scholarly journals Generalized Lichen Planus-like Eruption Related to Trimebutine

2020 ◽  
Author(s):  
Dimitra Koumaki ◽  
Vasiliki Koumaki ◽  
Alexander Katoulis ◽  
Sotirios Boumpoucheropoulos ◽  
George Evangelou ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Temporal Relationship ◽  
Skin Lesions ◽  
Histological Findings ◽  
Once Daily ◽  
Trimebutine Maleate ◽  
Drug Eruptions ◽  
Upper And Lower Extremities ◽  
Irritable Bowel ◽  
Lichenoid Eruption

Trimebutine is a spasmolytic agent with antimuscarinic effects that is used for the treatment of irritable bowel syndrome (IBS) and lower gastrointestinal tract motility disorders. Lichenoid drug eruptions (LDE) to trimebutine maleate have not been previously reported. Here we present the case of a 50-year-old male patient who developed an extensive lichenoid eruption on his upper and lower extremities and trunk 4 weeks after starting treatment with trimebutine maleate 300 mg once daily for IBS. Two months after discontinuation of the drug and administration of topical treatment with emollients and corticosteroids, the LDE cleared completely with no recurrence. The diagnosis of LDE due to trimebutine was made, based upon the clinical features resembling lichen planus, the histological findings of interface dermatitis, the evidence of a temporal relationship between drug intake and the development of skin lesions, and resolution upon discontinuation of the drug. To the best of the authors’ knowledge, LDE following trimebutine maleate intake has not been previously reported. Management of trimebutine-induced LDE includes withdrawal of the causative agent and treatment with potent topical corticosteroids.

scholarly journals Isolated Actinic Lichen Planus of the Lower Lip

2017 ◽  
Vol 9 (1) ◽  
pp. 131-134 ◽  
Author(s):  
Ellie Choi ◽  
Kong Bing Tan ◽  
Nisha Suyien Chandran
Keyword(s):  
Lichen Planus ◽  
Sun Exposure ◽  
Skin Lesions ◽  
Lower Lip ◽  
Drug Eruptions ◽  
Simplex Infection ◽  
Oral Lichen ◽  
Typical Skin

Oral lichen planus (LP) is a common manifestation in patients with LP; however, isolated lip LP is rare and may mimic other conditions such as lichenoid drug eruptions, actinic cheilitis, and early carcinoma in situ in the absence of typical skin lesions. Actinic lichen planus (ALP) is a variant of LP occurring on light-exposed areas in patients with dark skin. We report the case of a Chinese female with isolated ALP of the lower lip, mimicking herpes simplex infection at presentation. The presence of prognathism, involvement of the lower lip, and flares associated with sunlight reinforces the role of sun exposure in the development of this condition.

scholarly journals Inflammatory Skin Lesions in Three SARS-CoV-2 Swab-Negative Adolescents: A Possible COVID-19 Sneaky Manifestation?

2021 ◽  
Vol 13 (2) ◽  
pp. 181-188
Author(s):  
Giuseppe Ingravallo ◽  
Francesco Mazzotta ◽  
Leonardo Resta ◽  
Sara Sablone ◽  
Gerardo Cazzato ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Respiratory Symptoms ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sweat Glands ◽  
Histological Findings ◽  
Immune Mediated ◽  
Nodular Lesions ◽  
Immunohistochemical Evidence ◽  
Eccrine Sweat Glands

Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with various clinical manifestations, including skin lesions. In particular, during the COVID-19 pandemic lock-down period numerous chilblain-like lesions, mainly located on the feet, were observed in adolescents. The latter were often asymptomatic or associated with very mild respiratory symptoms. Here, we report three cases of acral nodular lesions in SARS-CoV-2 swab-negative adolescents with histological findings of chronic immune-mediated inflammation and immunohistochemical evidence of SARS-CoV-2 spike glycoproteins in endothelial cells and eccrine sweat glands. In one of these cases, the virus presence was confirmed by electron microscopy.

scholarly journals A clinicoepidemiological study of fixed drug eruptions at a tertiary centre of North India

