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PubMed1995

Ultraviolet-induced suppression of the primary allergic reaction. Four times the minimal erythema dose of ultraviolet B administered 24 hours prior to sensitization.

The effect of localized irradiation with 4 times the minimal erythema dose (MED) of ultraviolet B (UVB) 24 h prior to sensitization with dinitrochlorobenzene (DNCB) was examined. In a placebo-controlled design, 9 of 19 subjects were locally irradiated on the right buttock; 24 h later, DNCB (1000 micrograms) was applied to the right buttock in all 19 subjects, and subjects were examined 7 and 14 days later for the development of a primary allergic response (PAR). In those not developing a PAR, a challenge dose of DNCB (50 micrograms) was applied to the volar forearm and examined 2 days later for an elicitation response. A statistically significant difference was seen in the number of subjects developing a PAR, comparing the group irradiated with UVB versus the group not irradiated (33% vs 80%). There was no statistically significant difference seen in elicitation responses between the 2 groups. We have shown that intense localized UVB irradiation as early as 24 h prior to sensitization with a potent allergen at this site may inhibit the PAR but does not appear to affect the elicitation response at a distant site.

Adolescent↗
PubMed1999

Increased risk of erythema multiforme major with combination anticonvulsant and radiation therapies.

Erythema multiforme major (EMM; Stevens-Johnson syndrome) is a cutaneous disorder associated with a wide variety of factors including ingestion of drugs such as phenytoin and exposure to intracranial radiation therapy. Based on observations of a 47-year-old black man with brain metastases who developed EMM after combined phenytoin and radiation therapy, we conducted a MEDLINE literature search for articles on similar cases from 1966 to the present. Twenty cases were identified that support the hypothesis that EMM is associated with combined phenytoin and radiation therapy. The reaction, or its severity, has no relationship to the phenytoin or radiation therapy dosage, or to the histologic type of brain tumor. Also, EMM has no apparent age or gender predisposition in association with phenytoin-radiation therapy. Thus this is a clinical phenomenon that occurs with unusual frequency in patients with brain tumor who undergo radiation therapy while taking phenytoin. Phenytoin and other anticonvulsants such as phenobarbital and carbamazepine induce cytochrome P450 3A and produce oxidative reactive intermediates that may be implicated in hypersensitivity reactions such as EMM. Both carbamazepine and barbiturates have shown cross-sensitivity with phenytoin; furthermore, a case of EMM in a patient receiving carbamazepine and whole brain radiation therapy has been reported. As carbamazepine, valproate, and barbiturates have been associated with EMM, gabapentin may be considered as alternative anticonvulsant therapy when appropriate.

Adult↗
PubMed1999

Progeroid syndrome with facial teleangiectatic erythema, posterior subcapsular cataracts, calcification of basal ganglia and atrium septum defect type 2.

In this report we present the long-term follow-up findings in a young female born to consanguineous parents with the unique association of (1) a progeroid syndrome, (2) facial dysmorphism with relative microcephaly, triangular face, retrognathism and skin erythema, (3) bilateral posterior cataracts, (4) basal ganglia calcifications and (5) atrium septum defect type 2. Intelligence is borderline. Clinical evolution after normal puberty was positive with regression of the facial erythematous changes. Over the years differential diagnosis included progeria, hypohidrotic ectodermal dysplasia, Rothmund-Thompson syndrome, Cockayne syndrome, Bloom syndrome, but the clinical spectrum of abnormalities and the evolution with age were not compatible with one of these diagnoses. Parental consanguinity is in favour of autosomal recessive inheritance.

Abnormalities, Multiple↗
PubMed2001

Erythema elevatum diutinum mimicking extensive keloids; quiz 386.

GOAL: To describe a case of erythema elevatum diutinum (EED) that clinically mimicked extensive keloids. OBJECTIVES: Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Describe the clinical presentation and lesion appearance in EED. 2. Discuss the electron microscopic and laboratory findings of EED. 3. Outline treatment options for EED. CME: This article has been peer reviewed and approved by Michael Fisher, MD, Professor of Medicine, Albert Einstein College of Medicine. REVIEW DATE: April 2001. This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Albert Einstein College of Medicine and Quadrant HealthCom, Inc. The Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians. Albert Einstein College of Medicine designates this educational activity for a maximum of 1.0 hour in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. This activity has been planned and produced in accordance with ACCME Essentials.

Dapsone↗
PubMedDate not supplied

Linear gingival erythema in an HIV-seropositive man.

