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Erythema multiforme associated with autoreactivity to 17 alpha-hydroxyprogesterone.

We report a case of a 23-year-old woman who was afflicted with disseminated skin erythema multiforme-like eruptions that started at the menarche, relapsed at the premenstrual periods, dramatically spread during two pregnancies and cleared after abortion; the skin lesions responded dramatically to thalidomide treatment. A high-affinity binding factor to 17 alpha-hydroxyprogesterone (17-OHP) was found in the serum of this patient. Her lymphocytes did not proliferate in vitro after exposure to exogenous 17-OHP but showed significant chromatin activation. There was a decreased expression of HLA antigens at the surface of the patient's blood lymphocytes. This is a unique well-documented case of erythema multiforme most possibly due to autoreactivity to 17-OHP; the precise mechanism(s) of this autoreactivity has not been established.

17-alpha-Hydroxyprogesterone↗

[Erythema nodosum in Campylobacter jejuni colitis].

We report the case of a 27-years-old woman with erythema nodosum associated with ulcerative colitis due to Campylobacter jejuni as diagnosed by serology, endoscopy and histology. This case indicates a hitherto rarely described etiology of erythema nodosum.

Adult↗

Erythema induced by quartz-halogen sources.

The erythemal effect of 100-W quartz-halogen sources, previously predicted from radiation measurements, was directly measured on humans at a distance of 10 cm. Minimal erythema was produced in 15 min for skin type I. These data show that normal use of a desktop lamp should not usually lead to erythema in one day, but that long-term effects cannot be ignored, because for lifetime use at work, the relative risk for squamous cell carcinoma on the back of the hands is 3.4.

Carcinoma, Squamous Cell↗

[Etiology of toxic erythema in newborn infants and its effects on the health status of young children].

A total of 68 neonates with toxic erythema (TE) were examined for risk factors of its origin depending on the intensity of the clinical manifestations of erythema. It has been established that sensitizing factors (aggravated allergological anamnesis, food, allergens, late toxicosis of pregnancy) and high content of estrogen hormones in the newborn are implicated in the genesis of the generalized TE pattern. The study of the catamnesis of 84 children of the first three years of life with a history of TE of the newborn revealed that the children appeared highly susceptible to respiratory diseases and showed early formation of the allergic manifestations. It is recommended that neonates with marked TE should be attributed to the second health group and be administered the treatment and prophylactic measures beginning from the stay at the maternity home.

Age Factors↗

Erythema multiforme minor associated with Mycoplasma pneumoniae infection.

A young Bedouin woman with serologically proven Mycoplasma pneumoniae infection is presented. Along with pulmonary involvement, fever and bullous myringitis, she presented with erythema multiforme minor, a rare complication of mycoplasma infection of which many physicians may not be aware. The skin participation in mycoplasma infections is discussed. Mycoplasma infection should be considered in the differential diagnosis of erythema multiforme.

Adult↗

Erythema nodosum associated with acute cytomegalovirus mononucleosis in an adult.

Acute cytomegalovirus mononucleosis has been associated with maculopapular rashes, petechiae, purpura, urticaria, ulcerative lesions, and vesicular eruptions. Although erythema nodosum has been reported in association with a number of infectious and noninfectious diseases, to our knowledge it has not been associated with cytomegalovirus infections. We report the first case of an adult patient with acute cytomegalovirus mononucleosis who presented with erythema nodosum.

Acute Disease↗

Eosinophils in skin lesions of erythema multiforme.

To investigate the controversy regarding the presence of eosinophils in skin lesions of erythema multiforme, we undertook a retrospective clinicopathologic study of 19 recent cases that fulfilled clinical and histopathologic criteria for the disease. At least a few eosinophils were observed in 13 of 19 cases, and in four cases there were more than three per high-power field, qualifying as "tissue eosinophilia." Immunofluorescence studies in three cases with eosinophils failed to show the linear basement membrane zone fluorescence characteristic of bullous pemphigoid. Giemsa stains revealed that mast cells were present in lesions both with and without eosinophils. The only clinical features that distinguished patients with tissue eosinophilia from those without were an older age of incidence and a longer duration of disease prior to biopsy. Drugs were implicated as a causative factor in some patients both with and without eosinophils, but all four patients with tissue eosinophilia were believed to have drug-induced disease. We conclude that eosinophils do occur in skin lesions of erythema multiforme and are occasionally numerous.

Adult↗

Painful palmar and plantar erythema associated with hepatic artery infusion of 5-fluoro-2'deoxyuridine.

Painful palmar and plantar erythema is an uncommon systemic complication of chemotherapy and has been reported in association with methotrexate, cystosine arabinoside, doxorubicin, and 5-fluorouracil. The authors report a case in which the syndrome was precipitated by hepatic artery infusion of 5-FUdR. The previous recommendation that treatment of patients developing painful palmar-plantar erythema from other drugs may be successfully resumed using intrahepatic arterial infusion of FUdR must be reconsidered in light of the present report.

