- Palmar pustular psoriasis associated with teriflunomide treatment. [Journal Article]
- MSMult Scler Relat Disord 2018 Nov 19; 27:400-402
- CONCLUSIONS: Pustular psoriasis can be triggered by medications but has not been previously reported in association with teriflunomide treatment, to the best of our knowledge.
- Adipose tissue transplant in recurrent folliculitis decalvans. [Journal Article]
- IJInt J Immunopathol Pharmacol 2018 Mar-Dec; 32:2058738418814688
- Folliculitis decalvans is a rare clinical disorder classified as primary neutrophilic scarring alopecia with a slight preference for the male gender. Here, we report the use of autologous fat transpl...
Folliculitis decalvans is a rare clinical disorder classified as primary neutrophilic scarring alopecia with a slight preference for the male gender. Here, we report the use of autologous fat transplantation as a source of stem cell therapy for hair re-growth assisted by inflammatory action of the fat itself in a female patient. The patient underwent adipose transplantation in April and September 2017. After treatments, the patient had no new pustules and no longer had pain or burning sensation in the affected area. The hair has re-grown at the periphery area of alopecia appearing stronger and shinier.
- Gastrointestinal bleeding with severe mucosal involvement in a patient with generalized pustular psoriasis without IL36RN mutation. [Journal Article]
- JDJ Dermatol 2018 Nov 26
- Generalized pustular psoriasis (GPP) is a systemic inflammatory disease that presents with erythema and sterile pustules, pathologically characterized by Kogoj's spongiform pustules. GPP is sometimes...
Generalized pustular psoriasis (GPP) is a systemic inflammatory disease that presents with erythema and sterile pustules, pathologically characterized by Kogoj's spongiform pustules. GPP is sometimes accompanied by mucosal involvement, and the most common lesion is on the tongue. IL36RN mutation was found to contribute to the pathogenesis of GPP especially in patients who develop GPP without a past medical history of psoriasis vulgaris. The association of IL36RN mutation with mucosal involvement in GPP is controversial. We herein report a 60-year-old male GPP patient with no past history of plaque psoriasis presenting with not only severe skin lesions and arthritis but also severe mucosal involvements of pharyngeal and gastrointestinal lesions, which led to gastrointestinal bleeding. Our case did not have any mutation in the IL36RN gene. We should be aware that severe GPP can cause gastrointestinal bleeding. The relevancy of IL36RN mutation with mucosal involvement in GPP remains to be elucidated.
- Simplified management protocol for term neonates after prolonged rupture of membranes in a setting with high rates of neonatal sepsis and mortality: a quality improvement study. [Journal Article]
- ADArch Dis Child 2018 Nov 24
- In low-income and middle-income countries, courses of antibiotics are routinely given to term newborns whose mothers had prolonged rupture of membranes (PROM). Rational antibiotic use is vital given ...
In low-income and middle-income countries, courses of antibiotics are routinely given to term newborns whose mothers had prolonged rupture of membranes (PROM). Rational antibiotic use is vital given rising rates of antimicrobial resistance and potential adverse effects of antibiotic exposure in newborns. However missing cases of sepsis can be life-threatening.This is a quality improvement evaluation of a protocol for minimal or no antibiotics in term babies born after PROM in Papua New Guinea. Asymptomatic, term babies born to women with PROM >12 hours prior to birth were given a stat dose of antibiotics, or no antibiotics if the mother had received intrapartum antibiotics, reviewed and discharged at 48-72 hours with follow-up. Clinical signs of sepsis within the first week and the neonatal period were assessed. Of 170 newborns whose mothers had PROM, 133 were assessed at 7 days: signs of sepsis occurred in 10 babies (7.5%; 95% CI 4.4% to 13.2%) in the first week. Five had isolated fever, four had skin pustules and one had fever with periumbilical erythema. An additional four (3%) had any sign of sepsis between 8 and 28 days. There was one case of bacteraemia and no deaths. 37 were lost to follow-up, but hospital records did not identify any subsequent admissions for infection. A rate of sepsis was documented that was comparable with other studies in low-income countries. This protocol may reduce antimicrobial resistance and consequences of antibiotic exposure in newborns, provided safeguards are in place to monitor for signs of sepsis.
- Many pustules that itch…. [Journal Article]
- MSMed Sante Trop 2018 Nov 13
- Furuncular myiasis is a cutaneous parasitosis that occurs in tropical regions. It is manifested by lesions with the appearance of pustules, because of the presence of the fly larva in the skin. This ...
