Cause Of Erythema Research Articles

Erythematosquamous lesions of glans penis: clinical analysis of 45 cases

Objective To summarize clinical features of erythematosquamous lesions of glans penis, in order to provide a basis for their differential diagnosis. Methods A retrospective study was performed on 45 patients with erythematosquamous lesions of glans penis who visited dermatology clinics in Cangzhou People's Hospital in Hebei province. Results Among the 45 patients, 20 were diagnosed with psoriasis, 6 with lichen planus, 5 with lichen sclerosus et atrophicus, 1 with granuloma annulare, 8 with candidal balanoposthitis, and 2 with secondary syphilis, while the cause of erythema remained unknown in 3 patients. Conclusions Erythematosquamous lesions of glans penis are liable to be misdiagnosed, and careful systemic examination, together with laboratory and histopathological examination when necessary, is essential for their correct diagnosis. Key words: Balanitis; Erythema; Skin diseases, papulosquamous

The distribution of biologically effective UV spectral irradiances received on a manikin face that cause erythema and skin cancer

Solar ultraviolet (UV) radiation is a major cause of erythema and skin cancer in humans and the face is one of the highest risk sites. Biologically effective UV irradiation (UVBE) is wavelength-dependent, and risk assessment has been demonstrated based on the value of the received UV radiation. Therefore, this study measured the face skin exposure to UV spectral irradiance using a spectroradiometer and a head manikin, which were weighted by action spectra to calculate the UVBE that causes erythema (UVBEery), non-melanoma (UVBEnon-mel), human squamous cell cancer (UVBEh-SCC), and DNA damage (UVBEDNA-d). We determined that the biologically effective UVB and UVA irradiances on clear sky days had peak values at 65–73° SEA (8–9 UVI) and 55–68° SEA (6–7 UVI), respectively. In the 10–30° SEA range, the highly skin-damaging wavelengths were all observed at 300nm. However, in the 30–60°, 60–81°, and 10–81° SEA ranges, the highly skin damaging wavelengths were 300nm, 304nm and 300nm for UVBEery, respectively; 304nm, 306nm and 304nm for UVBEnon-mel, respectively; all 305nm for UVBEh-SCC, and two small peaks at 302nm and 312nm for UVBEDNA-d.

Vascular patterns in mature hypertrophic burn scars treated with fractional CO2 laser.

Fractional CO2 laser has recently emerged as a promising therapeutic modality to improve the texture and appearance of burn scars. An issue in many burn scars is persistent erythema, which traditionally has been treated with vascular lasers. Interestingly, fractional CO2 lasers have been shown to improve the appearance of burn scars, including erythema, but no mechanism has been proposed for this change. Our objective is to evaluate the histopathologic changes in vasculature in burn scars treated with fractionated CO2 laser, and to attempt to describe the mechanism behind reduced erythema following treatment. Uncontrolled, prospective study of ten patients with mature burn scars, from a clinical and histological perspective. Biopsy specimens were obtained before and 2 months after 3 treatment sessions. Anti-CD31 immunostaining was performed to highlight vascular patterns in biopsy specimens. In histological analysis, an increase in vascular density, particularly of small caliber vessels, was seen following treatment, with an 82.6% average increase in vasculature (P = 0.028). This increase in vascularity correlated with a decrease in clinical erythema and vascularity scores, measured using the Vancouver Scar Scale. Mature hypertrophic burn scars treated with a fractional CO2 laser showed a statistically significant increase in vascular density in the superficial dermis. A non-statistical decrease in clinically perceived erythema and improvement of overall appearance was seen. To our knowledge, this is the first report of increased vascular density in burn scars treated with fractional CO2 laser and suggests our prior assumptions on causes of erythema in mature hypertrophic scars may need to be challenged.

A Patient With Henoch-Schönlein Purpura Manifesting Unusual Symptoms and Clinical Course

We evaluated and treated a girl with Henoch-Schönlein purpura (HSP), who initially developed redness, swelling, and pain in all 4 limbs accompanied by Raynaud syndrome and then had convulsions and disturbance of consciousness. HSP was diagnosed based on later findings of purpura in both legs and a decrease in factor XIII activity not accompanied by thrombocytopenia. She was normotensive. A skin biopsy specimen showed small-vessel vasculitis accompanied by immunoglobulin A deposition. The cause of erythema and limb pain, convulsions, and disturbed consciousness presumably was vasculitis. The possibility of HSP should be considered in patients with limb pain despite initial absence of purpura and in patients with central nervous system symptoms such as convulsions.

