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PubMed2005

Acrokeratosis verruciformis of Hopf (Hopf disease): case report and review of the literature.

Acrokeratosis verruciformis of Hopf is an autosomal dominant genodermatosis usually presenting with multiple planar wart-like lesions, typically observed on the dorsum of the hands and feet. The disease is very rare and the pathogenesis remains unknown. Considerable controversy surrounds the nature and relationship of acrokeratosis and Darier disease and whether they are manifestations of one genetic abnormality. We describe the case of a 19-year-old man seen in our clinic with skin-coloured, flat, warty papules localized to the dorsum of the hands and feet. Both clinical and histological findings were compatible with acrokeratosis verruciformis. We also review the disease, particularly its relation with Darier disease and therapeutical options.

Adult↗
PubMed2001

Contact dermatitis due to printer's ink in a milk industry employee: case report and review of the allergen paraphenylenediamine.

Paraphenylenediamine is a common cause of occupational dermatoses in hairdressers, metallurgy workers, and others. Hand dermatitis developed in an employee of a milk packaging facility. The employee's hands were exposed to milk cartons embossed with wet printer's ink on a daily basis for 2 years. The worker was evaluated through a history, physical examination, and patch testing with 50 standard allergens. Patch testing revealed a positive reaction to paraphenylenediamine. The hand dermatitis resolved once the patient instituted protective measures. The worker's reaction might represent a delayed-type hypersensitivity reaction to printer's ink that contained this agent. More likely, the inciting agent was some other ingredient of the printer's ink that cross-reacts with paraphenylenediamine.

Adult↗
PubMed1994

Value of a second freeze-thaw cycle in cryotherapy of common warts.

A study of open, randomized, parallel-group design was performed to investigate the impact of a second freeze-thaw cycle on the cure rate, at 3 months, from cryotherapy of common warts on the hands and feet. Cryotherapy was performed at 3-week intervals, and subjects were randomized to receive either one or two freeze-thaw cycles. In addition, all subjects used keratolytic wart paints throughout the study, and plantar warts were pared prior to freezing. Three hundred subjects were recruited. At 3 months, 124 were cured, 83 were not cured, and 93 had defaulted. Among those who did not default the cure rate was 57% from the single freeze technique, and 62% from the double freeze technique, a difference of 5% (P = 0.53, 95% CI-8.1-18.6). Separate analyses for subjects with warts on the hands and on the feet demonstrated no effect of double freezing on hand warts. In contrast, for plantar warts, the cure rate was 41% from single freezing and 65% for double freezing, a difference of 24% (P = 0.04, 95% CI 2.9-44.4). The use of a double freeze-thaw cycle confers little or no advantage over a single freeze in the treatment of hand warts, but may be considerably more effective for plantar warts.

Adult↗
PubMed2003

Three cases of 'mechanic's hands' associated with interstitial pneumonia: possible involvement with foot lesions.

We describe three cases of the rare combination of lateral erythema and hyperkeratosis of the fingers that typify a condition known as 'Mechanic's Hands'. The first and the third cases were unusual in that the condition was associated with cutaneous involvement of the feet and interstitial pneumonia but not with myositis, or with only mild muscular involvement, while the second case was typical, being accompanied by myositis and detectable antibodies against histidyl transferase. We propose that Mechanic's Hands can occur in association with foot lesions and interstitial pneumonia, even if it is not accompanied by myositis.

Adult↗
PubMed1990

Patch testing with the "sesquiterpene lactone mix": a marker for contact allergy to Compositae and other sesquiterpene-lactone-containing plants. A multicentre study of the EECDRG.

6278 patients were patch tested with a sesquiterpene lactone mix (SL-mix) in 10 European clinics. 4011 patients were tested only with 0.1% SL-mix, 63 (approximately 1.5%) of whom were positive, with 26 (41%) of these cases being considered clinically relevant. There were no cases of active sensitization, though 5 cases of irritation were reported. 22 irritant reactions and 22 cases of active sensitization occurred when testing also with 1% and 0.33% concentrations of SL-mix. SL-mix 0.1% pet. is shown to be an important patch test and many relevant sensitizations will be missed without routine screening with such a mix. Most patients with SL-mix sensitivity presented with hand and/or face dermatitis, apparent photodermatitis or more generalised eczema.

Dermatitis, Contact↗
PubMed1988

Pustulosis palmoplantaris and chronic eczematous hand dermatitis. Treatment, epidermal Langerhans cells and association with thyroid disease.

