Common Dermatoses Research Articles

Pruritic Urticarial Papules and Plaques of Pregnancy Case Study

ABSTRACT A primiparous patient, 30 days postpartum, presented to the clinic with a chief complaint of an itchy red rash on her mid to lower abdomen. It started 2 days ago. The rash had spread to her upper thighs. Past medical history was negative for skin disease or atopy. Her examination exposed pruritic erythematous polymorphous papules, with subsequent coalescence of larger urticarial plaques on the mid to lower abdomen and upper thighs. The patient was diagnosed with pruritic urticarial papules and plaques of pregnancy (PUPPP). PUPPP is the most common dermatosis affecting about one in 200 pregnant women. It has no tendency to recur in subsequent pregnancies. The elevated differential diagnosis included pemphigoid gestationis and eczema. Drug eruptions, urticaria, and viral exanthems were also considered. The primary goal of PUPPP treatment is to alleviate pruritus and discomfort. Antihistamines and topical corticosteroids are often prescribed along with skin care recommendations. Patients frequently have limited relief from topical treatments or skin care strategies. The extent of patient discomfort mandates competent evaluation because treatment is symptomatic and PUPPP can be difficult to manage. Despite the discomfort related to severe pruritus, PUPPP is not harmful to the mother or baby.

Update vulval dermatology - diagnostics and therapy.

The vulva is a periorificial skin area and as such represents a transitional zone with unique functional and physiological characteristics. Knowledge of its anatomy is limited among both the general population and healthcare professionals, and unrealistic expectations of normal proportions are common. Ignorance of anatomical variations can cause unnecessary anxiety. In Germany, specialists in gynecology and obstetrics most commonly treat neoplastic vulvar dermatoses, while chronic inflammatory dermatoses commonly affecting the female genitalia (such as psoriasis, atopic dermatitis, hidradenitis suppurativa, and vitiligo) are typically treated by dermatologists. Both specialties treat infectious vulvar dermatoses and sexually transmitted infections. Certain dermatoses, such as lichen sclerosus, lichen planus, and lichen simplex chronicus, tend to affect the vulva preferentially; however, terminology can be confusing. Therefore, this article provides basic information on vulvar anatomy and physiology and summarizes recommendations for the diagnosis and management of the most common vulvar dermatoses, with a special focus on chronic inflammatory dermatoses, to provide a useful guide for all involved specialists in daily practice. Interdisciplinary collaboration and the establishment of dedicated consultation hours may help to improve the clinical care of vulvar dermatoses.

Evaluation of Very-High-Frequency Ultrasound Imaging Characteristics of Dermatofibroma.

Dermatofibroma (DF) is one of the common dermatosis, which is so challenging to diagnose that its misdiagnostic incidence is quite high. The very-high-frequency (VHF) ultrasound is particularly relevant to the diagnosis of DF. Herein, we analyze the sonographic features and application value of VHF ultrasound in the diagnosis of DF. Clinical data from 153 patients with pathologically confirmed DF from January 2019 to December 2023 were retrospectively analyzed using high-resolution VHF ultrasound, including size, location, shape, edge, boundary, interior echo, blood supply and so on. The VHF sonographic features of DF showed that the maximum diameter of the lesions was about 7.29 ±2.85 mm (mean ± standard deviation). In addition, most lesions were located in the middle and lower part of dermis (49%), with ill-defined (84%) and irregular shape (51%), 19% of which were serrated. Forty-four percent of lesions were hypo-echoic and heterogeneous, and 8% were complicated with calcifications. Nineteen percent of lesions presented as thickened dermal epidermal junction. Dermatofibroma are mostly hypovascular on color Doppler ultrasound. Forty-three percent of lesions were detected with punctate dotted blood flow signals. The correlation analysis showed blood flow classification and maximum diameter were not relevant. The DF based on VHF ultrasonographic findings is characteristic, such as <10mm, ill-defined, located in the dermis, thickened DEJ, serrated shape, punctute or no flow on Doppler, which provide crucial indicators for differential diagnosis, potentially reducing the rate of DF misdiagnosis.

