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PubMed2003

Bullous erythema ab igne.

Erythema ab igne is a localized, cutaneous condition, consisting of reticulate hyperpigmentation, dusky erythema, epidermal atrophy, and telangiectasia, all the result of repeated exposures to heat. We describe a patient with a bullous form of erythema ab igne: bullae and crusts within a localized area of reticular, brown, macular pigmentation on the lateral side of the left leg, an area that had repeated close exposure to an electrical heater over the previous 3 months. We believe that bullous erythema ab igne, something rarely reported in the literature, should be considered a well-defined variant of erythema ab igne; it may be more common than the literature suggests.

Blister↗
PubMed2003

Long-term follow-up of erythema nodosum.

One hundred and fifty-four patients with erythema nodosum who attended the skin clinic at Ramathibodi Hospital from January 1990 to December 2000 were evaluated retrospectively with regard to the etiology of erythema nodosum. Of 49 patients who attended the skin clinic during that time 26 returned for reevaluation. Of the 154 patients, their ages ranged from 10-72 years old; 138 were females, 16 were males. The most common cause of erythema nodosum was tuberculosis (12.3%). Upper respiratory tract infection was found in 3.9 per cent. Other causes included Behcet's disease, sytemic lupus erythematous, drugs, pregnancy, chronic myeloid leukemia, leprosy, Reiter's syndrome and inflammatory bowel disease. Of the 26 patients who returned for reevaluation, pulmonary tuberculosis was identified in only one patient who had developed erythema nodosum 16 months earlier. In conclusion, it was found that tuberculosis is still a predominant cause of erythema nodosum among Thai patients.

Adolescent↗
PubMed1989

Reduction of UV-induced erythema in normal subjects by applying methimazole.

Since free radicals are probably involved in the induction of erythema following ultraviolet (UV) irradiation, a study was conducted to investigate the influence of a topical application of methimazole (a free radical scavenger), before and at different times up to 2 h, after exposure to UV radiation. Seven subjects took part and erythema was assessed 6 h after exposure by a quantitative reflectance technique. Erythema was reduced at the sites that received methimazole 15 min prior to exposure and, although the trend was towards a decrease in erythema at the sites where methimazole was applied after exposure, the mean differences in these cases were not significant. It is believed that methimazole may have a useful role in the reduction of erythema following UV irradiation.

Administration, Cutaneous↗
PubMed1983

Irritation and staining by dithranol (anthralin) and related compounds. IV. Visual estimation of erythema compared with contact thermometry and laser Doppler flowmetry.

Irritation and staining caused by equi-irritant doses of dithranol (anthralin) and 10-butyryl dithranol (butantrone) were observed for one week after a single 24-hour exposure under occlusion. The test chambers were applied on the uninvolved dorsal skin of 11 psoriasis patients. The estimates of erythema were made with a refined reading scale, and to test the visual discriminatory power they were compared with objective measurements of contact temperature and blood flow of the skin. A sensitive thermistor and a novel laser Doppler flowmeter were used. On the whole, erythema, contact temperature and superficial blood flow, as interdependent parameters of cutaneous inflammation, all showed a time-dependent statistically significant correlation to the dose of dithranol and 10-butyryl dithranol. The intercorrelations between erythema and blood flow and between erythema and temperature were statistically significant, too. With the doses used, staining of the skin did not hamper the measurement of superficial blood flow, but it did exaggerate visual estimates of erythema at the 4th and 7th day readings.

Anthracenes↗
PubMed1984

[Etiology of erythema migrans disease and Lyme disease. Review and results of personal study].

