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PubMed1975

Granulomatous panniculitis in erythema nodosum.

A group of ten patients with granulomatous panniculitis was studied; five had erythema induratum of the tuberculous or the nontuberculous type and five had erythema nodosum. In both groups, histiocytic giant cells and lymphocytic inflammation of the fat were seen microscopically. Massive caseation was seen in the patients who had erythema induratum, but this was not a distinguishing feature between the tuberculous and the nontuberculous type. The clinical history in all instances was a reliable guide to diagnosis. No specific cause was found, and treatment was not specific. tin granulomatous panniculitis, the clinical pattern of disease is confusing in view of the histologic findings, and the diagnosis can be made with confidence only if the clinical findings are carefully correlated to the course of the disease.

Adult↗
PubMed1975

[The bullous variant of erythema annulare centrifugum Darier in Candida albicans infections].

A 15-year old male patient with Down-Syndrome suffering from a unusual vesicular type of erythema annular centrifugum Darier and a concurrent intestinal infection with candida albicans is described. Histology, immunhistological assay, and clinical observation allowed to differentiate Erythema annulare centrifugum from erythema exsudativum multiforme as well as dermatitis herpetiformis. On the basis of immunological findings and the clinical course, a hypersensitivity to candida albicans like a so-called "id-reaction" is assumed to be the main etiological factor in this case.

Adolescent↗
PubMed2003

[Erythema nodosum association with malignant lymphoma].

Erythema nodosum is the most frequent clinicopathological variant of the panniculitides. The disorder is a cutaneous reaction consisting of inflammatory nodular lesions, usually located on the lower extremities. It may be associated with a wide variety of diseases, infections, sarcoidosis, rheumatologic diseases, inflammatory bowel diseases, medications and malignancies. Relationship between erythema nodosum and malignant lymphoma is described in the article. A review of the literature suggest that the diagnosis of Hodgkin's and non-Hodgkin's disease should be considered in patients with unexplained erythema nodosum.

Adult↗
PubMed1997

Palpable migratory arciform erythema. Clinical morphology, histopathology, immunohistochemistry, and response to treatment.

BACKGROUND: Palpable migratory arciform erythema is clinically characterized by sharply circumscribed, infiltrated erythematous patches that tend to spread irregularly, resulting in arciform morphologic features. The histopathologic features are characterized by a patchy inflammatory perivascular and periadnexal T-lymphocytic infiltrate throughout the dermis. The disease runs a chronic course and is rarely described in the literature. OBSERVATION: Three middle-aged patients of both sexes had palpable migratory arciform erythema with 1, several, or multiple lesions on the trunk. There was a dense perivascular and periadnexal, predominantly lymphocytic infiltrate of the reticular dermis without any interstitial distribution of inflammatory cells. Absence of mucin deposits and plasma cells was a striking feature. The immunohistochemical profile showed an infiltrate dominated by T cells of polyclonal origin. In addition, polyclonal B cells and histiocytes were present in small numbers. In all 3 cases, oral antibacterial treatment resulted in a complete (2 patients) or temporary (1 patient) resolution of skin lesions. CONCLUSIONS: Palpable migratory arciform erythema shows distinctive differences in clinical and pathological features and treatment in contrast to other diseases with cutaneous lymphocytic infiltrates, including lymphocytic infiltration of Jessner and Kanof. Therefore, it is likely a distinct disease entity.

Adult↗
PubMed2004

Nonablative facial remodeling: erythema reduction and histologic evidence of new collagen formation using a 300-microsecond 1064-nm Nd:YAG laser.

