- Iatrogenic immunosuppression may favour Alternaria skin lesion flares. [Journal Article]
- BCBMJ Case Rep 2018 May 08; 2018
- Alternaria spp may cause opportunistic mycoses in the skin after cutaneous inoculation or through blood dissemination in immune-suppressed patients. Here, we describe a case of cutaneous infection wi...
Alternaria spp may cause opportunistic mycoses in the skin after cutaneous inoculation or through blood dissemination in immune-suppressed patients. Here, we describe a case of cutaneous infection with Alternaria spp in a 62-year-old man, presenting with multifocal papules and erythematous nodules involving distal limbs bilaterally. The absence of inflammatory bowel disease was confirmed by a gastroenterologist. The patient was under treatment for uveitis of unknown origin with immunosuppressive doses of cyclosporin and prednisolone for approximately 3 months. The diagnosis was based on clinical signs, demonstration of fungal elements in skin biopsies and deep fungal culture. Complete clinical remission was achieved by oral and systemic treatment with antifungal drugs. However, because cessation of the immunosuppressive medication was not possible, his clinical history was characterised by multiple flares requiring each time oral and intravenous antifungal treatment.
- Clinical and pathological features of myeloid leukemia cutis. [Journal Article]
- ABAn Bras Dermatol 2018; 93(2):216-221
- CONCLUSIONS: This was a retrospective and small sample study.In patients with myelogenous leukemia, skin infiltration usually occurs after, but occasionally before, the appearance of hemogram and myelogram abnormalities, and the presence of skin infiltration is often associated with a poor prognosis and short survival time. myeloid leukemia cutis often presents as generalized or localized nodules or masses with characteristic pathological and histochemical findings.
- A Rare Case of Cutaneous Diffuse Large B-cell Lymphoma Presenting as a Chronic "Infectious" Skin Ulcer. [Journal Article]
- OWOstomy Wound Manage 2018; 64(4):44-47
- Cutaneous diffuse large B-cell lymphoma (DLBCL) usually manifests as papules, nodules, or plaques. A rare case of a patient with a chronic skin ulcer and signs and symptoms of infection, including fe...
Cutaneous diffuse large B-cell lymphoma (DLBCL) usually manifests as papules, nodules, or plaques. A rare case of a patient with a chronic skin ulcer and signs and symptoms of infection, including fever and large amounts of yellow wound exudate, is presented. Fifteen (15) months before diagnosis, a 43-year-old otherwise healthy man noted soreness without apparent cause in his upper chest and a palpable 2 cm x 2 cm focal lump. The patient developed frequent fevers, and the lump enlarged over time, producing purulent exudate. For 14 months, the patient was examined and treated at 5 hospitals, but biopsies, smears, cultures, and various types of nucleic acid testing were negative. Antibiotics to treat the suspected but nonclassified infection were ineffective. Ultimately, debridement and pathological examination of necrotic tissue from the deep sinus revealed DLBCL. The patient was provided chemotherapy, surgical debridement, and negative pressure wound therapy. Wounds started to reduce in size once chemotherapy was initiated. The wound was surgically closed with a split-skin graft, and the patient was discharged 93 days following admission to the authors' facility. This case illustrates the possibility of cutaneous DLBCL in patients with chronic skin ulcers and infectious manifestation that do not respond to antibiotic therapy. Prompt deep tissue debridement and pathological examination of deep tissue will help confirm the presence of cutaneous DLBCL and guide required chemotherapy.
- Atrophic nodular cutaneous amyloidosis. [Case Reports]
- ABAn Bras Dermatol 2018 Jan-Feb; 93(1):111-113
- Primary cutaneous amyloidosis is limited to the skin without involving any other tissue. Nodular amyloidosis is rare, and atrophic nodular cutaneous amyloidosis is even rarer. We describe the fourth ...
Primary cutaneous amyloidosis is limited to the skin without involving any other tissue. Nodular amyloidosis is rare, and atrophic nodular cutaneous amyloidosis is even rarer. We describe the fourth case of atrophic nodular cutaneous amyloidosis by searching PubMed databases. A 52-year-old female presented to our hospital with a 2-year history of orange papules and nodules without subjective symptom on her right abdomen. Review of systems was negative. Atrophic nodular amyloidosis may progress to primary systemic disease in up to 7% of cases. Because our patient had no systemic involvement, she was diagnosed with atrophic nodular cutaneous amyloidosis based on characteristic symptoms and histopathologic examination. Routine follow-up for this patient is necessary to detect any potential disease progression.
