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PubMed2005

Epidemiologic study of the predisposing factors in erythema toxicum neonatorum.

BACKGROUND: Erythema toxicum neonatorum (ETN) is a very common disease, but its predisposing factors are still unknown. OBJECTIVE: To determine the predisposing factors of ETN. METHODS: Seven hundred and eighty-three neonates born in the same hospital during the same period were investigated, and the factors predisposing to ETN were evaluated in a case-control study. RESULTS: (1) The incidence of ETN is about 43.68%, and it is significantly higher in males than in females (p < 0.001). (2) Term birth (p < 0.05), first-pregnancy birth (p < 0.001), the birth season (summer and autumn, p < 0.005), being fed with milk powder substitute or a mixed diet (p < 0.001) and vaginal delivery (p < 0.001) are the predisposing factors of ETN. (3) The severity of ETN in neonates born by vaginal delivery is significantly correlated with the total length of labor (p < 0.001). CONCLUSION: Our findings suggest that environmental factors play an important role in the onset of ETN.

Case-Control Studies↗
PubMed2006

Mini erythema migrans--a sign of early Lyme borreliosis.

BACKGROUND: An erythema migrans (EM) remaining smaller than 5 cm in diameter, called mini EM by us, has not been addressed in detail. OBJECTIVE: To study the significance of the mini EM as a sign of Lyme borreliosis. METHODS: Patients with suspected mini EM were retrospectively selected out of 257 consecutive patients with EM. The diagnosis of mini EM rested on the cultivation of Borrelia burgdorferi. Species and subtype analysis of culture isolates was performed using outer surface protein A (OspA) polymerase chain reaction followed by restriction fragment length polymorphism and sequencing of the OspA gene. RESULTS: There was one patient with definite (0.4%) and another patient with a questionable mini EM. Borrelia garinii OspA type 6 was identified in the patient with the definite and B. burgdorferi sensu lato in the patient with the questionable mini EM. CONCLUSION: The mini EM represents an important and apparently uncommon sign of early Lyme borreliosis.

Adult↗
PubMed2006

Comparison of a two- or three-week regimen and a review of treatment of erythema migrans with phenoxymethylpenicillin.

BACKGROUND: A longer duration treatment is preferred in erythema migrans (EM) to prevent late complaints. OBJECTIVES: To determine whether 20 (20d-pt) or 14 days (14d-pt) of phenoxymethylpenicillin (PenV) have similar efficacy in treating EM and preventing further sequelae. PATIENTS AND METHODS: In a prospective double-centre study, 102 patients with EM were treated with PenV 1.5 million IU thrice daily for either 20 or 14 days and followed up for 12 months. RESULTS: The primary cure rate after treatment with PenV was 91.5% (79.6-97.6) for 20d-pt vs. 91.7% (77.5-98.2) for 14d-pt; p > 0.99). In 7 patients (4/20d-pt and 3/14d-pt), persistent or newly arising symptoms required retreatment. After 1 year, all patients were cured. The immune response showed no statistical difference between the treatment groups in the follow-up period. CONCLUSION: A 2-week treatment regimen of PenV seems to be as effective as a 3-week course with no statistical differences for clinical and serological findings after treatment.

Adult↗
PubMed2006

Recurring localized scarlatiniform scaled erythema Féréol-Besnier.

Recurring scarlatiniform scaled erythema of Féréol-Besnier is a rare disease characterized by recurrent episodes of a prodromal phase with general malaise, head and muscle aches, gastrointestinal complaints and fever followed by an erythematous rash leading to extensive desquamation of the involved skin. It exists in a generalized and localized variant, the latter mainly involving the hands and feet. Its cause is unknown, although it has been speculated that a hyperergic reaction to infectious agents or medications may be etiopathologically involved. A typical case of the localized variant of this obscure disease is described and the common literature is reviewed.

Diagnosis, Differential↗
PubMed2006

Prolonged parvovirus b19 viremia in spite of neutralizing antibodies after erythema infectiosum in pregnancy.

OBJECTIVE: To check the clearance of parvovirus B19 in the course of the development of neutralizing antibodies after Erythema infectiosum in pregnancy. METHODS: Parvovirus B19 serology (Parvovirus B19 IFA IgG, IgM Antibody Test Kit, Biotrin, Ireland and Immunoblot RIDA Blot Parvovirus B19, R-Biopharm, Germany) and polymerase chain reaction (PCR Parvovirus B19, Roche Diagnostics, Switzerland) were performed in eight predelivery sera, one cord blood sample and one serum 2 months after delivery. RESULTS: Acute parvovirus B19 infection in pregnancy was diagnosed by seroconversion in the IgM and IgG antibody class and detection of viral DNA by PCR. Despite the presence of neutralizing antibodies, PCR gave positive results in all subsequent sera including the cord blood sample and the post-delivery sample 7 months after primary infection. Neonatal examination on the 4th day after delivery was normal and no clinical sign of intrauterine infection was noted. CONCLUSIONS: Prolonged parvovirus B19 viremia infection can be seen in spite of neutralizing IgG antibodies and in IgM negative patients. Therefore, the presence of IgG antibodies in the absence of IgM antibodies should not always be interpreted as a past infection. The infectivity of patients with persistent parvovirus B19 infection requires further studies.