Long-standing hand and foot dermatoses, e.g. pustulosis palmoplantaris (PPP) and chronic eczematous hand dermatitis, severely affect the patients' quality of life. The cause of PPP is unknown and the disease usually responds unsatisfactorily to treatment. The aims of the studies of PPP were to determine the prevalence of thyroid disease and to evaluate the relative merits of treatment with etretinate, psoralen photochemotherapy (PUVA), and a combination of the two. Furthermore, epidermal Langerhans cells (LC) were quantified in lesional skin before and after treatment. The prevalence of thyroid disease was significantly increased in a group of PPP patients compared to normal individuals and psoriasis patients. Both hypo and hyperthyroidism were found. In addition, circulating autoantibodies to thyroid antigens were more common in patients with PPP than in the control group. The thyroid status was further examined in a new and larger group of PPP patients, including a 4-year follow-up examination of those with thyroid antibodies or subclinical thyroid dysfunction. The increased prevalence of thyroid diseases was corroborated when this PPP group was compared to an age and sex-matched control population sample from the same city. Some patients also showed biochemical evidence of gastric autoimmunity. Ninetyfour percent of the PPP patients were smokers at the time of onset of the skin disease, compared to 33% of the subjects in a control group. Patients with treatment-resistant PPP were recruited for a randomised, double-blind and placebo-controlled trial. A combination of etretinate and PUVA was more effective than monotherapy with etretinate or PUVA. The latter were equally effective. Etretinate frequently provoked side effects. Follow-up examinations showed a high relapse rate. Epidermal LC were visualised with monoclonal antibodies to Leu 6 and HLA-DR antigens utilizing an immunoperoxidase technique. Their number was increased in lesional skin. The number of HLA-DR positive LC was decreased following etretinate, and normalised with etretinate + PUVA. Chronic eczematous hand dermatitis is a common clinical challenge. These studies aimed at an evaluation of PUVA and UVB phototherapy in patients with recalcitrant lesions and to enumerate epidermal LC before and after treatment. PUVA was a highly effective mode of treatment and cleared all treated hands. UVB was better than no treatment but the dermatitis did not clear in any patient. The number of epidermal LC was increased in lesional palmar skin in both allergic contact dermatitis, irritant contact dermatitis and hyperkeratotic dermatitis of the palms.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed2001

Hand-foot syndrome associated with short infusions of combination chemotherapy with gemcitabine and vinorelbine.

The hand-foot syndrome (palmar-plantar erythrodysesthesia) is a side-effect which is associated with several cytotoxic agents (e.g. 5-fluorouracil, UFT, capecitabine, cytarabine, doxorubicin, liposomal-encapsulated doxorubicin). An association with a prolonged infusion of high doses of vinorelbine has also been described. To date a hand-foot syndrome after gemcitabine or short infusions of vinorelbine has not been reported before. The patient described here had a non-small-cell lung cancer stage IIIB disease and developed a hand-foot syndrome after short infusions of standard-dose chemotherapy of a combination with gemcitabine and vinorelbine.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

A variant of the chemotherapy-associated erythrodysesthesia syndrome related to high-dose cyclophosphamide.

A 33-year-old woman with stage IIIA non-Hodgkin's lymphoma unresponsive to ten cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) developed a variant of the chemotherapy-associated erythrodysesthesia syndrome following high-dose cyclophosphamide and radiation in preparation for an autologous bone marrow transplant. The patient first complained of a new rash on her fingers and toes on day 6 after her first dose of cyclophosphamide. Unlike the previous case reports in which patients presented with a palmar-plantar erythema, this patient's rash occurred on the dorsal aspects of her hands and feet, and not on her palms and soles. After evaluation by a dermatologist she was diagnosed as having a variant of palmar-plantar erythema induced by cyclophosphamide.

Adult↗
PubMed2001

Onychomycosis caused by Alternaria spp. in Tuscany, Italy from 1985 to 1999.

Cutaneous phaeohyphomycosis due to Alternaria spp. is reported with increasing frequency, especially in patients with immune deficiency. Onychomycosis caused by this mould is still rarely observed. Here we report nine cases observed in Tuscany in the period 1985-99; the agent was Alternaria alternata in eight cases and Alternaria chlamidospora in one. Diagnosis was made on the basis of repeated direct microscopic mycological examination and culture, confirmed by scanning electron microscope observation of fragments of colonies. In most cases, the clinical manifestations were dystrophy and distal subungual hyperkeratosis of one or two nails of the feet or hands. Seven cases were treated with oral itraconazole, successfully in six cases, as clinical and mycological recovery was confirmed at follow-up 1 year later.

Aged↗
PubMed1988

Prognosis and atopic background of juvenile plantar dermatosis and gluteo-femoral eczema.

A 10-year follow-up of patients with juvenile plantar dermatosis and gluteo-femoral eczema disclosed a worse prognosis than previously assumed, with a course in some cases protracted into adult age. The presence of atopy was established with a clinical point score system. It was found that 52% of the patients with juvenile plantar dermatosis and 80% of those with gluteo-femoral eczema were atopic. In many cases the childhood dermatitis was followed in adult age by a hand eczema. This was the case in 14% of the gluteo-femoral eczema patients, and no less than 26% of the juvenile plantar dermatitis patients.