- Thalidomide for the treatment of chronic refractory prurigo nodularis. [Journal Article]
- DODermatol Online J 2018 Mar 15; 24(3)
- Prurigo nodularis (PN) is a highly pruritic skin condition that is caused by chronic scratching. It occurs in patients with chronic itch and is characterized by multiple hyperkeratotic papules and no...
Prurigo nodularis (PN) is a highly pruritic skin condition that is caused by chronic scratching. It occurs in patients with chronic itch and is characterized by multiple hyperkeratotic papules and nodules. The pathogenesis of PN is unclear, but involves a complex interplay of numerous pathways including neurogenic and inflammatory factors. As such, PN is very difficult to treat and patients are often refractory to multiple medications before finding a treatment that is effective. We present a woman with a 20-year history of exuberant prurigo nodularis who failed multiple therapies, including dapsone, azathioprine, mycophenolic acid, prednisone, topical steroids, and phototherapy. She only obtained significant relief of chronic pruritus and lesion flattening with thalidomide 100mg daily. Thalidomide is an antipruritic and anti-inflammatory agent that has shown to be very effective in treating a variety of dermatologic conditions. However, its use today is limited by concerns for its teratogenic and neuropathic side effects. With strict adherence to medication protocols, these adverse effects can be minimized. As such, thalidomide should be considered for patients with refractory dermatologic conditions.
- Angiolymphoid hyperplasia with eosinophilia: a case report. [Journal Article]
- JMJ Med Case Rep 2018 Apr 02; 12(1):89
- CONCLUSIONS: Angiolymphoid hyperplasia with eosinophilia proves a therapeutic dilemma, because there is a large variety of proposed treatments, yet there is not enough data on most of them. Although the disease is not deadly by itself, it usually presents with disfiguring lesions that grimly affect the patient's quality of life. This warrants further research and efforts to find an effective cure and a unified therapeutic approach.
- Prospective Controlled Trial for the Treatment of Acne Keloidalis Nuchae With a Long-Pulsed Neodymium-Doped Yttrium-Aluminum-Garnet Laser. [Journal Article]
- JCJ Cutan Med Surg 2018 Mar/Apr; 22(2):236-238
- CONCLUSIONS: This study was limited by a small sample size and a high dropout rate, as well as the lack of a standardised scoring system for AKN.The long-pulsed Nd:YAG laser in conjunction with topical steroids shows promising results in the treatment of AKN, particularly the papular component, and is well tolerated by patients.
- [Chronic prurigo]. [Journal Article]
- HHautarzt 2018; 69(4):321-330
- Chronic prurigo is a disease characterized by the presence of chronic pruritus and singular or multiple usually hyperkeratotic symmetrically distributed itchy papules, nodules, and/or plaques. This c...
Chronic prurigo is a disease characterized by the presence of chronic pruritus and singular or multiple usually hyperkeratotic symmetrically distributed itchy papules, nodules, and/or plaques. This condition is difficult to treat and leads to a substantial impairment of the quality of life. It may originate from dermatological, systemic, neurological, psychiatric/psychosomatic, multifactorial or unknown conditions causing itch, which lead to prolonged scratching behavior and sensitization mechanisms and ultimately to the development of pruriginous lesions. Thorough diagnostic efforts, including a detailed clinical history and physical examination, as well as targeted complementary examinations should be initiated as soon as possible. The German guideline recommends topical steroids and phototherapy as first-choice options. Pimecrolimus and capsaicin (topical), as well as antihistamines, anticonvulsants, and immunosuppressive drugs (systemic) should be considered as valid alternatives.
- Disseminated cutaneous histoplasmosis with laryngeal involvement in a setting of immune reconstitution inflammatory syndrome. [Journal Article]
- SASouth Afr J HIV Med 2017; 18(1):693
- CONCLUSIONS: We present this case to remind clinicians that disseminated histoplasmosis in AIDS patients may occur as an expression of IRIS. A sudden onset of hoarseness with cutaneous lesions in a patient with disseminated disease should alert one to possible laryngeal histoplasmosis. Prompt recognition and treatment will avert the potential fatal complications of this disease.
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- Reducing the oral isotretinoin skin side effects: efficacy of 8% omega-ceramides, hydrophilic sugars, 5% niacinamide cream compound in acne patients. [Journal Article]
- GIG Ital Dermatol Venereol 2018; 153(2):161-164
- CONCLUSIONS: The cream formulated with 8% omega-ceramides, hydrophilic sugars, 5% niacinamide was effective in reducing xerosis and skin irritation, and was also successful in improving the patients' adherence to the oral isotretinoin treatment.