Erythema↗

Erythema annulare centrifugum: an unusual case due to hydroxychloroquine sulfate.

Erythema annulare centrifugum presents as a cutaneous hypersensitivity to diverse causes including fungal and yeast infections, parasitic infestations, drugs, and, rarely, occult malignancies. A prolonged case of erythema annulare centrifugum secondary to the use of hydroxychloroquine sulfate is presented. The prolonged time needed for clearing after discontinuation of the medication is thought to result from the melanocyte-binding characteristics of the drug.

Drug Eruptions↗

Action spectrum for UV erythema and reproduction of the skin lesions in hydroa vacciniforme.

Action spectra for UV erythema and reproduction of the skin lesions in 4 patients with hydroa vacciniforme (HV) were studied. Vesicles were successfully reproduced by repeated daily monochromatic irradiations of 330, 340, 350 and 360 nm for 5, 6 or 7 days. The daily doses were equivalent to global solar radiation for 70-190 min. The vesicles produced were identical to those of HV, macroscopically and histologically. Repeated daily exposures to a small dose of UVA produced vesicles, whereas a large but single exposure to UVA failed to do so. Daily exposures to UVB failed to produce the vesicles. The minimal erythema dose (MED) was lower than the minimum limits of the normal persons in the 290-310 nm range.

Adolescent↗

[A case of erythema nodosum in tularemia].

Since 1980 some epidemics of tularemia occurred, involving large areas of Tuscany (Italy). Among the different clinical features described in the classic form of tularemia, erythema nodosum never has been reported. One case of erythema nodosum, the first reported in course of tularemia, is described. The correct diagnosis is based on careful question about exposure to mammals and ticks. The importance of early treatment is stressed.

Adult↗

[Erythema dyschromicum perstans versus lichen planus].

Erythema dyschromicum perstans and lichen planus have been regarded as related. We describe the case of a 41 year old man presenting a relapsing dermatitis consisting of erythematous patches leaving behind ashy-gray macules. The lesions of lichen planus were atypical and the ashy dermatosis was transient. The possibility that some cases of lichen planus lead to an erythema dyschromicum perstans is discussed.

Adult↗

Development of neuroendocrine (Merkel cell) carcinoma mixed with squamous cell carcinoma in erythema ab igne.

Squamous cell carcinoma and neuroendocrine (Merkel cell) carcinoma are cutaneous neoplasms that have only occasionally been reported to coexist. Squamous cell carcinoma, but not neuroendocrine (Merkel cell) carcinoma, is a rare complication of erythema ab igne. This report describes the development of both neoplasms arising within the same tumor mass in an area of erythema ab igne.

Aged↗

[Clinical picture of erythema neonatorum].

Erythema neonatorum is the most common exanthematous eruption in neonates, which is always associated with an eosinophilic infiltration of the skin. Erythema neonatorum can be present at birth. It is of great importance in the differential diagnosis of pustular eruptions in newborns due to virus or bacteria, of miliaria pustulosa, and of incontinentia pigmenti.

Chickenpox↗

[Centrifugal annular erythema and African trypanosomiasis. Trypanid ].

The skin symptoms of trypanosomiasis in children are reviewed following report of one case of African trypanosomiasis (T. Gambiense). Trypanids, existing in 10-20% of patients during blood and lymphatic dissemination, appear are transient centrifugal annular erythemas made of few elements located on the trunk and roots of arms and thighs. Centrifugal annular erythema in a context of severe infections disease in a exposed subject coming from and endemic zone constitutes a characteristic diagnostic element.

Child, Preschool↗

[Erythema exsudativum multiforme in rickettsiosis].

A patient with Mediterranean spotted fever with a typical exanthema acquired in South Africa developed erythema multiforme 12 days after the beginning of the rickettsial infection. The exanthema caused by the rickettsial infection as well as the erythema multiforme were effectively treated with tetracyclines.

Bites and Stings↗

Environmental influences on UVB erythema.

In 31 volunteers the superficial skin temperature of one forearm was either raised or lowered by a warm or cold water bath. Immediately afterwards the individual minimal erythema dose (MED) for monochromatic light of 300 +/- 5 nm (UVB) was determined on both arms. Compared to the control forearm, a warm water bath significantly lowered the MED (p less than 0.001), whereas a cold water bath had no influence on the light sensitivity. In 14 volunteers the MED for polychromatic UVB was determined on the lower back with and without a continuous cold air flow 5 min before and during the UVB exposure. The continuous cold air flow significantly increased the MED (p less than 0.05). Environmental factors such as warm water or cold air have modulating effects on UVB erythema. These interactions should be considered when dealing with the effects of natural sun exposure or phototherapy.

Adolescent↗