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Dermatology Online Journal

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https://www.readbyqxmd.com/read/29447653/rituximab-and-intravenous-immunoglobulin-as-alternatives-to-long-term-systemic-corticosteroids-in-the-treatment-of-pemphigus-a-single-center-case-series-of-63-patients
#1
Ashley E Brown, Kiran Motaparthi, Sylvia Hsu
Rituximab and intravenous immunoglobulin [IVIg] have recently emerged as effective treatments for pemphigus refractory to corticosteroids [CS]. This case series sought to compare the clinical, serologic,and adverse effects of CS, IVIg, and rituximab in patients with pemphigus. A retrospective review of 63 patients with pemphigus vulgaris (PV), pemphigus foliaceus (PF), or paraneoplastic pemphigus (PNP)was performed. Clinical remission (CR), serologic remission (SR), and adverse effects were evaluated. Three study groups were compared: patients treated with systemic CS, refractory patients treated withIVIg, and refractory patients treated with rituximab...
January 19, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447659/paraneoplastic-pemphigus-in-a-34-year-old
#2
Laura E Melnick, Jenna M Beasley, Randi Kim, Nooshin Brinster, Kristen Lo Sicco
Paraneoplastic Pemphigus (PNP) is a rare and often fatal autoimmune mucocutaneous blistering disease associated with an underlying malignancy. It is thought to be caused by antibodies to tumor antigenscross-reacting with epithelial antigens, specifically desmosomal and hemidesmosomal antigens. There are at least five clinical morphologic variants of PNP, with the earliest and most consistent finding beingsevere stomatitis. Diagnosis of PNP requires direct immunofluorescence of perilesional skin and indirect immunofluorescence...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447658/primary-anetoderma-with-undifferentiated-connective-tissue-disease
#3
Lana X Tong, Jenna Beasley, Shane Meehan, Evan Rieder, Miriam Pomeranz, Kristen Lo Sicco, Alisa Femia, Randie Kim, Andrew G Franks
Anetoderma is a rare benign elastolytic disorder that is characterized by focal loss of elastin fibers on histopathology and is often recalcitrant to treatment. We present a case of a patient with a 20-year history of pruritic and painful hyperpigmented atrophic papules clustered on the neck, axillae, inframammary folds, and right medial thigh. Although the histopathologyof her axillary lesions was consistent with anetoderma, her clinical presentation is unusual given the extent of involvement, reported pain and pruritus, and sharp demarcation of the distribution...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447657/generalized-hyperhidrosis-secondary-to-presumed-eccrine-gland-dysfunction-with-possible-apocrine-metaplasia
#4
Kumar Sukhdeo, Jenna Beasley, Alisa Femia, Randie Kim
We present a 57 year-old man presented with generalized hyperhidrosis and widespread, smooth, flesh colored papules on the torso and extremities.Histological examination from multiple biopsies demonstrated morphologic alteration of the eccrine glands with an apocrine phenotype, suggesting eitherapocrine metaplasia or the presence of "apoeccrine glands." The morphologic similarities between eccrine, apocrine, and apoeccrine as they relate to ourpatient's histologic findings are discussed. We consider secondary causes of generalized hyperhidrosis, which may also play a role in this patient's presentation...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447656/local-heat-urticaria
#5
Forrest White, Gabriela Cobos, Nicholas A Soter
We present a 38-year-old woman with local heat urticaria confirmed by heat provocation testing. Heat urticaria is a rare form of physical urticaria that istriggered by exposure to a heat source, such as hot water or sunlight. Although it is commonly localized and immediate, generalized and delayed onset forms exist. Treatment options include antihistamines and heat desensitization. A brisk, mechanical stroke elicited a linear wheal. Five minutes after exposure to hot water, she developed well-demarcated,erythematous blanching wheals that covered the distal forearm and entire hand...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447655/epidermolysis-bullosa-acquisita
#6
Gabriela Cobos, Euphemia Mu, Jeffrey Cohen, Jenna Beasley, Nooshin Brinster, Alisa Femia
Epidermolysis bullosa acquisita (EBA) is a rare, acquired subepidermal blistering disease. EBA is characterized by autoantibodies to collagen VII,which serves to link the epidermis to the dermis. The two most common presentations of EBA are classical noninflammatory EBA and bullous pemphigoid-like EBA. Diagnosis of EBA can be challenging as it sharesclinical and histopathologic features with other blistering diseases. Treatment is often recalcitrant and will often necessitate multiple therapies. We presenta case of a thirty-six-year-old Chinese man with EBA and review the literature...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447654/papular-mucinosis-or-localized-lichen-myxedematosis-lm-discrete-papular-type
#7
Mitalee P Christman, Kumar Sukhdeo, Randie H Kim, Shane Meehan, Evan Rieder, Kristen Lo Sicco, Andrew Franks
