Number Of Dermatoses Research Articles

Grover’s disease — current understanding of transient and persistent acantholytic dermatosis

Grover’s disease is a papulo-vesicular pruritic dermatosis characterized by a transient, persistent, or asymptomatic course. We have analyzed the publications found in the PubMed and RSCI scientific literature databases between 1970 and 2022. The clinical manifestations of Grover’s disease, possible localization, etiological factors, and the histological and dermatoscopic picture of the disease are described. According to the literature, the putative associations with disease onset are highly variable and include insolation, pregnancy, hemodialysis, chemotherapy, sweating, a number of dermatoses, and a history of malignancy and organ transplantation. Seasonality of the process has also been described. To date, nine histologic patterns of the disease have been described, the most common being acantholytic dyskeratosis.

Adult-onset of Langerhans cell histiocytosis: a clinical case

Langerhans cell histiocytosis is mainly diagnosed in children, and its manifestation in adult age is quite uncommon. Skin rashes may be non-specific and mimic a number of dermatoses. Therefore, the clinical diagnosis is challenging and as a rule, such patients are misinterpreted and managed for other disorders by a dermatologist for some years.
 We present a clinical case of Langerhans cell histiocytosis with skin involvement in a 35-year female patient, who had been treated by a dermatologist for 2 years for pyoderma, seborrheic dermatitis, and skin fold candidiasis. Taking into account the clinical signs and symptoms and age of manifestation, we initially suspected familial benign pemphigus (Hailey-Hailey disease) or follicular dyskeratosis (Darier's disease). However, the histological assessment showed Langerhans cell histiocytosis confirmed by immunohistochemistry with anti-langerin, anti-CD1a, and anti-protein S-100 antibodies. The patient was referred to a hematologist for further work-upand specific treatment.
 In cases of any treatment resistant disorders, which do not respond to long-term conventional treatment, it is necessary to reconsider the diagnosis by means of histological investigation. It would allow for identification of a disease, which is uncommon in dermatology practice.

A Comprehensive Update of the Atypical, Rare and Mimicking Presentations of Mycosis Fungoides.

IntroductionMycosis fungoides (MF) is the most frequent subtype of primary cutaneous T cell lymphomas (pCTCL). The diagnosis may be particularly difficult in the early stages as well as in atypical and rare clinical presentations. Furthermore, MF may simulate a large variety of common dermatologic disorders and patterns, both histopathologically and clinically.MethodsA literature search was performed to provide a comprehensive update on the rare and atypical MF manifestations as well as the dermatoses and dermatological patterns that could be imitated by MF.ResultsA total of 114 publications were found describing a series of different dermatoses and dermatological patterns mimicked by MF, as well as some particular localizations of MF lesions and dermatoses that occur in preexisting MF lesions.ConclusionsThe number of dermatoses that can be imitated by MF is ever-increasing. Patients with common dermatologic conditions that prove to be treatment refractory should be biopsied without delay, and sequentially as necessary, to prevent delay in diagnosis and progression of disease. Clinicopathologic correlation is the best way of diagnosis.

Dermatological lesions among people living with HIV in Turkey

This study aimed to document the dermatoses and their relationships with CD4+ T lymphocyte counts and clinical stages of disease among people living with HIV followed by our Clinical Department, to investigate the effect of antiretroviral therapy (ART) on findings and to compare with real-world data. Medical records of people living with HIV were analyzed retrospectively in our outpatient clinic from January 2005 to June 2017. A total of 500 patient files were examined. 179 patients with dermatoses were included in the study. Demographic data, clinical and laboratory findings, dermatological findings, type and distribution of lesions, serological and histopathological examinations, diagnosis, treatment, and follow-up of patients were transferred to data forms. 84.4% of the patients were male and the mean age was 38.65 ± 11.6 years. The median CD4+ T lymphocyte count was 253/mm3 (range:0-1067). At least one dermatosis was present in 69.3% of the patients. Compared with their median CD4+ T lymphocyte counts, the ratio of CD4+ T lymphocytes was significantly lower in the group with three or more dermatoses (p = 0.019). Condyloma acuminatum (15.1%), drug eruption (13.4%), seborrheic dermatitis (11.7%), oral candidiasis (11.2%), dermatophytoses (11.2%), syphilis (8.4%), Kaposi's sarcoma (8.4%), and telogen effluvium (8.4%) were the most common dermatoses. Kaposi sarcoma (KS), oral candidiasis, onychomycosis, and molluscum contagiosum were significantly higher in the CD4+ T lymphocyte <200/mm³ group when CD4+ T lymphocyte threshold value was determined as 200/mm³. Compared with other TDF/FTC-containing regimens, a significantly higher proportion of alopecia was reported in patients receiving TDF/FTC/EVG/c (p = 0.007). Dermatoses may be a good clinical marker for detecting clinical stage and diagnosing HIV infection; also, there may be a significant increase in the number of dermatoses in advanced stages. Although there are only a few studies in the literature, it should be kept in mind that ART-associated alopecia rates may increase nowadays when ART is targeted at everyone.

