Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Nov 2004
Review Case ReportsRickettsialpox: report of three cases and a review.
Rickettsialpox is a rare mite-borne rickettsiosis that is encountered in urban populations in the eastern United States and throughout the world. It is characterized clinically by an eschar, fever, and a papulovesicular eruption. ⋯ It is thus important for clinicians to be familiar with rickettsialpox. We report 3 cases and review the epidemiology, clinical and laboratory findings, differential diagnosis, and management of this disease.
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J. Am. Acad. Dermatol. · Nov 2004
Review Case ReportsAcute lymphoblastic leukemia presenting with urticarial plaques and hypereosinophilia in a child.
Our report describes a previously healthy 10-year-old female who was seen for urticarial plaques and mild loss of appetite. An initial laboratory workup revealed an elevated leukocyte count of 30,000/microL and a peripheral eosinophil count of 22,500/microL. A skin biopsy showed a marked hypersensitivity tissue response with abundant eosinophils. ⋯ A bone marrow biopsy confirmed a diagnosis of acute lymphoblastic leukemia (ALL). ALL with hypereosinophilia (ALL/Eo) represents a rare and distinct subset of ALL, with more than 30 cases documented in the literature. Our discussion summarizes the clinical aspects of this disease and reviews the reported dermatological manifestations of ALL/Eo.
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J. Am. Acad. Dermatol. · Jun 2004
Review Case ReportsCutaneous drug eruption from cetirizine and hydroxyzine.
Topical application of the antihistamines commonly leads to sensitization for patients, but skin reactions provoked by their systemic use are very rare. The antihistamines cetirizine and hydroxyzine are piperazine derivatives, on the structural basis of an ethylenediamine, but the cross-reactions between the 2 have rarely been reported. ⋯ Oral challenge tests performed with cetirizine and hydroxyzine led to the same cutaneous reactions. He was given the diagnosis of drug eruption from cetirizine and hydroxyzine, which suggests that there were cross-reactions among cetirizine, hydroxyzine, and ethylenediamine.
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Arthropods are important in medicine for a multitude of reasons. Their bites and stings may induce allergic reactions, ranging from annoying to life-threatening. Many arthropod products are also capable of inciting allergic responses in sensitized persons. ⋯ Animals in these two classes are probably responsible for more morbidity and mortality worldwide than are any other group of venomous creatures. In general, the diagnosis of arthropod bites and stings is dependent on maintenance of a high index of suspicion and familiarity with the arthropod fauna not only in one's region of practice, but also in the travel regions of one's patients. Learning objective At the completion of this learning activity, participants should be familiar with the clinical manifestations caused by a variety of arthropods as well as the treatment and possible sequelae of arthropod attacks.