2018 ◽  
Vol 7 (1) ◽  
pp. 151
Author(s):  
Rohini Sharma ◽  
Sameer Abrol
Keyword(s):  
Research Work ◽  
Developed Countries ◽  
Skin Lesions ◽  
North India ◽  
Drug Reactions ◽  
Tertiary Centre ◽  
Drug Eruptions ◽  
Culprit Drug ◽  
Mucosal Involvement ◽  
Fixed Drug

Background: Various studies have found the overall incidence of cutaneous adverse drug reactions (CADR’s) in developed countries as 1-3%, while the incidence in developing countries is thought to be higher between 2 and 5%. FDEs’ share is seen to be about 15 -30% of all CADR’s as reported in various studies. Aim of the research work was to study the clinical and epidemiological features of fixed drug eruptions and to identify probable culprit drug or drugs using Naranjo ADR probability scale and to provide information to the patient regarding the drug responsible for his/her drug rash.Methods: A total of 180 patients of fixed drug eruptions were taken up for study who presented to skin OPD at a tertiary centre of North India. Diagnosis was made on the basis of history of drug intake prior to drug eruption, repetition of similar lesions on same as well as new sites on intake of same drug with improvement of skin lesions on discontinuation of the causative drug. Further on examination, skin lesions with typical morphology compatible with FDE were seen. Causality of the FDE was assessed according to the NARANJO ADR probability scale.Results: A total of 180 patients of FDE were studied. Males outnumbered the females. The most common class of drug implicated was antimicrobials seen in 115 patients followed by NSAIDS 65 patients. Regarding the clinical presentation both skin and mucosal involvement was seen. The most common skin lesions were erythematous to hyperpigmented and violaceous macules followed by bullous FDE.Conclusions: In summary, early recognition of FDE is important not only for the dermatologists but also for the clinicians of other specialties, so that the culprit drug is recognized and stopped immediately. Drug reactions are a common reason for litigation and has medicolegal pitfalls.

scholarly journals Anti-Centromere Antibody Positivity in a Patient with Generalized Morphea

2018 ◽  
Vol 10 (3) ◽  
pp. 226-230
Author(s):  
Fumi Miyagawa ◽  
Anna Nakajima ◽  
Yasuhiro Akai ◽  
Hideo Asada
Keyword(s):  
Systemic Sclerosis ◽  
Rna Polymerase ◽  
Rna Polymerase Iii ◽  
Skin Lesions ◽  
Histological Findings ◽  
Skin Manifestations ◽  
Polymerase Iii ◽  
Oral Steroids ◽  
Antibody Positivity

We report the case of a 45-year-old female with generalized morphea (GM), who exhibited positivity for the anti-centromere antibody (Ab). She frequently developed multiple sclerotic skin lesions, whose histological findings were compatible with morphea. She demonstrated favorable responses to topical and oral steroids. Cases of GM associated with systemic sclerosis (SSc)-specific Abs (anti-Scl-70 Ab, anti-centromere Ab, and anti-RNA polymerase III Ab) have rarely been reported. The previously reported GM cases involving anti-SSc-specific Abs exhibited some skin manifestations of SSc, such as nailfold capillary changes. However, our case did not show any signs of SSc or limited cutaneous SSc. More cases are needed to clarify whether GM with SSc-specific Abs leads to SSc.

scholarly journals Optimising the management of bladder pain syndrome

2020 ◽  
pp. 205141582095473
Author(s):  
Waleed Al-Singary ◽  
Reena Patel ◽  
Ujjal Sarkar ◽  
Hiten RH Patel
Keyword(s):  
Pain Control ◽  
Symptomatic Relief ◽  
Pain Syndrome ◽  
Skin Lesions ◽  
Bladder Pain Syndrome ◽  
Pain Clinic ◽  
Level Of Evidence ◽  
Bladder Pain ◽  
Irritable Bowel ◽  
Good Pain Control

