Reacción acneiforme como efecto adverso del apremilast / Acneiform reaction as an adverse effect of apremilast

El apremilast es un fármaco inhibidor de la fosfodiesterasa-4 que modula, a nivel intracelular, la expresión de citoquinas involucradas en la patogenia inflamatoria de la psoriasis. Su uso está indicado en la psoriasis en placas moderada y severa, con buenos resultados clínicos. Los principales efectos adversos son gastrointestinales y, en menos del 2% de los pacientes, dermatológicos, con exantema y foliculitis. Se presenta el caso de un paciente de 42 años que, luego de tomar el apremilast, desarrolló lesiones faciales que correspondieron clínica e histopatológicamente a una reacción acneiforme, con evolución favorable y resolución total del cuadro posterior a la suspensión del medicamento.

Apremilast is a phosphodiesterase-4 inhibitor that modulates the intracellular expression of cytokines, which are involved in the pathogenesis of psoriasis. Apremilast is indicated in moderate to severe plaque psoriasis, and it has shown good clinical results. The main adverse effects occur at a gastrointestinal level, and in less than 2% at the dermatologic level with exanthema and folliculitis. We present a 42-year-old patient that developed facial lesions after taking apremilast. The facial lesions were clinically and histopathologically correspond to an acneiform eruption. The patient evolved favorably and fully recovered after suspending apremilast.

A Case of Acneiform Eruption Induced by Bevacizumab / 대한피부과학회지

No abstract available.

Dasatinib (Sprycel®)-Associated Acneiform Eruption Improved by Dose Reduction due to Pleural Effusion in a Patient with Chronic Myeloid Leukemia / 대한피부과학회지

No abstract available.

Clinical Analysis of Drug Eruptions among Inpatients Seeking a Consultation with the Department of Dermatology / 대한피부과학회지

BACKGROUND: Drug eruptions are common in hospitalized patients. Rapid and accurate diagnosis is essential but often difficult. OBJECTIVE: This study defined the clinical features and causative drugs among inpatients presenting with drug eruptions. METHODS: We retrospectively analyzed the clinical and laboratory data of inpatients who sought consultations with the Dermatology Department for a diagnosis of drug eruptions. RESULTS: A total of 228 patients were diagnosed with drug eruptions, and this study included 139 patients. The highest incidence of drug eruptions was observed in patients in their 50s (22.3%). The most common latent period was up to 1 week (57.6%). The most common drug eruptions were exanthematous eruptions (59.7%), acneiform eruptions (10.8%), and urticaria (9.3%). The most common causative drugs were antibiotics (53.2%), followed by anticancer drugs (19.4%), and contrast media (6.5%). Laboratory abnormalities included eosinophilia (15.8%), abnormal liver function tests (7.9%), leukopenia (4.3%), an elevated serum creatinine level (2.2%), and leukocytosis (0.7%). CONCLUSION: In descending order, the most frequent drug eruptions were exanthematous eruptions, acneiform eruptions, and urticaria, and the most common causative drugs were antibiotics, anticancer agents, and contrast media. Prompt diagnosis and discontinuation of the causative drug are important in this context. Clinicians should be aware of cutaneous adverse drug reactions.

Esophageal aperistalsis in a patient with lipoid proteinosis

Lipoid proteinosis is a rare disorder with autosomal recessive inheritance, characterized by progressive deposition of hyaline material in the skin, mucous membrane, and different organs of the body, resulting in a multitude of clinical manifestations. A 34-year-old woman presented with hoarseness, dysphagia, eyelid beeding, and acneiform scars on the facial skin and extremities. The patient was diagnosed clinically as having lipoid proteinosis, which was confirmed by laryngeal biopsy. The objective of the present report is to describe this rare entity. This case report also illustrates that lipoid proteinosis may show protean clinical features and yet may remain undiagnosed for many years

Frecuencia, severidad y ubicación de erupciones acneiformes en hombres y mujeres tras una cirugía ortognática: estudio descriptivo longitudinal / Frequency, severity and location of acneiform eruptions in men and women after orthognathic surgery: longitudinal descriptive study