Adolescent↗
PubMedDate not supplied

Cutaneous ulcerations on hands and heels secondary to long-term hydroxyurea treatment.

Hydroxyurea is a chemotherapeutic agent used to treat myeloproliferative disorders and other non-neoplastic conditions. Cutaneous side-effects have been described in long-term therapy with hydroxyurea and include xerosis, hyperpigmentation, skin atrophy, erythema, alopecia, skin tumours and ulceration of the skin, particularly of the legs. We present a 71-year old patient with chronic myelocytic leukemia (CML) who developed extremely painful ulcers on the hands and heels as well as skin tumours while on long-term therapy with hydroxyurea. The ulcers were resistant to therapy but healed three months after discontinuation of hydroxyurea therapy.

Aged↗
PubMed1991

Milialike idiopathic calcinosis cutis and syringoma in Down's syndrome.

A 6-year-old girl with Down's syndrome presented milialike whitish small papules on her hands and feet and periorbital syringoma. Histopathological examination of the hand lesion revealed small localized calcium deposits and syringoma in the adjacent upper dermis. This is a very rare but typical case of calcinosis cutis with syringoma in a patient with Down's syndrome.

Adenoma↗
PubMed2004

Acrokeratosis paraneoplastica (Bazex syndrome): an atypical presentation.

A 62-year-old male presented with a 2-year history of hyperkeratotic lesions of the hands and feet. Previous treatment with topical steroids was unsuccessful. A complete physical examination revealed the presence of blood in the stool, and sigmoidoscopy showed an ulcerative growth at the rectosigmoid junction. The histopathology showed adenocarcinoma.

Adenocarcinoma↗
PubMed1992

Modern treatment of warts: cure rates at 3 and 6 months.

Four-hundred consecutive referrals with viral warts of the hands and/or feet were investigated to determine the cure rate from a combination of cryotherapy, keratolytic wart paint and paring. For treatment failures after 3 months, the value of continuing cryotherapy and of additional treatment with the immunomodulator inosine pranobex were assessed. Subjects were treated for 3 months with wart paint and cryotherapy and were randomized to receive, or not, paring in addition. Those who did not respond by 3 months were randomized to receive, or not, 3 months further cryotherapy, and to receive inosine pranobex 60 mg/kg/day for 1 week each month, or matching placebo. Fifty-two per cent of subjects were cured by 3 months. The chance of cure was inversely related both to the length of history and to the diameter of the largest wart. Paring improved the cure rate for plantar warts but not for hand warts. During the second 3 months the cure rate fell to 41%. Neither cryotherapy nor inosine pranobex significantly improved this response.

Adolescent↗
PubMed1997

The progression of nonsegmental vitiligo: clinical analysis of 318 patients.

BACKGROUND: Vitiligo is an acquired disorder with destruction of melanocytes and is characterized by cutaneous depigmentation with a progressive clinical course. We attempted to evaluate whether there was a relationship between the initial site and ultimate progression of nonsegmental vitiligo. METHODS: Three hundred and eighteen nonsegmental vitiligo patients were examined. Questionnaires regarding age, sex, duration of disease, family history, distribution of initial lesions, progression, and clinical type were recorded from personal interviews and case notes. RESULTS: Two hundred and eighty nine (90.9%) of the 318 patients showed progression of vitiligo at the time of examination. When the initial sites were the posterior trunk, hands, or feet, there was more progression of vitiligo to other body areas. The progression pattern was usually contiguous to the initial site. When the hands were the initial site, however, vitiligo most commonly progressed to the face. CONCLUSIONS: There may be a possible relationship between the initial site and ultimate progression of nonsegmental vitiligo. The progression pattern is usually contiguous to the initial site.

Back↗
PubMed2005

Ultraviolet-free phototherapy.

BACKGROUND: Ultraviolet (UV) radiation phototherapy has been used for decades in the management of common skin diseases. On the other hand, UV radiation is a complete carcinogen and as a consequence, UV phototherapy is usually not used for the long-term management of children and young adults and in combination with topical or systemic immunosuppressants. PURPOSE: The therapeutic effectiveness of a new UV-free irradiation device in the treatment of patients with atopic hand and/or foot eczema was studied. METHODS: In a single-blinded trial 10 patients with atopic hand and/or foot eczema were treated with a sham irradiation device and with the new developed UV-free irradiation device DermoDyne during the following 4 weeks. All irradiation's lasted 30 min per treatment three times weekly. RESULTS: UV-free irradiation was found to induce a significant clinical improvement of atopic hand and foot eczema (P = 0.0001) in marked contrast to the sham-irradiation (P = 0.39). CONCLUSION: Our studies demonstrate that visible light can be successfully used for the treatment of patients with atopic eczema.

Eczema↗