Objective: Clinicians have shown variable practice in the diagnosis and management of bladder pain syndrome (BPS). This study assessed pain localisation sites, common co-morbidities, investigations and treatment patterns in clinical practice. Patients and methods: We performed a retrospective analysis of 412 patients attending our pelvic pain clinic between 2004 and 2016. Frequency counts were used to summarise findings. Results: Pain in women ( N=388) was localised to the lower abdomen (92.0%), lower back (71.1%) and vagina (60.8%). Men ( N=24) typically presented with testicular pain with painful ejaculation (70.8%). Nearly all (95.4%) patients reported sexual dysfunction. Visceral neuropathic pain and autoimmune co-morbidities, such as irritable bowel syndrome, chronic headaches or migraines and skin lesions, were more prevalent in our cohort than in the general population. All patients had urine culture and sensitivities and flexible cystoscopy. Laparoscopy, urodynamic studies and bladder biopsies were mostly normal, but were essential in excluding other pathologies. Good pain control was achieved on amitriptyline (83.0%). Hydro-distension and benign bladder ulcer cauterisation provided temporary symptomatic relief. Conclusion: This study demonstrates that patient expectation management and education is essential in BPS, with most achieving good pain control with conservative measures and amitriptyline. Those receiving intravesical treatments will most likely require subsequent revisions. Level of evidence: Not applicable for this single-centre audit.

FGFR1 Mosaic Pathogenic Variant in Encephalocraniocutaneous Lipomatosis with Leptomeningeal Angiomatosis

2019 ◽  
Vol 18 (05) ◽  
pp. 258-262
Author(s):  
Marta Gómez-García de la Banda ◽  
Paula Fernández-Álvarez ◽  
Ángel Sánchez-Montañez García-Carpintero ◽  
Vicenç García-Patos ◽  
Eduardo F. Tizzano ◽  
...  
Keyword(s):  
Fibroblast Growth Factor Receptor ◽  
Receptor Gene ◽  
Growth Factor Receptor ◽  
Skin Lesions ◽  
Pathogenic Variant ◽  
Fibroblast Growth ◽  
Histological Findings ◽  
Brain Anomalies ◽  
Encephalocraniocutaneous Lipomatosis ◽  
Neurocutaneous Disorder

AbstractEncephalocraniocutaneous lipomatosis (ECCL) is a congenital neurocutaneous disorder. It is characterized by ocular anomalies (epibulbar choristomas), skin lesions (as nevus psiloliparus and subcutaneous lipomas), and central nervous system abnormalities (mostly arachnoid cysts, brain anomalies, vascular defects, and intracranial and spinal lipomas). Mutations in KRAS and fibroblast growth factor receptor gene-1 (FGFR1) are related to ECCL, explaining additional manifestations such as jaw tumors or gliomas. We report a pediatric patient with clinical, radiological, and histological findings consistent with ECCL and a mosaic pathogenic variant in FGFR1 found in the DNA from a non-cultured biopsy of the nevus psiloliparus and absent in blood and DNA from buccal mucosa.

scholarly journals Sodium Iodide: an Alternative Treatment Option for Feline Sporotrichosis?

2018 ◽  
Vol 46 (1) ◽  
pp. 7
Author(s):  
Beatriz Wanderosck Carvalho ◽  
Sandro Antonio Pereira ◽  
Anna Barretos Fernandes Figueiredo ◽  
Luisa Helena Monteiro De Miranda ◽  
Gabriela Reis Pereira-Oliveira ◽  
...  
Keyword(s):  
Clinical Cure ◽  
Sodium Iodide ◽  
Adverse Reactions ◽  
Complete Blood Count ◽  
Low Cost ◽  
Skin Lesions ◽  
Cutaneous Lesions ◽  
Once Daily ◽  
Alternative Treatment Option ◽  
Nasal Region

