SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A 83-year-old patient had been treated for pityriasis rubra pilaris with 70 mg etretinate daily. He developed acute renal impairment, with creatinine levels reaching 73 mg/l on day 7. After discontinuation of etretinate, all biological changes were reversible. Although renal impairment is not considered as retinoid side effect, the chronology of renal changes is very suggestive of etretinate responsibility.
The diagnostic significance of 8 previously proposed minor features of atopic dermatitis (AD) was evaluated. The minor features studied were: nipple eczema, cheilitis, Dennie-Morgan infraorbital fold, pityriasis alba, anterior neck folds, wool intolerance, white dermographism and infraauricular fissuring. The incidence of these features was appreciated in 105 patients with typical AD (median age 8.5 years) and compared to that in 113 control subjects (median age 16 years). The ages of all studied individuals ranged from 7 months to 24 years. Two of these signs, anterior neck folds and the Dennie-Morgan infraorbital fold as defined by us, were shown to be of no diagnostic significance. The other 6 features were confirmed to be valuable diagnostic clues in AD.
Eighty-one patients with dermatomycosis such as tinea corporis, tinea cruris, tinea pedis and pityriasis versicolor were treated with tolciclate 1% cream or miconazole 2% cream. Parasitological cure was obtained in 100% of the patients given tolciclate and in 97.4% of those given miconazole. Patients and investigator considered tolciclate treatment as excellent, respectively, in 76.2% and 73.8% of the cases. The corresponding figures for miconazole were 74.4% and 66.7%. Both treatments were well tolerated.
Topical corticosteroids are an essential part of the treatment regimen of children with atopic eczema and a number of other inflammatory dermatoses, such as infantile seborrhoeic eczema, pompholyx and contact dermatitis. A special form of treatment, the 'wet wrap technique, has been found to be effective in treating children with acute erythrodermic eczema in an inpatient setting. Therapy usually lasts for 3 to 5 days and is useful as crisis intervention therapy. On the other hand, in some conditions, for example pityriasis alba, perioral eczema or juvenile plantar dermatosis, therapy with these agents is generally not required or may not be useful. It is important to remember that care must be taken when a topical corticosteroid is prescribed in children, since this age group is particularly at risk of developing side effects. Thus, the patient should be monitored closely, and potent agents should be avoided.
Systemic isotretinoin has been used to treat severe acne vulgaris for 20 years. However, isotretinoin also represents a potentially useful choice of drugs in many dermatologic diseases other than acne vulgaris. Diseases such as psoriasis, pityriasis rubra pilaris, condylomata acuminata, skin cancers, rosacea, hidradenitis suppurativa, granuloma annulare, lupus erythematosus and lichen planus have been shown to respond to the immunomodulatory, anti-inflammatory and antitumor activities of the drug. Isotretinoin also helps prevent skin cancers such as basal cell carcinoma or squamous cell carcinoma. A combination of systemic isotretinoin and interferon-alpha-2a may provide a more potent effect than isotretinoin alone in the prevention and treatment of skin cancers.Systemic isotretinoin may be considered as an alternative drug in some dermatologic diseases unresponsive to conventional treatment modalities. However, randomized clinical trials aimed at determining the role of systemic isotretinoin therapy in dermatologic diseases other than acne vulgaris are required.
Three new members of the family of human herpesviruses (HHVs) have been identified in less than a decade, HHV 67 and 8. HHV-6 and HHV-7, both infecting T-lymphocytes and phylogenetically related to cytomegalovirus, were identified as causative agents of exanthema subitum. In addition, HHV-6 has been reported to manifest central nervous system tropism and to be frequently detected in normal brain tissue, but has also been associated with febrile seizures. HHV-7 has been suggested to be involved in the development of pityriasis rosea, but has also been found to occur in normal dermal tissue. HHV-8, related to Epstein-Barr virus and infecting B-lymphocytes, was the first herpesvirus to be identified with molecular techniques. Recent research has been focused on the involvement of proteins expressed by HHV-8 in the pathogenesis of two rare tumours, Kaposi's sarcoma and body-cavity B-cell lymphomas.
