Complaints Of Rash Research Articles

Combination of Psoriasis and Vitiligo in a Child with Sotos Syndrome: Clinical Case

Background. Psoriasis and vitiligo are chronic, relatively common dermatological diseases. Meanwhile, their combination in children is rare. The combination of psoriasis and vitiligo in a child with Sotos syndrome has not been previously described. Clinical case description. The boy, 10 years old, was hospitalized with complaints (according to his mother) of rashes on the scalp, body, and limbs, with mild itching that was not related to the time of day. The pathological skin process was widespread. The patient was hyperactive, restless, emotionally labile, irritable. Complaints of rashes was mentioned firstly at the age of 7. Sotos syndrome was established at the age of 8 (variant c.6559C>T (p.Arg2187Ter) in 23 exon of the NSD1 gene (5q35.3), autosomal dominant type of inheritance (pathological allele de novo)). Psoriasis vulgaris was diagnosed with secondary vitiligo (localized form) at the age of 8.5 years. Symptomatic antipruritic and external pathogenetic therapy was performed in the hospital. Phototherapy was not prescribed due to the relative contradiction (small retrocerebral cyst) and the peculiarities of major disease (hyperactivity, restlessness) that complicated to place the child in the phototherapy booth. Positive dynamics was noted during the treatment (14 days): no itching, decrease of peeling severity, flattening and blanching of psoriatic rash elements to spots of post-inflammatory hypopigmentation. The lesion (focus of depigmentation) on the right knee joint skin remained unchanged. The patient was discharged to outpatient care. The prognosis for Sotos syndrome and skin lesions is favorable. Conclusion. The first medical observation of the child with Sotos syndrome burdened with psoriasis and vitiligo is presented. The pathogenetic correlation of these diseases is not clearly defined. Management of such cases requires the joint collaboration of dermatologists, geneticists and pediatricians.

Early Onset of Mycosis Fungoides

Introduction. Mycosis Fungoides (MF) is a primary epidermotropic T-cell lymphoma characterized by clonal proliferation of small and medium-sized T-lymphocytes with cerebriform nuclei. MF accounts for ≥ 50 % of all cutaneous lymphomas.The purpose of the study — description of a rare clinical observation of the debut of the development of Mycosis Fungoides in a patient in adolescence.Materials and methods. To verify the diagnosis, pathomorphological and immunohistochemical examination of a skin biopsy from the most infiltrated tumor-like lesion was used. The patient, born in 1978, turned to the clinic of Ural Research Institute of Dermatovenerology and Immunopathology with complaints of rashes on the skin of the trunk, accompanied by itching and soreness. Patient had been ill since the age of 16, when he first noticed the appearance of red spots on the skin of the chest without subjective sensations. In the last year he noted a significant deterioration of the disease: an increase in the number of spots, an increase in the intensity of itching, the appearance of tumor-like elements on the skin of the buttocks. In December 2022, he visited a dermatovenerologist and, in order to clarify the diagnosis, was sent to the Ural Research Institute of Dermatovenerology and Immunopathology.Discussion. The etiopathogenesis of the disease and the analysis of the few literature sources on the topic allows us to see the difficulty in early diagnosis and diagnosis in patients with early clinical manifestations of GM.Results. This clinical case demonstrates the possibility of the debut of GM in adolescence, the complexity of diagnosis in the early stages of development.Conclusion. The clinical case demonstrates the debut of GM in adolescence, emphasizes the need for clinical oncological alertness among dermatovenerologists.

MDA5 Juvenile Dermatomyositis Misdiagnosed as Childhood Psoriasis: A Case Report

Juvenile Dermatomyositis (JDM) is a rare autoimmune disorder which mainly affects the skin and skeletal muscles. Characteristic features of this rare disorder include Gottron papules, heliotrope rashes and proximal muscle weakness. MDA5 positive JDM is usually associated with interstitial lung disease in later part of life. The authors report a case of an 11-year-old male child who presented to the Paediatric Department with complaints of rashes over extensor surfaces, Gottron papules and pain and weakness in all limbs. The child was on treatment from the Dermatology Department as a case of psoriasis for last six months. During hospital stay after detailed work-up, the child was diagnosed to have JDM. Anti-melanoma Differentiation-Associated gene 5 (Anti-MDA5) antibodies were positive in the present case. The child was treated with immunosuppressive drugs with supportive care and is currently on treatment for the last one and a half years and is largely asymptomatic. JDM requires meticulous clinical examination and specific investigations so that timely diagnosis can be made to ensure appropriate treatment. In the present index case, the authors describe the typical clinical presentation, newer investigative modalities like myositis specific antibody and treatment outcomes of this rare condition.

