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BMJ Case Rep 2021 Jun 8;14(6). Epub 2021 Jun 8.

Department of Dermatology, Mohammed V University of Rabat, Rabat, Morocco.

Hypereosinophilic syndrome (HES) is a rare haematologic disorder characterised by unexplained, persistent eosinophilia with organ involvement. We report the case of a 74-year-old patient who presented with a pemphigoid-like bullous rash as the only manifestation of an HES. This report highlights the importance of the dermatological manifestations of this potentially life-threating condition that may initially present as a skin-limited disease. Read More

Int J Mol Sci 2021 May 12;22(10). Epub 2021 May 12.

Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, 233 S. 10th Street, BLSB 406, Philadelphia, PA 19107, USA.

Recessive Dystrophic Epidermolysis Bullosa (RDEB) is a devastating skin blistering disease caused by mutations in the gene encoding type VII collagen (C7), leading to epidermal fragility, trauma-induced blistering, and long term, hard-to-heal wounds. Fibrosis develops rapidly in RDEB skin and contributes to both chronic wounds, which emerge after cycles of repetitive wound and scar formation, and squamous cell carcinoma-the single biggest cause of death in this patient group. The molecular pathways disrupted in a broad spectrum of fibrotic disease are also disrupted in RDEB, and squamous cell carcinomas arising in RDEB are thus far molecularly indistinct from other sub-types of aggressive squamous cell carcinoma (SCC). Read More

Ugeskr Laeger 2021 05;183(21)

Bullous skin diseases are characterised by a large group of diseases, where the essential clinical feature is fluid-filled skin lesions. Physicians in many different specialities can meet patients with bullous skin diseases, which include a wide range of skin diseases from mild cases to very severe and life-threating diseases. The aim of this review is to provide systematically approach of how make the accurate diagnosis, using important and basic elements of history taking, clinical and paraclinical examination. Read More

Med Clin North Am 2021 Jul;105(4):783-797

Department of Dermatology, University of Alabama at Birmingham, 510 20th Street South, FOT Suite 858, Birmingham, AL 35233, USA. Electronic address:

This evidence-based review highlights cutaneous infections of bacterial, viral, and fungal origin that are frequently encountered by clinicians in all fields of practice. With a focus on treatment options and management, the scope of this article is to serve as a reference for physicians, regardless of field of specialty, as they encounter these pathogens in clinical practice. Read More

Med Clin North Am 2021 Jul;105(4):577-597

Division of Dermatology, Department of Medicine, 3810 Springhurst Boulevard, Suite 200, Louisville, KY 40241, USA.

Severe cutaneous adverse reactions to medications (SCARs) include drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis. They are all non-immunoglobulin E mediated hypersensitivity reaction patterns, distinguished from simple cutaneous drug eruptions by immunologic pathogenesis and internal organ involvement. Herein the clinical features, diagnostic workup, and management considerations are presented for each of these major SCARs. Read More

Pan Afr Med J 2021 4;38:236. Epub 2021 Mar 4.

Dermatology and Venereology Department, Mohammed V University, Rabat, Morocco.

Toxic epidermal necrolysis-like acute cutaneous lupus erythematosus (TEN-like ACLE) is a rare manifestation of systemic lupus erythematosus (SLE). Because of its rarity, little is known about this entity. In this report, we describe a case of two women previously diagnosed with SLE that presented TEN-like skin lesions. Read More

Zhonghua Yi Xue Za Zhi 2021 Jun;101(20):1458-1462

Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

Since the discovery of Epstein-Barr (EB) virus from the cultured cells in Burkitt lymphoma tissue in African children in 1964, we have gradually taken in its oncogenicity and the link between this virus and multiple mucocutaneous diseases. This review exhibits the process of EB virus infection and summarizes the clinical manifestations and varied prognosis of EB virus-associated skin diseases. The cases of common skin diseases including psoriasis, dermatomyositis, pemphigus, pemphigoid, parapsoriasis, atopic dermatitis, urticaria, systemic lupus erythematosus, scleroderma, panniculitis,erythema multiforme and vasculitis coinciding with EB virus infection were collected for the analysis of their EB virus-associated complications, treatments and outcomes. Read More

BMJ Case Rep 2021 May 21;14(5). Epub 2021 May 21.

Respiratory Medicine, Homerton University Hospital NHS Foundation Trust, London, UK.

We present the case of a 38-year-old man, with congenital bullous emphysema, who presented with unilateral pleuritic chest pain, rigors and a non-productive cough. A chest X-ray on admission demonstrated extensive bilateral bullous lung disease with left-sided lung collapse. There were fluid levels present within several bullae, with the largest bulla compromising most of the posterior aspect of the left lung base. Read More

Clin Exp Dermatol 2021 May 21. Epub 2021 May 21.

Departments of, Department of, Dermatology, Fattouma, Monastir, Tunisia.

Medicine (Baltimore) 2021 May;100(20):e25955

Department of Family and Community Medicine, E-Da Hospital.