A retrospective clinico epidemiological study of pattern of dermatosis involving trigeminal distribution in a tertiary care center

Trigeminal nerve is the principal sensory nerve of face. Many dermatological conditions known occur in relation to trigeminal nerve distribution clinically presenting as unilateral facial lesions with strict midline demarcation. To study the clinical pattern and epidemiological determinants of dermatoses along trigeminal nerve among the patients of both the sexes, involving all the age groups. Thirty two patients presenting with skin lesions along trigeminal nerve presenting to Dermatology department of a tertiary care center, Bangalore, Karnataka, are selected for the study. Study design is retrospective hospital record based study conducted from January 2023 to January 2024. In this study, out of 32 patients most common dermatoses along trigeminal nerve were infection of which herpes zoster was seen thirteen (40.62%) patients, followed by nevi (n=6, 18.75%), pigmentary disorders (n=5, 15.62%), vascular disorder (n=4, 12.5%) and auto inflammatory disorder (n=4, 12.5%) was seen. Most common branch affected was ophthalmic followed maxillary branch .Females were more common and mean age was 24 years. Small sample size and rare clinical cases are included Studies focusing on the pattern of dermatoses involving the trigeminal nerve contribute to the advancement of medical knowledge and facilitate the development of novel diagnostic techniques and therapeutic modalities. By elucidating the underlying pathophysiological mechanisms and identifying potential risk factors, research in this field can lead to the development of more effective treatment strategies tailored to the specific needs of patients.

Clinico-histopathological characteristics and management outcome of rare chronic infective granulomatous diseases: A case series study

Granulomatous skin diseases are common cutaneous dermatoses commonly encountered by practicing dermatologist. Granulomatous skin lesions are distinctive pattern of chronic inflammatory response of skin due to reaction against various organic and inorganic antigens. Granulomas are characterized by focal collection of epithelioid cells or histiocytes, admixed with variable number of leucocytes (especially mononuclear cells) and multinucleated giant cells. Granulomatous reaction is a type IV hypersensitivity reaction evoked by poorly soluble reactive substances. Incidence and prevalence of different types of granulomatous dermatitis depend on geographic location. Granulomatous skin lesions are common in the eastern parts of India. Many granulomatous skin lesions have identical histomorphology and conversely a single pathology can produce varied histological features. Some rare suppurative chronic granulomatous skin diseases include Botryomycosis, Actinomycosis, Rhinosporoidosis, Nocardiosis, and Cutaneous Tuberculosis. To describe clinical, histopathological features and treatment outcome of rare chronic infective granulomatous diseases. In this observational case series study, we retrospectively analysed six biopsy proven cases of rare chronic infective granulomatous diseases presented to our department (OPD) of Dermatology, Venereology and Leprosy (DVL) over a period of six months between June 2023 to November 2023 at Great Eastern Medical School and Hospital (GEMS), Srikakulam, Andhra Pradesh, India. The patient’s full clinical history, morphology of lesions, histopathological findings and treatment outcome were analysed. Along with histopathology, other necessary laboratory investigations were performed if required. A total of six patients were involved in the study, of whom four were males and two were females. The male to female ratio was 2:1, with a slight male majority. The most common age group was 31-40 years for both males and females. Painful raised lesion for long duration was the predominant complaint among those patients. Out of these six rare chronic granulomatous diseases, bacterial infections were common than fungal infection. All the cases showed clinical improvement after one month of starting treatment.: Most of the patients had a chronic history with improper treatment. So, it is imperative that the clinical diagnosis has to be confirmed with histopathology for the definitive diagnosis and appropriate treatment of these rare chronic infective granulomatous diseases. All these rare cases showed excellent progress after starting the right treatment.

Study on the molecular mechanism of atopic dermatitis in mice based on skin and serum metabolomic analysis.