Lichen myxedematosus is condition characterized by localized areas of dermal deposition of mucin, presenting with firm papules localized to few areas of the body. The condition needs to be excluded from scleromyxedema, which, in addition to the firm papular eruption, has areas of induration and is usually associated with a monoclonal gammopathyand systemic symptoms. We present a 62-year-old woman with a several-year history of asymptomatic, firm papules over the face and arms with no evidence of thyroid disease or a monoclonal gammopathy,which is consistent with a diagnosis of localized lichen myxedematosus, the discrete papular variant...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447652/pyoderma-gangrenosum-acne-and-suppurative-hidradenitis-syndrome-in-end-stage-renal-disease-successfully-treated-with-adalimumab
#8
J De Wet, H F Jordaan, S M Kannenberg, B Tod, B Glanzmann, W I Visser
PASH syndrome (pyoderma gangrenosum, acne, and suppurative hidradenitis) forms part of the spectrum of autoinflammatory diseases. We report an unusual case of PASH syndrome in a patient with end-stagerenal disease (ESRD) who was successfully treated with the tumor necrosis factor inhibitor, adalimumab. The case underscores the challenges associatedwith the treatment of PASH syndrome as well as the ongoing search to establish a genetic basis for the syndrome. Renal impairment has been reported in association with pyoderma gangrenosum but has notbeen described in PASH syndrome...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447651/elective-time-during-dermatology-residency-a-survey-of-residents-and-program-directors
#9
Pushpinder Uppal, Rohini Shantharam, Tara Lynn Kaufmann
Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447650/characteristics-of-research-tracks-in-dermatology-residency-programs-a-national-survey
#10
Saisindhu Narala, Tiffany Loh, Kanade Shinkai, Taraneh Paravar
Pursuing research is encouraged in dermatology residency programs. Some programs offer specific research or investigative tracks. Currently, there is little data on the structure or scope of research tracks in dermatology residency programs. An anonymous online survey was distributed to the Association of Professors of Dermatology listserve in 2016. Program directors of dermatology residency programs in the United States were asked to participate and 38 of the 95 program directors responded. The survey results confirmed that a 2+2 research track, which is two years of clinical training followed by two years of research, was the most common investigator trackmodel and may promote an academic career at the resident's home institution...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447649/a-national-cross-sectional-analysis-of-dermatology-away-rotations-using-the-visiting-student-application-service-database
#11
Severine Z Cao, Vinod E Nambudiri
The highly competitive nature of the dermatology match requires applicants to undertake a variety of measures in the hopes of securing a residency position. Among the opportunities available to applicants is the chance to participate in away or "audition" rotations during their final year of undergraduate medical education. Away rotations are now performed by a majority of medical students applying into dermatology, but littleresearch has been done to describe the nature of this opportunity for interested applicants...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447648/dermatology-medical-education-a-multicenter-survey-study-of-the-undergraduate-perspective-of-the-dermatology-clinical-clerkship
#12
Parastoo Davari, Jillian W Millsop, Mary Ann N Johnson, Stefani R Takahashi, David H Peng, Joanna Badger, Brooks A Bahr, Kanade Shinkai, Chin-Shang Li, Nasim Fazel
BACKGROUND/AIMS: Limited data are available regarding the undergraduate dermatology clinical clerkship curriculum in the United States. Our primaryaim is to assess medical students' perspectives of the dermatology clinical clerkship. METHODS: A multicenter survey study was conducted, which included four California dermatology academic programs. A 17-item questionnaire was designed to investigate medical student perception with regard tothe overall educational value of the various teaching aspects of the dermatology clinical clerkship...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447647/association-of-pemphigus-and-systemic-corticosteroid-use-with-comorbid-health-disorders-a-case-control-study
#13
Derek Y Hsu, Joaquin Brieva, Beatrice Nardone, Dennis West, Jonathan I Silverberg
BACKGROUND: Pemphigus is a group of debilitating autoimmune blistering disorders associated with painful blisters of the skin and/or mucous membranes. Identification and management of the comorbiditiesof pemphigus is critically important to minimize morbidity and decrease mortality. OBJECTIVE: To identify the comorbid health conditions of pemphigus vulgaris. METHODS: This was a case-control study of 130 cases of pemphigus verified by a clinical and laboratory diagnosis and 390 age and sex-matched controls with complete follow-up at a large metropolitanquaternary care medical center...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447646/lichen-amyloidosis-of-the-scalp-and-forehead
#14
Yesul Kim, Michael D Ioffreda, Catherine G Chung
Lichen amyloidosis is a subtype of primary localized cutaneous amyloidosis (PLCA), which presents as discrete, firm, closely-set 1-3mm, dome-shapedbrown papules commonly involving the anterior aspect of shins and extensor surfaces of forearms. We present a case of an otherwise healthy man in his 30s with solitary facial involvement of lichen amyloidosis, which is very uncommon.
