Pattern of presentation of pompholyx at a principal referral point in Port Harcourt over a period of ten years

Background: Pompholyx is a type of hand eczema which is characterized by recurrent vesicles and bullae.It is seen commonly in the age group 20 -40 years, affects all races and has an equal sex distribution. It is commonly associated with contact allergic dermatitis and contact irritant dermatitis and atopy. Other associated factors include emotional stress, chronic illness such as HIV and physiological states like pregnancy. Pompholyx is said to be common in warm climate. In which the study area can be classified as such being a tropical climate in the Sub Saharan Africa. Pompholyx is a disease that reduces the quality of living of affected individuals and can bea cause of social stigmatization, often mistaken for a contagious infection such as scabies. It can also be a cause great discomfort to the body and mind leading to work and school absenteeism. Methodology:It was a retrospective cross sectional study of new pompholyx cases within the period of January 2006 to December 2015 from the new patient clinical register. Folders were retrieved and data was extracted using a semi-structured questionnaire developed from standard written medical literature on pompholyx. Data was analyzed using Statistical Package for Social Sciences version 20.Results:Thirty six new cases of pompholyx were seen within the period with an average incidence of 0.59% over the ten year period consisting of 22 females and 14 males with age range of 2- 65years.There was no statistical significant relationship between age categories and sex. The majority of cases were seen amongst students. The age 20-45 group constituted the highest number. 61% had a history of contact dermatitis with the major triggers being detergents, chemicals and metals. All patients were counseled and improved after receiving treatment from at least two of the five major classes of drugs- corticosteroids, antifungal, antibiotics, antihistamines and astringents. Conclusion:Pompholyx is a recurrent hand dermatitis characterized by vesicles and bullae though not common as the study reflects; it can be a source of mental and physical discomfort leading to a poor quality of life in affected individuals

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.

Eccrine Chromhidrosis Resembling Clinical Features of Pompholyx with Bile-Like Greenish Pigmentation on the Right Palm and Soles

No abstract available.

Dermatoses in pregnancy: Specific dermatoses vis-a-vis others, in a tertiary hospital in Kolkata

To document the frequency of specific and other dermatoses in pregnancy. Two hundred and twenty five consecutive pregnant patients irrespective of the duration of pregnancy and gravidity reporting to our skin OPD were enrolled in the study. Out of them, 218 patients who gave consent were included in the study. The specific dermatoses of pregnancy were subclassified into four main groups - atopic eruption of pregnancy [AEP], polymorphic eruption of pregnancy [syn. pruritic urticarial papules and plaques of pregnancy] [PEP], pemphigoid gestationis [PG], intrahepatic cholestasis of pregnancy [ICP]. 39 [68.4%] patients belonged to AEP, 14 [24.5%] to PEP, and 1 [1.8%] to PG and 3 [5.2%] to ICP. About half of the patients with AEP were found to have raised IgE level. Five STD patients were reported in the first trimester, 2 in second and 7 in third trimester. Patients reported with molluscum contagiosum [4], genital herpes [4], condyloma acuminata [3], primary chancre [1] and condyloma lata [1]. One patient with molluscum contagiosum was HIV positive. Among the non STD other dermatoses in pregnancy, scabies topped the list affecting in all trimesters. Fungal infections [tinea and pityriasis versicolor] was a close second. One case each of pompholyx, psoriasis, and leprosy reported to us. Early diagnosis of specific dermatosis of pregnancy may prevent harmful effect on mother and fetus

Larva migrans cutánea en un paciente viajero portador de dishidrosis: a propósito de un caso clínico / Cutaneous larva migrans in a traveling patient with dyshidrosis: a case report

Larva migrans cutánea es el resultado de una infección por nematodos y muestra una erupción serpiginosa característica. Con el aumento de los viajes a zonas tropicales, muchos pacientes pueden volver con ésta infección, que es a menudo, mal diagnosticada o tratada incorrectamente. Esta enfermedad cutánea parasitaria es causada por la migración de larvas provenientes de animales en la epidermis humana.

Cutaneous larva migrans is a result of a nematode infection and shows a characteristic creeping eruption. As travel to the tropics zone increases, many patients may be returning with this infection, which is often misdiagnosed or treated incorrectly. This parasitic skin disease is caused by the migration of animal hookworm larvae in the human epidermis.