Atopic dermatitis (AD) is a common chronic inflammatory dermatosis. However, the exact molecular mechanism underlying the development of AD remain largely unclear. To investigate comprehensive metabolomic alterations in serum and skin tissue between 2,4-dinitrofluorobenzene (DNFB)-induced AD-like mice and healthy controls, aiming to identify the potential disease biomarkers and explore the molecular mechanisms of AD. In this study, Untargeted metabolomics analysis was used to investigate both skin and serum metabolic abnormalities of 2,4-dinitrofluorobenzene (DNFB)-induced AD-like mice. Then, the metabolic differences among the groups were determined through the application of multivariate analysis. Additionally, the selection of predictive biomarkers was accomplished using the receiver operating characteristic (ROC) module. Our findings showed that levels of 220 metabolites in the skin and 94 metabolites in the serum were different in AD-like mice that were treated with DNFB compared to control mice. Uracil, N-Acetyl-L-methionine, deoxyadenosine monophoosphate, 2-acetyl-l-alkyl-sn-glycero-3-phosphcholine, and prostaglandin D2 are considered potential biomarkers of AD as obtained by integrating skin and serum differential metabolite results. Metabolomic data analysis showed that the metabolic pathways in which skin and serum are involved together include histidine metabolism, pyrimidine metabolism, alanine, aspartate, and glutamate metabolism. Our research explained the possible molecular mechanism of AD at the metabolite level and provided potential targets for the development of clinical drugs for AD.

Nanocarrier-Based Transdermal Drug Delivery Systems for Dermatological Therapy.

Dermatoses are among the most prevalent non-fatal conditions worldwide. Given this context, it is imperative to introduce safe and effective dermatological treatments to address the diverse needs and concerns of individuals. Transdermal delivery technology offers a promising alternative compared to traditional administration methods such as oral or injection routes. Therefore, this review focuses on the recent achievements of nanocarrier-based transdermal delivery technology for dermatological therapy, which summarizes diverse delivery strategies to enhance skin penetration using various nanocarriers including vesicular nanocarriers, lipid-based nanocarriers, emulsion-based nanocarriers, and polymeric nanocarrier according to the pathogenesis of common dermatoses. The fundamentals of transdermal delivery including skin physiology structure and routes of penetration are introduced. Moreover, mechanisms to enhance skin penetration due to the utilization of nanocarriers such as skin hydration, system deformability, disruption of the stratum corneum, surface charge, and tunable particle size are outlined as well.

Drug therapy safety during pregnancy and breastfeeding

The treatment of dermatological diseases during pregnancy and breastfeeding poses particular challenges for the therapist for medical and legal reasons. Maternal and fetal influencing factors must be taken into account and the special need for protection of the fetus, infant, and mother must be considered in the treatment decision, usually outside of the approval process. Due to the lack of or insufficient evidence for most therapies during pregnancy and breastfeeding, an individual risk-benefit assessment should always be carried out, which also takes into account the risk of nontreatment. In the case of difficult or potentially momentous decisions, information from relevant databases, intercollegiate consultation and, if possible, advice from aclinical ethics committee should be obtained. In any case, the parents, and in particular the mother, should be carefully informed and their consent should be obtained and documented. Recommendations can be made for common chronic inflammatory and infectious dermatoses, but these should be reviewed on acase-by-case basis. For other therapy situations, an individual analysis and decision-making process is necessary. Overall, however, it can be stated that digital data processing and availability, combined with careful analysis, empathetic consideration and information for those affected, enables asuccessful treatment decision to be made in the vast majority of cases.

What's New After NICE Acne Guidelines.

