Erythematous atrophic macules and papules following the lines of Blaschko. Focal dermal hypoplasia (FDH), or Goltz syndrome.
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Abdomen↗
Biomedical subjects
Giuseppe Militello
Publications and source records attributed to Giuseppe Militello.
Etanercept for the treatment of psoriasis in the elderly.
This study's objective was to analyze the effect of etanercept on Psoriasis Area and Severity Index (PASI) 50, PASI 75, and Dermatology Life Quality Index in geriatric and nongeriatric populations. We conducted a post hoc analysis of two large phase III randomized placebo trials of etanercept. There were no statistically significant differences between the elderly and young with regard to the number of patients reaching a PASI 50 or PASI 75 at any of the 3 dosing regimens. Baseline Dermatology Life Quality Index scores were not statistically significant between both groups and both the elderly and young had similar changes in Dermatology Life Quality Index with therapy. A limitation of the study was the small number of patients in the elderly group. In conclusion, psoriasis and its treatment has a similar impact on quality of life in the elderly as it does in the young.
Aged↗
Allergic contact dermatitis in children.
PURPOSE OF REVIEW: The following paper reviews the recent literature pertaining to allergic contact dermatitis in the pediatric population. RECENT FINDINGS: Allergic contact dermatitis may affect as many as 20% of the pediatric population. Recent studies implicate the following chemicals as the most common causes: nickel, topical antibiotics, preservative chemicals, fragrances and rubber accelerators. Several less common, but emerging, allergens have also been reported recently, including para-phenylenediamine in henna tattoos, cocamidopropyl betaine in 'no tears' shampoos and cleansers, and disperse dyes in clothing materials. Allergic contact dermatitis occurs less frequently in the first few months of life and increases in prevalence with increasing age. In the adolescent age group, females have significantly higher rates of allergic contact dermatitis on the face. This is likely explained by increased exposures to nickel in piercings and to preservative and fragrance chemicals in cosmetic products. SUMMARY: The documented rates of allergic contact dermatitis in children are on the rise. This increased prevalence may be due to increased chemical exposures in this age group, better recognition by pediatricians and perhaps more widespread use of epicutaneous patch testing. This review outlines the basic pathophysiology, epidemiology and clinical manifestations of allergic contact dermatitis in children.
Adolescent↗
Eccrine porocarcinoma arising in two African American patients: distinct presentations both treated with Mohs micrographic surgery.
Abstract Background Eccrine porocarcinoma (EPC) is a rare, malignant adnexal tumor that has been reported only three times specifically in African American individuals. Diagnosis and treatment of EPC is important, given the 20% local recurrence and regional metastatic rates. However, no standard of care has been developed to guide effective treatment. Methods We report two distinct clinical presentations of EPC, both in African Americans, and discuss a review of the literature. Results The neoplasms were successfully removed from both patients by Mohs micrographic surgery. Conclusions These two cases illustrate that EPC can have a variety of presentations and can occur in African Americans. Although there is no standard of care for treating EPC, Mohs is becoming a common technique of removing these lesions.
Acrospiroma↗
The utility of the TRUE test in a private practice setting.
BACKGROUND: Studies suggest that the Thin-Layer Rapid-Use Epicutaneous Test (TRUE Test) may be inadequate to completely diagnose a significant number of patients with allergic contact dermatitis (ACD). OBJECTIVE: To study the usefulness of the TRUE Test as a triage tool in a private practice setting. METHODS: A retrospective chart review of patients who were patch-tested with the TRUE Test between July 1, 2000, and June 30, 2004, in four private dermatology practices was conducted. RESULTS: Of the 183 patients evaluated, 50.8% had at least one positive reaction, 31.7% had a diagnosis of ACD, and 24.0% were suspected to have ACD from other allergens. Of the patients with positive reactions, 62.4% were determined to have reactions that were of present relevance. CONCLUSIONS: The TRUE Test allows patients with dermatitis to be triaged systematically in a private practice setting. It is important to supplement patch testing with the patients' personal products, especially in cases of facial or periorbital dermatitis, and to be aware of potential false negatives, particularly with fragrance and rubber additives.
Adolescent↗
The CLASI (Cutaneous Lupus Erythematosus Disease Area and Severity Index): an outcome instrument for cutaneous lupus erythematosus.
We developed and validated a measurement instrument (CLASI-Cutaneous Lupus Erythematosus Disease Area and Severity Index) for lupus erythematosus that could be used in clinical trials. The instrument has separate scores for damage and activity. A group of seven American Dermato-Rheumatologists and the "American College of Rheumatology Response Criteria Committee on SLE (systemic lupus erythematosus)" assessed content validity. After a preliminary session, we conducted standardized interviews with the raters and made slight changes to the instrument. The final instrument was evaluated by five dermatologists and six residents who scored nine patients to estimate inter- and intra-rater reliability in two sessions. Consultation with experts has established content validity of the instrument. Reliability studies demonstrated an intra-class correlation coefficient (ICC) for inter-rater reliability of 0.86 for the activity score (95% confidence interval (CI) = 0.73-0.99) and of 0.92 for the damage score (95% CI = 0.85-1.00). The Spearman's rho (Sp) for intra-rater reliability for the activity score was 0.96 (95% CI = 0.89 to 1.00) and for the damage score Sp was 0.99 (95% CI = 0.97-1.00). Clinical responsiveness needs to be evaluated in a prospective clinical trial, which is ongoing.
Humans↗
Lyral: a fragrance allergen.
Fragrances are a common cause of contact dermatitis and account for a large percentage of reactions to cosmetic products. Novel fragrance compounds that may not be detected by the common fragrance screening agents (including balsam of Peru and fragrance mix) are continually being produced. Lyral is one of those allergens found in many cosmetic and household products. This review will discuss the recent literature and the significance of this allergen to allergic contact dermatitis.
Aldehydes↗
Allergic contact dermatitis from isocyanates among sculptors.
Allergic contact dermatitis from isocyanates is rare. We present the cases of two sculptors who developed a dermatitis from polyurethane sculpting materials. The patients reacted to diphenylmethane diisocyanate and isophorone diisocyanate. One of the patients had positive patch-test reactions to 1,6-hexamethylene diisocyanate and toluene diisocyanate as well. The patients also exhibited a sensitivity to diaminodiphenylmethane, an amine that has been reported in other cases of isocyanate sensitivity.
Adult↗
Neoprene.
Neoprene is a synthetic rubber with many common uses, including use in shoe insoles and adhesives, orthopedic braces, and gloves. Many cases of type IV hypersensitivity from neoprene contact have been reported. Thioureas, the most commonly used vulcanization accelerators in the manufacture of neoprene, are responsible for the majority of these cases. However, thioureas are not included in the TRUE Test whereas the North American Contact Dermatitis Group standard tray contains only mixed dialkyl thioureas. Since most data indicate that many cases will be missed when only mixed dialkyl thioureas are used for screening, a more complete thiourea panel should be used when neoprene hypersensitivity is suspected.
Allergens↗