the prevalence of work-related hand eczema and associated risk factors in hospitals and outpatient units in Romania. The aim of this study is to discuss and to validate a questionnaire for surveying work-related skin diseases and exposure among healthcare providers.
Collapse
|
20
|
The Value of Ultrasonography in the Diagnosis and Monitoring of Localized Morphea — Case Report. JOURNAL OF INTERDISCIPLINARY MEDICINE 2016. [DOI: 10.1515/jim-2016-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: The aim of this presentation is to highlight the usefulness of high-frequency ultrasound (18 MHz) in localized morphea for: identification of the lesion, guided skin biopsy, quantification of skin thickness, evaluating the severity by measuring total echogenicity.
Case presentation: A 62-year-old Caucasian woman was referred to the Dermatology Department for a well-circumscribed indurate plaque localized on the right side of the abdominal wall and thigh. On clinical examination, a large well-delimited, indurate plaque, silvery in the center and surrounded by a purplish-red halo (lilac ring) was noticed on the right side of the abdomen and thigh. An ultrasound-guided punch biopsy was carried out and the microscopic examination of the biopsy revealed moderate interstitial inflammatory infiltrate together with abundant collagen bundles in the dermis and subcutis and a diagnosis of localized morphea (scleroderma) was established. Ultrasonography was performed and skin thickness was measured using high-frequency US (18 MHz) and was found to be 3.1 mm to 3.9 mm.
Conclusion: high frequency ultrasound is an inexpensive, easy to perform, noninvasive method, replacing surgical biopsy and offering a valuable quantification of skin fibrosis.
Collapse
|
21
|
|
22
|
Degradation Mechanism Induced by Psoriasis in Human Fingernails: A Different Approach. J Invest Dermatol 2016; 136:311-3. [PMID: 26763451 DOI: 10.1038/jid.2015.387] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
23
|
Diabetic dermopathy ("shin spots") and diabetic bullae ("bullosis diabeticorum") at the same patient. Pak J Med Sci 2015; 31:1275-6. [PMID: 26649029 PMCID: PMC4641298 DOI: 10.12669/pjms.315.7521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We present a diabetic patient with associated two diabetic dermatoses: diabetic dermopathy ("shin spots") and diabetic bullae. A 34-year-old man, with long history of diabetes mellitus, hypertension, and moderate obesity presented to Dermatology Unit for diagnosis of his skin lesions. On clinical examination multiple, light brown, irregular patches, with atrophic scars and crusts over large bullae were observed on the anterior aspect of both legs.
Collapse
|
24
|
Why Is Tinea an Annular Lesion With Centrifugal Growth? Int J Surg Pathol 2015; 23:652-3. [PMID: 26385338 DOI: 10.1177/1066896915606972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
25
|
Aplasia cutis congenita of the scalp--what are the steps to be followed? Case report and review of the literature. An Bras Dermatol 2015; 90:100-3. [PMID: 25672305 PMCID: PMC4323704 DOI: 10.1590/abd1806-4841.20153078] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 10/21/2013] [Indexed: 01/14/2023] Open
Abstract
Aplasia cutis congenita is a rare malformation characterized by localized congenital
absence of the skin. It rarely occurs on the trunk and limbs, and can occur in
isolation or as part of a heterogeneous group of syndromes. We report a case of a
4-day-old boy with a 5.6-cm- diameter tumor, with a central crust, non-indurate and
no inflammatory rim; localized on the scalp and a small, atrophic hairless scar
appeared 6 months later (approximately 5cm in length) at the site of the previous
tumor.
Collapse
|
26
|
Abstract
The prevalence of psychosomatic disorders among dermatological patients is high but frequently unreported because of difficulties in diagnosing and treating this patient group. Psychiatric and psychological factors may play different roles in the pathogenic mechanism of some skin diseases. The mainstay of diagnosis and treatment is the differentiation between skin disorders associated with psychiatric illness and those of a purely psychiatric nature. Dermatologists and psychiatrists should be aware of this pathology and work together as a team to resolve difficult cases, especially in children. The present paper highlights the psychocutaneous diseases most frequently seen by dermatologists in pediatric population.
Collapse
|
27
|
Steatocystoma multiplex - case report. Arch Clin Cases 2014. [DOI: 10.22551/2014.01.0101.10008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
28
|
|
29
|
The puzzled low prevalence of atopic dermatitis in kindergarten children in Romania. Pediatr Allergy Immunol 2014; 25:96-7. [PMID: 24289150 DOI: 10.1111/pai.12157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Senile/solar purpura like lesions developed in association with use of tumor necrosis factor-α (TNF-α) inhibitors. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2014. [DOI: 10.1016/j.jdds.2014.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
31
|
Erosio blastomycetica interdigitale sign of Candidiasis and diabetes! BANGLADESH JOURNAL OF MEDICAL SCIENCE 2014. [DOI: 10.3329/bjms.v13i1.16623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The terminology Erosio blastomycetica interdigitale is used to describe a clinical entity characterized by erosions disposed interdigitalis on the hands and /or feet, in persons with poor controlled diabetes mellitus, the agent incriminated being Candida Albicans.DOI: http://dx.doi.org/10.3329/bjms.v13i1.16623Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 105-106
Collapse
|
32
|
Lichen planus secondary complications associated with the use of biologic therapy for rheumatoid arthritis. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2013; 54:829-831. [PMID: 24322035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Biologic therapy such as Etanercept, which is a tumor necrosis factor alpha (TNF-α) inhibitor, has been extensively used as election therapy in rheumatoid arthritis. The purpose of this case presentation was to inform about the possibility that lichen planus lesions could potentially become complicated by secondary infections in patients treated with Etanercept. Furthermore, we aimed at analyzing if the complication of the cutaneous lesion was coincidental or it was due to the immunosuppressive systemic therapy, and whether the infected lesion would respond to antibiotic therapy. CASE SUMMARY The patient was a 59-year-old woman with rheumatoid arthritis and that have had lichen planus lesions for approximately 25 years. Only recently, she had been received immunosuppressive therapy (Etanercept and Methotrexate). Further on, the lichen planus flared up with a secondary infection determined by a Methicillin-sensitive Staphylococcus aureus. Uncommon myocardial complications were also characteristic of this case. RESULTS While a case report described already the appearance of lichen planus following Etanercept therapy (Battistella M et al., 2008), the possibility that the lesion could become secondary complicated following this therapy was never reported before, according to our knowledge. Additionally, we describe in this case the interplay between Etanercept therapy and hypertrophic cardiomyopathy. CONCLUSIONS Our case is not a lichen planus induced by Etanercept, but it is aggravated and secondary infected with Methicillin-sensitive Staphylococcus during the therapy. The additional cardiac complication (hypertrophic cardiomyopathy) may represent solely an evolutive sign of rheumatoid arthritis and therefore not influenced by Etanercept.
Collapse
|