Résumé
No abstract available.
Sujets)
Région mammaire , Lichen scléroatrophique , Lichens , Vitiligo , VulveRésumé
Tinea incognito is a dermatophytic infection induced by immunosuppressive agents that lacks the classic features of a typical fungal infection. Although the treatment of tinea incognito is simple and relatively easy, its clinical manifestation varies and can masquerade as various skin disorders, causing misdiagnosis and thus preventing prompt and appropriate treatment. Here, we report an interesting case of tinea incognito occurring after topical steroid administration in an immunosuppressed patient with dermatitis artefacta. A 40-year-old female patient who had been taking systemic glucocorticoid for 4 years for chronic inflammatory demyelinating polyneuropathy presented with itching multiple erythematous erosive lesions on the face and upper chest for 2 months. Initial biopsy produced nonspecific findings. The skin lesion was aggravated and became polycyclic and erythematous; after azathioprine was added, her chronic inflammatory demyelinating polyneuropathy became aggravated. A second biopsy confirmed hyphae in the cornified layer. Complete remission was achieved after admonishing oral terbinafine and topical amorolfine.
Sujets)
Adulte , Femelle , Humains , Azathioprine , Biopsie , Dermatite , Erreurs de diagnostic , Hyphae , Immunosuppresseurs , Polyneuropathies , Prurit , Peau , Thorax , TeigneRésumé
BACKGROUND: Tacrolimus ointment is a topical immunomodulator. Preliminary studies suggest that 0.1% tacrolimus is effective and has a proactive effect on atopic dermatitis with fewer complications than topical corticosteroids. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of tapering treatment with 0.1% tacrolimus ointment and its impact on quality of life in adult patients with atopic dermatitis in Korea. Korean adults with atopic dermatitis. METHODS: A total of 53 patients aged 15 to 54 years with moderate to severe atopic dermatitis applied 0.1% tacrolimus ointment for 12 weeks. The 0.1% tacrolimus ointment was applied along with a topical corticosteroid once daily during the 2-week induction phase and twice daily during the 2-week transitional phase. During the 8-week maintenance phase, the corticosteroid was discontinued and the 0.1% tacrolimus ointment alone was applied twice daily for 2 weeks and twice weekly for 6 weeks. Efficacy and quality of life were evaluated by the SCORAD and the Dermatology Life Quality Index (DLQI), respectively. RESULTS: SCORAD and DLQI values were significantly improved after 12 weeks of treatment. Symptoms were markedly improved after 2 weeks of applying the 0.1% tacrolimus ointment and the improvements were well maintained after tapering. Continuous improvement was observed throughout the study. Transient skin burning and itching occurred in about 43% of the patients, but gradually decreased in about 30% after continuous application. CONCLUSION: Tapering treatment with 0.1% tacrolimus ointment is safe and effective, and may replace the long-term use of topical corticosteroids, avoiding corticosteroid-associated adverse effects while maintaining clinical control and improving the quality of life of adult atopic dermatitis patients.