A Case of Tinea Manuum Caused by Trichophyton mentagropytes var. erinacei / 대한의진균학회지

Tinea manuum comprises roughly 5% of all cases of tinea, and the main culprit is known to be Trichophyton (T.) rubrum, T. mentagrophytes var. erinacei is a dermatophyte that may be transmitted from hedgehogs, and it has been reported in Korea now that vast diversity of pets are brought into existence. Tinea manuum caused by T. mentagrophytes var. erinacei, is frequently localized to the initial site of exposure, and thus may be confused with hand eczema or pompholyx. The patient visited the outpatient clinic with an erythematous scaly patch with pustule on the right finger after being initially misdiagnosed with housewife eczema. Numerous hyphae were evident on KOH smear examination, and confirmative diagnosis of tinea manuum caused by T. mentagrophytes var. erinacei was made after culturing scales from the lesion for molecular biological analyses. The patient is currently under follow-up without relapse after being treated systemic and topical antifungal agents.

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.

The Patch Test as a Useful Tool for Avoiding Suspected Allergens in Patients with Hand Eczema / 대한피부과학회지

BACKGROUND: Hand eczema is a common skin disease in the general population. The etiology of hand eczema is obscure and many causative factors have been proposed. However, there are only a few reported studies of the relevance of contact allergy in hand eczema. Objective: The purpose of this study was to evaluate the diagnostic value of the patch test for patients with hand eczema. METHODS: We analyzed the clinical characteristics and the results of the patch tests of the 37 patients with hand eczema and we then compared these with the clinical subtypes. RESULTS: 26 patients (70.3%) showed a positive test to one or more allergens. The common allergens were nickel sulfate (35.1%), mercury ammonium chloride (21.6%), and cobalt chloride (18.9%). The positive rates for a patch test were 82.4% for the vesicular form, 77.8% for the fissured form, 20.0% for the hyperkeratotic form and 66.7% for pompholyx, respectively. We found more significant improvement of the clinical symptoms in the vesicular group (57.1%) than that in the non-vesicular group (9.3%) after avoiding the verified allergens. CONCLUSION: This study shows that the patch test is a useful tool for the detection of contact allergens and it must be performed for the patients with hand eczema, and especially for those patients with the vesicular type.

The Patch Test as a Useful Tool for Avoiding Suspected Allergens in Patients with Hand Eczema / 대한피부과학회지

BACKGROUND: Hand eczema is a common skin disease in the general population. The etiology of hand eczema is obscure and many causative factors have been proposed. However, there are only a few reported studies of the relevance of contact allergy in hand eczema. Objective: The purpose of this study was to evaluate the diagnostic value of the patch test for patients with hand eczema. METHODS: We analyzed the clinical characteristics and the results of the patch tests of the 37 patients with hand eczema and we then compared these with the clinical subtypes. RESULTS: 26 patients (70.3%) showed a positive test to one or more allergens. The common allergens were nickel sulfate (35.1%), mercury ammonium chloride (21.6%), and cobalt chloride (18.9%). The positive rates for a patch test were 82.4% for the vesicular form, 77.8% for the fissured form, 20.0% for the hyperkeratotic form and 66.7% for pompholyx, respectively. We found more significant improvement of the clinical symptoms in the vesicular group (57.1%) than that in the non-vesicular group (9.3%) after avoiding the verified allergens. CONCLUSION: This study shows that the patch test is a useful tool for the detection of contact allergens and it must be performed for the patients with hand eczema, and especially for those patients with the vesicular type.

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 Clinicopathological Study of Palmoplantar Dermatoses / 대한피부과학회지