Furuncular myiasis is a cutaneous parasitosis that occurs in tropical regions. It is manifested by lesions with the appearance of pustules, because of the presence of the fly larva in the skin. This misleading appearance can delay diagnosis. The extraction of these Cayor worms can be facilitated by the use of a comedo-extractor.
- Disseminated Vegetating Plaques and Pustules. [Journal Article]
- JDJAMA Dermatol 2018 Nov 07
- Hypopyon pustules of Sneddon-Wilkenson disease. [Journal Article]
- IJInt J Dermatol 2018 Nov 09
- Dermatobia Hominis Infestation Misdiagnosed as Abscesses in a Traveler to Spain. [Journal Article]
- ADActa Dermatovenerol Croat 2018; 26(3):267-269
- Dear Editor, A 29-year-old woman presented with abscesses on her buttock and leg attributed to flea bites inflicted 5 days earlier on return to Spain after 2 months in Guinea-Bissau. Ciprofloxacin wa...
Dear Editor, A 29-year-old woman presented with abscesses on her buttock and leg attributed to flea bites inflicted 5 days earlier on return to Spain after 2 months in Guinea-Bissau. Ciprofloxacin was ineffective after 7 days, and she was referred for dermatologic evaluation. Examination revealed 4 round, indurated, erythematous-violet furunculoid lesions with a 1.5-2 mm central orifice draining serous material. She reported seeing larvae exiting a lesion, and we extracted several more (Figure 1). Parasitology identified Dermatobia (D.) hominis (Figure 2). Biopsy revealed intense dermal eosinophilic inflammatory infiltrate with a deep cystic appearance, surrounded by acute inflammatory infiltrate and necrotic material. Dermoscopy identified a foramen surrounded by dilated blood vessels and desquamation. A yellowish structure with a luminescent central ring was noted. Ultrasonography identified oval, hypoechoic, and hypovascular structures with inner echoic lines corresponding to cavities with debris and/or larval remains. Larvae were extracted before ultrasonography (Figure 1, b). Recommended treatment included topical antiseptic, occlusion of the infected area with paraffin, and 1% topical ivermectin; treatment resulted in incomplete resolution after 7 days. Furunculoid myiasis is more common in developing countries (1). Cases in Spain are usually imported, since the flies that produce this type of myiasis are not found locally. The species most frequently involved are D. hominis from Central and South America (botfly) and Cordylobia anthropophaga from the sub-Saharan region (tumbu fly) (2). We believe this was the first case in Spain imported from Guinea-Bissau. Several cases have been reported in Spain. Marco de Lucas et al. (3) reported a case in a Colombian male emigrant with multiple subependymal and intraventricular lesions, concentric blooming artifacts, and moderate hydrocephalus due to intracerebral myiasis. Another case was described by Arocha et al. (4). Central European countries continue to report new cases of imported furunculoid myiasis (5). D. hominis is a fly of the Oestridae family, approximately 1.5 cm long, yellowish-white in color, with a plumose edge (6). Larvae induce erythematous papules that sometimes ulcerate and resemble oils or large pustules, with a central orifice of about 1 mm, representing the larval respiratory pore. The lesions are usually painful (especially when larvae are still present) and pruritic, and produce sensations of movement under the skin. Lesions are located predominantly in exposed areas (7) and areas of contact with clothing and footwear, such as feet, buttocks, and external genitalia. Histopathology is not necessary for diagnosis, but usually reveals intense inflammatory infiltrate with abundant eosinophils surrounding larvae. (2) In our patient, ultrasound confirmed absence of living larvae within the cavity. D. hominis larvae show spontaneous movement in positive lesions and can be detected with ultrasound. Lesions in the hypodermis and dermis showed increased echogenicity of surrounding tissue, probably due to edema and inflammation (8). Diagnosis is established by comparing the lesion appearance with images of boils, abscesses, and inclusion of foreign body reaction cysts. Based on failed antibiotic therapy and travel to an endemic zone, myiasis should be considered in the differential diagnosis. Treatment consists of larval extraction through the respiratory orifice using pressure or a fine forceps or punch (9). Topical or oral ivermectin (10) can shorten the time to larval elimination. Physicians should be aware of this condition when travelers from endemic regions present with furuncular lesions, especially if movement is felt within the lesions or if lesions fail to heal. Myiasis is easily diagnosed based on clinical suspicion and epidemiological history, and is simple to treat.
- [46/m with pustules on the palms of the hands and the soles of the feet : Preparation for the specialist examination: part 8]. [Journal Article]
- HHautarzt 2018; 69(Suppl 2):109-113
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- PAPan Afr Med J 2018; 30:83