Erythema chronicum migrans (ECM), lymphadenosis cutis benigna and acrodermatitis chronica atrophicans (ACA) have been well known in Europe for a long time as skin diseases induced by tickbites. Earlier hints that these inflammatory dermatoses and associated disorders (erythema migrans disease) might be of spirochetal origin are now supported by the findings of several groups in the USA and Europe. In the United States the endemic occurrence of a new inflammatory disease which seems to be closely related to the European erythema migrans disease was first seen in Lyme, Connecticut, in 1975. This "Lyme disease" is also induced by tick bites and affects mainly skin and joints. In 1982 the isolation of a new spirochetal species cultivated from Ixodes dammini ticks was reported. Antibodies against these Ixodes dammini spirochetes (IDS) were detected by indirect immunofluorescence in patients with Lyme disease. In 1983 spirochetes were shown by Warthin-Starry silver stain in skin biopsies of erythema chronicum migrans, and nearly simultaneously the isolation of spirochetes similar to the IDS from skin, blood and cerebrospinal fluid of Lyme patients was reported in a few cases. Also, in Europe Borrelia-like spirochetes morphologically very similar to the IDS have been isolated from ticks of the indigenous species Ixodes ricinus by transmission to laboratory animals and cultivation in vitro. Antibodies against Ixodes ricinus spirochetes (IRS), but also against known Borrelia species have been shown in most sera of patients with erythema migrans disease, including meningoradiculitis Bannwarth, acrodermatitis chronic atrophicans and lymph-adenosis cutis benigna.(ABSTRACT TRUNCATED AT 250 WORDS)

Acrodermatitis↗
PubMed1982

[The incidence of subungual erythema].

In this study, 506 patients from several hospitals, especially from departments of internal medicine, were examined in order to find out the frequency of subungual erythemas (half and half nails, brown arcs). 44 patients suffered from small erythemas (less than 30%). The nails of 69 patients were inspected after kidney transplantation, only 5 of them revealed subungual erythema, 2 our of 61 healthy persons showed the subungual erythema. There were signs of renal failure in most patients with subungual erythema.

Adolescent↗
PubMed1994

Minimum erythema dose determination in individuals of skin type V and VI with diffuse reflectance spectroscopy.

Erythema induced by ultraviolet B radiation (UVB) or PUVA (psoralen+UVA) was measured by diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LD) on patients receiving UV phototherapy and on healthy volunteers of skin type V and VI. The height of the 577 nm absorbance peak of oxyhemoglobin was taken as a measure of erythema intensity. DRS spectra from skin sites exposed to a series of doses were similar in shape. The dose necessary to produce a 0.05 difference in absorbance between 577 nm and 630 nm was determined to be a good indicator of minimal erythema dose (MED) in UVB. DRS measurements proved very reliable in the determination of MED or minimum phototoxic dose) of deeply pigmented subjects. In individuals with skin types V or VI, DRS detects and provides a measure for UVB and PUVA erythema and distinguishes it from melanin pigment, even when the erythema is not obvious. LD measurements lose sensitivity with increasing pigmentation and fail altogether in highly pigmented skin (types V and VI). Diffuse reflectance spectroscopic techniques also make possible the detection of sub-visual threshold reactions. DRS improved the accuracy of MED and MPD determination and the objective standardization of phototesting procedures irrespective of the subject's pigment level.

Absorption↗
PubMed1993

Pericarditis associated with acral erythema of chemotherapy: a syndrome of cutaneous and serosal toxicities?

A nineteen-year-old woman whose Hodgkin's disease had relapsed experienced acral erythema in association with a asymptomatic pericardial friction rub following autologous bone marrow transplantation. An echocardiogram revealed a large pericardial and right pleural effusion. Since blood cultures gave negative results, renal function was normal, and the patient had neither neutropenia nor elevated temperature, an infectious cause was deemed unlikely and invasive procedures were not performed. These effusions resolved spontaneously. We propose that this patient's acral erythema and associated pericardial and pleural inflammation represent cutaneous and serosal toxic reactions to high-dosage chemotherapy that occur with the onset of leukocyte recovery. If so, acral erythema may signal the beginning of a toxic drug reaction. The appearance of erythema associated with lymphocyte recovery is due to immune hypersensitivity secondary to immaturity of the reconstituting immune system. Thus, we recommend that patients with acral erythema be examined for pleuropericarditis, especially if they experience chest pain.

Adult↗
PubMed1996

Similar Ro/SS-A autoantibody epitope and titer responses in annular erythema of Sjögren's syndrome and subacute cutaneous lupus erythematosus.

