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Case Reports in Dermatology

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https://www.readbyqxmd.com/read/28690519/delayed-diagnosis-of-basal-cell-carcinoma-of-the-upper-lip-the-possible-role-of-incidental-multinucleated-foreign-body-giant-cells
#1
Joshua P Hays, C Helen Malone, Will E Tausend, Brandon P Goodwin, Richard F Wagner
Herpes simplex and basal cell carcinoma (BCC) can have similar clinical presentations due to overlapping lesional morphology. We describe the unusual case of a BCC masquerading as herpes labialis due to a possible false-positive Tzanck smear. The confounding diagnosis led to a failed trial of valacyclovir and subsequent loss of the patient for 1 year before the lesion was biopsied and diagnosed as a BCC. This case report highlights the importance of careful inspection of herpetic lesions and that further investigation should be pursued if the etiology is uncertain or if the treatment is not yielding the expected results...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28690518/trichoscopic-findings-of-erosive-pustular-dermatosis-of-the-scalp-associated-with-gefitinib
#2
Tomohisa Fukui, Hideo Kitamura, Ken Harada, Hajime Nakano, Daisuke Sawamura
Alopecia associated with epidermal growth factor receptor (EGFR) inhibitor therapy is a rare cutaneous side effect with the potential to progress to scarring alopecia. Thus, dermatologists should make an early diagnosis. We present the case of a 57-year-old Japanese female with scarring alopecia associated with gefitinib, which is an EGFR inhibitor, including trichoscopic findings. The patient treated with gefitinib for non-small cell lung cancer experienced skin rash and hair loss of the scalp. The scalp lesions appeared similar to erosive pustular dermatosis of the scalp...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28690517/erythema-gyratum-repens-like-purpura-in-a-patient-with-sj%C3%A3-gren-syndrome
#3
Miyuki Fukunaga, Kazutoshi Harada, Kenichiro Mae, Kanae Wakamatsu, Noriko Kiriyama, Ryoji Tsuboi, Yukari Okubo
The etiology of purpura in Sjögren syndrome (SS) includes cryoglobulinemia, hypergammaglobulinemia, and leukocytoclastic vasculitis (LCV). The clinical symptoms of LCV associated with SS comprise palpable or nonpalpable purpura and urticarial vasculitis. Here, we report a case of LCV presenting as erythema gyratum repens (EGR)-like purpura in a 62-year-old woman with rheumatoid arthritis and SS. EGR-like skin lesions, characterized by annular lesions with expanding concentric pattern and coalescing to form a zebra-like pattern or grain of wood pattern, can appear in various autoimmune conditions; however, EGR-like eruption in SS is extremely rare...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28690516/eruptive-seborrheic-keratoses-restricted-to-plaque-patch-stage-mycosis-fungoides
#4
Eve Lebas, Pascale Quatresooz, Jorge E Arrese, Arjen F Nikkels
Eruptive seborrheic keratoses (ESK) are rare in dermatology. They are usually inflammatory in nature and may be encountered as Leser-Trélat sign. ESK may also be simultaneously observed with hepatic angiomas, chemotherapy, segmental neurofibromatosis, HIV or erythrodermic pityriasis rubra pilaris, psoriasis, and drug eruption. ESK may be transient and self-healing. Others recede after successful treatment of the underlying disease. In some instances, seborrheic keratoses may follow an isotopic response and remain strictly restricted to sites of previous eczema, photo-exposition or tattoos...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28690515/a-case-of-facial-partial-unilateral-lentiginosis-treated-with-low-fluence-1-064-nm-q-switched-neodymium-doped-yttrium-aluminum-garnet-laser
#5
En Hyung Kim
Partial unilateral lentiginosis (PUL) is an unusual pigmentary disorder characterized by numerous lentigines grouped within an area of normal skin. Although treatment is not necessary, many patients with facial PUL seek medical help for cosmetic reasons. There is no established standard treatment for PUL. Conventional lasers may cause postinflammatory hyperpigmentation because keratinocytes are injured during the process. Also, scarring, long downtime, and pain are important issues. A 19-year-old patient with facial PUL was successfully treated with low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611632/infliximab-induced-aseptic-meningitis-during-the-treatment-of-psoriatic-arthritis
#6
Yuki Matsuura-Otsuki, Takaaki Hanafusa, Hiroo Yokozeki, Kyoko Watanabe
A 42-year-old Japanese man presented with persistent headache during treatment for psoriatic arthritis (PsA) with infliximab. Treatment with infliximab was initiated 3 years before and the psoriatic skin lesions with arthritis were well controlled. However, after 21 doses of infliximab, the skin lesions and joint pain exacerbated and became intractable. Ten days after the dosage of infliximab was increased, the patient experienced headache and nausea with high fever. He had scaly, well-circumscribed erythemas on his trunk, extremities, and deformed nails...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611631/successful-treatment-of-chronic-staphylococcus-aureus-related-dermatoses-with-the-topical-endolysin-staphefekt-sa-100-a-report-of-3-cases
#7
Joan E E Totté, Martijn B van Doorn, Suzanne G M A Pasmans
