Atypical pompholyx presentation of secondary Staphyloccoccus and Klebsiella infections in a patient with premorbid Ebstein anomaly: A case report

Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial infection of pompholyx can happen and result in pain, swelling and pustules. Patient concerns: A 15-year-old girl complained of progressive wound and small bumps containing yellowish pus and crusts on her hands and feet for over 6 months and worsened in the last month before admission. She also had Ebstein anomaly. Diagnosis: Atypical pompholyx with secondary Staphylococcus and Klebsiella infections. Interventions: Wound care with wet dressing and applying moisturizer on crusts, application of antibiotics for Gram positive and negative bacteria and giving nutritional support with reckoning of proper calories. Outcomes: Skin lesions were completely healed and the patient was discharged after 10 days of hospitalization. Lessons: Atypical manifestation of pompholyx makes it hard to diagnose. The diagnosis can be confirmed with meticulous history-taking and physical examination. Wound caring and controlling of the infection should be done to earn an optimal outcome.

Helpful Clinical Features for Differential Diagnosis of Palmoplantar Pustulosis and Pompholyx / 대한피부과학회지

BACKGROUND: Palmoplantar pustulosis (PPP) and pompholyx are both chronic vesiculopustular conditions of the palms and soles. Because both share similar clinical and histological features, it is difficult even for dermatologists to differentiate between these two diseases. OBJECTIVE: To analyze clinical features that can be helpful in differentiating the two diseases. METHODS: The clinical history of 133 patients with vesicles or pustules on the palms and/or soles was evaluated. Patients were divided into a PPP group and a pompholyx group. RESULTS: There was no sex or age predilection in either group and no significant difference in overall localization and symmetry of lesions. Bilaterality was found in 75.0% of cases of PPP and 82.0% of cases of pompholyx. More lesions were found on the tip of the finger/toe, and the side of the toe in the pompholyx group than in the PPP group. However, there was no difference between two groups in lesions on the sides of fingers. More cases of PPP involved right distal interphalangeal (DIP) and bilateral proximal interphalangeal (PIP) joint areas compared with pompholyx. There were more smokers in the PPP group. Among several comorbidities, only atopic dermatitis and nummular eczema were associated with pompholyx. CONCLUSION: Several characteristics of patients and clinical findings may serve as useful “clues” to differentiate between and determine treatment for PPP and pompholyx.

A Case of Palmar Lichen Nitidus Presenting as a Clinical Feature of Pompholyx

Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN.

A Case of Pompholyx after Intravenous Immunoglobulin Therapy / 대한피부과학회지

Intravenous immunoglobulin therapy has been used to treat various immune-mediated diseases. Its utility in dermatology continues to expand, including treatment for autoimmune blistering disease, graft-versus-host disease, and dermatomyositis. It is generally considered safe, and serious adverse effects such as anaphylaxis, renal tubular necrosis or aseptic meningitis rarely occur. Furthermore, adverse skin reactions very rarely occur, but can include urticaria, pruritus, eczema, alopecia, lichenoid dermatitis or pompholyx. We describe a case of a 48-year-old man who developed vesicular eczema on his palms and soles after administration of intravenous immunoglobulin therapy for encephalomyelopathy.

A Case of Pompholyx Following Intravenous Immunoglobulin Therapy in Guillain-Barre Syndrome

No abstract available.

Skin diseases of male workers in painting workplace / 예방의학회지

Painting is risky work to occupational skin disease. This research was carried out to investigate the prevalence of occupational skin disease in painting department of a shipyard company in June 1996. Dermatological examination, self-administered questionnaire survey, compositional analysis of solvents used in painting and cleaning were conducted. Exposed group(n=379) was selected randomly in painting department and control group(n=151) was selected in those who had not exposed to paints or solvents. Exposed group was divided into two groups by substance to contact ; painters contact to paints and organic solvents and workers contact to cleaners mainly composed of organic solvents. The prevalence of contact dermatitis(11.9%) is significantly elevated compared with control group(2.6%), and age adjusted odds ratio(OR) is 4.95 (95% confidence interval[CI]: 1.75-14.03). The prevalence of Tinea pedis, the most common skin disease, in exposure group is 48.0%, and its age-adjusted odds ratio(OR) is significantly elevated compared with control group (OR:3.17, 95% CI:2.06-4.88). Pompholyx is also significantly elevated in prevalence(11.9%) and age-adjusted OR(OR:6.69, 95% CI:2.05-21.87). There were no difference in the prevalence of contact dermatitis, Tinea pedis, and pompholyx by use of protector, work type, and duration of employment in painting department. In exposure group, 71.1% suffer from contact dermatitis improved in vacation or holiday and 68.9% of them had lesion in exposed area, it suggest that contact dermatitis in exposed group is related to their work. In conclusion, workers in painting department have high risks of contact dermatitis, Tinea pedis, and pompholyx. A health policy should be provided to prevent skin disease among painting department.