Necrobiosis lipoidica of the scalp

Necrobiosis lipoidica is a chronic granulomatous skin disease of a vascular-exchange nature from the group of localized skin lipoidosis, accompanied by the development of degenerative changes in the connective tissue.
 The reason for the development of necrobiosis lipoidica is unknown, but the most common theory remains the theory of vascular disorders, including the deposition of immune complexes (IgM, complement component C3), microangiopathic changes (deposition of a glycoprotein in the walls of blood vessels), as well as other combinations of inflammatory and structural changes leading to collagen degeneration and decreased perfusion and oxygenation of the skin. Necrobiosis lipoidica occurs in association with systemic diseases (sarcoidosis, autoimmune thyroiditis, inflammatory bowel disease, such as ulcerative colitis, and rheumatoid arthritis) and can also occur in otherwise healthy individuals. Necrobiosis lipoidica is closely associated with diabetes mellitus.
 The predominant localization of necrobiosis lipoidica is tibial surface of the legs. Atypical localization is: skin of the scalp and face.
 Clinical polymorphism of necrobiosis lipoidica, possibility of transition from one form to another, its combination with other dermatoses can pose difficult diagnostic questions for the doctor.
 The article describes our own clinical observation of a patient with complaints of rashes on the skin of the legs and scarring alopecia in the scalp. The focus on the scalp had a tendency to grow and signs of development of scarring alopecia. According to the results of a biopsy performed at the Rakhmanov Department of Skin and Veneral Diseases, I.M. Sechenov First Moscow State Medical University, was diagnosed with "Necrobiosis Lipoidica". The case was interesting due to the extreme rarity of rashes on the skin of the scalp and the absence of dermatoscopic features of lesions in this area. Due to ongoing therapy for a month, there was a positive effect in the form of a lack of growth of existing plaques and the appearance of new ones, a decrease in the brightness of the color of the rash, a partial regression with an outcome in residual hyperpigmentation.
 Thus, despite the absence of a gold standard in the treatment of necrobiosis lipoidica, the most well-studied group of drugs for the treatment of the disease at the moment are glucocorticoids, which confirms our experience. Therapy of patients with necrobiosis lipoidica should be carried out by an interdisciplinary team (dermatovenereologist, endocrinologist, therapist).

Essential Thrombocythemia in Young Women

Background: Essential thrombocythemia (ET) is a rare disease in which there is an increase in the platelet count of more than 450,000/mm3. An increase in the number of platelets occurs due to increased proliferation of megakaryocyte series. Although there is an increase in the number of platelets in ET, it has impaired function. ET clinical manifestations in 50% of cases are asymptomatic, but in symptomatic cases can be vascular occlusive events or microvascular thrombosis.
 Case presentation: A 22-year-old woman with complaints of rash on the hands and feet. Physical examination found an enlarged spleen in Schuffner 1 and ecchymosis on the arms and legs, a platelet count of 811,000/mm3. The peripheral blood smear shows large platelets, the bone marrow picture shows megakaryocytes, which are very easy to find, the size varies with sufficient platelet emission, the JAK2 gene mutation examination shows mutation detection, while the BCR-ABL gene mutation results do not detect gene fusion. Treatment is given cytoreductive therapy in the form of hydroxyurea, while acetylsalicylic acid is not given because there are contraindications for administration.
 Conclusion: Essential thrombocythemia is a neoplastic proliferative disease that occurs in the megakaryocyte series. The diagnosis of ET mostly found mutations in the JAK2 gene. ET management according to risk classification, where acetylsalicylic acid can be given very low and low risk, while intermediate and high risk can be given cytoreductive therapy.

Features of clinical diagnosis of IgA-pemphigus in a patient with a long history of the disease

Ige-dependent pemphigus is a rare autoimmune vesicular disease and is characterized by painful and itchy vesicular rashes on the skin. Ige-dependent pemphigus is one of the rarest forms of autoimmune bullous dermatoses.
 The article describes the clinical case of patient T., aged 82 y.o., who applied to the Novosibirsk Regional Clinical Dermatovenerologic Dispensary with complaints of rashes on the skin of the trunk, limbs, periodically accompanied by itching. For the first time, rashes began to appear 20 years ago, more often in the summer. She was observed by a rheumatologist with a diagnosis of chronic vasculitis, during exacerbation, against the background of therapy with systemic glucocorticosteroids, the rashes regressed. During the last exacerbation after suffering a Novel coronavirus infection at the age of 82 y.о., patient turned to a dermatologist against the background of an injection of a solution with betamethasone, with partially regressed rashes, which made it difficult to establish a diagnosis. After 2 weeks, against the background of discontinuation of therapy, another exacerbation occurred, characterized by obvious clinical manifestations of neutrophilic bullous dermatosis in the form of flaccid pustulеs on the skin of the trunk, upper extremities, as well as serous-purulent crusts arranged in the form of rings and garlands. Based on the history, clinical features and laboratory studies, without the use of immunofluorescence, a provisional diagnosis of IgA-dependent pemphigus was made, systemic glucocorticoid therapy was prescribed with a long-term gradual withdrawal, with a positive effect.