Study of Clinical Profile Associated with Obesity amongst Dermatology Patients In A Tertiary Care Centre

Background: Obesity is a global epidemic. Obesity is associated with a number of dermatoses, including acanthosis nigricans, skin tag, keratosis pilaris, hyperandrogenism and hirsutism, striae distensae, and adiposis dolorosa. Objective: To elucidate the various skin changes in obesity and to determine if it is considered as an obesity marker. Methodology: 100 patients, aged 18 years or above satisfying the inclusion and exclusion criteria were drawn for a period of 18 months. Results: Out of 100 patients 54% were female, in their third and fourth decade. By occupation most of the females were housewives (40%) and the majority of males were farmers (14%). Type 2 diabetes mellitus was the most common systemic illness (24%). Pseudoacanthosis nigricans was the most prevalent skin change. 51% of patients had skin tags. 48% had striae distensae as a skin change. 10.86% male and 14.81% female patients had stasis dermatitis, 6% had leg venulectasias and 2% had leg ulcer. 26% had plantar hyperkeratosis. 41% of our patients had one or other types of fungal infections. Bacterial infections were detected in 15% cases, folliculitis being the commonest. Conclusion: Obesity is strongly related to several skin alterations that could be considered as markers of excessive weight. The dermatoses that showed a statistically significant relationship with obesity were Pseudo acanthosis nigricans, Skin tag, Striae, Plantar hyperkeratosis and Fungal infections. Prevention of obesity is important to prevent these dermatoses and dermatologists must work with primary care physicians and patients to reduce the harmful effects of obesity on the skin.

Skin lesions in diabetes mellitus: risk factors for development, clinical manifestations, prevention and treatment

The overall prevalence of skin lesions in diabetes mellitus varies from 51.1 to 97 %. More than 30 different dermatoses are described that either precede diabetes or develop against the background of manifest disease. Among a number of dermatoses, diabetic dermopathy, lipoid necrobiosis, disseminated granuloma annulare, bullosis diabeticorum, xanthomatosis, acanthosis nigricans, necrolytic migratory erythema, diabetic scleredema should be noted. Most often, patients with diabetes mellitus have dry skin and hyperkeratosis, which can cause trophic infected ulcers. As a prophylactic agent in such cases, today, SEPTOTON TM BBpharm cream with panthenol and lanolin is proposed

Skin changes and dermatological life quality index in chronic kidney disease patients in a tertiary hospital in Southern Nigeria.

Cutaneous changes commonly occur in chronic kidney disease (CKD), however, there is limited information on its effect on quality of life of these patients. This study determined the prevalence and pattern of skin changes in CKD patients and their effects on the dermatology life quality index (DLQI) of the patients. This was a descriptive cross-sectional study that involved stages 3-5 CKD patients who were examined for skin changes. The effects of the observed skin changes on DLQI were assessed using the standardized DLQI questionnaire. One hundred and five CKD patients participated in the study consisting of 56 males and 49 females with a mean age of 51.93 ± 15.23 years. The prevalence of cutaneous changes was 94.3%. Common skin manifestations were pallor 99 (94.3%), hyperpigmentation 58 (55.2%), fluffy hair 55 (52.4%), Lindsay nails 48 (45.7%), and pruritus 44 (41.9%). The effect of dermatoses on DLQI was mild in 34 (32.4%), moderate in 13 (12.4%), and severe in 4 (3.8%).There was no significant association between dermatoses and CKD stage. There was significant positive correlation between DLQI scores and number of skin dermatoses (r = 0.522, P = <0.001), duration on maintenance hemodialysis (r = 322, P = 0.017). There was significant negative correlation between DQOL scores and packed cell volume (r = -0.232, P = 0.022). On multiple regression analysis, number of dermatoses was the only significant predictor of DLQI (P = <0.001). Skin changes occur commonly in CKD patients and significantly affected their DLQI. This study highlights the significant burden that skin changes add to CKD.

