Erythematous Plaques Research Articles

Drug-Induced Sweet’s Syndrome by Xcopri

Background: Sweet's syndrome (SS) is a relatively rare, self-limiting dermatological condition predominantly affecting women aged 30-50. It is characterized by the sudden onset of erythematous plaques, nodules, or papules on the skin and is often accompanied by fever, leukocytosis, and systemic symptoms. While most SS cases are idiopathic, approximately 5% are drug-induced. Case: This case report describes a 34-year-old female with a medical history significant for epilepsy who presented with diffuse erythematous papules on the bilateral upper extremities. The onset of these symptoms coincided with the initiation of Xcopri (cenobamate tablets) in her medication regimen. Conclusion: To our knowledge, this report highlights the first case of Xcopri-induced SS. We interpret this patient's presentation as a cutaneous response secondary to an adverse drug reaction and aim to emphasize the importance of obtaining a thorough medication history at each clinical consultation.

Acrodermatitis Enteropathica Following a Pull-Through Procedure

Abstract Introduction: Acrodermatitis Enteropathica is a rare condition traditionally expressed by perioral or acral dermatitis, diarrhea, and alopecia. Acrodermatitis Enteropathica can be inherited or acquired, with the acquired form linked to zinc deficiency. The pull-through procedure is a method used to treat Hirschsprung’s disease, a condition in which the large intestine is missing nerve cells that make it difficult to pass stool, which can lead to obstruction and absorption issues. Complications of pull-through procedures have been associated with bowel obstruction and malabsorption of essential nutrients, including zinc. Case Report: We present a 16-month-old male who developed perioral dermatitis, well-demarcated erythematous plaques, and alopecia after a pull-through procedure related to Hirschsprung’s disease. Discussion: Acrodermatitis Enteropathica can present with various cutaneous lesions, and dermatologists should be familiar with the differing morphologies. In this paper, we encourage dermatologists to consider Acrodermatitis Enteropathica as a differential diagnosis for patients who develop cutaneous lesions following pull-through procedures. Keywords: Acrodermatitis Enteropathica, Hirschsprung’s Disease, zinc deficiency, case report

Naevoid Blaschkoid Psoriasis: A curable mosaic abnormalities of the skin.

Naevoid Blaschkoid Psoriasis is a rare and underdiagnosed subtype of linear psoriasis. Characteristic aspects of naevoid blaschkoid psoriasis include a late onset of asymptomatic erythematous and scaly plaques along with blaschko line. Here, we report on a patient with a delayed definitive diagnosis of mosaic pattern skin in early infancy, who experienced significant clearing of skin plaques after treatment with an interleukin 17 (IL-17) inhibitor (secukinumab). This case reminds clinicians to take psoriasis into consideration under the differential diagnosis of blaschkoid dermatoses.

Approach of Shoshan and Sanshaman Chikitsa in Management of Mandal Kushtha w.s.r. to Psoriasis

Psoriasis is a chronic inflammatory, hyperproliferative skin disease. It is characterised by well-defined, erythematous scaly plaques, particularly affecting extensor surfaces, scalp and nails, and usually follows a relapsing and remitting course. Psoriasis affects approximately 1.5%-3% of populations of European ancestry but is less common in Asian, South American and African populations. It occurs equally in both sexes and at any age; although it is uncommon under the age of 5 years, more than 50% of patients present before the age of 30 years. Aims and Objectives: To find out the effect of Ayurvedic medicine and Shodhan chikitsa in the management of Mandal kushtha (psoriasis). Material and Methods: A 53-year-old male patient having complaint of skin lesion on scalp, upper back and abdomen area with red demarcation from last 15 years. Lesion having silvery scales and falling all rubbing with severe itching. This condition clinically correlated to Mandal Kushtha described in Ayurveda. Mandal Kushiha has Shwelam Raklam varna, Sthirar, Styanam and Utsana Mandala (skin begins with special characters. Acharya Charaka mentioned Shodhan Chikitsa for purification of Kushtha Roga. Result and Discussion: Considering The sign and symptoms patient was treated with classical Vamana Karam (therapeutic emesis) and Virechana karma (therapeutic purgation) according in line of treatment of Kushtha (psoriasis). Assessment was done before treatment, after treatment and after follow-up. Pictures were taken before treatment and after treatment. Remarkable improvement was noticed in scaling, induration and itching after Vamana and Virechanа treatment and residue only hyper pigmented pink lesion.