Three new members of the family of human herpesviruses (HHVs) have been identified in less than a decade, HHV 6 7 and 8. HHV-6 and HHV-7, both infecting T-lymphocytes and phylogenetically related to cytomegalovirus, were identified as causative agents of exanthema subitum. In addition, HHV-6 has been reported to manifest central nervous system tropism and to be frequently detected in normal brain tissue, but has also been associated with febrile seizures. HHV-7 has been suggested to be involved in the development of pityriasis rosea, but has also been found to occur in normal dermal tissue. HHV-8, related to Epstein-Barr virus and infecting B-lymphocytes, was the first herpesvirus to be identified with molecular techniques. Recent research has been focused on the involvement of proteins expressed by HHV-8 in the pathogenesis of two rare tumours, Kaposi's sarcoma and body-cavity B-cell lymphomas.
INTRODUCTION: In the past few years new human herpes viruses (HHV): HHV-6, -7 and -8 have been discovered. According to the most recent literature, they might have an important role in etiopathogenesis of some dermatological diseases. HUMAN HERPESVIRUS 6: HHV-6 was isolated in 1984 from peripheral blood lymphocytes of AIDS patients and patients with different lymphoproliferative diseases. Up to now, two variants of this virus have been identified, A and B, which differ in genetic, biological and immunological characteristics. The etiological importance of variant A, has not yet been clarified, while variant B is considered to be the major cause of many diseases, such as exanthema subitum in infants. In many cases primary infection is associated with elevated temperature, without rash. HUMAN HERPESVIRUS 7: HHV-7 was isolated in 1990 from activated peripheral blood CD4+ T cells of healthy persons. The virus is ubiquitous and more than 80% of babies and infants are affected. Presence of DNA sequences of this virus in mononuclear cells of peripheral blood, skin and plasma of pityriasis rosea patients, points to possible connection between this illness and HHV-7 infection. HUMAN HERPESVIRUS 8: HHV-8 was first identified in tissue samples of patients with Kaposi's sarcoma associated with AIDS in 1994. DNA virus sequences were also isolated in HIV negative persons with Kaposis's sarcoma. Presence of virus can be established in mononuclear cells of peripheral blood, endothelial cells that cover vascular spaces and spindle cells within skin changes. Modes of transmission are still not clarified. However, HHV-8 was identified in some other dermatological diseases as well.
Up to date, the treatment of palmar/plantar hyperkeratoses presents a therapeutic problem. The known therapeutic procedures result in short-term improvement only, if any at all. In these investigations involving 68 patients suffering from palmar/plantar hyperkeratoses of different etiology, small doses of vitamin A acid locally applied, produced a striking improvement in hypertrophic lichen planus of palms or soles: the regression was complete and in most cases permanent. The skin texture of patients with genetic keratoses and callosities became normal within a few weeks: but this condition remained free of symptoms only as long as vitamin A acid was used as a maintenance dose once or twice weekly. In hyperkeratotic eczema, pityriasis rubra pilaris, and verrucae plantaris vitamin A acid locally applied was found to be unsuitable for treatment. The possible side effects of this treatment are mentioned. Several possibilities regarding the way of action of vitamin A acid are discussed.
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a severe variant of pityriasis lichenoides et varioliformis acuta characterized by high fever and papulonecrotic skin lesions. Here we report a case of a 14-year-old boy with typical features of FUMHD and unusual manifestation of extensive skin necrosis in intertriginous regions including axillae, neck, inguinal and antecubital areas. Systemic administration of corticosteroid and erythromycin led to rapid healing of ulcerations without residual scar formation. Review of the literature showed male-predominance and favorable outcome in pediatric cases of FUMHD.
The papulosquamous diseases have certain common morphologic appearances which may at times lead to confusion in diagnosis. They do not have any common etiologic factor. The most common diseases in this category are psoriasis, seborrheic dermatitis, lichen planus, pityriasis rosea, and secondary syphilis. Exfoliative erythroderma is included here since it rarely may be a complication of a pre-existing papulosquamous disease such as psoriasis, seborrheic dermatitis, and lichen planus.
Among 466 children under the age of 12 years who presented with eczema in a 5-year period, 68 p. 100 were atopic. 136 had various atypical signs of atopy. 44 suffered from pityriasis alba of sufficient intensity to justify referral for this reason; 10 had the typical features of seborrhoeic dermatitis of infants. 27 suffered from "forefoot" eczema ("juvenile plantar dermatosis"). The course and characteristics of this condition are discussed and compared with the series recently described in the West of Scotland. Our cases were exactly similar except for an aggravation in the summer months and the fact that our cases responded poorly to topical corticosteroids alone though improved with coal tar. Atopy and contact sensitivity to shoe materials are rare in both groups. We feel that this may be classified as "frictional" dermatitis and agree with our Scottish colleagues that the introduction of nylon socks during the last ten years may be important.
