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PubMedDate not supplied

Suppression of UV-induced erythema by topical treatment with melatonin. Influence of the application time point.

The UV-suppressive effect of topical melatonin was assessed at different application time points in a double-blind randomized clinical trial. The lower back of 20 healthy volunteers was treated with 0.6 mg/cm2 melatonin or vehicle either 15 min before or 1, 30 or 240 min after UV irradiation. The erythema was evaluated visually and measured by chromametry 24 h after irradiation. UV-absorbing effects of melatonin were measured at a concentration of 8 microg/ml with a spectrophotometer. Melatonin absorbs UV light at a wavelength of 225-275 nm which is clearly below the wavelength of UVA and UVB (290-390 nm). The visual score showed that application of melatonin 15 min before irradiation significantly suppressed erythema compared to treatment with vehicle alone (p < 0.001). Similar results were found by chromametry (p < 0.001). Treatment after irradiation showed no UV suppression. The erythema suppressive effect of melatonin might be explained by the radical-scavenging mechanism of quenching meanly hydroxyl radicals (.OH) which are known to be most present in sunburn reaction of the skin. The protective effect of the pre-irradiation treatment might be explained by penetration into the skin within 15 min and the presence in a local concentration at the irradiation time point.

Administration, Topical↗
PubMed1999

Bacterial interdigital scaly erythema (Kitamura): a possible new clinical entity.

Four patients with scaly erythema on their finger webs and sides of their fingers during summer are described. These patients were working in either butcher's shops or a sushi bar, where they handled raw meat, chicken or fish for many hours. The eruptions first appeared as scaly erythema, sometimes accompanied by small pustules, on the second, third and fourth finger webs, and later the erythema extended to the sides of the fingers and palms. Maceration and/or shallow erosion sometimes appeared on the finger webs. Symptoms were usually mild; the patients complained of slight itching, irritation or pain. Direct examination of specimens stained with Parker blue-black ink containing KOH revealed scales containing bacterial granules or filaments. Several species of bacteria were cultured including Corynebacterium sp. Fungus was not detected in either KOH specimens or in cultures. The lesions responded rapidly to topical or oral antibiotics; however, they recurred frequently during hot and humid weather. Hitherto a similar condition has not been described and is possibly a new clinical entity.

Adolescent↗
PubMed2001

Pentoxifylline attenuates UVB-induced cutaneous erythema.

BACKGROUND: The mechanism for ultraviolet-B (UVB)-associated cutaneous erythema may involve production of tumor necrosis factor alpha (TNF-alpha). Pentoxifylline inhibits TNF-alpha production. OBJECTIVE: To assess the effect of oral pentoxifylline on UVB-induced erythema in humans. METHODS: Baseline minimum erythema doses (MEDs) for UVB were measured. Subjects received pentoxifylline 400 mg orally every 8 h for 4 doses. MED assays were repeated 2 h after the last dose of pentoxifylline. Pre- and posttreatment MED results were assessed by the paired t test. RESULTS: Oral administration of pentoxifylline to 7 normal adults elevated the MED for UVB in all 7 individuals. CONCLUSION: Pentoxifylline may diminish the cutaneous sunburn response to UVB radiation when it is administered prior to ultraviolet exposure.

Adult↗
PubMed2001

Topical metronidazole does not abate UVB-induced erythema.

BACKGROUND: The capacity of topical metronidazole to reduce erythema severity scores in rosacea has been attributed to its anti-inflammatory activity. METHODS: Nine healthy subjects were irradiated on three 1-cm(2) areas on their volar forearm with 2 MEDs of UVB. Twenty-four hours later, one of the irradiated areas was treated daily with metronidazole 1% vanishing cream, one with the vehicle only and the third was left untreated (control). The intensity of erythema was measured, at 24, 48, 72 and 96 h after irradiation, by a Chromameter CR200 (Minolta, Japan) and expressed in the L*a*b* system. The a* parameter was taken as the measure of redness. RESULTS: Overall, redness diminished over time in a linear way, but treatments did not influence it significantly. CONCLUSION: In our vehicle, metronidazole 1% cream failed to abate the UVB-induced erythema. An activity other than the anti-inflammatory one should be suggested to explain the topical metronidazole efficacy in rosacea.

