Dermatitis Exfoliative Publications (2840)


Dermatitis Exfoliative Publications

Skinmed 2016 1;14(6):469-471. Epub 2016 Dec 1.
Singapore General Hospital, Singapore.

A 62-year-old woman presented with a 2-year history of extensive, pruritic dermatosis over her face, trunk, and limbs. She was initially treated for psoriasis with methotrexate 5 mg twice weekly and topical clobetasol cream; however, her condition worsened, and she was admitted for generalized exfoliative dermatitis. Examination showed generalized erythema and scaling affecting her face (Figure 1A), chest (Figure 1B), back, and limbs. Read More

There were also cervical, axillary, and inguinal lymphadenopathy. Laboratory studies revealed a high white blood cell count of 125×10(9)/L (reference range: 4-10×10(9)/L), hemoglobin level of 11.9 g/dL (reference range: 12-16 g/dL), and normal platelet level of 396×10(9)/L (reference range: 140-440×10(9)/L). Results from direct Coombs test were negative and lactate dehydrogenase levels were normal.

J. Cutan. Pathol.
J Cutan Pathol 2016 Dec 21. Epub 2016 Dec 21.
Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida.

Nivolumab is a programmed cell death receptor-1 (PD-1) antibody used in the treatment of metastatic or unresectable melanoma. Cutaneous reactions are the most common adverse events reported with these agents and are rarely severe or life-threatening. Here we present a case report describing the clinicopathological findings of a patient with a fatal toxic epidermal necrolysis (TEN) eruption associated with use of nivolumab for treatment of metastatic melanoma. Read More

The patient developed a pruritic, morbiliform eruption, which slowly progressed over 3 months to a tender, exfoliative dermatosis. Histology initially showed interface dermatitis and subsequently revealed full thickness epidermal necrosis. The diagnosis of TEN was made. From initial biopsy to TEN presentation, there was an increase in the number of CD8+ lymphocytes within the dermal-epidermal junction and an increase of programmed death ligand 1 (PD-L1) expression in both lymphocytes and keratinocytes. Despite treatment with infliximab, high-dose steroids and intravenous immunoglobulin, the patient expired. Herein we describe what we believe is the second case of TEN associated with anti-PD1 therapy reported in the literature. Increased expression of PD-L1 by immunohistochemistry was observed as the eruption progressed to TEN. Early diagnosis and treatment is necessary in these fatal TEN reactions secondary to the anti-PD-1 antibody therapies.

Dermatol Reports
Dermatol Reports 2016 Jun 19;8(1):6599. Epub 2016 Sep 19.
Department of Medicine, Loma Linda University School of Medicine; Department of Medicine, VA Loma Linda Healthcare System, Loma Linda, CA, USA.
Turkiye Parazitol Derg
Turkiye Parazitol Derg 2016 Sep;40(3):117-120
Clinic of PetZone, Nicosia, Northern Cyprus.
Ann Dermatol
Ann Dermatol 2016 Dec 23;28(6):765-768. Epub 2016 Nov 23.
Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.

Eccrine syringofibroadenoma (ESFA) is a rare benign cutaneous adnexal lesion characterized by a hyperplastic epithelium and eccrine ductal differentiation. In the present case, a 73-year-old Korean male presented with symmetrical numerous widespread, pinkish nodules with a cobblestone appearance over both legs for 2 years. He had a history of generalized erythematous scaly patches over his entire body for 20 years. Read More

On histopathologic findings, diagnosis of ESFA was confirmed. Our unusual and interesting case emphasizes the first report described one case in which multiple cobblestone like ESFAs arising from long-standing exfoliative dermatitis.

Mycopathologia 2016 Nov 16. Epub 2016 Nov 16.
UP Interactions Cellules Environnement, VetAgro Sup, Univ Lyon, 69280, Marcy l'Etoile, France.

Dermatophytoses in animals are fungal diseases of the skin caused by dermatophyte fungi of the genus Microsporum or Trichophyton. Because the infection is generally follicular, the most common clinical sign is one or many circular areas of alopecia with variable erythema, scaling and crusting, and the primary differential diagnoses are follicular infections, such as bacterial folliculitis and demodicosis. Although dermatophyte folliculitis or ringworm is the most commonly observed lesion of dermatophytoses in animals, other presentations may be observed according to the host species and the dermatophyte involved: dermatophyte folliculitis or ringworm, scaling and crusting in dermatophytosis due to Microsporum persicolor, nodule in case of kerion or mycetoma, matted hairs, seborrheic dermatosis or miliary dermatitis in cats, generalized exfoliative dermatoses in dogs, cats and horses, superficial non-follicular pustules, papules and macules in the Devon Rex cat, pruritic dermatophytoses in dogs, cats and horses, and onychomycosis in dogs, cats and horses. Read More

Since manifestations of dermatophytosis are highly variable, particularly in the cat, dermatophytosis should be considered in case of any annular, papular, nodular or pustular dermatoses, alopecic or not, sometimes pruritic, and nodular dermatoses as well.