The purpose of this investigation was to determine if a relationship exists between anxiety and skin diseases. It was hypothesized that subjects wtih different dermatoses would have different anxiety levels. Subjects with the following skin diseases were compared: atopic dermatitis, cystic acne, noncystic acne, tinea versicolor, and pityriasis rosea. Anxiety levels were measured by use of the State-Trait Anxiety Inventory (STAI). The STAI consists of two twenty-item self-report rating scales for two types of anxiety: A-State anxiety, which is transitory or situational, and A-Trait anxiety, which is chronic or an enduring personality trait. A one-way analysis of variance revealed significant differences between the aforementioned groups in both A-State and A-Trait anxiety, with the mean elevations highest in the subjects with disfiguring acne (cystic) and intolerably prurific eczema (atopic dermatitis).
Ninety-nine patients with psoriasis were treated topically with 6-aminonicotinamide (6-AN) in four years. In a double-blind study, 1% 6-AN gel was superior to 0.1% triamcinolone acetonide in 29 comparisons, equal in three, and inferior in one when applied without occlusion for four weeks. In an open study, 1% 6-AN was better than four "potent" steroid creams in 34 comparisons, equal in four, and inferior in one. Substantial improvement or complete clearing of plaques occurred in 85 of 99 patients. Tachyphylaxis occurred in ten, but was not permanent. Mucocutaneous toxicity appeared in 25% but was usually easily controlled. Tinnitus occurred in four, but none had deterioration of audiogram readings. The combination of topical 6-AN and oral niacinamide therapy gives promise of an effective and safe treatment for psoriasis. One of three patients with pityriasis rubra pilaris improved considerably with 6-AN.
A synergism between vitamins A and E has been demonstrated by a number of investigators, notably Stanley R. Ames, who showed that in rats on a vitamin E deficient diet, the serum vitamin A level remained low, no matter how much vitamin A was given by mouth, or even by injection, but that adding vitamin E to the diet restored the vitamin A serum level to normal. We have utilized these observations with a high degree of success where vitamin A alone had failed to control three dermatologic conditions involving a defect in keratinization, namely, keratosis follicularis (Darier's disease), pityriasis rubra pilaris, and acne vulgaris. It is possible that a number of additional dermatoses characterized by dyskeratosis or hyperkeratosis might also be benefited by this combination.
Occasionally we observe particular varieties of psoriasis and in rare cases transitional features with other diseases, which pose problems concerning the differential diagnosis and the nosological classification. This communication deals with the following clinical and histological aspects of psoriasis: 1) Sebopsoriasis. Relationship of psoriasis to pityriasis rubra pilaris. 2) Erythema annulare centrifugum type of psoriasis. 3) Is subcorneal pustular dermatosis an expression of pustular psoriasis? 4) Salient histopathological criteria for the diagnosis of the different atypical forms of psoriasis. 5) Presentation of an unusal case with striated and retiform verrucous psoriasis-like eruptions, which show a relationship to parakeratosis variegata.
The authors report a case of Mucha-Habermann disease in childhood. Mucha-Habermann disease is not a very well known, though not infrequent, disease. It is characterized by recurrent erythematous-papular-vesicular skin lesions associated with arthralgia or arthritis or large joints. Prognosis is generally favourable although an evolution towards Pityriasis Lichenoides Chronica and/or Mycosis Fungoides is possible. There are not specific laboratory findings for this form. Diagnosis is essentially based on histology showing an immunopathogenetic vasculitis. At the present time there is not a safe therapy for the disease; there are however indications for the use of Erythromycin and we followed these in our therapy with positive results.
Diseases in which involvement of the nails may be helpful in the diagnosis of dermatologic disease elsewhere include psoriasis, lichen planus, Darier's disease, alopecia areata and totalis, keratotic scabies, scleroderma, and lupus erythematosus and dermatomyositis. Dermatologic diseases in which involvement of the nail commonly occurs but is relatively nonspecific and not diagnostic include dermatitis, lichen striatus, parakeratosis pustulosa, pityriasis rubra pilaris, acrokeratosis paraneoplastica, pemphigus vulgaris, epidermolysis bullosa, porokeratosis of Mibelli, and acanthosis nigricans. These entities are described and treatments summarized as appropriate.