Administration, Cutaneous↗
PubMed2002

Sun exposure is an aggravating factor responsible for the recalcitrant facial erythema in adult patients with atopic dermatitis.

BACKGROUND: In Japan, a considerable number of adult patients with atopic dermatitis suffer from recalcitrant facial erythema that resists common treatment with topical corticosteroids and antihistamines. OBJECTIVE: Our purpose was to investigate the potential role of sun exposure in the aggravation of these facial lesions. METHODS: The history of photoaggravation was taken from 74 adult patients with atopic dermatitis who suffered from recalcitrant facial erythema. Repeated UVB and UVA phototests were performed in 36 patients. Surface markers of infiltrating cells in UVB-provoked lesions were characterized immunohistochemically. RESULTS: Forty-one of 74 patients experienced an exacerbation of the facial lesions after sun exposure. UVB testing revealed an abnormal, papular response in 14 of 36 patients. All of the 14 patients complained of clinical aggravation after sun exposure. No abnormal reactions were observed at UVA testing. In UVB-provoked lesions, CD4+ cells were predominant to CD8+ cells. CONCLUSION: Exposure to UVB radiation may be responsible for the recalcitrant facial erythema in at least some of the patients with atopic dermatitis.

Adolescent↗
PubMed1995

Lichen planus presenting with erythema-multiforme-like bullous lesions in a patient with systemic scleroderma.

A patient with systemic scleroderma is described who developed a cutaneous eruption of papules and vesicobullae. Over time, the latter turned into papules. The histopathological and immunofluorescence features of the papular lesions were unequivocally those of lichen planus, while those of the bullous lesions reminded of erythema multiforme. Histologically, erythema multiforme shares common features with lichenoid reactions, such as necrotic keratinocytes. Our case suggests that erythema multiforme and lichen planus may coexist or succeed each other as different stereotype immune reactions against the same antigen(s) within the epidermis.

Blister↗
PubMed1988

Measurement of erythema and tanning responses in human skin using a tri-stimulus colorimeter.

A 'Minolta Tri-Stimulus Colorimeter II' was evaluated for obtaining objective measurements of early changes in erythema and tanning. The meter showed a subtle, continuous transition between the primary erythematous response and the delayed tanning of skin which was below the visual threshold for detection. Thereafter, the a* (redness) value of the meter showed a significant linear correlation with the dermatologist's perception of erythema while the b* (yellow) value showed a significant correlation with the perception of tanning. This capability of the tri-stimulus colorimeter to simultaneously evaluate the hue and saturation of skin color affords an improved opportunity to quantitate the transition from erythema to tanning without subjective bias.

Adolescent↗
PubMed1988

Recurrent erythema nodosum, arthritis and IgA nephropathy.

Erythema nodosum and IgA nephropathy are nosologic entities with an immunologic background. IgA nephropathy is a specific disease of the kidneys, while erythema nodosum may be associated with other illnesses. We report a unique case in which intermittent hematuria due to IgA nephropathy was superimposed on recurrent attacks of erythema nodosum and arthritis. A common pathophysiology is suggested.

Adult↗
PubMed2004

Herpes zoster laryngis with prelaryngeal skin erythema.

A 74-year-old man came to our hospital with complete left vocal cord paralysis and erythema of the prelaryngeal skin. The patient also had mucosal swelling and erosions in the left arytenoid cartilage, aryepiglottic fold, and pyriform sinus. Herpetic vesicles developed over the prelaryngeal erythema 4 days after admission. An increase in the varicella-zoster immunoglobulin G level to 3,294 IU/mL confirmed varicella-zoster virus infection of the larynx and prelaryngeal skin. The patient was treated with acyclovir without marked effect. Nevertheless, in cases of unilateral vocal cord paralysis and erythema of the ipsilateral prelaryngeal skin, we advise that herpes zoster laryngis must be considered and treatment with early intravenous acyclovir started.