BACKGROUND AND DESIGN: Studies were conducted to determine whether certain types of Ro autoantibodies are unique to subacute cutaneous lupus erythematosus and annular erythema of Sjögren's syndrome. Ten American subacute cutaneous lupus erythematosus sera, 11 Japanese annular erythema of Sjögren's syndrome sera, and 39 control sera were tested by enzyme-linked immunosorbent assay with recombinant 52- and 60-kd Ro fusion proteins, native 60-kd Ro protein, and native La/SS-B protein. RESULTS: Japanese annular erythema of Sjögren's syndrome sera and American subacute cutaneous lupus erythematosus sera share several types of anti-52-kd and anti-60-kd Ro autoantibodies. However, these antibodies were found significantly more often and in significantly higher titers in sera from patients with Sjögren's syndrome who did not manifest these skin diseases. Patients with high Ro autoantibody titers were likely to have overt exocrine gland dysfunction. CONCLUSIONS: The failure to identify disease-specific Ro autoantibodies in subacute cutaneous lupus erythematosus and annular erythema of Sjögren's syndrome sera suggests that additional factors influence the development of these skin diseases. However, similarities in the Ro autoantibody responses and in the clinical features of subacute cutaneous lupus erythematosus and annular erythema of Sjögren's syndrome suggest that these two skin diseases might arise from a similar pathogenic process.

Asian People↗
PubMed1997

Elevated Th1 cytokine mRNA in skin biopsies and peripheral circulation in patients with erythema nodosum.

It is generally believed that erythema nodosum is the result of an immunologic attack centered within the subcutaneous fat. This belief, however, is based on indirect evidence. The aim of this study was to analyze whether erythema nodosum could represent an example of a polarized Th1 or Th2 immune response. We have studied herein, by semiquantitative coupled reverse transcription-polymerase chain reaction the Th1 (IL-2, IFN-gamma) and Th2 (IL-4, IL-10) cytokine gene expression in skin biopsies and peripheral blood from eleven patients with erythema nodosum. As controls, we studied skin and peripheral blood from nine healthy subjects. We found expression of Th1 cytokines in most erythema nodosum skin lesions as well as in their peripheral blood. Both Th1 and Th2 cytokine gene expressions were scarcely or not detected in the skin and peripheral blood of control subjects. These results directly demonstrate that a polarized Th1 immune response occurs in the skin lesions of erythema nodosum patients regardless of the wide variety of provoking agents.

Adolescent↗
PubMed1997

[Persistent erythema multiforme associated with chronic hepatitis C virus infection. Efficacy of interferon alpha].

INTRODUCTION: Persistant erythema multiforme is a rare form of erythema multiforme with subacute typical and atypical lesions that occur during several months. Some cases are associated with chronic viral infection. CASE REPORT: A 23 year-old man, with a past history of intravenous drug addiction and chronic hepatitis C virus infection, presented persistant erythema multiforme for 18 months. The histopathological picture was those of infectious erythema multiforme and the seric total complement level was low. Two courses of alpha-interferon treatment were quickly efficient on cutaneous lesions, and relapse occurred after discontinuation. DISCUSSION: In previously reported cases of persistant erythema multiforme, etiologic complementary investigations are not always specified. However, viral infections should be considered. In cases of chronic infection, hepatitis C may induce immune disorders through persistent antigenic stimulation.

Adult↗
PubMed1998

Tanning in human skin types II and III offers modest photoprotection against erythema.