Describir la frecuencia de erupciones acneiformes y/o exacerbaciones de un acné previo tras una cirugía ortognática. La muestra consta de 57 pacientes (n=57) de ambos sexos, sometidos a una cirugía ortognática, los cuales fueron evaluados en: el preoperatorio (0-7 días previos); en distintas etapas de la cirugía; postoperatorio inmediato (7 ­ 15 días post cirugía) y postoperatorio mediato (30 ­ 40 días postquirúrgicos). En todos los controles clínicos mencionados se determinó la presencia/ausencia, ubicación, severidad y diagnóstico de las erupciones acneiformes. El 52,6 % de los pacientes sometidos a cirugía ortognática presentaron erupciones acneiformes, siendo mayores en las mujeres en comparación con los hombres. La severidad de las erupciones acneiformes es mayor en el postoperatorio inmediato en comparación al preoperatorio y postoperatorio mediato. La ubicación más frecuente del acné corresponde a la región frontal, tanto en el preoperatorio (22,8 %) como en el postoperatorio inmediato (31,6 %). En el postoperatorio mediato la zona más frecuente es la geniana (39 %). La frecuencia de acné post cirugía ortognática es elevada, siendo mayor en mujeres que en hombres. La severidad de este acné es mayor en el postoperatorio inmediato. La región frontal corresponde a la zona más frecuente de aparición de las erupciones acneiformes en el postoperatorio inmediato y la zona geniana en el postoperatorio mediato. El diagnóstico de estas erupciones acneiformes corresponde a un acné esteroidal, por lo que se puede sugerir un posible plan de tratamiento, con el fin de mejorar el postoperatorio de las pacientes y evitar, en lo posible, futuras manifestaciones en nuevas pacientes sometidas a este tipo de cirugía.

Describe the frequency of acneiform eruptions and / or exacerbations of a previous acne after orthognathic surgery. The sample consisted of 57 patients (n = 57) of both genders, undergoing orthognathic surgery, who were evaluated with a follow-up of 2 postoperative months, at different stages of surgery; Preoperative (0-7 days), immediate postoperative (7-15 days) and mediate postoperative (30-40 days). The presence / absence, location, severity and diagnosis of acneiform eruptions were determined in all clinical controls. The frequency of acneiform eruptions corresponds to 52.6 % of patients undergoing orthognathic surgery, being higher in women compared to men in relation to the presence of acneiform eruptions and / or exacerbations of a previous acne after the intervention. The severity of acneiform eruptions is greater in the immediate postoperative period compared to the preoperative and mediate postoperative period. The most frequent location to be found in the facial region is in the frontal area, both in the preoperative (22.8 %) and in the immediate postoperative period (31.6 %). In the postoperative period, the most frequent is the genial area (39 %). The appearance of acneiform eruptions corresponds to steroidal acne. The frequency of acne post orthognathic surgery is high, being higher in women than in men. The severity of this acne is greater in the immediate postoperative period. The frontal region corresponds to the most frequent area of onset of acneiform eruptions in the immediate postoperative period and the genial area in the postoperative period. The diagnosis of these acneiform eruptions corresponds to a steroidal acne, so it is possible to suggest a possible treatment plan, in order to improve the postoperative of the patients and to avoid, as far as possible, future manifestations in new patients undergoing this type of surgery.

TeleCondutas: acne / TeleGuides: acne

Acne é a dermatose mais comum, acometendo cerca de 80% dos adolescentes e adultos jovens. É caracterizada por lesões não-inflamatórias (comedões abertos e/ou fechados) e por lesões inflamatórias (pápulas, pústulas, cistos ou nódulos) tipicamente localizados na face, pescoço, dorso, tórax e braços. A etiologia da acne vulgar resulta da associação dos seguintes fatores: hiperqueratinização e obstrução do infundíulo folicular, devido à descamação anormal do epitélio folicular; aumento da produção de sebo estimulada pelos andrógenos; colonização do folículo pelo Propionibacterium acnes, gerando inflamação. Esta guia apresenta informação que orienta a conduta para casos de acne no contexto da Atenção Primária à Saúde, incluindo: classificação da acne vulgar, Características da acne vulgar, Erupção acneiforme, Diagnóstico da acne vulgar, Tratamento - Orientações gerais, Tratamento - Medicamentos, Terapia tópica, Antibióticos sistêmicos, Terapia antiandrogênica, Acne na Gestante, Acompanhamento, Encaminhamento para serviço especializado.

Analysis of Dermatologic Diseases in Patients Receiving Anticancer Treatments: A Retrospective Study of 140 Cases / 대한피부과학회지