Aged↗
PubMed1984

Can erythema nodosum and reactive arthritis be a sequel to Shigella flexneri gastroenteritis?

Erythema nodosum and seronegative arthritis associated with diarrhoea was previously regarded as implying the presence of inflammatory bowel disease. Recently, however, erythema nodosum has been described as a sequel to diarrhoea caused by infection with Salmonella typhimurium, Yersinia enterocolitica and Campylobacter jejuni. We report two patients in whom erythema nodosum and reactive arthritis followed acute Shigella flexneri gastroenteritis, a rare association.

Adult↗
PubMed1994

Erythema multiforme and hypersensitivity myocarditis caused by ampicillin.

OBJECTIVE: To report a case of erythema multiforme and hypersensitivity myocarditis caused by ampicillin. CASE SUMMARY: A 13-year-old boy was treated with ampicillin and gentamicin because of suspected septicemia. Medications were discontinued when erythema multiforme and congestive heart failure caused by myocarditis occurred. The patient was treated with methylprednisolone and gradually improved. Macrophage-migration inhibition (MIF) test with ampicillin was positive. DISCUSSION: After most infections causing erythema multiforme and myocarditis were ruled out, a drug-induced allergic reaction was suspected. Positive MIF test for ampicillin showed sensitization of the patient's lymphocytes to ampicillin. CONCLUSIONS: Hypersensitivity myocarditis is a rare and dangerous manifestation of allergy to penicillins.

Adolescent↗
PubMed2000

Erythema nodosum associated with antiphospholipid antibodies: a report of three cases.

Erythema nodosum is a dermatologic condition characterized by painful, erythematous nodules on the anterior surfaces of the lower extremities. Its association with a variety of conditions has been previously described. We present three cases of erythema nodosum in patients with elevated anticardiolipin antibodies. In one patient, a temporal relationship was seen in the simultaneous detection of antibodies and skin lesions. We propose an association between erythema nodosum and the antiphospholipid antibody syndrome (APS).

Adult↗
PubMed1988

Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin.

In 15 months we encountered eight patients with intracranial tumors who developed erythema multiforme (EM) or erythema multiforme bullosa (Stevens-Johnson syndrome). All occurred shortly after use of phenytoin (DPH) and brain radiation therapy (WBRT). The clinical picture differed from the classic form of EM in that the erythema began on the scalp and spread to the extremities, progressing in three cases to extensive bullous formation. There were no cases of EM among patients who received either DPH or radiotherapy alone. The combination of DPH, WBRT, and tapering of steroids seems to predispose to EM. The pathogenesis of the disorder is probably immunologic. In the absence of seizures, anticonvulsants should not be given routinely to patients with brain tumors. When anticonvulsants are necessary in patients scheduled for WBRT, DPH may not be the drug of choice.

Adult↗
PubMed2000

Parvovirus infection of keratinocytes as a cause of canine erythema multiforme.

Erythema multiforme major was diagnosed in a dog with necrotizing parvoviral enteritis. Skin lesions consisted of ulceration of the footpads, pressure points, mouth, and vaginal mucosa; vesicles in the oral cavity; and erythematous patches on the abdomen and perivulvar skin. Microscopic examination of mucosal and haired skin specimens revealed lymphocyte-associated keratinocyte apoptosis at various levels of the epidermis. Basophilic cytoplasmic inclusions were seen in basal and suprabasal keratinocytes. Immunohistochemical staining, performed with canine parvovirus-2-specific monoclonal antibodies, confirmed the parvovirus nature of the inclusions in the nucleus and cytoplasm of oral and skin epithelial cells. This is the first case of canine erythema multiforme reported to be caused by a viral infection of keratinocytes. This case study indicates that the search for epitheliotropic viruses should be attempted in cases of erythema multiforme in which a drug cause cannot be identified.