Mucocutaneous Manifestations of HIV and the Correlation with WHO Clinical Staging in a Tertiary Hospital in Nigeria.

Skin diseases are indicators of HIV/AIDS which correlates with WHO clinical stages. In resource limited environment where CD4 count is not readily available, they can be used in assessing HIV patients. The study aims to determine the mucocutaneous manifestations in HIV positive patients and their correlation with WHO clinical stages. A prospective cross-sectional study of mucocutaneous conditions was done among 215 newly diagnosed HIV patients from June 2008 to May 2012 at adult ART clinic, Wesley Guild Hospital Unit, OAU Teaching Hospitals Complex, Ilesha, Osun State, Nigeria. There were 156 dermatoses with oral/oesophageal/vaginal candidiasis (41.1%), PPE (24.4%), dermatophytic infections (8.9%), and herpes zoster (3.8%) as the most common dermatoses. The proportions of dermatoses were 4.5%, 21.8%, 53.2%, and 20.5% in stages 1–4, respectively. A significant relationship (using Pearson's Chi square with P value <0.05) was obtained between dermatoses and WHO clinical stages. Pearson's correlation coefficient showed a positive correlation between the number of dermatoses and the WHO clinical stages. Dermatoses can therefore serve as diagnostic and prognostic markers in resource limited settings to initiate HAART in clinical stages 3 and 4.

Diagnosis and treatment of tick infestation and tick-borne diseases with cutaneous manifestations

Hard and soft ticks may be associated directly or indirectly with a number of dermatoses, both infectious and inflammatory in origin. Morbidity may occur as a result of tick bites, tick toxicosis, and even infestation. These arthropod vectors may transmit life-threatening protozoan, bacterial, rickettsial, and viral diseases with systemic and cutaneous findings. Additionally, ticks may transmit more than one pathogen with subsequent human coinfection. This article reviews the presentation of tick-borne illnesses and the medical management of these diseases. Among others, diseases such as ehrlichiosis, anaplasmosis, babesiosis, tularemia, borrelioses, tick-borne encephalitides, rickettsial spotted fevers, and tick typhus are discussed in this article. The recognition of skin manifestations associated with these diseases is paramount to early diagnosis and treatment initiation.

Deep Morphea after Vaccination in Two Young Children

A number of dermatoses have been reported to appear in close temporal or spatial relationship to the intramuscular injection of vaccines. We describe two young children who had morphea consistent with the deep morphea type (morphea profunda) that appeared at the site of a previous vaccination. Trauma has been implicated as an important trigger of morphea, both in children and in adults. Furthermore, vaccines might induce an immune response, which could lead to morphea in predisposed individuals.

Chronic desquamative gingivitis as part of mucocutaneous manifestations

Desquamative gingivitis is a clinical feature of a variety of diseases. In this paper, the clinical features of dermatoses or mucocutaneous disorders where desquamative gingivitis is presenting manifestations have been reviewed (lichen planus, mucous membranes pemphigoid and pemphigus vulgaris). Other less common mucocutaneous disorders affecting the oral mucosa (lupus erythromatosus, linear IgA, plasma cell gingivitis, chronic ulcerative stomatitis and psoriasis) are also described. Correct identification of these conditions entails taking a careful history and performing a thorough intra-oral examination. Presence of cutaneous, nasal, ocular and genital lesions should be carefully elicited from the patient. The clinical manifestations, investigations and modalities of treatment are reviewed. Desquamative gingivitis (DG) is a clinical feature of a variety of diseases. It is characterised by epithelial desquamation, erythema, ulceration, and/or the presence of vesiculobullous lesions of the gingiva and other oral tissues. This phenomenon can be a manifestation of a number of dermatoses, most commonly lichen planus, mucous membrane pemphigoid (cicatricial pemphigoid), and pemphigus vulgaris [1-3]. Other causes include allergic reactions to toothpastes/mouth rinses (plasma cell gingivitis) [4-6], Crohn's disease [7], psoriasis [8], linear IgA disease [9] and chronic ulcerative stomatitis [10]. Desquamative gingivitis can be mistaken for plaque induced gingivitis and this can lead to delayed diagnosis and inappropriate treatment of serious dermatological diseases such as pemphigoid or pemphigus [11-14]. Desquamative gingivitis as a presenting feature is most commonly noticed in oral lichen planus (OLP) [15-17]. Sudanese Journal of Dermatology Vol. 4(1) 2006: 16-27