Rationale: Mucous membrane pemphigoid (MMP) is a rare, autoimmune bullous disease that affects mucosal surfaces and skin. Early and aggressive treatment initiation may be warranted due to the risks of serious complications. However, it can be challenging to make an initial diagnosis. Read More

J Eur Acad Dermatol Venereol 2021 Jun;35(6):1251-1277

Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.

Introduction: Dermatitis herpetiformis (DH) is a chronic, pruritic, gluten-induced skin disorder characterized by subepidermal granular IgA deposition and a variable degree of enteropathy identical to that seen in coeliac disease. So far, there has been no European consensus about the management of DH.

Methods: The guidelines were created by small subgroups of a guideline committee consisting of 26 specialists from various medical fields and one patients' representative. Read More

Clin Med (Lond) 2021 05;21(3):162-165

St John's Institute of Dermatology, London, UK

Immunobullous diseases are blistering cutaneous disorders that are caused by pathogenic antibodies binding to protein targets within the skin. There are a range of immunobullous disorders with characteristic morphology that relates to the structural properties of the target protein. In this article we will describe the pathogenesis, clinical features and treatment of the most common immunobullous disorders. Read More

Dermatol Online J 2021 Apr 15;27(4). Epub 2021 Apr 15.

Department of Dermatology, Stanford University School of Medicine, Redwood City, CA.

Subcorneal pustular dermatosis is a rare chronic relapsing bullous neutrophilic dermatosis. Because it can be associated with monoclonal gammopathy of undetermined significance and multiple myeloma, screening for these conditions is necessary. Herein, we present a case of subcorneal pustular dermatosis, with concurrent monoclonal gammopathy of undetermined significance, successfully treated with acitretin. Read More

BMJ Case Rep 2021 May 12;14(5). Epub 2021 May 12.

Department of Medicine, Michigan State University College of Human Medicine, Lansing, Michigan, USA.

We present a case of a 43-year-old man with a medical history of paroxysmal atrial fibrillation that presented with acute onset generalised vesiculobullous rash of 1-week duration. The rash was initially noticed on his groin and then spread to his hands, feet and mucosal surfaces. Laboratory tests were unremarkable, including an extensive infection aetiology work-up. Read More

N Engl J Med 2021 05;384(19):1848

Hospital Universitario 12 de Octubre, Madrid, Spain

BMJ Case Rep 2021 May 11;14(5). Epub 2021 May 11.

Department of Cellular Pathology, North Bristol NHS Trust, Westbury on Trym, UK.

A young woman presented with mucocutaneous blisters and ulcerating lesions, and was diagnosed with erythrodermic pemphigus complicated by bronchiolitis obliterans. Her clinical condition did not improve on immunosuppressive therapy. She had a history of an asymptomatic retroperitoneal mass, presumed to be a dermoid cyst, followed up clinically. Read More

Clin Dermatol 2021 Jan-Feb;39(1):149-162. Epub 2020 Dec 14.

Unit of Dermatology, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Skin is one of target organs affected by the novel coronavirus SARS-CoV-2, and in response to the current COVID-19 pandemic, a fast body of literature has emerged on related cutaneous manifestations. Current perspective is that the skin is not only a bystander of the general cytokines storm with thrombophilic multiorgan injury, but it is directly affected by the epithelial tropism of the virus, as confirmed by the detection of SARS-CoV-2 in endothelial cells and epithelial cells of epidermis and eccrine glands. In contrast with the abundance of epidemiologic and clinical reports, histopathologic characterization of skin manifestations is limited. Read More

Clin Dermatol 2021 Jan-Feb;39(1):12-22. Epub 2020 Dec 17.

Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy.

A wide range of cutaneous signs are attributed to COVID-19 infection. This retrospective study assesses the presence and impact of dermatologic manifestations related to the spread of COVID-19 in Lombardy, the geographic district with the first outbreak in Italy. A cohort of 345 patients with laboratory confirmed COVID-19 was collected from February 1, 2020 to May 31, 2020. Read More

Autoimmun Rev 2021 Jul 7;20(7):102852. Epub 2021 May 7.

Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Autoimmune blistering diseases are a heterogenous group of dermatological disorders characterized by blisters and erosions of the skin and/or mucous membranes induced by autoantibodies against structural proteins of the desmosome or the dermal-epidermal adhesion complex including the hemidesmosome. They consist of the two major disease groups, pemphigus and pemphigoid diseases (PPDs). The diagnosis is based on clinical findings, histopathology, direct immunofluorescence, and detection of circulating autoantibodies. Read More

Exp Dermatol 2021 May 9. Epub 2021 May 9.

Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon.