Yao syndrome: a novel systemic autoinflammatory disease with cutaneous manifestations.

Yao syndrome (YAOS) is a novel systemic autoinflammatory disease linked to the nucleotide-binding oligomerization domain (NOD2) gene. It is characterized by periodic fevers, gastrointestinal (GI) symptoms, arthritis, and dermatitis, among other symptoms. A sparse literature exists on this disease, and little is known about its dermatological manifestations. A review of available literature was performed to characterize the cutaneous manifestations of Yao syndrome. Cutaneous manifestations were documented in 85.7% of patients, with common characteristic descriptions of erythematous patches and plaques involving the face, trunk, abdomen, and extremities. Based on our review of treatment modalities employed for Yao syndrome, prednisone is an appropriate initial approach, with oral sulfasalazine and other disease-modifying antirheumatic drugs serving as appropriate secondary options. YAOS should be considered in the differential diagnosis of patients presenting with a dermatitic rash, especially in the context of concurrent articular symptoms, periodic fever, and GI symptoms.

Delayed Pressure Urticaria Associated With Altitude Chamber Training Responsive to Cyclosporine and Omalizumab.

Delayed pressure urticaria (DPU) is a subset of chronic inducible urticaria. It is characterized by the formation of wheals anytime between 30 minutes and 24 hours after stimulus exposure of localized pressure application. In this case report, we discuss a military flight crew member with no significant past medical history who developed DPU following rapid decompression in an altitude chamber. The chamber training included an uneventful ascent to 45,000 feet, higher than he had been previously, and a rapid decompression. About 16 hours later, he developed pruritic swelling of his hands and feet, along with diffuse deep nodular swelling, erythematous plaques, and erythematous nodules. His DPU was refractory to monotherapy treatment with antihistamines, and he continued to develop lesions in weight-bearing areas. Control of symptoms was achieved through combination treatment of a second-generation antihistamine, a leukotriene receptor antagonist, and an immunosuppressant (cyclosporine). His waiver to return to flight status was denied while on cyclosporine. He was transitioned to a monoclonal antibody that binds free immunoglobin E (omalizumab) with resolution of symptoms and was cleared to return to active duty.

Severe Atopic Dermatitis Treated by Wet Wrapping: An Observation at the Dermatology Hospital of Bamako (Mali)

Introduction: Wet wrapping is a local care technique adapted to the treatment of severe forms of eczema. It is a good alternative for AD resistant to the usual local treatments. We report a case. Observation: A 5-month-old infant, with a personal history of allergic rhinitis has been seen in a dermatological for diffuse skin eruption and pruritus evolving in flare-ups since 4 months, without improvement after several courses of dermocorticoids, anti-H1, and emollient from several doctors. Clinical examination revealed erythematous plaques surmounted by vesicles with a crumbled border located on the convexities and extension face of the limbs and in the folds behind the ears and diffuse skin xerosis. The examination of the other devices was unremarkable. The evaluated SCORAD was 59.8. We carried out the treatment by the wet wrapping technique, a clear regression of the cutaneous lesions and pruritus with the decrease of the SCORAD from 59.8 to 8.8 in 1 month of treatment. Discussion: This observation further illustrates the effectiveness of the Wet wrapping technique in the management of recalcitrant atopic dermatitis. In resource-poor countries, Wet wrapping may be an alternative for recalcitrant forms of atopic dermatitis. For fostering critical nurse observation as a source of research topics, we propose four strategies. First, cultivating awareness through a culture of evidence-based practice and critical reflection on common practice. Second, stimulating persistence in addressing moral dilemmas concerning better care despite resistance. Third, facilitating interprofessional learning in an open culture, where diverse perspectives are valued, and it is psychologically safe to bring them in. Fourth, overcoming funding disparities and facilitating nurse-led research, acknowledging the underrepresentation of nurses in funding agencies. These measures aim to empower nurses to observe critically, use their unique perspectives, and bring in research topics.

