Facial Eruption Research Articles

Psoriasiform drug eruption: A case series with a review of the literature.

The present case series examined five instances of psoriasiform drug eruption diagnosed between 2014 and 2022 at the study site and 23 cases of drug eruption manifesting psoriasiform lesions which had been reported between 1986 and 2022. The causative drug, distribution of the skin eruptions, clinical latency to eruption, treatment course, and histopathological findings were investigated. The most common causative agents were calcium channel blockers (CCB) (64.5%). Of the 28 cases of psoriasiform drug eruption for which details of the eruption sites were reported, 46.4% occurred on the face, which was slightly higher than the usual distribution of psoriasis. CCB were responsible for 80.0% of the cases of facial skin rash. The mean time from the administration of the suspected drug to eruption onset was 25.0 months (range: 0.5-120 months; median: 13.0 months). In all the cases, the skin rash improved after the causative drug was discontinued. CCB were the most common causative agent, and the eruptions more commonly occurred on the face than in normal psoriasis, suggesting that it is especially important to confirm whether there is a history of CCB administration in psoriasis patients with extensive, facial skin eruptions.

Evaluation of Demodex mite in chronic urticaria

Objective: Determining the possible role of Demodex mites in patients with chronic urticaria Methods: Demodex screening results in 49 patients with chronic urticaria were evaluated retrospectively. Results: The mean number of Demodex mites per 1 cm2 measured with standardized skin-surface biopsy (SSSB) was 0.89 which was at a similar level as control groups in the literature. Conclusion: Demodex mites seemed not to play a role in patients with chronic urticaria who had no facial eruptions. Patients with skin eruptions with the possible contribution of Demodex as rosacea could be investigated for chronic urticaria in other studies.

SYSTEMIC LUPUS ERYTHEMATOSUS: UPDATE ΟN THE DIAGNOSIS, PREVALENCE, CLINICAL MANAGEMENT, INFLAMMATORY MARKERS, NEW HORIZONS IN THE PATHOGENESIS, MANIFESTATIONS AND PROGRESS IN TREATMENT

Introduction: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multisystem involvement, generating chronic inflammation and damage of more than one organ. It is usually clinically and serologically diagnosed with the presence of autoantibodies. Lupus is a Latin term meaning wolf, due to the fact that the typical facial eruptions of the pathology are very similar to the bite marks of a wolf. Objective: to detail the current information related to systemic lupus erythematosus, description, etiology, epidemiology, pathophysiology, histology, classification, clinical manifestations, treatment and differential diagnosis. Methodology: a total of 45 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 35 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: lupus, SLE, autoimmune, multisystemic. Results: Familial segregation and high concordance rates in identical twins strongly suggest a genetic contribution to SLE, however there is no obvious pattern of inheritance. Females have 10 times the risk of developing SLE compared to males. Lupus in males is less common but has a propensity to be more severe. About 80 to 90% of individuals with SLE show musculoskeletal involvement in the course of the disease, ranging from mild arthralgias to deforming arthritis. Avascular necrosis with or without the use of steroids may occur in 10% of individuals with SLE and is most often bilateral and affects the hip joints. Conclusions: systemic lupus erythematosus presents a wide range of clinical and histopathologic manifestations. Adequate education of affected individuals with systemic lupus erythematosus about the possible clinical manifestations can lead to early recognition and intervention, which may prevent potential significant organ damage. The role of markers and autoantibodies in the differential diagnosis of the pathology is essential. Treatment of SLE is aimed at preventing organ damage and achieving remission. The choice of treatment will depend on the altered organ system(s) and the extent of the involvement. Education of the affected individual, physical measures, lifestyle and emotional support play an important role in the comprehensive treatment of SLE. KEY WORDS: lupus, SLE, autoimmune, manifestations, treatment.

Drugs for rosacea.

Rosacea is a common, chronic inflammatory facial eruption of unknown cause. It is more prevalent in women than in men, and disease onset typically occurs after age 30. Rosacea is characterized by erythema, telangiectasia, and flushing, and sometimes by recurrent, progressive crops of acneiform papules and pustules, usually on the central part of the face. Some patients develop granulomas and tissue hypertrophy, which may lead to rhinophyma (a bulbous nose), particularly in men. Blepharitis and conjunctivitis are common. Keratitis and corneal scarring occur rarely.

Facial Papulopustular Eruption during the COVID-19 Pandemic in Patients Treated with EGFR Inhibitors.