Linear gingival erythema (LGE) is part of the spectrum of periodontal disease that exists in the HIV-infected population. Here, a typical case of LGE is presented and described. The microbiology and therapeutics of LGE are discussed, as well as this condition's relationship to more severe, rapidly destructive infectious diseases--such as necrotizing ulcerative periodontitis and necrotizing stomatitis.

Gingivitis↗
PubMed2005

Rare presentation of endocrine pancreatic tumor: a case of diffuse glucagonoma without metastasis and necrolytic migratory erythema.

Glucagonoma is a very rare endocrine pancreatic tumor. At diagnosis, most glucagonomas are malignant and often metastatic. Suspicion of glucagonoma is based on characteristic presentations known as "glucagonoma syndrome". Glucagonoma is often found in the pancreatic body and/or tail and is usually large enough to be localized by computed tomography. We report a case of diffuse glucagonoma necrolytic migratory erythema (NME) in a 45-year-old man with mild diabetes mellitus, mild anemia, and weight loss over 1.5 years. Diffused enlarged pancreas was noted on abdominal ultrasonography incidentally during a routine health check-up. The levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were within normal limits. No enlarged lymph node or extrapancreatic tumor mass was found by several imaging studies. Total pancreatectomy was performed, and the pathology revealed glucagon-producing islet cells and intrapancreatic vascular emboli of tumor cells. He died due to internal bleeding and sepsis after surgery. Presentation of diffuse malignant glucagonoma with tumor emboli but no metastasis or NME is unusual.

Glucagonoma↗
PubMed1989

[Assessment of the antiphlogistic effect of naftifin-HCl in the UV-B erythema test].

In a placebo-controlled double-blind comparative study conducted in 19 healthy volunteers, naftifin hydrochlorid cream was tested against clotrimazole 1%, clotrimazole 1%+hydrocortisone 1%, and various hydrocortisone preparations (0.5%; 1%; 2.5%) for erythema-suppressive effects. The anti-inflammatory effect of naftifine hydrochloride demonstrated earlier was confirmed in this study. The results prove a potency comparable to that of weak topical glucocorticosteroids.

Administration, Topical↗
PubMed1985

[Erythema toxicum neonatorum with pustulation versus transient neonatal pustular melanosis].

A girl with widespread vesicular pustular lesions present at birth is reported. The differential diagnosis is discussed, with an extreme eruption of erythema toxicum neonatorum and the newly described entity transient neonatal pustular melanosis (TNPM) under consideration. This benign, self-limited, pustular eruption, with lesions present at birth, requires no specific therapy, but must be distinguished from the neonatal skin manifestations of viral, bacterial and fungal diseases. The condition should not be confused with others involving sepsis.

Dermatologic Agents↗
PubMed1983

[Comparison of 3 corticoid preparations with the vasoconstriction and erythema test].

The efficacy of a new topic preparation of the corticosteroid Halcinonide containing 5% Urea has been examined and then compared with two commercial preparations of Halcinonide and Betamethasonevalerate respectively. Although these two corticosteroids usually do not belong to the same class of potency, there could not be found any significant difference neither with the vasoconstriction assay nor with the Pyrexal erythema. The influence of the three most important parameters, that are vehicle, occlusion and skin condition, is a subject of discussion.

Administration, Topical↗
PubMed1976

[A "new cause of erythema nodosum worth knowing: yersinia-infections (author's transl)].

In the German literature little has so far been published on the appearance of erythema nodosum (e.n.), particularly in childhood, following Yersinia infections. We have seen a boy aged 10 years and 8 months with marked e.n. on the legs and mildly on the left fore-arm. This had been preceeded by typical enteritic symptoms; contact with numerous animals was noteworthy. When we treated him with penicillin V, septic fever and a rise in the ESR occurred. Serologic examination showed high titres against Yersinia pseudotuberculosis. The titre of type I fell, that of type II rose which indicated a mixed infection. In view of the increasingly common reports on e.n. following Yersinia infections in adults we have to assume that in childhood, too, Yersinia infections will be found increasingly as a cause of e.n.

Child↗
PubMed1995

Rare presentation of endocrine pancreatic tumour: a case of glucagonoma without necrolytic migratory erythema?