BACKGROUND: Palmoplantar dermatoses have frequently been encountered in the dermatologic field. Many previous studies have focused on the specific diseases of palmoplantar dermatoses; however, none of them have included a the comprehensive study of palmoplantar dermatoses. OBJECTIVE: The purpose of this study was to investigate the epidemiological aspects of palmoplantar dermatoses, with a brief review of the common palmoplantar dermatoses. METHODS: We retrospectively reviewed the data of 237 patients who had been biopsied for palmoplantar dermatoses between January 2000 and December 2004 at Our Lady of Mercy Hospital, The Catholic University of Korea. RESULTS: The results were as follows; Female to male ratio was 1 : 1.01. The mean age at diagnosis was 37.5+/-20.1 years. The mean duration of the disease was 35.9 months and ranged from 2 days to 50 years. Palmoplantar dermatoses appeared on the palms in 49 (20.6%) patients, the soles in 123 (51.9%) patients, and both the palms and soles in 65 (27.4%) patients. The most common five diseases of palmoplantar dermatoses were palmoplantar pustulosis (23.2%), verruca (11.4%), pompholyx (10.1%), palmoplantar keratoderma (8.9%), and contact dermatitis (8.0%). Of the 237 patients, 65 (27.4%) patients were accompanied with other dermatoses; fungal infection (13.9%), eczema (7.6%), onychodystrophy (3.4%), psoriasis (1.7%), erythema multiforme (1.3%), hyperhidrosis (1.3%), drug eruption (0.8%), or lichen simplex chronicus (0.4%). Of the 237 patients, 51 (21.5%) patients were accompanied with systemic diseases; Cardiovascular diseases (8.4%), endocrine diseases (6.6%), hepatobiliary diseases (4.6%), malignancy (3.4%), pulmonary diseases (2.5%), or gastrointestinal diseases (1.3%). CONCLUSION: Our study shows that the biopsy of palmoplantar dermatoses is gradually increasing. Further investigation with a wider and larger population is necessary to understand the epidermiology of palmoplantar dermatoses, and, based on the epidermiology of palmoplantar dermatoses, accurate diagnosis and proper treatment of palmoplantar dermatoses could then be achieved.

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

No abstract available.

Childhood eczema: a comparative analysis

Introduction Dermatological disorders affect children of all ages. Eczema is a common problem, along with infections and infestations. This study was carried out to determine frequency of various types of childhood eczema in our community. The study comprises an audit of freshly registered cases of childhood eczema presenting in the outpatient department of BISD from 1st October 2001. Till 31st March 2003, over a period of 18 months. A total of 1038 patients, of either sex, up to 15 years of age were included. There were 541 [52%] males and 497 [48%] females. All the clinically diagnosed cases were subclassified into: atopic dermatitis, pityriasis Alba, seborrheic dermatitis, contact dermatitis, napkin dermatitis, xerotic eczema, infective eczema, pompholyx, nummular eczema, and lichen simplex chronicus. The patients were divided into three groups according to age; infancy, 1-5 years and 5-15 years. Atopic dermatitis [26%] was the most common type seen followed by pityriasis alba [25%], seborrheic dermatitis [2 1%], contact dermatitis [7%], napkin dermatitis [7%], xerotic eczema [6%], infective eczema [4%], nummular eczema [1.5%], pompholyx [1.5%] and lichen simplex chronicus [1%]. There were 445 [42.9%] infants, 283 [27.3%] in the 1-5 years group and 309 [29.8%] in 5-15 years group. Atopic eczema [44%], seborrheic dermatitis [65%], napkin dermatitis [88%] and xerotic eczema [51%] were the most common in infancy. In the 1-5 year group, infective eczema [55%], atopic dermatitis [31%]. pityriasis alba [28%] and contact dermatitis [23%] were seen commonly. In the 5-l5year group, pityriasis alba [51%], contact dermatitis [47%], xerotic eczema [29.5%] arid atopic dermatitis [24%] had the highest frequencies. The clinical patterns of childhood eczema in our population are the same with some variations in frequency. Most of the patients present within the first 5 years of life

Comparison of Local Bath-PUVA with Steroid Treatment in Palmoplantar Pustular Psoriasis and Dyshidrotic Eczema / 대한피부과학회지

BACKGROUND: Local bath-PUVA(LB-PUVA) therapy has been recently tried for the treatment of palmoplantar pustular psoriasis and chronic eczema with successful results. However it has not been reported that the effectiveness of LB-PUVA was compared with that of steroid treatment which is the most available treatment. OBJECTIVES: The purpose of this study was to assess the effectiveness, symptom-free interval, recurrence rate and side effects of local bath-PUVA(LB-PUVA) therapy in palmoplantar pustular psoriasis and dyshidrotic eczema which had been resistant to conventional treatments and to compare these results with those of the steroid treatment. METHODS: Twenty four patients with palmoplantar pustular psoriasis, dyshidrotic eczema and palmoplantar keratoderma were treated with local bath-PUVA and the control group of twenty patients with systemic and topical steroid. 1. Local bath-PUVA therapy After a 15-minute bath in 1mg/L of methoxsalen solution(0.0001%), the palms or soles or both were exposed immediately to UVA radiation by UV/PUVA200. The initial standard dose was 1.5 J/cm2, and the patients were treated three times a week. 2. Systemic and topical steroid therapy The patients treated with 10-15mg of oral prednisolone once a day and high-potency steroid(Dermovate ointment) to the lesion topically for 4-8 weeks. The efficacy, symptom-free interval and side effects were assessed for 6-12 months after termination of the treatments. RESULTS: The following results were obtained from this study. 1. In the objective study, severity scores before and after treatment significantly differed in palmoplantar pustular psoriasis treated with local bath-PUVA (p<0.001). 2. In the subjective study, steroid treatment was more effective than LB-PUVA treatment for dyshidrotic eczema and palmoplantar pustular psoriasis. 3. Remission period was significantly longer (mean 9.1+/-2.8 months vs. 5.2+/-3.1 months) and recurrence rate, lower (26.7% vs. 68.9%) after LB-PUVA treatment than after steroid treatment in palmoplantar pustular psorisis and dyshidrotic eczema. 4. One patient with palmoplantar keratoderma was effectively treated by LB-PUVA. CONCLUSION: Local bath-PUVA therapy can be used as an effective and safe treatment method of palmoplantar pustular psoriasis and possibly palmoplantar keratoderma.