Obesity and dermatology

Obesity is associated with a number of dermatoses. It affects cutaneous sensation, temperature regulation, foot shape, and vasculature. Acanthosis nigricans is the most common dermatological manifestation of obesity. Skin tags are more commonly associated with diabetes than with obesity. Obesity increases the incidence of cutaneous infections that include: candidiasis, intertigo, candida folliculitis, furunculosis, erythrasma, tinea cruris, and folliculitis. Less common infections include cellulitis, necrotizing fasciitis, and gas gangrene. Leg ulcerations, lymphedema, plantar hyperkeratosis, and striae are more common with obesity. Hormonal abnormalities and genetic syndromes (Prader-Willi) are related to obesity and its dermatoses; however, cellulite is not related to obesity.

Alterações dermatológicas em crianças com Aids e sua relação com categorias clínico-imunológicas e carga viral

FUNDAMENTOS: Desde o início da epidemia da Aids as dermatoses têm sido freqüentemente descritas em pacientes com essa doença, com relatos de casos atípicos e estudos de séries de pacientes adultos; no entanto, há poucas publicações sobre alterações cutâneas em pacientes pediátricos com Aids. OBJETIVOS: Estudo prospectivo para avaliar a presença de dermatoses em 40 pacientes pediátricos com Aids. MÉTODOS: Quarenta pacientes, com idade inferior a 13 anos e portadores de Aids, foram estudados por um período de seis meses para avaliação de: número de alterações dermatológicas; suas características clínicas; distribuição conforme as categorias clínico-imunológicas e o valor da carga viral. RESULTADOS: A prevalência de dermatoses foi de 82,4%, na primeira consulta, e, no acompanhamento longitudinal, 92,5% dos pacientes tiveram alterações dermatológicas, com proporção de cinco diagnósticos por doente. As crianças com classificação clínico-imunológica grave e carga viral acima de 100.000 cópias/ml apresentaram maior número de alterações dermatológicas quando comparadas àquelas das categorias clínico-imunológicas leves. A proporção de diagnósticos por paciente na categoria clínica C foi de 6,8 e na A de 3,6; na categoria imunológica grave, de sete, e na leve de 3,7; e na carga viral &gt; 100.000 de 7,3, e na &lt; 100.000 de 4,2 (todos com significância estatística). CONCLUSÃO: As dermatoses foram freqüentes nas crianças com Aids e ocorreram em maior número nos pacientes pertencentes às categorias graves. A elevada freqüência de alterações da pele nos pacientes pediátricos com a doença indica ser imprescindível sua avaliação dermatológica minuciosa e freqüente.

CO2-Laser-Therapie - Eine Alternative zu herkömmlichen Behandlungsmethoden bei ausgedehnten Basalzellpapillomen

Methods of Treatment in Enlarged Basalcellpapillomas After a careful check-up of indication and consideration of different therapeutic methods, the use of the carbon dioxide laser proved to be a valuable addition in the spectrum of dermatosurgical therapy in a number of dermatoses and tumors. Significantly shorter procedures of operation and anaesthesia, resulting from the specific features of the carbon dioxide laser, allow a quick remobilisation and an early discharge to the care of the physician, especially in cases of multiple occurring or enlarged tumors.

Cutaneous Disorders Associated With Bone and Joint Changes

A number of dermatoses associated with skeletal changes have been collected and organized for presentation with brief comment. Categories include deep fungous infections, neurodermatoses, congenital dermatoses, new growths and lymphomas. The illustrative material has been chosen to demonstrate the importance of awareness by the physician of the association of cutaneous and skeletal changes.