Acne remains one of the most common inflammatory dermatoses seen worldwide. There are significant challenges when managing acne relating to a variety of factors, including (1) lack of consensus on the use of the numerous available grading systems and outcome measures, (2) appreciation of the numerous areas that relate to severity, (3) the chronic nature of acne which requires a longitudinal approach to management (including both facial and truncal disease), and (4) the need to target acne early to avoid physical and psychosocial scarring. Consideration of these aspects when managing acne should result in improved outcomes. Acne guidelines review the available evidence based on robust clinical trials and are usually supplemented with some expert opinion when evidence is not available. In this paper, the UK Acne Working Group reflects on the latest National Institute for Health and Care Excellence (NICE) acne guidelines with a goal of providing additional practical insights. The group have identified areas where new evidence has now become available since the formulation of the NICE acne guidelines. This publication considers newly approved acne medications in the UK, guidance on assessing acne severity, approaches to managing truncal acne, acne sequelae, and adult female acne with hormonal therapies.

Papulosquamous scalp dermatoses: key aspects of differential diagnosis and treatment

Psoriasis and seborrheic dermatitis are common papulosquamous dermatoses. When localized only on the scalp, they often have very similar clinical manifestations and require a comprehensive differential diagnostic approach. The article presents the main comparative clinical and diagnostic characteristics of psoriasis and seborrheic dermatitis of the scalp, including trichoscopy features and pathomorphological markers. Topical therapy with glucocorticosteroids, keratolytics and agents with antifungal activity is of key importance in the treatment of papulosquamous diseases. Modern topical drugs with a fixed combination of active ingredients provide an effect on several pathogenetic mechanisms at once, are stable, compatible, and convenient for use by patients. One of the main drugs for the treatment of psoriasis and seborrheic dermatitis is a solution of betamethasone dipropionate and salicylic acid (trade name – Akriderm SK), which in terms of anti-inflammatory activity is comparable to the highest strength topical corticosteroids, while providing a faster response to therapy and effectively relieving symptoms of itching and peeling. This is confirmed by the authors’ own clinical experience and demonstrated in the clinical cases described in the article.

The most common dermatoses of athletes

Introduction and purpose The skin and subcutaneous tissue constitute the body's protective barrier. It also fulfills important physiological functions. It protects internal organs against the harmful effects of environmental factors and maintains the balance between the human body and the environment. Athlete's dermatoses are a wide group of skin diseases that may occur as a result of specific conditions to which people who practise sports are exposed. Some skin diseases are characteristic of specific sports, while others may occur regardless of the type of physical activity performed. Mechanical damage to the epidermis, excessive humidity, contact with pathogens and exposure to various environmental factors play a key role in the development of these diseases. Regular dermatological check-ups are crucial for identifying and treating skin lesions and preventing mass infections caused by infectious agents. The study discusses the most common dermatoses in athletes, including fungal, bacterial and viral infections, contact dermatitis and dermatoses caused by mechanical and environmental factors. Materials and methods The literature included in the PubMed, BioMed Central and Polish Medical Platform databases is searched by means of the words such as dermatosis, sport, skin, fungal, bacterial, viral infection, contact dermatitis. Quoted sources in selected works were also used. ConclusionsMany factors can have a harmful effect on the skin, negatively affect its function as an integral barrier of the body and, consequently, cause the development of dermatoses, which are quite common among athletes due to frequent contact with sweat, clothing, sports equipment and the environments in which they train. Prevention is an important element in minimizing the risk of skin problems and this is key to maintaining health and continuing physical activity.

Novel trends of frequency, demographics and clinical presentation of skin disorders in only public hospital in south of Lahore: A Descriptive observational study over 1 year.

Objective: To study the pattern of skin diseases in our population with respect to different age groups, gender and seasonal variations. Study Design: Observational Retrospective study. Setting: Department of Dermatology, Lahore General Hospital, a tertiary care referral hospital situated in second big city of Pakistan i.e Lahore. Period: July 2021 to June 2022. Methods: A total of 65284 patients presenting to skin OPD were studied. Demographic details were noted and diagnosis was made after detailed history, examination and appropriate investigations like scraping or smears. Data was analyzed for various age groups, gender distribution and effect of variables on diagnosis. Results: Out of 65284 patients, 38 %were male &amp; 62% were female. Most of the patients (43%) were in age group of 21-40 years. Scabies was the most prevalent dermatosis and affected 27% of study population. Three most common dermatosis were tinea, scabies and acne. The maximum number of dermatosis was seen in the months of summer. Conclusion: Infectious diseases pose a major burden to skin health of most of the population suffering from dermatological problem. Fungal infections and scabies are treatable but very common diseases contributing in burden of dermatological disorder in population presenting to hospitals.