Granulomatous perioral dermatitis

Parents of patient S., born in 2018 applied with complaints of rashes on the skin of her daughter's face, accompanied by itching for a year. Topically used cream methylprednisolone aceponate and methylene blue. Objectively: the pathological process was widespread, localized on the skin of the face. On the skin of the face, congestive hyperemia, multiple miliary pustules, vesicles, already opened in places, covered with serous crusts, multiple pink papules were visualized periorally. When conducting a histological examination of the affected area of the skin of the face, characteristic signs for granulomatous dermatitis were revealed: in the follicles, foci of necrosis, macrophages with an admixture of neutrophilic leukocytes, single eosinophils and giant multinucleated cells. In the deep layers of the dermis, rough, unevenly thickened and in places multidirectional bundles of collagen fibers with signs of necrosis and the presence of giant cell granulomas, as well as numerous giant cell granulomas without necrosis, exocytosis of lymphocytes, which is characteristic of granulomatous dermatitis, were determined. The diagnosis was made: Perioral dermatitis, granulomatous form. We were prescribed a long-term oral administration of an antibiotic of the macrolide group, externally calcineurin blockers, emollients and ointments containing zinc. On the background of the ongoing treatment, the rash resolved. There was a stable remission.

A Case Study on Pompholyx (Dyshidrotic Eczema) w.s.r. to Vicharchika

Besides the miraculous achievement of modern medical science, humanity is passing through a horror of disease and drug phobia, particularly in developing countries like India, where poverty and illiteracy account for the man’s ignorance towards the principles of health care. Skin is one of the five ‘Gyanindriyas’ as described in Ayurvedic texts. It is responsible for ‘Sparsha Gyan’ or touch sensation; therefore it plays a great role in physical and mental well-being of any individual. The skin is highly complex organ which plays a vital role in the body’s general working. The unbroken skin is the nature’s dressing over the body’s it acts as an effective barrier against the entry of diseases and its damage results in a whole host problems. Approximately 15% of all patients who visits the doctors to do for care of the skin as the wise saying ‘skin patients never cured and never die. When a skin disorder occurs it is rooted in tissues like fat, blood etc. Skin disorders occur due to aggravated Pitta Dosha. The built up toxins due to imbalanced Pitta cause Pompholyx. Pompholyx is a type of eczema, in which intensely itchy blisters that develop on the edges of the fingers, toes, palms and soles of feet appear. It may be acute or chronic and it affects teenagers and adults. In the present case 42yrs old female patient, who presented with complaints of rash over palm of left hand associated with intense itching, deep seated oozing wound and burning sensation has been presented here. She was treated with Ayurvedic treatment regimen for 40 days and she recovered fully with no symptoms left.

Case report on tuberous sclerosis

Patient M., 23 years old, consulted a dermatologist with complaints of rashes on the face, which had bothered since childhood. On objective examination, skin lesions were widespread. A visual examination revealed spots of hypopigmentation, angiofibromas of the face, shagreen fate of the skin, periungual fibromas. She was diagnosed with tuberous sclerosis. Further examination revealed a neoplasm in the brain and right kidney, damage to the lungs, tubular bones, lymphadenopathy. The patient continues to be monitored by a neurologist and therapist. Based on the results of CT scan of the chest organs, an oncologist's consultation was scheduled to conduct an oncology search. Thus, with skin manifestations characteristic of this disease, it is necessary to conduct a comprehensive examination to identify concomitant pathology and early diagnosis of complications.

Systemic lupus erythematosus presenting as stevens johnson syndrome in a thirty years old female: a case report

Background: SJS occurs almost exclusively secondary to drugs but very rarely, SLE can be an inciting factor for SJS without presence of an offending drug. The association is extremely rare, however few cases have been reported. Case presentation: We present a case report of a thirty year old female who presented to the rheumatology clinic with complaints of rash on her face, swelling of the lips and oral ulcers with severe hemorrhagic cheilitis. She also complained of persistent high grade fever with development of blisters on her face and oropharyngeal mucosa. She had been suffering from pain in multiple joints which did not respond to NSAIDs. A diagnosis of SLE presenting as SJS was established. Patient was given good supportive care, steroids, DMARDs and analgesics, to which she responded well and recovered. Conclusion: Stevens Johnson Syndrome is an uncommon, severe dermatological condition usually caused secondary to drugs. Secondary cause of the disease may rarely be co-existence of an autoimmune condition like SLE, as present in our patient.

Anaphylactic reactions due to pantoprazole: case report of two cases.