Papulopustular rash (PPR) is the most frequent cutaneous adverse event during treatment with epidermal growth factor receptor inhibitors (EGFRis). Although often mild in severity, it can impair patients' quality of life and may also be a reason for discontinuing or changing the dose of the antineoplastic treatment. During COVID-19 pandemics, the use of surgical masks drastically increased and it had an impact on the face skin microenvironment, favoring the worsening of dermatological pathologies. We reported the relapse of PPR in patients treated with EGFR inhibitors who consistently wore face masks (>6 hours/day). All the patients developed the PPR within 6 months of starting mask use. Compared to the PPR occurred previously, after mask use, the skin eruption was more severe and affected mainly those regions of the face which came into contact with the mask. Patients received topical or systemic treatment, obtaining complete response in 65.7% of the cases. The establishment of an early treatment for the PPR allows continuing the oncologic treatment, without any suspension which could result in a decreased oncologic outcome. In conclusion, when using these devices, it is recommended to use special precautions, particularly in oncologic patients, by using a daily prophylactic skincare and replacing masks regularly with regular and frequent breaks.

Lupus erythematosus comedonicus and vegetans: A challenging definition

AbstractA 39‐year‐old man presented with an acneiform facial eruption, bilateral vegetating erythematous plaques on the inguinal folds, focal palmoplantar keratoderma, keratotic violaceous plaques of the dorsum of both hands, and whitish striated lesions on the oral mucosa. Laboratory work‐up showed high titre of ANAs, anti‐SSA(Ro) and anti‐SSB(La) and hypocomplementemia (low C4). Three skin biopsies from different locations were suggestive of cutaneous lupus erythematosus (CLE). Treatment with hydroxychloroquine 400 mg/day plus topical and systemic corticosteroids led to significant clinical improvement after 2 months. Lupus erythematosus comedonicus is a form of discoid CLE and clinically characterized by acneiform lesions. Vegetating lesions, named as lupus erythematosus vegetans, are extremely rare in CLE. The combination of both manifestations in our patient may be better described as ‘lupus erythematous comedonicus and vegetans’.

Isotretinoin for treatment of a challenging case of scleromyxoedema. Comment on 'Localized papulonodular facial eruption inHIV'.

We present our experience regarding the successful use of isotretinoin as a valuable therapeutic option for lichen myxoedematosus.

Microblading-transmitted Monkeypox infection: fomites matter.

Microblading is an increasingly popular semipermanent tattooing technique used for eyebrow pigmentation, involving the use of needles. During the 2022 mpox outbreak in Spain, a 47-year-old woman with no relevant medical history presented with a 10-day facial skin eruption.

Localized papulonodular facial eruption in a patient withHIV.

A 47-year-old woman with HIV presented with a nodular eruption on her face.

A Single Case Study on Successful Ayurvedic Management of Yuvanpidika W.S.R. to Acne Vulgaris

People today place a high value on their physical appearance and health. The face is the most significant organ for displaying a person’s beauty. Acne vulgaris is one of the most common skin disorders which dermatologists have to treat, mainly affect adolescents, though it may present at any age. Acne by definition is multifactorial chronic inflammatory disease of pilosebaceous units. Various clinical presentations include seborrhea, comedones, erythematous papules and pustules, less frequently nodules, deep pustules or pseudocysts, and ultimate scarring in few of them. Acne has four main pathogenetic mechanism-increased sebum productions, follicular hyperkeratinization,Propionibacterium acnecolonization, and the products of inflammation. In recent years, due to better understanding of the pathogenesis of acne, new therapeutic modalities are designed. Different hormones target different parts of the skin. These actions may have an impact on the function and appearance of specific skin cells, such as sebaceous glands, hair follicles, and pigment-producing cells. This most significant and beautiful organ is impacted by some adolescent anomalies, namely those between the ages of 16 and 30. The disease’s characteristics resemble those of acne. It is thought to be one of the most common skin disorders and an adolescent condition. In young people, acne vulgaris is a persistent inflammatory skin disorder. The world’s oldest known system of medicine is Ayurveda. Acharya Sushrutahas mentioned the skin disease under “Kshudra Rogas”andMukhadushika is one of them. These facial eruptions resemble thorns like that of Shalmali. Due to its tendency to influence a person’s personality and diminish one’s facial beauty, it is known asMukhadushika. Kapha, Vata, Meda, and Raktaare the Doshasand Dushyasinvolved in Mukhadushika, and these have a localized impact on the person’s face. It is a skin condition that has a negative impact on a person’s look and demeanor. The appearance of blackheads, papules, pustules, and cysts is its defining features. These days, the community is more aware of this issue because of poor dietary practices

508 Complex case of mycosis fungoides – possible treatment with imiquimod

We are presenting the case of a 54-year-old female patient, smoker, known with mycosis fungoides since 2007, with a certain diagnosis since 2014, currently being treated with acitretin 40 mg per day, who was referred first to our Clinic for the presence of a generalized facial eruption constituted by well-defined erythematous tumour plaques and placards, with a histopathological picture compatible with lymphoma. Soon she developed tumours with ulcerations, purulent secretions and serohematic crusts on the surface, generalized pruritus and scratching lesions.

