Dermatology : international journal for clinical and investigative dermatology
-
Dermatology (Basel) · Jan 2009
Case ReportsDisseminated herpes zoster mimicking rheumatoid vasculitis in a rheumatoid arthritis patient on etanercept.
Tumor necrosis factor-alpha (TNFalpha)-blocking agents are immunomodulating agents introduced for treatment of a variety of chronic inflammatory disease conditions. Adverse effects include an increased incidence of infections. Clinically, these infections often have atypical presentations that may hamper prompt diagnosis. ⋯ Therapy with intravenous acyclovir followed by oral valacyclovir allowed complete resolution of acute skin changes. In immunosuppressed patients, the possibility of infection with atypical presentation must always be kept in mind, and that this might mimic other disease conditions. Broad differential diagnosis and an extended diagnostic workup help in establishing the correct diagnosis.
-
Dermatology (Basel) · Jan 2009
Case ReportsCutaneous T cell lymphoma complicating severe atopic dermatitis. Is making a diagnosis the main challenge?
The association between severe long-term atopic dermatitis (AD) and the risk of skin lymphoma is still a matter of debate, since epidemiological studies have shown contradictory results. We report 2 cases of patients with a documented history of severe longstanding atopic disease, who had never been treated with topical or systemic calcineurin inhibitors, and who developed a cytotoxic cutaneous T cell lymphoma (CTCL). For these 2 patients, clinical manifestations preceded the diagnosis of CTCL. ⋯ These cases illustrate the difficulty in diagnosing CTCL in patients with severe AD and extensive inflammatory skin lesions. The transition between severe AD and CTCL is progressive; histological findings and molecular evidence of TCR clonality are detected after the clinical changes. These 2 cases lend further support to the hypothesis of an association between severe long-term AD and CTCL.
-
Dermatology (Basel) · Jan 2009
The psoriasis family index: preliminary results of validation of a quality of life instrument for family members of patients with psoriasis.
Psoriasis can have a major impact on the lives of patients, the members of their families and their partners. ⋯ The PFI is a simple and practical measure to assess the HRQoL of family members/partners of patients with psoriasis.
-
Dermatology (Basel) · Jan 2009
Clinical TrialTreatment of nail psoriasis with a two-compound formulation of calcipotriol plus betamethasone dipropionate ointment.
Treatment of nail psoriasis remains a challenge. ⋯ The calcipotriol plus betamethasone dipropionate two-compound ointment, applied once daily for 12 weeks, was shown to improve nail psoriasis.
-
Dermatology (Basel) · Jan 2009
Case ReportsEpidermodysplasia verruciformis in a HIV-positive patient homozygous for the c917A-->T polymorphism in the TMC8/EVER2 gene.
Epidermodysplasia verruciformis (EV) is a rare autosomal-recessive disorder characterized by widespread and persistent infection with human papilloma virus (HPV) and a risk of malignant degeneration. Most cases of EV are caused by mutations in the two EV genes, EVER1/TMC6 and EVER2/TMC8. The clinical presentation of EV takes two different forms, which coexist in most cases. Over a period of years, patients develop plane warts and pityriasis versicolor-like lesions. Sixteen cases of EV in HIV-positive patients have been clinically investigated and reported in the literature. However, different inherited susceptibilities towards HPV infection in immunodeficient patients, like HIV-positive patients, have only rarely been addressed. ⋯ These results support the hypothesis that the combination of immunodeficiency and a susceptibility allele may contribute to the differences in occurrence of EV in HIV-positive patients.