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Pustulosis palmoplantaris and its relation to chronic recurrent multifocal osteomyelitis.

In previous study we found that clavicular lesions in chronic recurrent multifocal osteomyelitis (CRMO) in young patients was associated with palmoplantar pustulosis (PPP). In this work the relationship between sternoclavicular lesions and PPP was studied in a group of adult patients. The sternoclavicular region of 52 patients with PPP and 25 control persons was examined by tomography. Among the PPP patients there were inflammatory lesions in the sternal synchondroses in 3 patients. There were no such lesions in the controls. In this unselected population of adult patients there was thus no definite association between PPP and sterno-clavicular lesions. In young patients on the other hand, CRMO with clavicular lesions may be another, probably noninfectious, cause of PPP.

Adult↗

[Pseudoporphyria].

A 46-year-old patient with chronic renal failure receiving maintenance haemodialysis for 3 years had a few months history of blister formation and skin fragility involving the face, arms and dorsa of the hands. In this case clinically mimicking porphyria cutanea tarda (PCT) no demonstrable abnormality in the porphyrin metabolism excretion was detected.

Diagnosis, Differential↗

Treatment of palmoplantar pustulosis with Tigason.

In a double-blind, cross-over trial with Tigason and placebo, the parameters of palmoplantar pustulosis underwent significant changes during the retinoid therapy. A hand-over effect was clearly indicated during the placebo period and several patients experienced long-lasting remissions.

Adult↗

HAND ECZEMA.

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Adrenal Cortex Hormones↗

Successful treatment of hand and foot psoriasis with efalizumab therapy.

Hand and foot psoriasis can appear in a plaque-type or pustular-type form. Any form of psoriasis that occurs on the hands and feet can have a debilitating effect on the patient's daily functions. Here we present a case series of patients with plaqueor pustular-type hand and foot psoriasis whose conditions were successfully managed with the biologic agent efalizumab. In many of these patients, the disease was refractory to multiple systemic psoriasis treatments. Treatment with efalizumab was effective and well-tolerated, with few adverse events. Many of the patients described here reported an improvement in both their physical functioning and health-related quality of life. The efficacy of efalizumab in treating these cases of hand and foot psoriasis suggests that it may provide therapeutic benefit.

Adult↗

Dogger Bank Itch and cyclosporin.

Two cases of Dogger Bank Itch responding to oral cyclosporin (Neoral) are reported. The first, a 42-year-old shell-fisherman, presented with eczema on his face, forearms and hands. Oral prednisolone was ineffective and in subsequent years systemic steroids and topical clobetasol propionate allowed him to continue his work. In the shellfishing season of 1996, cyclosporin (Neoral) was introduced and the eczema was subsequently satisfactorily controlled. The second fisherman, aged 46, presented with an irritant eczema of the hands and forearms. Initial treatment with emollients and potent topical steroids had little effect. A subsequent course of cyclosporin provided good control of the eczema.

Administration, Oral↗