An Observational Study on Female Genital Dermatoses and the Impact of Chronic Genital Dermatoses on Quality of Life in Adult Females.

Female genital dermatoses (FGD) or vulvar dermatoses are a group of disorders that affect the vulva and contiguous parts. Most of the FGDs can be chronic or recurrent. Effects on Quality of life (QoL) in patients having dermatological conditions are well studied but this is not the case in vulvar dermatoses. We aimed to study the etiology of genital dermatoses in females attending the Dermatology Out Patient Department (OPD) and to assess QoL in females with chronic FGD (>6 weeks duration). This was an observational study on female patients with vulvar complaints presenting to dermatology OPD. Both venereal and nonvenereal dermatoses were enrolled. QoL was assessed in females with chronic FGD using a self-administered Dermatological Life Quality Index (DLQI) questionnaire. Sample size was calculated using the formula Categorical variables were presented as numbers and percentages (%) and continuous variables were presented as mean ± standard deviation (SD) and median. The normality of the data was tested by the Kolmogorov-Smirnov test or non-parametric test. A t-test was used for the estimation of the mean. Ninety-seven patients were included in our study; Vulvovaginal candidiasis was the most common dermatoses (22.6%); Lichen simplex chronicus (11.3%) the commonest non-venereal dermatoses. 57 (58.7%) had chronic FGD, among whom 43 (75.4%) had significant QoL impairment. Infectious etiologies predominated. There was significant impairment in QoL in females with chronic FGD.

A study of autologous serum therapy in patients of chronic urticaria at a tertiary care center in western India

Background: Chronic urticaria (CU) is a common and troublesome dermatosis for patients. Approximately 30-50% of patients with CU have an autoimmune basis for their condition, as shown by a positive skin test for ASST, this subgroup is known as Autoreactive chronic urticaria. autologous serum therapy (AST) is considered a potential curative for this auto-reactive subgroup. Our study aimed to find out the efficacy of AST in both ASST positive and ASST negative CU patients. Methods: A cohort of 100 patients of CU were prospectively analyzed for incidence of ASST (+) patients out of total and efficacy of autologous serum injections for sequential 6 weeks in both ASST (+) and ASST (-) CU patients. The response of AST was recorded by the urticaria total severity scale (TSS) every week for 6 weeks and at 18 weeks. Results: The mean baseline TSS in the ASST (+) group was 12.14±1.66 and in the ASST (-) group was 11.77±1.45 (p-value- 0.5). The mean TSS at 18 weeks in the ASST (+) group was 1.30±1.51 and in the ASST (-) group was 2.17±2.02 (p-value-0.151). At 18 weeks of treatment, complete clearance was present in 44.6% of the ASST (+) group and 31.4% in the ASST (-) group (p value-0.151). Conclusions: AST can be considered as a first line of treatment, in patients of CU irrespective of the results of ASST, which is cost-effective and has long-lasting effects.

Prevalence of dermatoses in geriatric singaporeans in the community - a cross-sectional study