BACKGROUND: A number of anticancer agents are known to induce many adverse reactions in the skin. Related cutaneous adverse drug reactions influence the morbidity, mortality, and anti-cancer regimen of the patients. A multidisciplinary approach to cancer management has been emphasized. OBJECTIVE: To identify the causative anticancer agents and frequency of adverse reactions in the skin. METHODS: We retrospectively reviewed the medical records of patients who consulted at the Dermatology Department of Busan Paik Hospital and Haeundae Paik Hospital from January 2013 to February 2015. RESULTS: A total of 140 patients were enrolled. Among the 45 patients treated with antimetabolite analogs (30 cytarabine, 7 gemcitabine, 3 methotrexate, 2 fludarabine, 2 doxifluridine, and 1 decitabine), exanthematous drug eruption (49.1%) was the most common reaction, followed by hand-foot syndrome (28.3%). Among the 35 patients treated with fluorouracil (22 5-fluorouracil and 13 capecitabine), hand-foot syndrome (47.2%) was the most common, followed by acneiform eruption (25.0%). Among the 24 patients treated with epidermal grow factor receptor inhibitors (10 erlotinib, 10 cetuximab, and 4 gefitinib), acneiform eruption (54.8%) was the most common, followed by xerosis (19.4%). Among the 11 patients treated with anthracyclines (9 doxorubicin, 1 daunorubicin, and 1 idarubicin), acneiform eruption (45.5%) was the most common, followed by hand-foot syndrome (36.4%). Among the 7 patients treated with taxanes (4 docetaxel and 3 paclitaxel), hand-foot syndrome (42.8%) was the most common. Among the 6 patients treated with angiogenesis-inducing inhibitors (3 sorafenib, 2 pazopanib, and 1 sunitinib), hand-foot skin reaction (66.7%) was the most common. Only 2 patients (1.4%) changed treatments due to intolerable skin reactions. CONCLUSION: Clinicians should be aware of the various skin reactions of anticancer agents and predict their clinical course effectively.

Bromoderma in an infant

Abstract Bromoderma is a cutaneous eruption caused by the absorption of bromide. Clinical manifestations include acneiform and vegetative lesions. We report the case of an infant with bromoderma caused by the use of syrup for abdominal colic containing calcium bromide. The lesions regressed after discontinuation of the drug.

Acneiform Eruption Induced by Dacomitinib (PF-00299804) / 대한피부과학회지

Dacomitinib (PF-00299804) is a newly developed irreversible pan-HER (human epidermal growth factor receptor) inhibitor for the treatment of non-small cell lung cancer (NSCLC). Inhibiting HER-1 (epidermal growth factor receptor, EGFR), HER-2, and HER-4 may induce similar cutaneous side effects to those of traditional EGFR inhibitors. We report two patients who developed acneiform eruption on the face and trunk, induced by dacomitinib treatment for NSCLC. The skin lesions appeared 3~4 weeks after the initiation of dacomitinib use, and they improved after oral minocycline and topical clindamycin treatment. There has been no report of acneiform eruption after dacomitinib treatment in Korean dermatology journals.

Acneiform Eruption Induced by Dacomitinib (PF-00299804) / 대한피부과학회지

Dacomitinib (PF-00299804) is a newly developed irreversible pan-HER (human epidermal growth factor receptor) inhibitor for the treatment of non-small cell lung cancer (NSCLC). Inhibiting HER-1 (epidermal growth factor receptor, EGFR), HER-2, and HER-4 may induce similar cutaneous side effects to those of traditional EGFR inhibitors. We report two patients who developed acneiform eruption on the face and trunk, induced by dacomitinib treatment for NSCLC. The skin lesions appeared 3~4 weeks after the initiation of dacomitinib use, and they improved after oral minocycline and topical clindamycin treatment. There has been no report of acneiform eruption after dacomitinib treatment in Korean dermatology journals.

Acneiform Eruption Induced by Radotinib (IY5511 : HCL) / 대한피부과학회지

No abstract available.

Oral manifestations of lipoid proteinosis: a case report and literature review

Lipoid proteinosis is an uncommon autosomal recessive metabolic disorder that presents in early life with hoarseness and pox-like acneiform scars involving the skin and mucous membranes. Previous studies have attributed the prevalence of lipoid proteinosis to consanguineous parents. This paper reports a classical case of lipoid proteinosis with oral manifestations but without a history of consanguinity

Pityrosporum folliculitis in a patient diagnosed with acneiform drug eruption

Pityrosporum folliculitis (PF) is a polymorphic dermatomycosis characterized by the development of multiple follicular papules and pustules. This disease occurs mainly in the seborrheic areas of the face, back and chest. Being aggravated by hot weather and sweating, PF has shown to be a common disease in the tropics. Clinically, it may present similarly as other diseases such as acneiform drug eruption. Differentiation between these two disease entities and an objective method of ruling out PF are important in our setting as management will differ. We report a case of pityrosporum folliculitis in a patient who had a history of chronic oral steroid intake and presented clinically with an acneiform eruption on his face, chest and back. Microscopy and skin biopsy revealed the presence of Pityrosporum. The patient was successfully treated with systemic and topical anti-fungal medications. We postulate that in this patient, immunosuppression due to exogenous steroids may be the predisposing factor for pityrosporum folliculitis. Since acneiform drug eruption and pityrosporum folliculitis may present similarly, misdiagnosis is common. We suggest that when presented with an acneiform eruption in an immunosuppressed patient, direct microscopy of KOH mounts of lower comedonal