We have investigated the photoprotective properties of tanning using erythema as an endpoint. Previously unexposed buttock skin sites of 16 young, healthy adults (8 skin type II, and 8 skin type III) were exposed daily (Mon-Fri) for 2 weeks to 0.5 and 0.75 minimal erythema doses (MED) of solar-simulated radiation (SSR). Erythema and melanin levels were assessed daily both visually and quantitatively using a reflectance device. One week after the last tanning treatment, MED reassessments were made on pretreated sites and on adjacent nontreated sites, including sites from which stratum corneum was removed by tape stripping. Compared to skin type II, similar daily SSR treatments produced less erythema and more evident tanning in skin types III. Independent of skin type, all volunteers showed an increased MED value when assessed on the 0.75 MED- and 0.5 MED-treated sites compared to the MED value assessed on adjacent untreated sites. We express any increase in MED as an induced protection factor (IPF), i.e. (MED post-tan/MED pre-tan). Our data show mean IPF of 1.4 and of 2.1 in the 0.5 and 0.75 MED-treated sites respectively, in skin types II. Similar values were obtained in skin types III with IPF of 1.5 and 2.3 for the 0.5 and 0.75 MED-treated sites, respectively. In all cases, removal of the stratum corneum lowered the IPF by about 20%. Our results show that SSR-induced melanogenesis, whether in skin type II or III, offers only moderate protection against erythema and suggest that SSR-induced stratum corneum thickening affords less photoprotection than tanning.

Adult↗
PubMed2000

Necrolytic acral erythema associated with hepatitis C: effective treatment with interferon alfa and zinc.

BACKGROUND: Necrolytic acral erythema is a recently described necrolytic erythema that is unique in its exclusive acral location and strong association with hepatitis C. OBSERVATION: We report the first case of necrolytic acral erythema in the United States. The patient is a 43-year-old black woman who presented with a 4-year history of tender, flaccid blisters localized to the dorsal aspect of her feet. Serum zinc and glucagon levels were normal. Serum antibodies were positive for hepatitis C, and a liver biopsy specimen showed chronic hepatitis. She was successfully treated with interferon alfa-2b and zinc. We review all previously reported cases. CONCLUSIONS: Necrolytic acral erythema is a distinct entity. In a review of the literature, most patients were between 35 and 55 years of age, although 1 patient was 12 years old. Five of 8 patients were female. Four of 7 patients described previously were treated with variable success using oral zinc sulfate and amino acids, whereas 2 were successfully treated with interferon alfa. All patients were infected with hepatitis C. Necrolytic acral erythema appears to be a skin disorder linked to infection with hepatitis C virus that responds to treatment with interferon alfa and oral zinc.

Acrodermatitis↗
PubMed1998

[Effect of various salt solutions on ultraviolet B-induced erythema and pigmentation].

The combination of saltwater baths and subsequent ultraviolet irradiation is an effective treatment for psoriasis and atopic dermatitis. The aim of the present study was to determine the photosensitizing properties of two commercially available bath salts, original salt from the Dead Sea and sodium chloride. To address this issue, test areas on the volar aspects of the forearms were soaked with salt solutions for 15 minutes prior to ultraviolet-B (UVB) irradiation. The salt concentrations tested were 1%, 3% 5% and 15%. Tap water followed by UVB and UVB alone served as controls. Erythema was determined by visual and photometric measurement, and delayed tanning was assessed by colorimetry. Erythema obtained by wetting the skin prior to UVB irradiation was more pronounced than erythema induced by UVB alone. The most prominent erythema was yielded by tap water + UVB. The salts had a differing photosensitizing capacity and the strongest erythema was produced by the 5% solutions. There was only a moderate influence on delayed tanning by bathing the skin prior to irradiation. The results from the present study indicate that soaking the skin with salt solutions or tap water increases skin sensitivity to subsequent UVB irradiation. This may contribute to the effectiveness of salt water baths followed by UV irradiation and may account for an increased sunburn risk after bathing.

Adult↗
PubMed1976

The influence of corticosteroids and topical indomethacin on sunburn erythema.

The extent to which topical and intradermal corticosteroids and topical indomethacin suppress sunburn erythema was investigated in human volunteers. Both agents retarded the onset and decreased the magnitude of delayed erythema. Suppression by corticosteroids was not demonstrable with ultraviolet doses larger than 2 MEDs (minimal erythema dose). Below 2 MEDs, topical betamethasone valerate produced a dose-related suppression of erythema. Indomethacin was more effective and produced a measurable dose-dependent suppression against 3 and 6 MEDs. Despite significant inhibition of erythema, sunburn damage to epidermal cells was not altered by these drugs.