Macrophage P2Y6R activation aggravates psoriatic inflammation through IL-27-mediated Th1 responses

Purinergic signaling plays a causal role in the modulation of immune inflammatory response in the course of psoriasis, but its regulatory mechanism remains unclear. As a member of purinoceptors, P2Y6R mainly distributed in macrophages was significantly up-expressed in skin lesions from patients with psoriasis in the present study. Here, the severity of psoriasis was alleviated in imiquimod-treated mice with macrophages conditional knockout of P2Y6R, while the cell-chat algorithm showed there was a correlation between macrophage P2Y6R and Th1 cells mediated by IL-27. Mechanistically, P2Y6R enhanced PLCβ/p-PKC/MAPK activation to induce IL-27 release dependently, which subsequently regulated the differentiation of Th1 cells, leading to erythematous and scaly plaques of psoriasis. Interestingly, we developed a novel P2Y6R inhibitor FS-6, which bonds with the ARG266 side chain of P2Y6R, exhibited remarkable anti-psoriasis effects targeting P2Y6R. Our study provides insights into the role of P2Y6R in the pathogenesis of psoriasis and suggests its potential as a target for the development of therapeutic interventions. A novel P2Y6R inhibitor FS-6 could be developed as an anti-psoriasis drug candidate for the clinic.

Incidencia de micosis fungoide en pacientes con psoriasis vulgar crónica

Background: Psoriasis is a chronic dermatosis, characterized by erythematous and scaly plaques, affecting 2 -3% of people worldwide. And on the other hand we have mycosis fungoides, the most common cutaneous T-cell lymphoma, which presents manifestations that vary from erythematous macules to tumors. These two pathologies are independent, however, their clinical and pathological similarity has generated erroneous diagnoses. However, literature has marked a possible connection between the two. The relationship between psoriasis and mycosis fungoides, as well as the appearance of mycosis fungoides after systemic treatment for psoriasis, has generated a great enigma and really requires exhaustive study. Material and methods: A systematic review of publications of studies on the incidence of mycosis fungoides in chronic psoriasis vulgaris patients is carried out, and a meta-analysis will be carried out that incorporates all the published information available using the online databases pubmed, google scholar, trip medical database, Embase, prospero International prospective register of systematic reviews Results: The systematic review concluded that 47 cases met the inclusion criteria, that is, patients with a history of long-standing psoriasis vulgaris, of which 38 patients received biological therapy and 32 patients developed mycosis fungoides. Conclusion: The association between mycosis fungoides and long-standing psoriasis vulgaris is a complex issue, mainly due to its difficulty in clinically differentiating both diseases, which often generates an erroneous diagnosis. Likewise, there have been cases of coexistence of both pathologies and the appearance of mycosis fungoides secondary to long-standing treatments for psoriasis vulgaris. A clear association between psoriasis and mycosis fungoides has not yet been established. However, it is possible that this connection is favored by the immunopathology of psoriasis due to the constant activation of the immune system and the presence of Th17 cells, predisposing to the development of mycosis fungoides. However, there are few studies on these topics specifically. It is imperative that more studies be conducted to understand the mechanisms involved, develop and establish more specific management guidelines against therapies for patients with pre-existing risk factors. Some studies have suggested an association between the use of biologic therapies for psoriasis and an increased risk of developing or exacerbating mycosis fungoides in certain patients. However, the evidence is still inconclusive and more research is needed to fully understand this relationship. Concern about the impact of immunological therapies in long-standing psoriasis vulgaris highlights the need for constant monitoring and long-term investigations to better understand the long-term effects of these treatments. The actual incidence and prevalence of the relationship between long-standing psoriasis vulgaris and mycosis fungoides cannot be determined with certainty

Pustular Psoriasis of Pregnancy Successfully Managed with Steroid and Cyclosporine – A Case Report

Pustular psoriasis of pregnancy is a well-known dermatosis of pregnancy. Erythematous plaques with pustular rings and central erosions affecting the intertriginous regions are one of the most common presentations. It can be severe during pregnancy and may impact both the mother and the foetus if not treated. It typically disappears quickly after birth, but there is a chance of recurrence with increased severity in consecutive pregnancies. Systemic corticosteroids are the treatment of choice in generalised pustular psoriasis of pregnancy (GPPP). Cyclosporine also plays a role in the management. We present a case of GPPP in a 30-year-old woman who was treated with systemic corticosteroids and cyclosporine with an uneventful childbirth and a normal foetus.