BACKGROUND: A variety of nonablative lasers have been used to improve skin color and toning. Evidence of new collagen has been seen. Using blinded observer analysis of electron microscopic changes, we have documented the effect of a nonablative Nd:YAG laser on collagen production and its relationship to patient age. OBSERVATIONS: Ultrastructural analysis of 9 patients showed a decrease in overall collagen fiber diameter in the papillary dermis at 1 month and 3 months after 3 treatment sessions. This is consistent with the formation of new collagen. Younger patients had a greater decrease in collagen fiber diameter compared with older patients. The change in collagen fiber diameter with time as well as the relationship between that change and the patient's age were statistically significant (P<.001). Photographic evaluation showed that those patients with preexisting erythema showed improvement in erythema along with an associated improvement in skin quality. There were no adverse events. CONCLUSIONS: Microsecond Nd:YAG lasers appear to be safe for nonablative laser remodeling. Our study indicates that microsecond Nd:YAG lasers can produce new collagen formation in the papillary dermis. In addition, the condition of patients with erythema may be improved. Younger patients may form more new collagen compared with older patients with photodamage.

Adult↗
PubMed1982

Erythema nodosum and kerion of the scalp.

Three children had pustular patches develop over the occipital areas of the scalp. Colonies of Trichophyton mentagrophytes grew on cultures with Sabouraud's dextrose agar with antibiotics. After a week of topical treatment with 1:10,000 potassium permanganate solution and oral treatment with griseofulvin, typical nodules of erythema nodosum appeared over the shins, ranging in diameter from 1 to 4 cm. Nodules on the legs resolved spontaneously within 12 days in the three children. Erythema nodosum occurring in patients with kerion may be interpreted as individual allergic hypersensitivity reactions as a result of the immune host response to allergenic products from the primary site of infection. This possibly may cause immune complexes that precipitate erythema nodosum.

Child↗
PubMed1989

Acral erythema secondary to high-dose cytosine arabinoside with pain worsened by cyclosporine infusions.

Acral erythema after high-dose cytosine arabinoside (Ara-C) has been described as a painful, sharply demarcated, and intense erythema of the palms and soles. This phenomenon occurred and is described in three out of three allogeneic bone marrow transplant (BMT) recipients who received high-dose Ara-C and total-body irradiation for conditioning therapy via the same protocol. These patients also received cyclosporine and methotrexate as prophylaxis for acute graft-versus-host disease. Two of the three patients experienced an increase in the pain associated with acral erythema during cyclosporine infusions and required large doses of narcotic analgesics. Since alcohol intensifies the pain of stomatitis and cyclosporine is manufactured in an alcohol base, the high alcohol content is suspect as the causative factor for this adverse reaction/drug interaction.

Adolescent↗
PubMed2004

Association of a long-chain fatty acid-CoA ligase 4 gene polymorphism with depression and with enhanced niacin-induced dermal erythema.

Hypotheses about relationships between changes in membrane lipids and mental illness have focused primarily on three long-chain polyunsaturated fatty acids: arachidonic acid (AA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Membrane deficiencies of these fatty acids have been reported in schizophrenia (AA, EPA, and DHA) and in depression (EPA and DHA). Long-chain fatty acid-CoA ligase type 4 (FACL4; MIM 300157) is a key enzyme involved in the metabolism of AA, EPA, and DHA. FACL4 selectively esterifies these fatty acids with co-enzyme A, forming acyl-co-A, which can then be incorporated into membrane phospholipid. We used niacin-induced dermal erythema as one index of AA metabolism to identify a common C to T single nucleotide polymorphism (SNP) in the first intron of the FACL4 gene (Xq22.3), which is associated with enhanced dermal erythema in both schizophrenia and control subjects. Male subjects with the T0 genotype showed greater dermal erythema following topical application of methylnicotinate, suggesting that this polymorphism may be in linkage disequilibrium with a functional polymorphism of the FACL4 gene that modulates re-sequestration of agonist-released free AA. We also examined the allele frequency of this polymorphism in 555 European-Americans (EA), including 229 control subjects, 198 subjects with major depression, 58 with schizophrenia or schizoaffective disorder, and 70 with alcohol dependence without co-morbid psychiatric illness. We observed a significant excess of the T allele in subjects with major depression, as compared with controls (49% vs. 38%; P = 0.003) and a non-significant excess of the T allele in schizophrenia (44%; P = 0.29). The allele frequency for subjects with alcohol dependence did not differ from controls.

Alleles↗
PubMed1982

Effects of temperature on ultraviolet-induced erythema of human skin. I. Convective cooling.