Effectiveness and tolerance of Janus kinase inhibitors for the treatment of recalcitrant atopic dermatitis in a real-life French multicenter adult cohort

Effectiveness and tolerance of Janus kinase inhibitors for the treatment of recalcitrant atopic dermatitis in a real-life French multicenter adult cohort

33521 Two cases of oral baricitinib associated papular eruption on face

Background: Janus kinase (JAK) inhibitors reduce inflammation by interrupting JAK-STAT pathway and are used for various disease. However, cutaneous adverse effects including reactivation of herpes simplex virus, herpes zoster, disseminated molluscum contagiosum, and acneiform eruptions were reported. In addition, few cases of granulomatous inflammation after JAK inhibitor use have been reported recently. Methods: Patient 1, a 40-year-old woman, presented with erythematous papules on periorbital and perioral area for 13 months. She had been taking prednisolone and hydroxychloroquine for rheumatoid arthritis (RA) for 1 year, but symptoms were not controlled. Thus, oral baricitinib was administered. After 2 months, facial lesions appeared. Patient 2, a 64-year-old woman, presented with erythematous papules on face developed 2 weeks ago. She has been taking baricitinib for RA because of inadequate response to methotrexate. Facial eruption occurred 4 months after initiation of baricitinib. Results: For patient 1, histopathologic examination showed dense dermal infiltration of lymphocytes, histiocyte and few plasma cells, which implicated granulomatous dermatitis. Doxycycline and topical gentamycin/prednicarbate were given and the lesions showed response. Patient 2 showed improvement after treatment with doxycycline, topical metronidazole, and topical ivermectin. However, lesions aggravated 7 months after doxycycline cessation with continuous baricitinib use. Conclusion: Although JAK inhibitors are known to be effective for the treatment of granulomatous diseases like sarcoidosis, granulomatous drug eruption has been reported. In our cases, facial skin lesions appeared 2 and 4 months after starting baricitinib, respectively. Our cases imply that dermatologists should be aware of the potential association between JAK inhibitors and cutaneous eruption.

33521 Two cases of oral baricitinib associated papular eruption on face

Background: Janus kinase (JAK) inhibitors reduce inflammation by interrupting JAK-STAT pathway and are used for various disease. However, cutaneous adverse effects including reactivation of herpes simplex virus, herpes zoster, disseminated molluscum contagiosum, and acneiform eruptions were reported. In addition, few cases of granulomatous inflammation after JAK inhibitor use have been reported recently. Methods: Patient 1, a 40-year-old woman, presented with erythematous papules on periorbital and perioral area for 13 months. She had been taking prednisolone and hydroxychloroquine for rheumatoid arthritis (RA) for 1 year, but symptoms were not controlled. Thus, oral baricitinib was administered. After 2 months, facial lesions appeared. Patient 2, a 64-year-old woman, presented with erythematous papules on face developed 2 weeks ago. She has been taking baricitinib for RA because of inadequate response to methotrexate. Facial eruption occurred 4 months after initiation of baricitinib. Results: For patient 1, histopathologic examination showed dense dermal infiltration of lymphocytes, histiocyte and few plasma cells, which implicated granulomatous dermatitis. Doxycycline and topical gentamycin/prednicarbate were given and the lesions showed response. Patient 2 showed improvement after treatment with doxycycline, topical metronidazole, and topical ivermectin. However, lesions aggravated 7 months after doxycycline cessation with continuous baricitinib use. Conclusion: Although JAK inhibitors are known to be effective for the treatment of granulomatous diseases like sarcoidosis, granulomatous drug eruption has been reported. In our cases, facial skin lesions appeared 2 and 4 months after starting baricitinib, respectively. Our cases imply that dermatologists should be aware of the potential association between JAK inhibitors and cutaneous eruption.

MANAGEMENT OF MUKHADUSHIKA (ACNE VULGARIS) BY AN AYURVEDIC APPROACH – A CASE STUDY

One of the most prevalent disorders seen in modern clinical practice is mukhadushika, which is characterized by facial eruptions that look like thorns (shalmalikantakavata). It is seen more from an aesthetic perspective than a medicinal one. It is classied in the Samhitas as a Kshudraroga, which are regarded to be mild illnesses. However, in rare instances like Mukhadushika, this can lead to a signicant aesthetic handicap and cause great emotional anguish. It can be likened to Acne vulgaris, a persistent inammatory disorder of the pilosebaceous follicles on the face, based on its clinical characteristics. It is characterized by the formation of papules, pustules, cysts, and comedones (black heads), some of which may heal to leave pitted scars. To some degree or another, modern medicine has been unable to completely eradicate this illness. The ShodhanaChikitsa like Virechana, Vamana, Nasya, and Lepa have been primarily referenced in the classics for this condition. In the treatment of Mukhadushika, clinical observation has demonstrated the effectiveness of Sadyovirechana and Manjishtha lepa. Here is a case report of a 19 years old male who arrived with red, sensitive acne on cheeks and chin along with excruciating discomfort and a burning feeling.