Staphylococcus aureus plays an important role in skin and soft tissue infections and contributes to the pathophysiology of complex skin disorders such as atopic dermatitis. Bacterial resistance against commonly used antibiotics has increased considerably in the last decades demanding alternative treatment approaches. We present 3 cases where patients with chronic and recurrent S. aureus-related dermatoses were successfully treated with Staphefekt SA.100. Staphefekt SA.100 is a recombinant phage endolysin for topical skin application that specifically targets both methicillin-sensitive and methicillin-resistant S...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611630/sweet-s-syndrome-successfully-treated-with-granulocyte-and-monocyte-adsorption-apheresis
#8
Asami Fujii, Yoko Mizutani, Yuki Hattori, Tomoko Takahashi, Hidenori Ohnishi, Shozo Yoshida, Mariko Seishima
Sweet's syndrome is a neutrophilic dermatosis characterized by an abrupt onset of painful erythematous lesions showing neutrophilic infiltrates in the dermis. Fever and an elevated neutrophil level are generally observed. Sweet's syndrome may be idiopathic, malignancy-associated, or drug-induced (mainly involving granulocyte colony-stimulating factor (G-CSF) administration). Although systemic corticosteroids are usually effective, the symptoms of Sweet's syndrome recur in some refractory cases. Herein, we report a case of a 55-year-old Japanese woman with recurrent symptoms of fever (>39°C) and painful erythematous lesions on her four extremities, trunk, and neck...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611629/cutaneous-corynebacterium-infection-presenting-with-disseminated-skin-nodules-and-ulceration
#9
Antonios G A Kolios, Antonio Cozzio, Annelies S Zinkernagel, Lars E French, Thomas M Kündig
In the context of the European migrant crisis, more and more cases of cutaneous diphtheria are seen. A typical presentation includes painful cutaneous ulcerations with grayish-whitish pseudomembranes. Here we present 2 male Eritrean patients suffering from cutaneous nontoxigenic Corynebacterium diphtheriae (patient 1) and Corynebacterium striatum (patient 2) infection.
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611628/overlapping-dress-and-stevens-johnson-syndrome-case-report-and-review-of-the-literature
#10
Aneline Casagranda, Mariano Suppa, Florence Dehavay, Véronique Del Marmol
Drug-induced severe cutaneous adverse reactions (SCARs) include acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms (DRESS), and epidermal necrolysis (Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis). The identification of the causal drug is crucial in order to avoid further exposure, but making the right differential diagnosis of the type of SCAR is equally important since treatment, follow-up, and prognosis of different SCARs are not the same. These syndromes are distinct entities with different clinical, biological, and histological patterns, but sometimes the early distinction between 2 SCARs can be extremely challenging, and overlapping conditions could therefore be taken into consideration, although true overlapping SCARs are very rare when using strict diagnostic criteria (described by the RegiSCAR group)...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611627/panniculitis-associated-with-mek-inhibitor-therapy-an-uncommon-adverse-effect
#11
Miruna Negulescu, Florian Deilhes, Vincent Sibaud, Emilie Tournier, Laurence Lamant, Serge Boulinguez, Nicolas Meyer
The combination of MEK inhibitor (cobimetinib, trametinib) and BRAF inhibitor (vemurafenib, dabrafenib) is now the first-line treatment in patients with BRAF V600-mutated metastatic melanoma. This association reduces cutaneous adverse events induced by BRAF inhibitors alone, including photosensitivity, hand-foot syndrome, hyperkeratosis, alopecia, skin papillomas, keratoacanthomas, and squamous-cell carcinomas. While panniculitis has exceptionally been reported with BRAF inhibitors, this rare side effect has never been described with the use of MEK inhibitors...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611626/angioimmunoblastic-t-cell-lymphoma-mimicking-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome
#12
Joanna Mangana, Emmanuella Guenova, Katrin Kerl, Mirjana Urosevic-Maiwald, Valerie C Amann, Cornelia Bayard, Reinhard Dummer, Lars E French
Angioimmunoblastic T-cell lymphoma (AITCL) is a rare, aggressive lymphoma which derives from follicular helper T cells, commonly affecting the elderly population. It accounts for 2% of all non-Hodgkin lymphomas, with a reported 5-year overall survival rate of less than 30%. Very often, the clinical picture of AITCL encompasses systemic symptoms such as generalized lymphadenopathy, hepatosplenomegaly, skin rash, anemia, and polyclonal hypergammaglobulinemia. Here we report on the case of a female patient who presented with clinical features resembling drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) prior to the definitive diagnosis of AITCL...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611625/necrolytic-acral-erythema-in-seronegative-hepatitis-c
#13
Ploychompoo Srisuwanwattana, Vasanop Vachiramon
Necrolytic acral erythema (NAE) is a distinctive skin disorder. The exact cause and pathogenesis is still unclear. Most studies report an association of NAE with hepatitis C virus (HCV) infection. We report a 64-year-old woman who presented with chronic mildly pruritic brownish to erythematous rashes on both lateral malleoli for 7 months. The clinical and histopathological findings were compatible with NAE. However, the serologic marker for HCV was negative.