Background: Sporotrichosis is caused by pathogenic fungi of the genus Sporothrix. The clinically relevant species are S. schenckii, S. globosa and S. brasiliensis. In Brazil, S. brasiliensis is the most prevalent etiological agent among humans and cats. In cats with sporotrichosis, skin lesions are mainly characterized by nodules and ulcers, usually located in the head, nasal region and limbs. The presence of respiratory signs concomitantly with cutaneous lesions is frequent, especially sneezing, and may be associated with lesions located in the nasal mucosa. Ketoconazole (KTZ), itraconazole (ITZ), potassium iodide (KI), sodium iodide (NaI), terbinafine (TRB), fluconazole (FLZ) and amphotericin B (AMB) are the drugs currently available for treating feline sporotrichosis. ITZ remains the drug of choice. ITZ combined with KI has been successfully used in the treatment of naïve cats (especially cases with lesions in the nasal region), cases of recurrence and refractory to ITZ. Clinical cure with NaI has been described in some cases, but its use has been limited by adverse reactions. The conventional formulation is the saturated solution and the recommended dose in the treatment of feline sporotrichosis is 10 mg/kg every 12 h. Cats are sensitive to iodide preparations and should be carefully monitored for clinical evidence of iodism, such as apathy, anorexia, vomiting, diarrhea, hypothermia, hyperthermia, cardiomyopathy, hyperexcitability, muscular spasms and ptyalism. The purpose of this study was to evaluate the therapeutic response of NaI capsules in feline sporotrichosis.Materials, Methods & Results: An observational cohort study was conducted in cats with sporotrichosis at the Laboratory of Clinical Research in Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil. Twenty-eight cats with sporotrichosis confirmed by isolation of Sporothrix spp. in culture, no previous systemic antifungal therapy, and weight above 3.0 kg, were included in the study. The treatment consisted of NaI oral capsules (5 mg/kg/once daily). In cats without clinical improvement after one month of treatment, the dose was increased (10 mg/kg/once daily). The cats were followed up monthly by clinical examination, complete blood count and biochemical analysis (urea, creatinine, alanine aminotransferase - ALT, aspartate aminotransferase - AST, alkaline phosphatase - FA). All procedures were approved by the Animal Ethics Committee (CEUA/Fiocruz), number LW 56/13, and the informed consent term was obtained from all tutors. Clinical cure was achieved in six (21.4%) cases and treatment failure was observed in 13 (46.4%) animals. Seven (25%) cats were lost during follow up, and unknown causes of death occurred in two cases (7.1%). Ten animals (35.7%) presented clinical adverse reactions at some point during treatment. Hyporexia and weight loss were the most frequent ones. Three cats presented alteration in renal function.Discussion: Treatment of feline sporotrichosis in epizootic areas has been a challenge for veterinarians and tutors. Additionally, there are few studies evaluating treatment regimens for this mycosis in animals. In this study, NaI was compounded in capsules, because it is easier to administer when compared to the solution, as previously described for KI. Despite the low cost and the convenient administration of the capsule, NaI presented a low cure rate with the dose used. The study of new pharmaceutical forms and lower doses of low-cost drugs is necessary in a scenario of epizootic sporotrichosis, where investments for the development of new antifungal agents are scarce.

scholarly journals Case Report: Paradoxical acrodermatitis of Hallopeau-like eruption following anti-IL-17 therapy

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 336 ◽  
Author(s):  
Giulia Tadiotto Cicogna ◽  
Francesco Messina ◽  
Linda Nalotto ◽  
Serena Szekely ◽  
Mauro Alaibac
Keyword(s):  
Psoriatic Arthritis ◽  
Inflammatory Cytokine ◽  
Skin Lesions ◽  
Underlying Disease ◽  
Histological Findings ◽  
Key Factors ◽  
Immune Mediated ◽  
Inflammatory Cytokine Response ◽  
Cytokine Imbalance ◽  
Nail Involvement

Psoriasis is a chronic immune-mediated inflammatory disease. Up to 40% of patients with psoriasis may develop psoriatic arthritis.  Currently, interleukin (IL)-17/IL-23 pathways are identified as key factors in the immunopathogenesis of both conditions. Here we describe the case of a patient who developed psoriasiform skin lesions 10 months after the initiation of anti-IL17 therapy for psoriatic arthritis. The underlying disease had responded well to the therapy, but the patient developed a striking pustular eruption at the fingers with nail involvement, onycholysis, yellow discoloration, and subungual keratosis. Clinical and histological findings were consistent with an acrodermatitis continua of Hallopeau-like eruption. Skin lesions subsided after discontinuation of the responsible anti-IL17 agent. The interpretation of this paradoxical side effect of biological therapies remains unclear but may relate to an unbalanced inflammatory cytokine response induced by the inhibition of TNF activity. It is likely that patients, who are genetically prone, may respond exaggeratedly to a cytokine imbalance. The identification of this kind of patient, in the future, could be useful in order to choose the correct therapy.

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