Occupational Dermatitis of Railroad Workers

Skin diseases are recognized to be the most common of all occupational diseases. Authorities estimate that industrial dermatoses comprise more than 60% of all occupational ills.1In the railroad industry, which employed about 949,000 workers in 1959,2one could expect a substantial number of dermatoses, both occupational and nonoccupational. Statistics of the United States Railroad Retirement Board3indicate that 162 pensions were granted 1956-1960 inclusive because of disability based on all types of diseases of the skin without reference to occupational status. During this period 2 employees of the Baltimore and Ohio Railroad received pensions because of occupational dermatitis. Like other industries, the railroads in recent years have experienced a number of changes. There has been, for example, a considerable trend toward the use of diesel engines; the Baltimore and Ohio Railroad started dieselization in 1935 and completed it in 1957. The dermatoses encountered have been greatly

Eosinophilic response after inunction of hydrocortisone ointment experiments demonstrating lack of significant absorption and of systemic effects.

RECENTLY the local application of hydrocortisone acetate ointment has been reported to have a favorable effect in a number of dermatoses. 1 Because of this the possible percutaneous absorption of hydrocortisone and potential systemic effects were thought worthy of investigation. One of the reasons which had been considered as a hypothetical explanation of the effectiveness of topically applied hydrocortisone in contrast to the ineffectiveness of topically applied cortisone was the possible percutaneous absorption of the former. 2 The previously demonstrated apparent lack of absorption of topically applied cortisone in normal subjects fits in with this theory. 3 It was also theorized that the apparent beneficial effects of hydrocortisone acetate ointment upon skin lesions located beyond and removed from the actual site of application could possibly be explained on the basis of absorption, with mild systemic effects. It is today well established that a reduction in the circulating eosinophile count

STRESS DERMATOSES Suggested Integration of the Allergic-Psychogenic Dermatoses

THE SOLE purpose of this presentation is to suggest a point of view from which one may regard a considerable number of dermatoses, many of which seem quite unrelated to one another, not as separate disease entities but as different facets of the same fundamental kind of disturbance of the normal state. By this it is not meant that the disorders so regarded are all the same disease. They are still different diseases, with different manifestations, different treatments, and different prognoses. But curious similarities may be observed among them: One disease may have the same apparent cause as another; in many of them the cause is obscure, and in many it is believed to be either allergy or emotional tension, or both; transition from one disease to another may occur in some cases; transition from one cause to another may occur in some of the diseases; two or more diseases

Dermatoses which may have an allergic etiologic basis.

This presentation is designed not to embody new ideas in cutaneous allergy but rather to give a brief clinical characterization of some of the dermatologic entities that experience has shown not infrequently arise as a result of altered reactivity. To decide whether or not a dermatosis may have an allergic basis, the first step is to make a dermatologic diagnosis if possible, and it is hoped that this presentation may be of help to the nondermatologist in this connection. The diagnosis will indicate whether allergy is a relatively certain, a possible or an unlikely etiologic factor, or need not be considered. It will also suggest the most probable form of allergy, if any, and the type of investigation required from this point of view. In 1940 Sulzberger 1 listed a number of dermatoses, grouped as to likelihood of allergic causation as follows: Group 1.— In many instances proved to be

ORAL BISMUTH THERAPY IN DERMATOLOGY

DURING the past twenty-five years bismuth has been employed extensively in the treatment of disease. It has proved an effective agent not only in syphilotherapy but also as an empiric remedy in a number of varied dermatoses, in the majority of which the etiologic basis has not been clearly established. Until recently, salts of bismuth have been administered by intramuscular injection and the results of oral administration of the drug have been disappointing, not because of a poor therapeutic response but because of gastrointestinal intolerance. Sodium bismuth triglycollamate (bistrimate®),1one of the newer bismuth salts available for oral administration, gives promise of being therapeutically effective without producing a high percentage of severe reactions. Gross and Wright2have reported satisfactory results from the use of this agent in the treatment of syphilis and a number of dermatoses known to be responsive to bismuth therapy. Sawicky3has