ABSTRACT
The id reaction, which is also known as autoeczematisation or autosensitisation dermatitis, refers to the acute development of dermatitis at a site distant from the site of the primary inflammatory cutaneous reaction. Many stimuli have been reported as causes of id reactions, including allergic contact dermatitis. The exact prevalence of id reaction is unknown, however, id reactions have been found to occur in 4%-5% of cases of dermatophyte infections and in up to 37% of patients with stasis dermatitis. This condition has no known predilection for any race, sex or age groups. Shoe dermatitis is a type of contact dermatitis developed following the contact of the foot’s skin with shoe’s parts that contain different chemical substance that harbor the potentiality to be an immune trigger. Among the potential allergens, rubber is found to be the most common shoe-related allergen reported in the literature. Other known allergens include: cements, dichromats used in tanning, dyes, anti-mildew agents, formaldehyde, and nickel eyelets or nickel arch supports. The pathogenesis of allergic contact dermatitis is a type IV, delayed-type immune response that provoked by cutaneous contacts with different material that have the ability to stimulate antigen-specific T-helper 1 (TH1) in a sensitized individual. The clinical presentation of id reaction includes acute onset of pruritic erythematous eruption with symmetrical distribution that follows the primary dermatitis by one to two weeks. Authors report a 27-year-old male who presented with generalized, symmetric pruritic and eczematous eruption following localized shoe dermatitis.
ABSTRACT
Objective To evaluate the therapeutic effect of endovenous laser ablation (ELA) combined with foam sclerotherapy (FS) and mucopolysaccharide polysulfate (MP)cream on stasis dermatitis.Methods From December 2015 to May 2017,52 patients with 60 lesional limbs were enrolled from Department of Dermatology of Sichuan Provincial People's Hospital.The 60 lesional limbs were randomly and equally divided into 3 groups by a random number table and remainder grouping:combination group,MP group and control group.All the 3 groups were firstly treated with ELA in the main great saphenous vein.Then,the combination group was treated with FS followed by topical MP cream for 4 weeks.After the laser therapy,the MP group was treated with topical MP cream for 4 weeks,and the control group was treated with topical mometasone furoate cream alone for 4 weeks.The eczema area and severity index (EASI) and visual analogue scale (VAS) for itching scores in the above 3 group were recorded before treatment and 4 weeks after treatment.Statistical analysis was done by paired t-test for comparisons before and after treatment,one-way analysis of variance (ANOVA) for intergroup comparison,and least significant difference (LSD)-t test for multiple comparisons.Results No significant difference was observed before treatment among the combination group,MP group and control group in the EASI (9.64 ± 4.58,9.94 ± 4.18,9.50 ± 4.41 respectively,F =0.052,P ＞ 0.05) or VAS scores (7.25 ± 1.29,7.50 ± 1.19,7.45 ± 1.32 respectively,F =0.218,P ＞ 0.05).After 4-week treatment,the combination group,MP group and control group all showed significantly decreased EASI (3.54 ± 1.57,5.86 ± 2.39,7.04 ± 2.75 respectively) and VAS scores (2.35 ± 0.67,3.85 ± 0.67,4.65 ± 1.23 respectively) compared with those before treatment (t =4.30-18.80,all P ＜ 0.05).After 4-week treatment,the EASI score was significantly lower in the combination group than in the MP group and control group (both P ＜ 0.05),while there was no significant difference between the MP group and control group (P ＞ 0.05).Additionally,the VAS score was significantly lower in the combination group than in the MP group and control group (both P ＜ 0.05),as well as in the MP group than in the control group (P ＜ 0.05).Conclusions ELA combined with FS and topical MP cream shows better short-term efficacy for the treatment of stasis dermatitis compared with ELA combined with topical MP cream or mometasone furoate cream.The combination with topical MP cream is superior to that with topical mometasone furoate cream in improving itching.The long-term efficacy needs to be observed further.