Convective cooling of human skin to 20 degrees C or less for 1 h immediately after ultraviolet-B irradiation (UV-B, 290-320 nm) results in a significant increase in erythemal threshold when erythema was observed at 4-6 h postirradiation. Cooling the skin immediately before UV-B irradiation showed no consistent influence on the erythema response. In neither case was an effect of cooling on erythemal threshold apparent when erythema was evaluated at 24 h postirradiation. These effects may be due to alterations in the diffusion kinetics of chemical mediators of inflammation, modification of vascular responsiveness, or reflect changes in temperature-dependent cellular repair or expression of UV-induced damage.

Adult↗
PubMed1980

Light-induced skin cancer and prolonged uv-erythema.

The individual minimal erythema dose (MED) and the persistence of a marked erythema (8 MED) was monitored over 3 weeks (300 nm +/- 10 nm) in 4 groups: White students with fair complexion compared with students of homogenous pigmentation as well as skin carcinoma patients compared with a control group of the same age, i.e., older than 50 years. The MED of the 4 groups gives no significant differences, while the skin carcinoma group shows in 80% a prolonged erythema persistence (control group only 28%). This phenomenon does not seem to correlate with the skin type and may be useful in identifying high-risk patients prone to light-induced skin cancer.

Adult↗
PubMed1982

Reduction of the erythema response to ultraviolet light by nonsteroidal antiinflammatory agents.

The effect of three nonsteroidal antiinflammatory agents (NSAIA) on ultraviolet B (UV-B)-induced erythema was studied in normal human volunteers. Aspirin, indomethacin, and ibuprofen were administered orally 2 h before exposure to UV-B from fluorescent sunlamps and at 4-h intervals for a total of four doses. The minimal dose of light to produce erythema (MED) was determined for each subject with and without drugs. There was a 240% increase in the mean MED when the NSAIA were given. NSAIA, given orally, can increase the threshold for UV-B-induced erythema when administered near the time of irradiation.

Anti-Inflammatory Agents↗
PubMedDate not supplied

Azithromycin versus doxycycline for treatment of erythema migrans: clinical and microbiological findings.

The effectiveness of azithromycin and doxycycline in the treatment of erythema migrans was compared in a prospective randomized trial. One hundred seven adult patients with typical erythema migrans, examined in the Lyme Borreliosis Outpatients' Clinic, University Department of Infectious Diseases in Ljubljana, were included in the study. Fifty-five patients received azithromycin (500 mg twice daily for the first day, followed by 500 mg once daily for four days) and 52 patients received doxycycline (100 mg twice daily for 14 days). The mean duration of skin lesions after the beginning of treatment was 7.5 +/- 5.9 days (median value 5, range 2-28 days) in the azithromycin group and 11.4 +/- 7.8 days (median value 9, range 2 days--8 weeks) in the doxycycline group (p < 0.05). Borrelia burgdorferi was isolated from erythema migrans in 28 patients before therapy: in 13 out of 52 in the doxycycline group and in 15 out of 55 in the azithromycin group. Three months after therapy, the culture was positive in four out of 13 patients treated with doxycycline and in one of the 15 patients who received azithromycin. A biopsy was repeated in all the patients with a positive isolation from the first skin specimen. During the first 12 months' follow-up, three patients treated with doxycycline but none in the azithromycin group developed major manifestations of Lyme borreliosis, while 15 doxycycline recipients and 10 azithromycin recipients developed minor consecutive manifestations.

Adolescent↗
PubMedDate not supplied

Treatment failure in erythema migrans--a review.

Patients with erythema migrans can fail to respond to antibiotic therapy. Persistent or recurrent erythema migrans, major sequelae such as meningitis and arthritis, survival of Borrelia burgdorferi and significant and persistent increase of antibody titres against B. burgdorferi after antibiotic therapy are strong indications of a treatment failure. Most, if not all, antibiotics used so far have been associated with a treatment failure in patients with erythema migrans. Roxithromycin and erythromycin are definitely or probably ineffective. However, doxycycline, amoxicillin, cefuroxime, ceftriaxone, azithromycin and high-dose penicillin V perform comparably well.