The case of a 61-year-old woman with a probable pancreatic glucagonoma in reported. The clinical peculiarity of this case is the lack of the characteristic necrolytic migratory erythema (NME); the patient presented asthenia, weight loss and hyperglycemia. Ultrasonography, CT-scan and arterography showed a irregular pancreatic mass and secondary diffuse hepatic lesions. Fine needle aspiration cytology with immunohistochemistry and glucagon serum levels yielded to the diagnosis. Surgical treatment was not proposed because of the advanced stage of the disease; therefore, chemotherapy (streptozotocin, 5-fluorouracil) was performed. During a 16-month follow-up period the patient did not develop NME.

Female↗
PubMed1995

[Erythema exsudativum multiforme major].

UNLABELLED: Erythema exudativum multiforme major (EEMM), also know as Stevens-Johnson syndrome, may cause severe conjunctival and corneal alterations. The etiology remains unknown. The aim of are study was to evaluate the clinical course, therapy and prognosis of ocular involvement. PATIENTS AND METHODS: In a retrospective study, we evaluated ten patients with EEMM who were treated between 1986 and 1994 at the University Eye Clinic Tübingen. RESULTS: The age of the four female and six male patients varied between 5 and 70 years. Drugs as a possible precipitating factor were found in all cases (acetylsalicylicacid, sulfonamide, erythromycin, cotrimoxazole, Valproinicacid, paracetamol). Eight patients experienced an infection at the same time. Clinically, we were able to differentiate two groups regarding severity of the disease. Seven patients were characterized by ocular alterations that only involved the conjunctiva, leading to conjunctival scars. In those cases local treatment with antibiotics and corticosteroids was effective. In the second group severe ocular damage occurred, with symblephara, keratinization and consecutive perforating keratoplasty. Secondary infections became evident in a total of six cases from the two groups. SUMMARY: Drugs as a possible precipitating factor could be identified in all cases. In eight of ten patients previous infection was known. This agrees with literatures reports of viral infections (e.g. herpes simplex) as cofactors causing EEMM, especially for the aggressive form, remains unresolved. The danger of possible superinfection should always be taken into consideration.

Adolescent↗
PubMedDate not supplied

Erythema migrans-like rash illness at a camp in North Carolina: a new tick-borne disease?

BACKGROUND: Borrelia burgdorferi, the causative agent of Lyme disease, has never been isolated from a patient thought to have acquired Lyme disease in any southeastern state. OBJECTIVE: To investigate 14 cases of an erythema migrans (EM)-like rash illness that occurred during 2 summers at an outdoor camp in central North Carolina in an effort to determine the etiologic, epidemiological, and clinical aspects of this illness. METHODS: Using active surveillance, we identified cases of clinically diagnosed EM in residents and staff of the camp. We collected clinical and demographic information; history of exposure to ticks; acute and convalescent serum antibodies to B. burgdorferi, Rickettsia rickettsii, and Ehrlichia chaffeensis; and cultures for spirochetes from biopsy specimens of skin lesions. Serum samples from a group of residents and staff who did not develop rashes were tested for the same antibodies. We speciated ticks removed from people and collected from vegetation. RESULTS: We identified 14 cases of EM-like rash illness during the 2 summers. Of the 14 case-patients, 10 had associated mild systemic symptoms and 1 had documented fever. All 14 case-patients had removed attached ticks, and 8 remembered having removed a tick from the site where the rash developed a median of 12 days earlier (range, 2-21 days). One tick removed from the site where a rash later developed was identified as Amblyomma americanum, the Lone Star tick; 97% of ticks collected from vegetation and 95% of ticks removed from people were A. americanum. No spirochetes were isolated from skin biopsy specimens. Paired serum samples from 13 case-patients did not show diagnostic antibody responses to B. burgdorferi or other tick-borne pathogens. CONCLUSIONS: This investigation suggests the existence of a new tick-associated rash illness. We suspect that the disease agent is carried by A. americanum ticks. In the southern United States, EM-like rash illness should no longer be considered definitive evidence of early Lyme disease.

Adolescent↗
PubMed1998

Diaper dermatitis in an adult. A case of erythema papuloerosive of Sevestre and Jacquet.

BACKGROUND: Irritants, friction and occlusion favor dermatitis or inflammatory reactions in the diaper area. Diaper dermatitis is not found exclusively in children but also in adults wearing a diaper for urinary incontinence. CASE: We report a case of eroded papules on the labia majora in a woman with urinary incontinence. CONCLUSION: Erythema papuloerosive of Sevestre and Jacquet is an unusual dermatitis due to irritant agents in the diaper area that may also affect adults. As this dermatitis may resemble neoplasia and venereal disease, it can be easily misdiagnosed, especially in adults.

Aged↗

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