BackgroundLittle is known about the prevalence of dermatoses in “skin-well” geriatric Singaporeans. We aim to identify the prevalence of dermatoses and their associations within the geriatric population in Singapore, and to understand the distribution of dermatological encounters presenting to primary care physicians, and the resultant referral behaviour.MethodsA joint quantitative-qualitative study was performed across 8 months. Patients aged 65 years and above who visited a local polyclinic for management of non-dermatological chronic diseases were recruited. They were administered questionnaires, and underwent full skin examinations. Online surveys were disseminated to polyclinic physicians under the same healthcare cluster.Results201 patients and 53 physicians were recruited. The most common dermatoses identified in patients were benign tumours and cysts (97.5%), and asteatosis (81.6%). For every 1-year increase in age, the odds of having asteatosis increased by 13.5% (95% CI 3.4–24.7%, p = 0.008), and urticarial disorders by 14.6% (95% CI 0.3–30.9%, p = 0.045). Patients who used any form of topical preparations on a daily basis had higher odds of having eczema and inflammatory dermatoses (OR 2.51, 95% CI 1.38 to 4.56, p = 0.003). Physicians reported dermatological conditions involving 20% of all clinical encounters. Eczema represented the most commonly reported dermatosis within the first visit. 50% of dermatology referrals were done solely at the patient’s own request.ConclusionThe prevalence of dermatoses in the elderly in Singapore is high, especially asteatosis. Prompt recognition by the primary healthcare provider potentially prevents future morbidity. Outreach education for both primary care physicians and the general public will be key.Ethics approvalNational Healthcare group (NHG) Domain Specific Review Board (DSRB), Singapore, under Trial Registration Number 2020/00239, dated 11 August 2020.

A Clinico-Histopathological Study of Nail Dermatoses in a Tertiary Care Hospital.

Introduction Nail disorders account for an important component of all dermatological conditions.Nail abnormalities can result from local pathology or systemic diseases. Pathologies can lead to pain and impaired fine touch and are aesthetically distressing. Clinical assessment of nail pathologies is seldom accurate; moreover, the limited available investigative modalities make it difficult to correctly diagnose the disorders. Nail biopsies provide crucial histological information, especially for nail-limited dermatoses, though they are infrequently used and technically challenging. Proper biopsy techniques are vital to avoid complications like nail dystrophy and to ensure accurate diagnoses and effective treatments. Materials and methods A cross-sectional and observational study was conducted in the Dermatology Department of a tertiary care hospital in Maharashtra from November 2022 to July 2024, involving 51 patients aged 8-80 years with undiagnosed nail dermatoses. Patients with bleeding disorders, anesthesia allergies, and peripheral vascular diseases were excluded. Ethical clearance and written consent were obtained. In the case of pediatrics, patients' parental consent was obtained. Observation and results The age of the patients ranged from eight to 74 years, with a mean age of 38.04 years. The most affected age groups were 20-29 and 30-39 years old. Nineteen (37%) were manual laborers, followed by 10 (20%) students and nine (18%) professional workers. Symptoms lasted from one month to eight years, with a mean duration of 16.65 months. The most common dermatoses diagnosed clinically were as follows: 18 (35.3%) were onychomycosis, 16 (31.4%) were psoriasis, and eight (15.7%) were lichen planus. However, on histopathology, 20 (37.2%) were onychomycosis, followed by 16 (31.4%) of psoriasis, and eight (15.7%) were lichen planus. Conclusion This study highlights the critical role of nail biopsies in diagnosing nail disorders, particularly among middle-aged males who were manual laborers by occupation. It underscores the importance of combining clinical and histopathological approaches to accurately diagnose and manage, advocating for continued research and collaboration to improve patient outcomes.

What's the Impact of Safety Footwear on Workers Concerning Foot-Related Problems? A Systematic Review.

This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions. A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle-Ottawa Scale. Descriptive statistic was used to present data. The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal-toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters. Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.