Adult↗
PubMed1993

Quantitative evaluation of drug-induced erythema by using a tristimulus colour analyzer: experimental design and data analysis.

Pulsed-light reflectance using the Minolta Chroma Meter CR-200 was evaluated as a quantitative method for the noninvasive assessment of drug-induced erythema on the flexor surface of the forearm. Nicotinate esters were used as model vasodilators. Several parameters derived from the data were analysed using analysis of variance (ANOVA) and Tukey's multiple range tests appropriate for the study designs used. The effects of varying concentrations of methylnicotinate and of different nicotinate esters were found to be statistically significant. This non-invasive technique was found to be particularly useful in ranking the cutaneous responses elicited by the topical application of increasing concentrations of methylnicotinate in a single subject, as well as in a group of 6 volunteers.

Adult↗
PubMed1976

A case of unusual SLE related syndrome characterized by erythema multiforme, angioneurotic edema, marked hypocomplementemia, and Clq precipitins of the low molecular weight type.

Our patient and those of Agnello et al. had identical clinical symptoms such as erythema multiforme, arthralgias and angioneurotic edema and both differed from systemic lupus erthematosus in several important points, i.e., in spite of marked hypocomplementemia the nephropathy is not prominent and it needs high-dose steroids to eliminate the clinical and serological abnormalities. In addition to the features reported by Agnello et al. we found increased viral antibody titers in our patient's sera.

Adult↗
PubMed1995

Erythema nodosum, lichen planus and lichen nitidus in Crohn's disease: report of a case and analysis of T cell receptor V gene expression in the cutaneous and intestinal lesions.

A wide variety of cutaneous manifestations have been described in association with Crohn's disease (CD). We describe a patient with a 2-year history of CD who developed both lichen planus (LP) and lichen nitidus (LN) in addition to erythema nodosum (EN) lesions. The clinical course of EN reflected the activity of the bowel disease, whereas LP and LN appeared to persist independently of the ongoing disease activity. Immunohistochemical studies of the infiltrates in these cutaneous and intestinal lesions showed that the majority of the infiltrates were T cells expressing T cell receptor (TCR)-alpha beta. Analyses of TCR V gene expression in these infiltrating T cells demonstrated a different pattern of V beta expression that provides an explanation for the difference in the clinical courses of these lesions. LP and LN lesions are likely to be mediated by T cells with antigen specificity distinct from those that cause EN and intestinal lesions.

Adult↗
PubMed1994

Clinical, serological and immunogenetic features of Japanese anti-Ro/SS-A-positive patients with annular erythema.

Sixteen anti-Ro/SS-A-positive patients with recurrent annular erythema, which has recently been recognized as a unique cutaneous manifestation of Sjögren's syndrome, were studied. Eight of the 16 patients met the American Rheumatism Association criteria for systemic lupus erythematosus. Fifteen patients had anti-La/SS-B antibodies. Antibodies against U1RNP were detected in 2 patients with systemic lupus erythematosus, 1 with anti-Sm antibodies. Patterns of autoimmune response to Ro/SS-A antigens were variable by immunoblot analysis. HLA typing by the standard complement-dependent microcytotoxicity assay revealed that all the 16 patients were positive for HLA-DRw52 antigens but negative for either HLA-B8 or HLA-DR3 which is reportedly associated with the autoimmune response to Ro/SS-A antigens in white and black patients.

Antibodies, Antinuclear↗
PubMed1994

Clinical and immunological analysis of annular erythema associated with Sjögren syndrome.

Clinical and immunopathological analysis was performed on 24 cases of Sjögren syndrome with annular erythema (AESjS). AESjS predominantly appears on the cheek of the face where skin temperature is relatively low in comparison with other sites. VCAM-1 and ICAM-1 were strongly expressed on endothelial cells of AESjS, while epidermal expression of ICAM-1 was focal and weak. VCAM-1 mRNA expression was also much more intense compared to systemic lupus erythematosus. The lymphocyte response to staphylococcal enterotoxin B was higher in AESjS than that of controls, and cells positive for T cell receptor V beta 6,9,12 were expanded after the culture. Superantigen-driven endothelial-cell-dependent T cell infiltration to the skin plays a crucial role in AESjS.

Adolescent↗
PubMed1994

Localization of perforin in viral vesicles and erythema multiforme.

BACKGROUND: Perforin (Pf), a pore-forming protein, is a cytolytic protein of killer cells. Its deposition in lesioned skin has not been studied. OBJECTIVE: The purpose of this study is to show Pf deposition in the lesioned skin and Pf expression in the dermal infiltrates of various inflammatory skin diseases. METHODS: Frozen specimens obtained from 29 patients with 5 different diseases were immunohistochemically stained. RESULTS: Granular deposition of Pf was found in the lesioned skin in 2 out of 5 cases of viral vesicles and in 3 out of 7 cases of erythema multiforme. In the cases with Pf deposition, the percentages of Pf+ cells in the dermis were higher than in those without deposition. CONCLUSION: Pf released from natural killer cells or cytotoxic T lymphocytes may play a role in tissue damage.