BackgroundDrug-induced hypersensitivity reaction is of great clinical significance in therapeutics. The objective of this reporting of two cases is to show that anaphylaxis reaction can occur with pantoprazole.Case summariesA 38-year-old female reported to the emergency ward in a critical condition, with a history of periorbital edema, edema of the skin, pruritus, nausea, vomiting, and difficulty breathing 20 minutes after ingestion of a pantoprazole 40 mg tablet. A 32-year-old female reported to the emergency ward in a critical condition, with complaints of rashes all over the body, itching on the whole body, and swollen lips and eyes after ingestion of a pantoprazole 40 mg tablet.ConclusionIt is necessary for all health care providers to know that pantoprazole can cause anaphylaxis, which is a life-threatening reaction, and to be cautious while prescribing it.

The Effect of Acute Allergic Reactions on Diastolic Heart Function

Diastolic heart failure is characterized by the presence of heart failure symptoms despite preserved systolic function. Cytokines released during allergic reactions may impair diastolic heart function, either through their direct toxic effects or by inducing coronary artery spasm. The purpose of this study was to examine the effects of acute allergic reactions on diastolic heart function. Fifty patients, randomly selected from those who were admitted to the emergency room between May 2010 and December 2010 with the complaints of rash and itching, and who were subsequently diagnosed with allergic reactions based on the clinical and laboratory findings, were included in the study as the allergy group. Thirty healthy volunteers, in whom the diagnosis of allergy was ruled out based on the clinical and laboratory data, were use as the control group. Diastolic heart functions were evaluated in patients presenting with allergic reaction as well as in control subjects. There was no significant difference between the two groups in terms of basal systolic functions, diameters of the cavities and wall thicknesses, and biochemical parameters. Color M mode flow progression velocities, E ratios, E/A ratios and mitral lateral annulus tissue Doppler velocities measured by echocardiography at Day 0 and Day 5 were significantly altered in the allergy group (p < 0.05). Impairment in diastolic functions was observed following acute allergic reactions. Acute allergic reactions could be a cause of mortality and morbidity if they lead to the development of diastolic heart failure.

Cold-induced urticaria with a familial transmission: a case report and review of the literature

IntroductionCryopyrin-associated periodic syndrome is a rare genetic disorder causing cold-induced urticaria, severe arthralgias, and (potentially) renal failure and hearing loss. Therapies that effectively control the symptoms and prevent the complications of this debilitating disorder are now available, making recognition of this disease important.Case presentationA 60-year-old Caucasian woman presented with complaints of rash and joint pains to a general medicine clinic. Her history showed that her symptoms were linked to cold exposure, but the results of a cold stimulation time test were negative. Several generations of her family had similar symptoms.ConclusionsThis case highlights the importance of considering cryopyrin-associated periodic syndrome in the differential diagnosis of cold-induced urticaria. Several medications targeting interleukin-1-beta are available, providing significant relief from symptoms and improvement in quality of life in affected patients.

Vomiting From Multivitamins: A Potential Drug Interaction

A commercial weight loss program with a client base composed of >95% women experienced sporadic complaints of nausea and vomiting after changing its multivitamin supplier. This retrospective and observational study was designed to determine if related adverse event reports were significant, and to investigate potential mechanism for their occurrence in this group of subjects, many of whom were concurrently receiving oral contraceptives or hormone replacement therapy. Incidence of nausea, vomiting, rash, and total complaints in the 3 months following the change of the multivitamin formulation was compared with the same complaints in the 3 months before the change. In the 3 months following the multivitamin change, there were 166 complaints of nausea and vomiting, 9 complaints of rash and 194 total complaints from a group of 88,468 patients. In the 3 months before the change in the multivitamin, there had been 2 complaints of nausea and vomiting, no complaints of rash, and 11 total complaints from 88,252 patients. The difference detected by a chi-squared test was significant for all events studied; nausea and vomiting (P < 0.0001), rash (P < 0.02), and total complaints (P < 0.0001). The altered multivitamins contained added citrus bioflavanoids not included in the original formula. Citrus bioflavanoids decrease the clearance of exogenous estrogens by inhibiting cytochrome P450 enzyme systems. Elevated estrogen levels could account for the increased incidence of nausea and vomiting. This experience demonstrates that adding dietary herbal supplements to multivitamins may be associated with adverse interactions with prescription drugs.

A case discussion on eczema

Eczema is a form of dermatitis where inflammation of epidermis occurs. The exact cause of eczema is not known. Although it is activated by the immune system and is related to allergic reactions, it is not the same as other allergic reactions. In Ayurveda, the disease is described by the name “Vicharchika.” Virechana is the best line of management for skin disorders. Controlling eczema more effectively can make a radical improvement to the patient's quality of life. A case report of 45-year-old male, who presented with complaints of rashes over dorsum of both foot associated with intense itching and burning sensation, oozing wound posterior to lateral malleolus and dorsum of left foot has been presented here.

New Persil—A case of rash complaints?

New Persil—A case of rash complaints?