Antibodies, Bacterial↗
PubMed1985

Palmar erythema in rheumatoid arthritis.

Palmar erythema ("liver palms") was seen in 32/100 consecutive patients with classical rheumatoid arthritis and in 10/100 patients with various other internal diseases (p less than 0.001). Age of the patients, sex, duration of disease, titer of rheumatoid factor, stage of disease, erythrocyte sedimentation rate and frequency of volar tenosynovitis of the hands did not differ between patients with and those without palmar erythema. Ulnar deviation of the fingers was less common and the hemoglobin content of the blood was higher in patients with palmar erythema.

Adolescent↗
PubMed1990

Erythema nodosum and Hodgkin's disease.

Erythema nodosum is an unusual manifestation of Hodgkin's lymphoma. One patient with long remission of Hodgkin's disease manifested persistent erythema nodosum beginning one and three months before relapse was clinically evident. So, the diagnosis of Hodgkin's disease should be considered in patients with unexplained recurrent erythema nodosum.

Adult↗
PubMed1987

The diagnostic value of gastrocnemius muscle biopsy in sarcoidosis presenting with erythema nodosum and hilar adenopathy.

Five cases of sarcoidosis were identified among twenty cases of erythema nodosum, admitted to the Department of Medicine, during a two-year period. The clinical picture was dominated by hilar adenopathy and erythema nodosum in all cases. All five patients had gastrocnemius muscle biopsy performed, which revealed noncaseating epithelioid granuloma in four. Diagnosis in the fifth patient was made by transbronchial lung biopsy. The present study suggests, that gastrocnemius muscle biopsy might be considered as the initial diagnostic procedure of choice in this, more commonly seen in Caucasians, syndrome of sarcoidosis, presenting with hilar adenopathy and erythema nodosum, based on its safety, ease of performance and relatively high sensitivity and specificity.

Adolescent↗
PubMed1996

Suppression of UV-induced erythema by topical treatment with melatonin (N-acetyl-5-methoxytryptamine). A dose response study.

Oxygen-centred free radicals play an important role in the pathogenesis of acute and chronic UV-induced skin damage as well as in skin aging. In this double-blind randomized study the efficacy of topically applied melatonin (N-acetyl-5-methoxytryptamine), a potent free radical scavenger, in the suppression of UV-induced erythema was assessed. A group of 20 healthy volunteers were irradiated with 0.099 J/cm2 UVB on four 5-cm2 areas on the lower back and topically treated with various concentrations of melatonin (0.05, 0.1, 0.5%) in a nanocolloid gel as carrier or with carrier alone. The UV-induced erythema was examined 8 and 24 h after irradiation by visual scoring and chromametry. A distinct dose response relationship was observed between the topical dose of melatonin and the degree of UV-induced erythema. Significant differences (P < 0.05) were found in redness (chromameter a-value and visual scoring) 8 h after irradiation between the areas treated with melatonin at 0.5% and those treated with melatonin at 0.05% or with the carrier. These results might open a new approach in the prevention and control of free radical-influenced skin diseases.

Administration, Topical↗
PubMed1996

[Erythema elevatum and diutinum in Crohn disease].

A 35-year-old woman suffering from Crohn's disease for 3 years developed painful erythematous nodular lesions predominantly on the dorsa of her hands and feet, as well as on her elbows and wrists. The clinical features and histopathological picture of leukocytoclastic vasculitis were both highly suggestive of erythema elevatum diutinum. No improvement of the skin lesions was observed during treatment with high doses of oral steroids. In contrast, treatment with dapsone resulted in a marked reduction of skin lesions. During a new attack of her Crohn's disease the erythema elevatum diutinum lesions flared again. The parallel clinical course of erythema elevatum diutinum and Crohn's disease, as well as the detection of immune complexes and neutrophilic granulocytes in lesions of both diseases, strongly suggest a common etiology. This hypothesis is discussed in context with this case and the recent literature.

Adult↗