Painful red nodules in female patient with recent travel history: a case report

IntroductionDermatologic pathology can be both challenging and frustrating in the Family Practice setting.Case presentationWe report the case of a 38-year-old female that presented initially with a few, small red nodules on both the upper and lower extremities, which were painful to touch. This patient had an extremely vague picture, which included recent upper respiratory infection and recent travel to Europe. Erythema Nodosum was suspected and work-up initiated to determine underlying cause. ASO titer ultimately confirmed recent Streptococcal infection. Although the primary diagnosis was not made until follow-up visit, treatment was started based on understanding of common causes of Erythema Nodosum.ConclusionUsing the patient's history, a differential diagnosis knowing the common causes of EN can help direct diagnostic evaluation.

Differential diagnosis of skin lesions after allogeneic haematopoietic stem cell transplantation.

Allogeneic haematopoietic stem cell transplantation (i.e. bone marrow or peripheral blood stem cell transplantation) is a common procedure in the treatment of various haematological disorders such as aplastic anaemia, (pre)leukaemias, some malignant lymphomas, multiple myeloma and immunodeficiency states. Many of these patients develop erythematous skin lesions following transplantation. Although graft- versus-host disease is the major differential diagnosis in these situations, many other causes of erythema are encountered. The large number of transplant patients means that more and more pathologists are confronted with the challenging problem of making a correct diagnosis in these situations. In this review article we therefore describe the different causes of erythema and their differential diagnoses. In most cases the clinical presentation is related to the microscopical features. Besides acute and chronic graft-versus-host disease, we discuss the (common) drug reactions and non-specific features such as Sweet's syndrome, erythema nodosum and eosinophilic folliculitis. In addition, we deal with the recurrence of original diseases and infections. With this knowledge every pathologist should feel comfortable when looking at skin biopsies of patients after haematological stem cell transplantation.

The origin and role of erythema after carbon dioxide laser resurfacing. A clinical and histological study.

Transient erythema, which can last up to 3 months after carbon dioxide (CO2) laser skin resurfacing, is a usual side effect with pulsed or rapidly scanned CO2 lasers. We evaluated the cause of erythema in the clinical setting and by histology in order to determine if and how we may decrease it, or even eliminate it. Ten patients who underwent resurfacing were recruited to this study. Skin punch biopsies were taken at 0, 7, 21, and 90 days and analyzed by light microscopy. Erythema was noticed from about day 8, when the crusting on the skin surface was exfoliated. It reached its maximum intensity after 14 days, and had disappeared by 60-90 days. Histology showed an early inflammatory response, with an immature neopithelium, and rich vascularization. The normal epidermis had returned by 90 days, and during this period there was reduced optical scattering and absorption in melanin. Although the erythema is an unwanted side effect in the patient's eyes, it is to be expected and thus represents the effects of a combination of epidermal immaturity, reduced melanin absorption of light, reduced dermal optical scattering, and increased blood flow secondary to the surgically induced inflammatory response.

C-reactive protein levels in venous ulceration: An indication of infection?

The role of bacteria in the pathogenesis of venous ulcers is unclear. It is difficult to be clinically certain of the presence of infection. Routine bacteriology is often unhelpful, and any simple investigation that improves diagnosis in this situation would be of value. C-reactive protein (CRP) levels are useful in detecting infection in other situations, and they may be of value in this context as well. C-reactive protein levels were measured in 50 patients with venous leg ulcers and in 20 patients with active venous eczema. There was no elevation of CRP levels in patients with eczema alone, nor in the majority of patients with ulcers. Sixteen patients had raised CRP levels: 7 had clinically obvious infection, and 9 had erythematous skin of uncertain cause surrounding their ulcers. All had positive bacterial cultures from the ulcer base, with β-hemolytic streptococci the main contaminant. Treatment with an appropriate antibiotic reduced CRP levels to normal, cleared the bacteria from the ulcers, and was associated with resolution of erythema. CRP levels appear to distinguish between infectious and inflammatory causes of erythema in patients with gravitational disease.