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.

Dishidrosis: estudio de 89 pacientes / Dyshidrosis: a study of 89 patients

Se llevó a cabo un estudio de 89 pacientes portadores de lesiones de aspecto dishidrótico, desde diciembre de 1990 hasta marzo de 1994. El grupo estaba constituido por 55 mujeres y 34 varones, con un promedio de edad de 37,7 años. A todos los pacientes se les realizó rutina de laboratorio, parasitológico de materia fecal y estudios micológicos de la lesión, hallándose en estos últimos un 55 por ciento de positividad (siendo en su mayoría T. rubrum). Esto nos permitió inferir que en realidad se trataban de verdaderas tiñas, a pesar de cumplir con algunas de las cuatro variantes clínicas de la enfermedad (vesiculosa-descamativa-pustulosa o ampollar), por lo que consideramos que es imprescindible el estudio micológico de estas lesiones

Evaluation of Minor Clinical Features of Adolescence and Adult Atopic Dermatitis in Korea / 대한피부과학회지

BACKGROUND: Three age-depedent clinical phases(infantile, childhood and adult phase) of atopic dermatitis(AD) were recognized. We think that for t he diagnosis of AD there seems to be some differences in minor clinical features of diagnosic significance according to each phase, yet only a few studies about them. OBJECTIVES: The purprrse of the present study was to evalute the diagnostic significance of total 39 minor clinical features of AD in Korean adolescenc and adult popluation, all but only skin were proposed by our previous study for Korean children. METHODS: The frequeney of 39 minor clinical features wistudied in 82 patients with typical AD compared to that in 109 control subjects. The age all studied individuals ranged from 13 to 42 years. Furthermore, some characteristic micro features of AD in them were compared with those from our previous study for Korean children. RESULTS: Twenty-seven minor features including xerosis, peifolhcular accentuation, frontal lichenification, anterior neck folds, eyelid eczema, Dennie-Mogan folds, auricular fissure/eczema, pityriasis alba, ventiral wrist eczema, infragluteal eczcm, sandpaper-like skin lesions on elbow/knee/lateral malleblus, white dermographism, scalaling, Hertoghes sign, orbital darkening, cheilitis, facial erythema/pallor, hyperlinear paln, ichthyosiform skin lesions, nipple eczema, nummular eczema, pompholyx, itchy hyperker totic lesions of dorsal hands, knuckle dermatitis of hands, hangnail, non-specific hand/foot dermatitis, chronic dermatophytosis were shown to be of much diagnostic signiic, nce(P<0.001). CONCLUSION: We think tiat 13 minor features such as Hert piges sign, cheilitis, facial erythe- mapallor, hyperlinear ichthyosiform skin lesions, ripile eczema, nummular eczema, pompholyx, itchy hyperkpratotic lesions of dorsal hands, kzukle dermatitis of hands, hangnail, non-specific hand/foot dermatitis, chronic dermato h tosis are specific for Korean adolescence and adult population with AD. Taken together, to propose that these 13 minor features be added to a gardeline for the large scale field sirvy on the incidence and prevalence of AD in the Korea adolescence and adult population.

Disidrose: estudo prospectivo de 600 casos / Dyshidrosis: prospective study of 600 cases

O autor realizou um estudo prospectivo em 600 pacientes portadores de disdrose. Após uma revisäo bibliográfica a respeito mostra os resultados obtidos em relaçäo ao sexo, raça, idade, profissäo, localizaçöes das lesöes, meses de freqüência e possíveis causas etiológicas