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PubMed2001

Marginal papular acrokeratodermas: no racial limitations for a clinical spectrum that responds to acitretin.

Marginal papular acrokeratoderma (MPA) encompasses a group of disorders that share crateriform, keratotic papules along the margins of the hands and feet. We report a unique case of a Philippino woman, with focal acral hyperkeratosis (FAH) associated with sensorineural hearing loss. The clinical phenotype of FAH (hereditary MPA without elastorrhexis) is expanded and the hypothesis of a racially limited disorder is weakened. Effective treatment of this embarrassing condition with acitretin is demonstrated.

Acitretin↗
PubMed2002

Aquagenic syringeal acrokeratoderma (transient reactive papulotranslucent acrokeratoderma).

In 1996, English and McCollough described an unusual entity in 2 sisters characterized by a transient and recurrent keratoderma exclusively on the palms after water exposure. The condition developed 3-5 min after exposure to water and resolved within a short time after drying. This finding was associated with a tightening sensation. Yan et al. coined the term 'aquagenic palmoplantar keratoderma', and the designation 'aquagenic syringeal acrokeratoderma' was suggested by MacCormack et al. Until now, a total of 8 cases have been reported. We documented 2 new cases with acquired aquagenic syringeal acrokeratoderma. A 25-year-old female had observed within the last 3 months a burning sensation on the palms after some minutes of water contact. Physical examination revealed a perfectly normal skin on the palms. Three minutes after water immersion of 20 degrees C, a whitish discoloration appeared on the palms and a thickening of the palmar skin was visible. In addition, the eccrine pores were much more prominent. Few minutes after drying the skin, the situation returned to a normal state. The second patient, a 33-year-old female noticed a painful whitish discoloration of the skin on the palms after a short period of water immersion. Sometimes the white skin could be peeled off. In the last year, hyperhidrosis developed, and a more reddish aspect of the palms appeared. In our office after rinsing the hands with water at room temperature, a whitish discoloration in the center of the palms appeared which was associated with a painful sensation. After drying, the whitish lesions disappeared almost completely within 30 min. Aquagenic palmar keratoderma describes an acquired and transient condition which occurs after brief exposure to water and disappears after drying within minutes to an hour. Only rarely may a slight hyperkeratosis remain for a longer time. The possible pathophysiology and treatment options are discussed.

Acrodermatitis↗
PubMed2002

Combined vaccination by measles and hepatitis B vaccines: a new cause of Gianotti-Crosti syndrome.

An 11-month-old boy presented with Gianotti-Crosti syndrome. He had received measles and a third dose of hepatitis B vaccines 2 weeks before the onset of the eruption. There were no clinical symptoms of any viral infection at the presentation. Serological tests for common viral infections were negative. The combination of measles and hepatitis B vaccines was likely the relevant factor in the etiology.

Acrodermatitis↗
PubMed2003

Gianotti-Crosti syndrome associated with endogenous reactivation of Epstein-Barr virus.

A 6-year-old girl with Gianotti-Crosti syndrome, which appeared to be caused by a reactivation of Epstein-Barr virus (EBV), is presented. The patient had had infectious mononucleosis at the age of 3 years. Since the titer of anti-EBV capsid antigen antibody was high at 1,280 and the titer of early antigen DR IgG, which increases during the early stage or reactivation, was high at 80 during the recovery stage, the patient was diagnosed as having Gianotti-Crosti syndrome associated with reactivation of EBV. Its clinical symptoms associated with reactivation of EBV were similar to those of that associated with primary EBV infection, in that the present patient had acrolocated papulovesicular dermatitis, superficial lymph node enlargement and mild hepatopathy. This patient provides valuable information in that reactivation was also observed with EBV like other types of herpesvirus.

Acrodermatitis↗