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611624/flare-up-of-rheumatoid-arthritis-by-anti-ctla-4-antibody-but-not-by-anti-pd1-therapy-in-a-patient-with-metastatic-melanoma
#14
Nicoletta F Jaberg-Bentele, Michael Kunz, Shatha Abuhammad, Reinhard Dummer
A 47-year-old female patient with rheumatoid arthritis (RA) treated with methotrexate, was diagnosed with metastatic melanoma. After surgical removal of the tumor, the patient started treatment with ipilimumab while methotrexate was stopped. One week after initiation of ipilimumab, the patient developed typical symptoms of RA. Analgetic therapy was started. After 4 cycles of ipilimumab, melanoma progression was radiologically evident. The treatment plan was changed to pembrolizumab (anti-PD1 antibody), and the patient did not show active signs of RA anymore...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611623/visual-loss-induced-by-adalimumab-used-for-plaque-psoriasis
#15
Norman Saffra, Konstantin Astafurov
A 61-year-old Caucasian male with severe plaque psoriasis without joint involvement was initiated on adalimumab therapy. Shortly thereafter he presented to the emergency room with acute loss of vision in the right eye. A comprehensive systemic workup was instituted which included magnetic resonance imaging (MRI) with and without gadolinium of the brain and orbits. MRI revealed findings that were consistent with CNS demyelination and retrobulbar optic neuritis. Immediate cessation of adalimumab was instituted without any other systemic therapy...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28611622/psoriatic-alopecia-in-a-patient-with-systemic-lupus-erythematosus
#16
Wimolsiri Iamsumang, Tueboon Sriphojanart, Poonkiat Suchonwanit
Psoriasis is a chronic, recurrent, and relatively common inflammatory dermatologic condition, which demonstrates various clinical manifestations including hair loss. It was once believed that alopecia was not a presentation of scalp psoriasis, but it is now widely accepted that psoriatic alopecia exists. Although the majority of patients get hair regrowth, it can potentially lead to permanent hair loss. Herein, we report a case of 26-year-old female patient with systemic lupus erythematosus who presented with scalp hair loss and nonpruritic scaly plaques on the scalp...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28559815/pruritic-urticarial-papules-and-plaques-of-pregnancy-occurring-postpartum-treated-with-intramuscular-injection-of-autologous-whole-blood
#17
En Hyung Kim
Pruritic urticarial papules and plaques of pregnancy (PUPPP) is one of the most common diseases associated with pregnancy. In most cases, the skin lesions develop in the third trimester of primigravidas. There are no systemic alterations seen in PUPPP; however, most patients report severe pruritus. A 34-year-old woman presented 1 week postpartum with typical clinical features of PUPPP. The patient showed good response to intramuscular injection of autologous whole blood with no adverse effects to the patient or her baby...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28559814/the-rare-case-of-pemphigus-vegetans-in-association-with-malnutrition-children-in-the-multidisciplinary-management
#18
Oki Suwarsa, Endang Sutedja, Hartati Purbo Dharmadji, Pramita Kusuma, July Rahardja, Reti Hindritiani, Hendra Gunawan
Pemphigus vegetans is a clinical variant of pemphigus vulgaris, accounting for 1-2% of all very rare pemphigus cases in children. The involvement of the oral mucosa in this disease is usually accompanied by severe pain that aggravates the patient's malnourished condition. Conversely, malnutrition may also reduce vulnerability towards autoimmune diseases. Although pemphigus vegetans has never been reported to develop in a child with marasmus before, we encountered a case of pemphigus vegetans in a severely malnourished patient...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28559813/interruption-of-sneddon-wilkinson-subcorneal-pustulation-with-infliximab
#19
REVIEW
Lorenz Kretschmer, Julia-Tatjana Maul, Thomas Hofer, Alexander A Navarini
Subcorneal pustular dermatosis (SCPD, Sneddon-Wilkinson disease) is a rare chronic-relapsing skin disorder that typically manifests as flaccid sterile pustules without systemic symptoms. Although the accumulation of neutrophils is acknowledged to be a hallmark of SCPD, its exact pathomechanism is still not known. Several chemotactic factors have been implicated in neutrophil recruitment and invasion, including the proinflammatory cytokine TNF-α. These findings correspond well with clinical reports of successful off-label use of TNF blocking agents in cases that were refractory to first-line therapy, mostly with dapsone...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28559812/rapid-involution-of-pustules-during-topical-steroid-treatment-of-acute-generalized-exanthematous-pustulosis
#20
Christiane Kley, Carla Murer, Julia-Tatjana Maul, Barbara Meier, Florian Anzengruber, Alexander A Navarini
Acute generalized exanthematous pustulosis (AGEP) is a dramatic generalized pustular rash of severe onset, which is considered a serious cutaneous adverse reaction to drugs. However, even though the clinical features are impressive and are often accompanied by systemic inflammation, it can be controlled quickly and safely by topical steroids subsequent to interruption of the offending drug. Here, we describe the management of a case and the evolution of the pustular rash. An elderly woman consulted with a generalized crop of 2-3 mm, nonfollicular pustules on erythematous background...
January 2017: Case Reports in Dermatology
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