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447645/vulvar-metastatic-crohn-disease-clinical-histopathological-and-ultrasonographic-findings
#15
María Pousa-Martínez, Fernando Alfageme, María Antonia González de Domingo, Dolores Suárez-Masa, Marta Calvo, Gastón Roustán
Metastatic Crohn disease (MCD) is an unusual type of cutaneous Crohn disease characterized by skin lesions separated from the lesions of the gastrointestinal tract. The diagnosis of MCD is essentially histological,showing noncaseating granulomas in the dermis and subcutaneous fat tissue. We report a case of MCD with vulvar involvement and clinical, histopathological, and ultrasonographic findings of this disease.
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447644/cutaneous-metastasis-to-the-scalp-as-the-primary-presentation-of-colorectal-adenocarcinoma
#16
Sarita R Shah, Danielle S Applebaum, Silvia Potenziani, Yve T Huttenbach, John Wolf, Ida F Orengo
Eruptaneous metastasis is an uncommon presentation of colorectal adenocarcinoma that can occur years after diagnosis of the primary cancer or manifest as the first sign of malignancy. It is essential to diagnose these metastases immediately, as this late-stage development carries a poor prognosis. The scalp is one of the less common sites for skin metastases and nodules may be mistaken for benign entities. In this case report, we report on the case of a 61-year-old woman with CREST syndrome who presented with a cutaneous metastasis to the scalp as the first sign ofcolorectal adenocarcinoma...
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447643/a-case-of-leukocytoclastic-vasculitis-caused-by-novel-anticoagulant-rivaroxaban
#17
Riley Dean, Alison M Messer, Melanie Pickett, Richard Jahan-Tigh
Cutaneous leukocytoclastic vasculitis (LCV) is type of small vessel vasculitis that commonly presents as palpable purpura involving the lower extremities and buttocks. Approximately half of cases are idiopathic, but the disease may be triggered by infection, drug reaction, inflammatory disease, or other causes. We report a case of leukocytoclastic vasculitis secondary to the novel anticoagulant rivaroxaban (Xarelto®).
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447642/is-it-just-a-psoriasiform-dermatitis
#18
Olalla Figueroa-Silva, Martina Espasandín-Arias, Francisco Javier García-Martínez, Virginia Fernández-Redondo, Jaime Toribio
Bazex syndrome (BS) is a rare paraneoplastic syndrome most frequently associated with squamous cell carcinomas of the upper aerodigestive tractand other tumours. Characteristically, cutaneous lesions precede the diagnosis of malignancy. We report a 72-year-old patient with 1-year history of acral dermatitis. The diagnosis of BS was based on the presence of psoriasiform acral dermatitis and the evidence of two simultaneous tumors (prostate adenocarcinoma and undifferentiated carcinoma ofthe submandibular gland)...
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447641/flame-figures-in-linear-iga-bullous-dermatosis-a-novel-histopathologic-finding
#19
E Fulton, F Jan, M J Zimarowski
BACKGROUND: Linear IgA bullous dermatosis (LABD) is an autoimmune subepidermal blistering disease usually with a neutrophil rich inflammatory infiltrate, and characterized by linear IgA deposition at the basement membrane zone (BMZ), and neutrophil predominant dermal inflammation. We report a case of LABD with numerous eosinophils and flame figure formation, a unique histopathologic finding not previously reported. A 69-year-old woman presented with a rapidly progressive, intensely pruritic rash over forearms, breasts, axillae, hips, and thighs...
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29447640/classic-form-of-eosinophilic-pustular-folliculitis-in-an-immunocompetent-girl-rapid-and-complete-resolution-after-low-dose-oral-indomethacin-treatment
#20
Alexandra Monastirli, George Antoniades, Nikiforos Kapranos, Efstathia Pasmatzi, George Badavanis, Dionysios Tsambaos
Eosinophilic pustular folliculitis (EPF) is a rare noninfectious pruritic dermatosis, first described by Ise and Ofuji in 1965. We report the case of a 15-year oldimmunocompetent girl that presented with a widespread papulopustular eruption four days after her arrival in Japan. The clinical diagnosis of the classicform of EPF was confirmed by histological examination of the lesional skin that revealed an intense, mainly eosinophilic, dermal infiltrate within and aroundpilosebaceous units. Oral administration of lowdose indomethacin (25 mg/day) led to a complete resolution of the eruption within 6 weeks without causing any side effects...
November 15, 2017: Dermatology Online Journal
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