ABSTRACT
Antithrombin is one of the main endogenous anticoagulants. Antithrombin deficiency may result from hereditary or acquired factors. Inherited antithrombin deficiency is an uncommon autosomal disorder associated with a tendency to venous thromboembolism. Stasis dermatitis occurs as a result of venous stasis caused by venous incompetence or deep vein thrombosis. Furthermore, lipodermatosclerosis that refers to the skin induration and hyperpigmentation of the legs, often occurs in patients who have venous insufficiency. We report a case of stasis dermatitis, complicated by lipodermatosclerosis on both legs of a patient with hereditary antithrombin III deficiency.
Subject(s)
Humans , Anticoagulants , Antithrombin III Deficiency , Antithrombin III , Dermatitis , Fibrin , Hyperpigmentation , Leg , Skin , Venous Insufficiency , Venous Thromboembolism , Venous ThrombosisABSTRACT
Behcet's disease is a systemic vascular disorder induced by autoimmune mechanisms. As a vascular complication of Behcet's disease, thrombophlebitis has been commonly reported. Stasis dermatitis results from prolonged venous insufficiency including thrombophlebitis, which implies the possibilities of association between stasis dermatitis and Behcet's disease. We present a 51-year-old man with Behcet's disease accompanied with asymptomatic brownish ill-defined patch on the left leg. This case suggests that stasis dermatitis might be associated with Behcet's disease by complication of vascular system.
Subject(s)
Humans , Middle Aged , Dermatitis , Leg , Thrombophlebitis , Venous Insufficiency , Venous ThrombosisABSTRACT
Membranous lipodystrophy is a peculiar type of fat necrosis, present in patients with various types of skin disease. It is characterized by the presence of microcysts and macrocysts lined by amorphous eosinophilic material with a crenelated arabesque appearance. The eosinophilic lining and microgranules stain positively with periodic acid Schiff, are resistant to diastase. Membranous lipodystrophy can classify into primary idiopathic and secondary types. One of the most common cause of the latter is arterial or venous insufficiency. Stasis dermatitis is a consequence of impaired venous drainage of the legs. The microvascular ischemia is inconsistent and appears to be the main factor of stasis dermatitis and venous ulceration. We report a case of subcutaneous membranous lipodystrophy in a patient with stasis dermatitis.
Subject(s)
Humans , Amylases , Dermatitis , Drainage , Eosinophils , Fat Necrosis , Ischemia , Leg , Lipodystrophy , Periodic Acid , Skin Diseases , Varicose Ulcer , Venous InsufficiencyABSTRACT
Stasis dermatitis is characterized by hyperpigmented lesions occuring as a result of venous stasis of the lower half of the legs. It is often associated with venous thrombosis, varicose vein, obesity, congestive heart failure. Histopathologic findings include fibrosis, new blood vessel formation, and hemosiderin deposition in dermis layer. We here report a case of stasis dermatitis due to excessive weight gain in a patient with peritoneal dialysis. A 50-year-old man on peritoneal dialysis was admitted with edema and hyperpigmentated lesion on both lower legs. He gained weight of 8 kg for 3 months because of excessive oral intake without ultrafiltration failure. Skin biopsy of the hyperpigmented lesion revealed vascular proliferation, infiltration of inflammatory cells, fibrosis, and hemosiderin deposition in dermis. We started hemodialysis in order to correct weight gain and leg edema. After 3 months later, the skin lesions much improved.
Subject(s)
Humans , Middle Aged , Biopsy , Blood Vessels , Dermatitis , Dermis , Edema , Fibrosis , Heart Failure , Hemosiderin , Kidney Failure, Chronic , Leg , Obesity , Peritoneal Dialysis , Renal Dialysis , Skin , Ultrafiltration , Varicose Veins , Venous Thrombosis , Weight GainABSTRACT
Liposclerosis is a feature of chronic venous insufficiency. Clinically, liposclerosis is characterized by induration and variable hyperpipmention located on the skin of the leg and ankle. A 49-year-old male was presented with dark brown colored indurated plaque with the appearance of an inverted bottle on the lower leg. He had a history of stasis dermatitis on the area. The main histopathologic finding was broad septal fibrosis, where there were scattered hemosiderin, thick-walled and tortuous vessels, and fibrin deposition stained by phosphotungstic acid-hematoxyline (PTAH) stain.