An 80-year-old woman with severe pruritic erythematous and hyperkeratotic plaques

An 80-year-old woman with severe pruritic erythematous and hyperkeratotic plaques

Clinical characteristic and outcomes of psoriasis patients in a multicentre outpatient healthcare institution in Colombia

IntroductionPsoriasis is a chronic inflammatory disease characterized by scaly erythematous plaques, systemic inflammation, and an elevated cardiovascular risk. Due to its complexity in treatment and the frequent occurrence of comorbidities, characterizing patients diagnosed with psoriasis enrolled in care programmes becomes paramount for enhancing health outcomes. ObjectiveTo provide a comprehensive description of the sociodemographic, clinical features, and outcomes of a cohort of patients diagnosed with psoriasis in a multicentre outpatient healthcare institution in Colombia. Materials and methodsA cohort study was conducted involving patients diagnosed with psoriasis. Inclusion criteria required a minimum follow-up duration of three months. Quantitative variables were summarized using the median and interquartile range, while qualitative variables were presented with measures of frequency and 95% confidence interval. Changes in the final values of PASI, DLQI, NAPSI, and BSA from baselines were assessed through percentage comparisons, analysed using chi-square test. ResultsA total of 1155 patients were included, with a median age of 53 years and the majority were men (58%). Plaque psoriasis was the predominant type, observed in 78.7%. Psoriatic arthritis was diagnosed in 18.9%. The most prevalent comorbidity was hypertension, identified in 23.0% (95% CI 20.6 to 25.6%), followed by diabetes at 12.5% (95% CI 10.6 to 14.5%) and cardiovascular disease at 10.6%. A significant proportion of patients were classified as overweight and obese, 43.9% (n=479) and 20.9% (n=228), respectively. Regarding treatment modalities, the majority received biological therapies (39%), followed by systemic therapy (22.2%), and topical therapy (17.5%).During the follow-up period, a considerable percentage of patients experienced some decrease in disease activity. A PASI75 response was achieved by 28.5% (95% CI 25.4% to 31.8%), and PASI90% was achieved by 18% (95% CI 15.4% to 20.9%). A bivariate analysis based on Body Mass Index showed a lower response in patients with overweight or obesity, thought these differences were not statistically significant (p=.937). Notably, a higher percentage of patients with no response were observed among those with hypertension (62.9% p=.123), diabetes mellitus (64.7% p=.393), cardiovascular disease (51.5% p<.001), and chronic kidney disease (55.6% p=.014) when compared with patients who achieved therapeutic goals. ConclusionsWe present the largest psoriasis cohort in Colombia. A majority of our patients showed improvement in disease activity based on clinimetric measures. Nevertheless, the presence of comorbidities significantly reduces the likelihood of achieving a treatment response. A multidisciplinary approach combined with tight follow-up ensures better outcomes, highlighting the importance of implementing real-world, multidisciplinary care programmes.

Periocular Manifestation in Acute Atopic Dermatitis in a Paediatric Patient. A Case Report

Atopic dermatitis is a chronic skin condition characterized by itchy, scaly, and crusted lesions, most commonly affecting infants and children. The condition presents with intense pruritus and a chronic course with exacerbations. Periorbital involvement is expected due to the thin and sensitive skin in this area, and the inflammation can be exacerbated by rubbing or scratching. This case reports a 5-year-old girl with bilateral periorbital inflammation that had been present for 4 hours. She had a history of atopic dermatitis and no known surgical history or medication allergies but was allergic to shellfish. No medication or topical cream was administered for the described episode. Upon waking up, she presented with newly developed periorbital inflammation. She had not consumed any food to which she was known to be allergic, and there had been no increase in eyelid scratching. There was no recollection of contact with any toxic agents. During the physical examination, erythematous scaly plaques were observed on both cheeks, chin, and neck, and periorbital inflammation accompanied by eyelid and periorbital Dennie-Morgan fold. The primary diagnosis was periorbital atopic dermatitis in the context of an acute atopic dermatitis flare-up. The prescribed treatment included prednisolone acetate (Estilsona) for five days and pimecrolimus for the atopic dermatitis. Atopic dermatitis is a complex condition with a multifactorial aetiology, and its management can be challenging. Further research is needed to develop more effective treatments for atopic dermatitis.

