Lichen simplex chronicus and prurigo nodularis

2001 ◽  
pp. 219-220
Keyword(s):  
Prurigo Nodularis ◽  
Lichen Simplex Chronicus

Update on Intralesional Steroid: Focus on Dermatoses

2010 ◽  
Vol 14 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Robert N. Richards
Keyword(s):  
Clinical Studies ◽  
Skin Diseases ◽  
Prurigo Nodularis ◽  
End Points ◽  
Package Inserts ◽  
Inflammatory Dermatoses ◽  
Lichen Simplex Chronicus ◽  
Intralesional Steroid ◽  
The 1960S ◽  
Product Package

Background: Intralesional steroid (ILS; usually triamcinolone acetonide) is commonly used, and the literature contains much information about its use in keloids, hemangiomas, and alopecia areata. Little has been written about its use in inflammatory dermatoses such as psoriasis and localized dermatitis since the 1960s, the conditions for which it was originallymost studied and used. Objective: To clarify the use of ILS and to encourage its use in psoriasis and localized dermatitis. Methods: Medline peer-reviewed literature in English (1956–2008) was searched for the use of ILS in all skin diseases. Six standard textbooks of dermatology were reviewed. Information as to how they used ILS was obtained from a questionnaire completed by 33 dermatologists and from personal discussions with 15 other dermatologists. Additional information was obtained from 40 years of personal ILS use and from observation of 42 dermatologists working intermittently in our office over the past 25 years. ILS product package inserts and company drug monographs were reviewed. Results: ILS is used by most dermatologists, but there are considerable divergences in technique and dosing. Current textbooks contain little on its use in psoriasis and localized dermatitis. There have been no clinical studies since the 1960s, and their end points and descriptions were somewhat vague by today's standards. Product package inserts are dated and not helpful. Nevertheless, the use of ILS is safe and economical, and the original authors and our office have found it consistently to be virtually 100% effective at 2.5 mg/mL in small plaques of psoriasis on the trunk and limbs and highly effective in localized dermatitis (such as lichen simplex chronicus, prurigo nodularis, and nonspecific eczema). Clinical studies indicate that we can safely increase our ILS from the usual 3 cc (7.5 mg) to 6 cc (15 mg) or even to 8 cc (20 mg) for patients over 50 kg every 3 to 4 weeks. Serum cortisol can be performed if there are concerns about adrenal suppression, with use in periorbital hemangiomas and with intranasal ILS. Blindness (from central artery occlusion) was reported with injections of ILS around the eyes wih older products during the early development stages; and more recently with the use of ILS for periorbital hemangiomas and with ILS used intranasally. It has never been reported with low pressure injections of ILS using triamcinalone acetonide at 2.5 mg around the eyes. Limitations: No formal clinical studies since the 1960s. Poor statistical end points. Conclusions: ILS at 2.5 mg/cc is safe, economical, and effective and its greater use should be encouraged in inflammatory dermatoses such as psoriasis and localized dermatitis. Further well-designed research would be helpful.

scholarly journals Histopathological spectrum of Psoriasiform dermatitis

2016 ◽  
Vol 6 (12) ◽  
pp. 975-980
Author(s):  
PL Jayalakshmy ◽  
AM Babitha ◽  
S Sankar ◽  
G Nandakumar
Keyword(s):  
Tertiary Care ◽  
Age Distribution ◽  
Histopathological Study ◽  
Tertiary Care Centre ◽  
Prurigo Nodularis ◽  
Inflammatory Dermatoses ◽  
Pityriasis Rubra Pilaris ◽  
Lichen Simplex Chronicus ◽  
Hard Evidence ◽  
Skin Biopsies

Background: Psoriasiform dermatitis is a frequently encountered terminology in a wide variety of inflammatory dermatoses. It often poses challenges to both dermatologists and pathologists alike. Clinical features when considered alone may not be reliable, as they vary with both disease duration and treatment. On the contrary, histopathological material constitutes definite hard evidence, which can be preserved and will continue to be available for future review. The objective of the study is to study the histopathological findings in Psoriasiform dermatitis.Materials and Methods: This is a retrospective study in a tertiary care centre in Kerala, South India. All cases diagnosed as Psoriasis or mentioned as one of the differential diagnosis were included. The material included 66 skin biopsies. Patients with a previous diagnosis of the same were excluded from the study.Results: The lesions comprised 9% of the total number of skin biopsies. The age distribution pattern revealed that the highest percentage was in the 41-60 year age group (50%) with a male preponderance of 65%. Psoriasis was the most common lesion (60.60%) and Lichen simplex chronicus was the second most common lesion (10.60 %), encountered in the study.Conclusion: Some of the histopathological features are specific and characteristic for each entity like Psoriasis, Pityriasis rubra pilaris, Pityriasis rosea and Inflammatory linear verrucous epidermal nevus whereas some overlap in lesions like Prurigo nodularis, Lichen simplex chronicus and Allergic contact dermatitis. Hence, combination of proper clinical observation and histopathological study will give a conclusive diagnosis.

Prurigo nodularis and lichen simplex chronicus

2008 ◽  
Vol 21 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Torello Lotti ◽  
Gionata Buggiani ◽  
Francesca Prignano
Keyword(s):  
Prurigo Nodularis ◽  
Lichen Simplex Chronicus
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