Animals↗
PubMed2002

Acute pancreatitis, hepatic cholestasis, and erythema nodosum induced by carbimazole treatment for Graves' disease.

A 33-year old female was diagnosed as Graves' disease and started on carbimazole. One month later when she was already euthyroid only on carbimazole therapy, she developed acute pancreatitis associated with mild cholestatic hepatitis and erythema nodosum. Carbimazole therapy was interrupted, pancreatic and liver function gradually improved and became normalized two weeks later. Other potential etiological causes of acute pancreatitis, hepatitis and erythema nodosum were excluded. Rechallenge with a single dose of carbimazole led to a new episode of acute pancreatitis and cholestatic hepatitis one day later. The appearance of different hypersensitivity reactions including pancreatitis, hepatitis and erythema nodosum, together with the observation that the interval between drug intake and onset of symptoms became shorter with repeated exposure to carbimazole, point to an immune-mediated mechanism. Carbimazole has to be added to the list of drugs capable of inducing acute pancreatitis, and should be emphasized the need to discontinue this medication as soon as there is evidence of pancreatic dysfunction.

Acute Disease↗
PubMed2004

The glucagonoma syndrome and necrolytic migratory erythema: a clinical review.

The glucagonoma syndrome is a rare disease in which a typical skin disorder, necrolytic migratory erythema, is often one of the first presenting symptoms. Weight loss and diabetes mellitus are two other prevalent characteristics of this syndrome. Necrolytic migratory erythema belongs to the recently recognized family of deficiency dermatoses of which zinc deficiency, necrolytic acral erythema and pellagra are also members. It is typically characterized on skin biopsies by necrolysis of the upper epidermis with vacuolated keratinocytes. In persistent hyperglucagonemia, excessive stimulation of basic metabolic pathways results in diabetes mellitus at the expense of tissue glycogen stores, and muscle and fat mass. Multiple (essential) nutrient and vitamin B deficiencies develop, which contribute to the dermatosis. In addition, glucagonomas may produce various other products, like pancreatic polypeptide, that add to the catabolic effects of glucagon.

Adolescent↗
PubMed2004

[Erythema nodosum leprosum case series report: clinical profile, immunological basis and treatment implemented in health services].

Erythema nodosum leprosum is an acute inflammatory event in the chronic course of leprosy. It is considered an immunological disorder and an important cause of morbidity and disability. We evaluate the clinical profile, serology and histopathology 58 erythema nodosum leprosum patients sequentially recruited, from July- December 2000, in an endemic area in Central Brazil (Goiás State). Half of the reactins were considered severe and 66% of the cases had the first episode of reaction during specific treatment. The majority of patients and controls were positive to anti-PGL-I IgM. The more frequent histopathological findings in erythema nodosum leprosum were presence of intracellular acid-fast bacilli, perivascular/peradnexial mononuclear inflammatory infiltrate, and neural aggression. Ninety six percent of the patients were treated with systemic steroid in the first episode. The results point out to the association between ENL and neuritis and the rare adoption of thalidomide as a solely medication in the health services.

Adrenal Cortex Hormones↗
PubMed2005

Erythema elevatum diutinum as a first clinical manifestation for diagnosing HIV infection: case history.

CONTEXT: Erythema elevatum diutinum is a chronic and rare dermatosis that is considered to be a variant of leukocytoclastic vasculitis. It is probably mediated by immune complexes. It is generally associated with autoimmune, neoplastic and infectious processes. Recently, it has been added to the group of specific dermatoses that are associated with HIV. CASE REPORT: We report on the case of a patient who had erythema elevatum diutinum as the first clinical evidence for diagnosing HIV infection. Dapsone was used in the treatment of this patient, and partial regression of the lesions was achieved within 15 days, even before anti-retroviral therapy was prescribed. CONCLUSION: When there is a diagnosis of erythema elevatum diutinum, HIV infection should be investigated, especially in atypical and exacerbated clinical manifestations.

Anti-Infective Agents↗