Pseudoacné de la línea transversa nasal: variedades de presentación / Pseudoacné transverse nasal line: varieties of presentation

El pseudoacné de la línea transversa nasal (PLTN) es un cuadro benigno, no asociado a patología sistémica, que se caracteriza por la presencia de lesiones similares a las del acné en la unión de los tercios medio e inferior del puente nasal, sitio que anatómicamente corresponde a la zona de unión de los cartílagos nasales alares y triangulares. En esta área anatómica han sido descriptas líneas de color piel, hipo o hiperpigmentadas, con o sin atrofia, que en su trayecto pueden desarrollar quistes de milium, comedones, pápulas y/o pústulas. El diagnóstico de PLTN debe ser considerado en todo paciente con una pápula de evolución crónica o quistes de milium en la línea transversa nasal, especialmente si tiene antecedentes de frotamiento de la nariz o rinitis alérgica. Presentamos 10 pacientes, 9 pediátricos y un adulto, con lesiones en la línea transversa nasal. Las diferentes manifestaciones clínicas observadas fueron pápulas, comedones, quistes de milium y/o hipopigmentación. Concluimos que las lesiones en la línea transversa nasal son más frecuentes que lo descripto en la literatura y que existe un espectro clínico muy amplio, que va desde una mínima hipopigmentación lineal hasta la presencia de lesiones quísticas. Algunos autores, al igual que nosotros, se replantean el nombre de esta entidad por la presencia de comedones.

Pseudoacne of the nasal crease is a benign isolated condition, characterized by lesions that resemble acne at the junction of the middle and lower thirds of the nose, known as nasal crease, that anatomically corresponds to the site of union of the alar and triangular nasal cartilages. Different types of lesions have been described in this area: atrophic lines, hypo or hyperpigmented lines with or whithout atrophy that may develop milium cysts, comedones, papules and/or pustules. Pseudoacne of the nasal crease should be suspected in any individual with chronic papular lesions or milia over the nasal crease, especially when having a history of chronic rubbing of the nose or rhinitis. We present 10 patients (9 children and an adult) with lesions over the nasal crease. Different clinical manifestations observed were: papules, comedones, milium cysts and/or hypopigmentation. We conclude that these clinical presentations are likely much more common than reported in the literature and that a wide spectrum of lesions exists, ranging from a minimal hypopigmented crease to cystic lesions. Considering the common finding of comedones, we also suggest -as well as other authors- that the name pseudoacne should be revised.

Efectos adversos dermatológicos de los inhibidores del factor de crecimiento epidérmico / Dermatologic side effects associated with the epidermal

Los inhibidores del receptor de factor de crecimiento epidérmico son un grupo de drogas nuevas usadas para el tratamiento de tumores en estadios avanzados. Estas drogas producen conmucha frecuencia toxicidad cutánea. El objetivo de este artículo es realizar una revisión de estas reacciones cutáneas y el manejo de las mismas.

Epidermal growth factor - receptor inhibitors constitute a new group of drugs used for the treatment of malignant tumors in advanced stages. These drugs produce with high frequency cutaneous toxicity. The aim of this paper is to review those cutaneous reactions, and their management.

Vellus hair cysts presenting as an atypical acneiform eruption / Cisto de pelo velos apresentando-se como erupção acneiforme atípica

A 32-year-old male patient presented for 8 months an asymptomatic therapy-resistant acneiform eruption on his back and buttocks. Skin examination showed several inflammatory papules, which evolved to hyperpigmentation. At the same distribution non inflammatory papules, which resembled rice grains, were also observed. Light microscopy showed small keratin-filled cysts, with an epithelial multilayered wall, without granular layer. Keratin and some vellus hairs were identified inside the cyst, confirming the diagnosis of vellus hair cysts. Diagnosis of vellus hair cysts should be suspected in cases of multiple papules or therapy-resistant cases of acneiform eruptions.

Um paciente de 32 anos apresentou há 8 meses uma erupção acneiforme resistente à terapêutica, localizada no dorso e nádegas. Ao exame apresentava inúmeras pápulas inflamatórias, que evoluiam para hiperpigmentação. Na mesma distribuição havia lesões não inflamatórias, lembrando grão de arroz. A microscopia óptica demonstrou cisto dérmico cuja parede era de epitélio estratificado, sem camada granular, preenchido de queratina e com pelos no interior, confirmando o diagnóstico de cisto de pelo veloso. Essa entidade deve ser suspeitada em casos de múltiplas pápulas ou erupções acneiformes resistentes à terapia.