Natural Product-Derived Compounds Targeting Keratinocytes and Molecular Pathways in Psoriasis Therapeutics.

Psoriasis is a chronic autoimmune inflammatory skin disorder that affects approximately 2-3% of the global population due to significant genetic predisposition. It is characterized by an uncontrolled growth and differentiation of keratinocytes, leading to the formation of scaly erythematous plaques. Psoriasis extends beyond dermatological manifestations to impact joints and nails and is often associated with systemic disorders. Although traditional treatments provide relief, their use is limited by potential side effects and the chronic nature of the disease. This review aims to discuss the therapeutic potential of keratinocyte-targeting natural products in psoriasis and highlight their efficacy and safety in comparison with conventional treatments. This review comprehensively examines psoriasis pathogenesis within keratinocytes and the various related signaling pathways (such as JAK-STAT and NF-κB) and cytokines. It presents molecular targets such as high-mobility group box-1 (HMGB1), dual-specificity phosphatase-1 (DUSP1), and the aryl hydrocarbon receptor (AhR) for treating psoriasis. It evaluates the ability of natural compounds such as luteolin, piperine, and glycyrrhizin to modulate psoriasis-related pathways. Finally, it offers insights into alternative and sustainable treatment options with fewer side effects.

WHAT TO EXPECT FROM MICROBLADING OF THE EYEBROWS

Microblading of the eyebrows, a kind of cosmetic tattooing that has become very popular in the last decade, it can nevertheless cause adverse skin reactions at the tattoo site, including infections, allergic reactions, and even sarcoid reactions. These reactions can lead to a reduction in the quality of life. We report tow cases of adverse reactions following microblading of the eyebrows, the first patient 40-year-old women presenting with a 7 -month history of erythematous lesions on the eyebrow, A biopsy was performed, which came back a sarcoidosis granulomatous reaction, Our patient was put on intralesional corticosteroid and synthetic antimalarials with good improvement, the second patient have 38 year-old women consulting for erythematous, oozing, pruritic lesions after 3 days of application microblading of the eyebrows, . The dermatological examination revealed the presence of edematous erythematous plaques surmounted by vesicles with crumbling contours located on both eyebrows. The diagnosis of contact eczema was retained, and the patients was put on a low-class topical corticosteroid for 10 days with good improvement.

Skin Metastases from Breast Cancer: Case Report

Breast cancer is the second most common cancer diagnosed in women. Skin metastases result from infiltration of the skin due to cell proliferation. The incidence of cutaneous metastases varies from 0.6-10.4%. We present a 52-year-old woman diagnosed with infiltrating ductal carcinoma triple-negative, who presented with a localized dermatosis that affects the chest with a erythematous plaque, nodular and ulcerated in appearance, with irregular and well-defined edges. Breast carcinoma can present metastases in skin, recognizing the diversity of clinical presentations in a timely manner, is the key to a timely diagnosis and reducing mortality.

Retrospective study of the clinical significance of the neutrophil-to-lymphocyte ratio in 79 patients with palmoplantar pustulosis.