Adolescent↗
PubMed1993

Pigmentary demarcation lines of pregnancy with erythema.

We describe two patients with pregnancy-associated pigmentary demarcation lines overlapped by erythematous changes. In both cases, there was a symmetrical well-defined erythematous pigmentation involving the buttocks and flexor aspects of the legs. After normal delivery the erythema disappeared within 7-10 days, followed by slow resolution of the pigmentation. Compression by the enlarged uterus of peripheral nerves issuing at S1-S2 is proposed as a mechanism of these changes.

Adult↗
PubMed1993

Erythema chronicum migrans: an electron-microscopic study.

Spirochaetal organisms are found in skin specimens obtained by biopsy from a erythema chronicum migrans lesion. The histological picture shows a logical localization of a lymphohistiocytic cell infiltrate: deep dermal in the central papule and superficial in the erythematous border. The electron-microscopic characteristics of the micro-organisms in these specimens (regular waving appearance with coils every 0.8-1.2 microns, oblique striation of periplasmatic fibrils, cross-section of 0.3 micron, membranes) correspond to the spiral-like structure of Borreliae isolated from blood. The Borreliae seem to move freely through the matrix of the dermis and are not phagocytized. This brings on the typical clinical picture of the centrifugally spreading erythematous band.

Animals↗
PubMed1992

Sterile transient neonatal pustulosis is a precocious form of erythema toxicum neonatorum.

A sterile pustular skin eruption was observed in 17 of 3,541 newborn infants examined over a period of 30 months. The skin eruption was always present at birth and fulfilled the clinical criteria of transient neonatal pustular melanosis (TNPM). However, some days after birth, all of them but 1 developed skin lesions typical of erythema toxicum neonatorum (ETN). Histological examination of 11 biopsies obtained at the age of 1 day showed intracorneal neutrophilic pustules in 4 and subcorneal intraepidermic eosinophilic pustules in 7. On the basis of our findings and a literature review we consider that a clear-cut differentiation between TNPM and ETN is not always possible. We propose the name sterile transient neonatal pustulosis to unify these conditions.

Diagnosis, Differential↗
PubMed1990

Erythema multiforme-like eruptions: a rare side effect of topical immunotherapy with diphenylcyclopropenone.

We report 3 cases of erythema multiforme following topical application of diphenylcyclopropenone (DCP) for the treatment of alopecia areata. This eruption represents a rare side effect which could be controlled with corticosteroids given both systemically and topically. When this unusual reaction occurred, treatment with DCP was stopped. In one of the patients, subsequent topical immunotherapy with squaric acid dibutylester was not complicated by this side effect and resulted in complete hair regrowth.

Administration, Topical↗
PubMed1987

Gyrate erythema in a patient with dental radicular cyst.

Nonspecific gyrate erythemas (NGE) are commonly associated with hypersensitivity reactions to exogenous or endogenous antigens. A case of NGE with clinical resemblance to tinea corporis in a patient with a dental radicular cyst is reported. Cutaneous lesions disappeared after surgical excision of the dental cyst. The clinical and pathological details are described and the relationship between radicular cyst and cutaneous lesions discussed. Earlier reports are reviewed and the possibility of a focal origin is emphasized.

Erythema↗
PubMed1985

Erythema multiforme (Stevens-Johnson syndrome)--chart review of 123 hospitalized patients.

The charts of 123 patients hospitalized with erythema multiforme were reviewed. Antecedent infections and the administration of drugs were associated with 15 and 32% of the cases, respectively. Pyrexia arthralgia, photosensitivity, abnormal liver function tests and abnormal urine sediment were common findings. The length of stay in hospital was 12.6 +/- 0.7 days (mean +/- SE), time to initial improvement after onset was 10.3 +/- 0.6 days and time to complete resolution was 23.0 +/- 2.4 days. The presence of bullous skin lesions and greater overall severity were associated with longer hospitalization. Antecedent respiratory tract symptoms were related to shorter hospitalization. Steroid therapy was not associated with a shorter time for initial improvement to occur, while the average length of stay in hospital was 4.2 days longer than that for the patients not treated with corticosteroid.

Age Factors↗
PubMed1985

New experimental approach to measure the skin-reflected light. Application to cutaneous erythema and blanching.

By modifying the blood supply in the upper part of the dermis, the colour of the skin is changed by any material in contact with it. This is a great difficulty when we want to measure the colour intensity in erythema or blanching. To avoid this problem, we designed and built a device which measures the skin reflectance value without any contact with the skin. The use of this device on man to study the skin blanching after application of dermocorticoids allows us to determine the more potent drug among a series (clobetasol propionate) and, for a given drug (betamethasone), the more efficient preparation (oil-in-water emulsion). The study of the effect of increasing irradiation doses of ultraviolet light show that the sensitivity of the device is equivalent to that of the clinical assessment and that the relationship between the irradiation dose and the skin reflectance is sigmoidal.

Betamethasone Valerate↗