P01: ‘Age is just a number’: a rare facial blistering eruption in an 18‐year‐old female

P01: ‘Age is just a number’: a rare facial blistering eruption in an 18‐year‐old female

Facial milia-like eruption in a patient with alopecia

Facial milia-like eruption in a patient with alopecia

Facial demodicosis in the immunosuppressed state: a retrospective case series from a tertiary referral center.

Data on Demodex in the immunosuppressed state is limited, focusing mainly on patients with human immunodeficiency virus and hematological malignancies. The aim of this study was to describe the manifestations of facial demodicosis in diverse immunosuppressive states. The medical records of all patients followed at a Demodex outpatient clinic of a tertiary medical center from January 2008 to November 2020 were retrospectively reviewed. Data on patients who were immunosuppressed while with demodicosis were retrieved. The cohort included 28 patients (17 women and 11 men; median age, 58 years). Types of immunosuppression included treatments with hydroxyurea for polycythemia vera/essential thrombocytosis, mycophenolic acid, tacrolimus, and prednisone for liver and/or kidney transplantation, prednisone with cyclosporine/methotrexate/azathioprine/rituximab mainly for autoimmune diseases, mercaptopurine with/without anti-tumor necrosis factor alpha (TNF-α) for Crohn's disease, chemotherapy for neoplasms, anti-TNF-α for psoriasis, and Cushing's syndrome. The clinical types of demodicosis included: papulopustular, erythematotelangiectatic and fulminant rosacea, hyperpigmented, pityriasis folliculorum, pustular folliculitis, and dermatitis. The diverse clinical presentations led to various differential diagnoses. Topical treatment with ivermectin (monotherapy/combination with other treatments) was effective. Clinicians treating immunosuppressed patients should be familiar with the different forms of demodicosis and include them in the differential diagnosis of facial eruptions.

Topical corticosteroid therapy for facial acneiform eruption due to EGFR inhibitors in metastatic colorectal cancer patients: a randomized controlled trial comparing starting with a very strong or a weak topical corticosteroid (FAEISS study, NCCH1512, colorectal part).

Although pre-emptive therapy with oral tetracycline, moisturizer, sunscreen, and topical corticosteroid is useful for preventing acneiform eruption (AfE) due to epidermal growth factor receptor (EGFR) inhibitors, no studies have examined the efficacy of topical corticosteroids themselves, or investigated the optimal potency of corticosteroid for treating facial AfE (FAfE). Screened patients with RAS wild-type colorectal cancer started pre-emptive therapy with oral minocycline and moisturizer on initiation of cetuximab or panitumumab therapy. Patients who developed grade 1 or 2 FAfE were randomly allocated to two groups: a ranking-down (RD) group that started with a very strong corticosteroid and serially ranked down every 2weeks unless FAfE exacerbated; and a ranking-up (RU) group that started with a weak corticosteroid and serially ranked up at exacerbation. FAfE grade, patient quality of life, and adverse events (AEs) with topical corticosteroid were evaluated every 2weeks. The primary endpoint was the total number of times grade 2 or higher FAfE was identified in the central review of the 8-week treatment period. No significant differences in total numbers of grade 2 or higher FAfE or in AEs caused by topical corticosteroids were observed between groups during the 8weeks. Incidence of grade 2 or higher FAfE tended to be lower in the RD group during the first 2weeks. Considering the long-term care of FAfE, the RU regimen appears suitable and should be considered the standard treatment for FAfE due to EGFR inhibitor therapy. UMIN Clinical Trials Registry (UMIN000024113).

Case report: Acute Localized Exanthematous Pustulosis Following mRNA-1273 SARS-CoV-2 Vaccination

Acute localized exanthematous pustulosis (ALEP) is a rare subtype of acute generalized exanthematous pustulosis (AGEP) with identical histologic findings. It results from a T-cell related neutrophilic inflammatory response and is characterized by monomorphic sterile pustules confined to the face, neck, or chest. Two cases of similar facial pustular eruptions in association with the messenger RNA–1273 SARS-CoV-2 vaccine have been reported, both in males of lighter skin over 50 years old. To highlight this rare reaction and its clinical appearance in patients of pigment-rich skin, we report the case of a young adult female with ALEP following injection of the RNA–1273 SARS-CoV-2 vaccine.