Palmoplantar pustulosis (PPP) is a chronic relapsing inflammatory skin disease characterized by multiple vesicles, pustules, and erythematous plaques on the palms and soles. The exacerbation of PPP is strongly associated with focal infections, such as tonsillitis, dental infections, and sinusitis, in Japan. Recently, the neutrophil-to-lymphocyte ratio (NLR) has been widely used as a convenient and useful marker for clinical conditions and various diseases; however, an association between PPP and NLR has not yet been established. We retrospectively analyzed 79 patients with PPP from our hospital to evaluate the clinical significance of the NLR. The average NLR value in patients with PPP was significantly higher than that in healthy controls (2.30 ± 1.02 vs 1.69 ± 0.45, P < 0.001). A comparative analysis of patients with PPP with and without infectious complications showed that there was a statistical difference in the NLR between patients with PPP with and without focal infections, whereas no significant difference was found for metal allergy, smoking, and pustulotic arthro-osteitis. Multivariate analysis indicated that the NLR was significantly associated with focal infections (odds ratio = 18.38, 95% confidence interval 3.86-87.35, P < 0.001). The NLR was also significantly correlated with C-reactive protein levels (P = 0.013, r = 0.2857). Interestingly, after symptom improvement, the NLR significantly decreased from the baseline levels. Furthermore, statistical analysis using the Youden's index revealed that an NLR of 2.28 or higher was associated with the risk of any focal infections in patients with PPP. These results suggest that the NLR has potential applications as a biomarker of the presence of focal infections in patients with PPP.

Effectiveness of Systemic and Topical Combination Therapy for the Treatment of Pustular Psoriasis: A Meta-Analysis Study

Introduction: Pustular psoriasis is a rare and severe variant of psoriasis, characterized by sterile pustules that appear over erythematous plaques. Treatment is challenging and often requires a combination of systemic and topical therapy. This meta-analysis study aims to evaluate the effectiveness of systemic and topical combination therapy for the treatment of pustular psoriasis. Methods: Relevant publications were identified through electronic searches in PubMed, Scopus, and Web of Science. Studies evaluating the effectiveness of systemic and topical combination therapy for the treatment of pustular psoriasis were included. Data were extracted and analyzed using random effects statistics. Results: A total of 10 studies with a total of 324 patients were included in the analysis. Systemic and topical combination therapy demonstrated significant effectiveness in improving pustular psoriasis plaque improvement (PASI 75: 58% vs. 23%, p&lt;0.001) and time to recurrence (12 months vs. 6 months, p&lt;0.001) compared with systemic therapy or single topical. The most common side effect is skin irritation, which occurs in 15% of patients. Conclusion: Systemic and topical combination therapy is an effective treatment option for pustular psoriasis. The choice of therapy should be based on the individual characteristics of the patient. Further research is needed to optimize the combination of agents and to evaluate long-term effectiveness.

Risky Behavior of Men who have Sex with Men (MSM) Increases the Risk of HIV and Syphilis Infection

The incidence of sexually transmitted infections in man who have sex with man (MSM) is increased among human immunodeficiency virus (HIV) patients. HIV and syphilis are two sexually transmitted diseases that frequently interact and modify the symptoms and signs of the disease. A case of a 27-year-old male with generalized multiple erythematous plaques including palms and soles since 4 days ago was reported. The patient has been diagnosed with HIV since 2017. The patient is sexually active with a male sex partner and rarely uses condoms. Diagnosis of syphilis is made based on anamnesis, physical examination, and laboratory tests. The treatment was benzathine penicillin G 2.4 million units in 3 doses. The combination of HIV and syphilis needs longer therapy and requires serological follow-up for up to 24 months.

Syphilitic Unorthodoxy: A Case of Lues Maligna in a Human Immunodeficiency Virus-negative 28-year-old Filipino Male

Lues maligna, also known as malignant syphilis, is an uncommon variant of syphilis at the secondary stage – more commonly reported in immunocompromised patients or those with concomitant human immunodeficiency virus (HIV) infection. In this report, we present a case of a 28-year-old HIV-negative male with a 9-month history of multiple, well-defined, irregularly-shaped, erythematous papules, and small plaques evolving to ulcerated plaques and nodules with crusts, associated with pain, pruritus, and episodes of fever, arthralgia, and weight loss. Positive treponemal and nontreponemal tests, aided by histopathologic findings consistent with syphilis led to the diagnosis of lues maligna. Significant improvement of lesions was noted with 3 weekly doses of 2.4 million units of benzathine penicillin G. For patients presenting with painful and pruritic erythematous ulcerated plaques with crusts associated with systemic symptoms, and with a significant sexual history despite testing negative for HIV infection, a high index of suspicion for uncommon presentations of other sexually transmitted infections such as syphilis could aid in early diagnosis and subsequent treatment.