Comprehensive considerations for dermatologists: the application of FDG-PET in evaluating cutaneous lesions in pediatric Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a complex disorder characterized by the clonal proliferation of Langerhans cells, primarily affecting children and adolescents. This condition exhibits a wide spectrum of clinical presentations, necessitating a multidisciplinary approach for diagnosis, treatment, and follow-up. Cutaneous manifestations of LCH are significant, mimicking common dermatoses and posing diagnostic challenges. [18F]Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) has emerged as an important tool in the evaluation of pediatric LCH, offering insights into disease activity, extent, and therapeutic response. Moreover, FDG-PET provides a non-invasive means to distinguish between active LCH skin lesions and other dermatological conditions with similar clinical appearances, enhancing diagnostic accuracy and aiding in disease monitoring. This educational review summarizes the utility of nuclear imaging techniques, with a focus on PET scans, in the diagnosis and management of cutaneous pediatric LCH. A comprehensive literature search identified seven relevant articles, including retrospective studies and case reports. These studies highlight the efficacy of FDG-PET in localizing active LCH skin lesions, monitoring disease activity, and guiding treatment decisions. FDG-PET represents a valuable imaging modality for dermatologists, oncologists, and pediatricians managing pediatric LCH patients with cutaneous involvement. This non-invasive technique contributes to improved diagnostic accuracy and facilitates early intervention, ultimately enhancing patient care and outcomes.

Immunophenotyping and viral studies in pityriasis lichenoides et varioliformis acuta lesions.

The underlying pathogenesis of pityriasis lichenoides et varioliformis acuta (PLEVA) remains unclear, although immunologic injury and viral etiology have been suggested. To evaluate and expand the immunophenotype of PLEVA and to search for possible viral pathogens. Formalin-fixed, paraffin-embedded specimens of 20 patients with PLEVA and 9 patients with common inflammatory dermatoses (ID) were studied for immunophenotyping and for human herpesvirus (HHV) 1 and 2, cytomegalovirus (CMV), HHV-8, parvovirus B19, and Epstein-Barr virus (EBV) immunohistochemistry. The presence of HHV-6, HHV-7, and enteroviruses was assayed molecularly. The numbers of CD8+ T cells and T-cell intracellular antigen-1 (TIA-1)+ cells were statistically significantly higher in PLEVA compared to the ID group. Immunohistochemistry for human HHV-1 and HHV-2, CMV and HHV-8, parvovirus B19, and in situ hybridization for EBV were all negative. There was molecular evidence for HHV-7 in only one PLEVA case (5%). Molecular studies for HHV-6 and enterovirus involvement were negative in all the PLEVA specimens. The predominant T-cell infiltrate in PLEVA is dominated by CD8+ cells, and by increased numbers of TIA1+ cells, which may indicate a cytotoxic T-cell damage to the epidermis. Viral presence was not detected.

Prevalencia de manifestaciones dermatológicas en pacientes con inmunodeficiencia común variable

Objective: Estimate the prevalence of dermatological manifestations in Mexican patients with common variable immunodeficiency. Methods: Cross-sectional and retrospective study, based on the analysis of records of patients with a diagnosis of common variable immunodeficiency, treated at the Siglo XXI National Medical Center (Mexican Social Security Institute), according to the criteria of the European Society of Immunodeficiencies (ESID). and of which only 3 had a genetic diagnosis with the following mutations: IRF2, CTLA4 and PIK-3, belonging to the Immunodeficiency Clinic of the National Medical Center Siglo XXI (IMSS), to evaluate dermatological manifestations, review of laboratory tests: IgA, IgM, IgG and type of replacement therapy with Immunoglobulin. The statistical analysis was carried out with the SPSS program; Descriptive statistics were used to analyze the data, according to the type of variable to be analyzed. Results: 36 patients were included, of which 55.5% were women; with median age 34 years (18-94). The prevalence of dermatological manifestations was 70% (n = 25). 30.5% had a history of infectious dermatosis and 39.5% had a history of non-infectious dermatosis. The most common dermatosis was irritant contact dermatitis in 13.8% of patients. All received replacement therapy with human immunoglobulin, 33.3% intravenously and the rest subcutaneously. Conclusions: Common variable immunodeficiency is an inborn error of immunity, with different clinical manifestations in various organs and systems (the skin is one of these). Dermatological manifestations are not usually described in patients with common variable immunodeficiency; However, it is important to identify them due to their relationship with certain complications (increased risk of superinfection), due to skin disruption and biological therapies. Keywords: Antibody immunodeficiency; Common variable immunodeficiency; skin diseases.