Neutrophil extracellular traps (NETs) are implicated in the pathogenesis of multiple inflammatory dermatoses. However, characterization of NETs in neutrophilic dermatoses was performed on very limited number of patients; this limitation precluded definitive conclusions. In this case series of 57 patients, we compared the amounts of neutrophils producing NETs in cutaneous lesions of different entities of neutrophilic dermatoses (17 with pyoderma gangrenosum, 37 with Sweet's syndrome and three with subcorneal pustular dermatosis). Read More

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2021 Apr;43(2):166-172

Department of Dermatology,Translational Medicine Center,National Clinical Research Center for Dermatologic and Immunologic Diseases,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.

Objective To investigate the clinical manifestations,diagnosis,treatment,and laboratory examination characteristics of 8 pemphigus patients with high titers of anti-desmoglein antibodies in remission. Methods A retrospective study was conducted for the pemphigus patients diagnosed and treated in the department of dermatology from January 2013 to September 2020.The patients should have the serum anti-desmoglein antibodies ≥150 U/ml in remission or the antibody levels dropped less than 20%(calculated based on the maximum detection limit of 150 U/ml)of their initial ones detected before treatment,and the clinical and laboratory data of patients eligible for the inclusion criteria were collected. Read More

Nat Commun 2021 05 4;12(1):2505. Epub 2021 May 4.

Centre for Regenerative Medicine "Stefano Ferrari", University of Modena and Reggio Emilia, Modena, Italy.

Autologous epidermal cultures restore a functional epidermis on burned patients. Transgenic epidermal grafts do so also in genetic skin diseases such as Junctional Epidermolysis Bullosa. Clinical success strictly requires an adequate number of epidermal stem cells, detected as holoclone-forming cells, which can be only partially distinguished from the other clonogenic keratinocytes and cannot be prospectively isolated. Read More

BMJ Case Rep 2021 May 4;14(5). Epub 2021 May 4.

Dermatology, University Hospital Limerick, Limerick, Ireland.

Clin Infect Dis 2021 05;72(9):1667-1668

Department of General Pediatrics and Pediatric Infectious Diseases, Necker Hospital for Sick Children, AP-HP, Université de Paris, Paris, France.

Biol Bull 2021 04 8;240(2):118-131. Epub 2021 Apr 8.

AbstractMud blister worms bore into oyster shells; and oysters respond to shell penetration by secreting new layers of shell, resulting in mud blisters on inner surfaces of oyster shells. We conducted two experiments in off-bottom oyster farms along Alabama's coast in summer 2017 to explore the dynamics of worm infestation, blister formation, and shell repair. Results support our hypothesis that only a small proportion of worms that bore into oysters cause blisters. Read More

Clin Case Rep 2021 Apr 20;9(4):2507-2509. Epub 2021 Mar 20.

Department of Dermatology Cheikh Khalifa International Hospital University Mohamed IV of Health Sciences Casablanca Morocco.

The aim of my clinical image is to recall this rare and benign form of pustular psoriasis and to insist on the role of the triggers of pustular psoriasis, mainly the drugs. Read More

Front Immunol 2021 16;12:665522. Epub 2021 Apr 16.

Molecular and Cell Biology Laboratory IDI-IRCCS, Rome, Italy.

COVID-19 is characterized by a severe pulmonary disease due to severe acute respiratory syndrome (SARS)-CoV-2 infection. For clinicians involved in the management of patients with chronic autoimmune diseases the risk linked to the conditions itself and to drug-induced immunosuppression during the COVID-19 pandemic is a major topic. Pemphigus is a rare autoimmune blistering disease (AIBD) of the skin and mucous membranes caused by autoantibodies to desmosomal components, desmoglein 1 and 3. Read More

Medicina (Kaunas) 2021 Apr 20;57(4). Epub 2021 Apr 20.

San Diego Family Dermatology, National City, CA 91950, USA.

Dyshidrosiform bullous pemphigoid is a variant of bullous pemphigoid. At least 84 patients with dyshidrosiform bullous pemphigoid have been described. Dyshidrosiform bullous pemphigoid usually presents with pruritic blisters in elderly individuals; the hemorrhagic or purpuric lesions on the palms and soles can be the only manifestation of the disease. Read More

Int J Mol Sci 2021 Apr 7;22(8). Epub 2021 Apr 7.

Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Pirogov Russian National Research Medical University, Ostrovityanova 1, 117997 Moscow, Russia.

The recessive form of dystrophic epidermolysis bullosa (RDEB) is a crippling disease caused by impairments in the junctions of the dermis and the basement membrane of the epidermis. Using ectopic expression of hTERT/hTERT + BMI-1 in primary cells, we developed expansible cultures of RDEB fibroblasts and keratinocytes. We showed that they display the properties of their founders, including morphology, contraction ability and expression of the respective specific markers including reduced secretion of type VII collagen (C7). Read More

Medicine (Baltimore) 2021 Apr;100(17):e22387

Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia.

Introduction: Drug induced oral erythema multiforme a rare clinical entity which involves only the lips and oral mucosa without skin involvement. These lesions are difficult in diagnosing with other oral ulcerative lesions with similar clinical manifestations.

Patient Concerns: This article presents 2 case reports of Oral erythema multiforme in which drugs were the precipitating factor. Read More