Administration, Topical↗
PubMed2005

Efficacy of 1% 4-ethoxybenzaldehyde in reducing facial erythema.

BACKGROUND: Facial erythema is a common postsurgical and dermatologic problem. It is commonly the result of dermal inflammation arising from either a facial surgical procedure, such as laser resurfacing, dermabrasion, or a face peel, or from an underlying dermatologic condition, such as rosacea. Facial erythema is difficult for the dermatologist to treat in both settings because topical corticosteroids cannot be used long term on the thin facial skin and anti-inflammatory oral or topical antibiotics have associated side effects. OBJECTIVE: The goal of this pilot study was to evaluate the anti-inflammatory effect of 1% 4-ethoxybenzaldehyde in a rosacea model of facial erythema. METHODS: Thirty subjects with mild to moderate stable rosacea were enrolled in this 4-week, double-blind, vehicle-controlled study. Photographs, investigator assessment, and subject assessment were the efficacy criteria. RESULTS: There was a statistically significant reduction in facial erythema (p<.01) in those subjects who used the active for 4 weeks, as well as a statistically significant improvement in uneven skin tone (p<.01) and the overall severity of the disease (p<.01). There was no statistically significant difference in any of these three indices in the vehicle-treated group. CONCLUSION: The results suggest that benzaldehyde-derived anti-inflammatory agents may be useful in reducing facial erythema in a rosacea model.

Administration, Topical↗
PubMed2005

Validity of using tuberculin skin test erythema measurement for contact investigation during a tuberculosis outbreak in schoolchildren previously vaccinated with BCG.

BACKGROUND: Few studies have examined the validity of administering tuberculosis control measures based on tuberculin skin test (TST) erythema measurement. The present study aimed to clarify the relationship between the erythema and the induration seen following TST and to evaluate the validity of diagnosing tuberculosis infection based on the erythema following TST in school-aged contacts who had been vaccinated with bacillus Calmette-Guérin (BCG) in infancy. METHODS: A 56-month longitudinal study from January 1999 through September 2003 followed 566 junior high school students in Kochi City who were contacts of an infectious tuberculosis case. To evaluate the diagnostic accuracy of the erythema and induration following TST of the contacts, false-positive and false-negative TST results were noted. RESULTS: The natural logarithm of the erythematous response size was linearly related to the induration size. When the size of the erythematous response was used to determine the presence of tuberculosis infection, the proportion of infected children increased with increasing exposure to the index case. When the TST results in the contact investigation were interpreted together with the change in the size of the erythematous response from that observed at the regular school-entry checkup, false positive test results were avoidable among the students who had a large erythematous response after the contact investigation TST, but whose response was only slightly larger than their erythematous response following the school-entry TST. Among the students whose TST results were negative, 1.9% developed tuberculosis. CONCLUSION: Both erythema and induration measurement were equally effective for identifying tuberculosis infection in schoolchildren vaccinated with BCG.

Adolescent↗
PubMed1998

[Acral erythema and HIV infection].

BACKGROUND: Acral erythema is a non specific skin condition observed in connective tissue diseases, viral infections and toxic skin reactions. More recently, this symptom has been reported in HIV-infected patients. CASE REPORT: We observed two cases of acral erythema in HIV seropositive patients. Both patients were drug abusers. Erythema was limited to the limbs with no clinical manifestation of connective tissue disease. Both consumed approximately 40 tablets of codeine daily and had hepatitis C without cirrhosis. DISCUSSION: Our 2 cases of acral erythema in HIV-infected patients can be added to 32 cases of digital erythema in HIV patients reported in the literature. The common features in most of these patients was intravenous opiate abuse and hepatitis C without cirrhosis. The degree of immunodeficiency, the nature of opportunistic infections and antiretroviral treatments do not appear to affect the development of skin signs. HIV infection, simultaneous HIV-HCV infection and codeine suggest they might have a pathogenic role in the development of distal vascularization disorders.

Acrodermatitis↗