Ann. Allergy Asthma Immunol.
Ann Allergy Asthma Immunol 2016 Nov 24;117(5):514-519. Epub 2016 Oct 24.
King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

Imatinib is a tyrosine kinase inhibitor indicated for the treatment of gastrointestinal stromal tumors (GISTs) and certain neoplastic diseases; however, nonimmediate adverse reactions are common.
To describe the process of imatinib slow desensitization in patients who experienced nonimmediate reactions to imatinib and the dynamic change in drug-specific CD4(+)CD25(+)CD134(+) T-lymphocyte percentages.
Five patients diagnosed as having GISTs and with a recent history of imatinib-induced nonimmediate reactions (maculopapular exanthema with eosinophilia, exfoliative dermatitis, palmar-plantar erythrodysesthesia, and drug rash with eosinophilia and systemic symptoms) were desensitized using a slow desensitization protocol. Read More

The reintroduced imatinib dosage was stepped up every week starting from 10 mg/d and increasing to 25, 50, 75, 100, 150, 200, and 300 mg/d until the target dose of 400 mg/d was achieved. Prednisolone of up to 30 mg/d was allowed if allergic reactions recurred. The percentages of CD4(+)CD25(+)CD134(+) T cells present after incubating peripheral blood mononuclear cells with imatinib, at baseline and after successful desensitization, were analyzed using flow cytometric analysis.
By using a slow desensitization technique, all patients were able to receive 400 mg/d of imatinib, and prednisolone was gradually tapered off. The percentages of imatinib-induced CD4(+)CD25(+)CD134(+) T cells decreased from a mean (SD) of 11.3% (6.5%) and 13.4% (7.3%) at baseline to 3.2% (0.7%) and 3.0% (1.1%) after successful desensitization, when stimulating peripheral blood mononuclear cells with 1 and 2 μM of imatinib, respectively.
Slow desensitization is a helpful procedure in treating patients with imatinib-induced nonimmediate reactions other than simple maculopapular exanthema. The reduced percentages of imatinib-induced CD4(+)CD25(+)CD134(+) T cells in these patients may be associated with immune tolerance.

J Pharmacol Pharmacother
J Pharmacol Pharmacother 2016 Jul-Sep;7(3):142-5
Department of Dermatology, Silchar Medical College, Silchar, Assam, India.

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a type of severe adverse cutaneous drug reaction characterized by fever, skin eruption, hematological abnormalities, and internal organ involvement. Although anticonvulsant drugs are mainly implicated in DRESS, newer anticonvulsants such as oxcarbazepine-induced definite cases of DRESS syndrome are rare and oxcarbazepine-induced DRESS syndrome presenting as exfoliative dermatitis is even rarer. We report a case of a 35-year-old male who developed DRESS syndrome presenting as exfoliative dermatitis after taking oxcarbazepine for 3 weeks. Read More

Dermatitis 2016 Sep-Oct;27(5):248-58
From the *Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; †Allergy Center and Department of Dermatology, University Hospital, Republic University of Uruguay, Montevideo; ‡Department of Dermatology and Allergy Center, Center for Innovative Medical Technology, Institute of Clinical Research, University of Southern Denmark, Odense; §Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden; ∥Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Germany; ¶Department of Dermatology, University Hospital Jena, Germany; #Department of Dermatology, National Skin Centre, Singapore; **Contact Allergy Unit, Department of Dermatology, University Hospital KU Leuven, Belgium; ††MGM Medical College, Kamothe, Mumbai, India; ‡‡Department of Dermatology, Catholic University of Louvain, Brussels, Belgium; §§Department of Dermatology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul; ∥∥Department of Dermatology, UCSF School of Medicine, San Francisco, CA; ¶¶Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; ##Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation, Melbourne, Victoria, Australia; ***Institute of Dermatology, Bangkok, Thailand; †††Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal General Hospital, Quebec, Canada; ‡‡‡Dermatologic Department, Division of Medicine, Phramongkutklao Hospital, Bangkok, Thailand; and §§§Department of Cutaneous Allergy, St. John's Institute of Dermatology, King's College, Guy's Hospital, London, United Kingdom.

The International Contact Dermatitis Research Group proposes a classification for the clinical presentation of contact allergy. The classification is based primarily on the mode of clinical presentation. The categories are direct exposure/contact dermatitis, mimicking or exacerbation of preexisting eczema, multifactorial dermatitis including allergic contact dermatitis, by proxy, mimicking angioedema, airborne contact dermatitis, photo-induced contact dermatitis, systemic contact dermatitis, noneczematous contact dermatitis, contact urticaria, protein contact dermatitis, respiratory/mucosal symptoms, oral contact dermatitis, erythroderma/exfoliative dermatitis, minor forms of presentation, and extracutaneous manifestations. Read More