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Introduction@#IgA pemphigus is a rare, distinct variant of Pemphigus characterized by vesiculopustular eruptions mediated by IgA autoantibodies targeting keratinocyte cell surface antigens, desmocollins 1-3 and sometimes desmogleins 1 and 3. Its classical features have been described in literature but atypical cases have also been documented. This report presents such case posing a diagnostic dilemma.@*Case Report@#A 35-year-old female presented with a 16-year history of intermittent eruptions of multiple hyperpigmented, annular and circinate, desquamating plaques and coalescing flaccid pustules on erythematous bases on the scalp, neck, trunk, and extremities. Histopathologic examination revealed subcorneal pustular dermatitis, and direct immunofluorescence was positive for granular intercellular IgG and IgA deposits in the epidermis. Antinuclear antibody test was negative and C3 level was normal. Antibody tests against desmogleins 1 and 3 were both negative. Topical potent corticosteroid therapy resulted in complete resolution of all lesions in three weeks.@*Conclusion@#Diagnostic dilemmas arise when laboratory results do not correlate with clinical findings. Findings of IgA autoantibodies in patients with pemphigus-like skin eruptions led to the diagnosis of subcorneal pustular dermatosis type of IgA pemphigus. Dapsone is the treatment of choice although topical potent corticosteroid alone may provide complete remission in some cases, avoiding the potential adverse effects of systemic therapy
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Dermatopatias VesiculobolhosasRESUMO
INTRODUCTION@#Common warts are frequent benign cutaneous and mucosal infections. However, recommendations from previous studies have focused on personal and public factors to prevent warts and reduce its transmission. This study aimed to determine the prevalence of common warts and its relation to individual, family, school, public, and occupational factors.@*METHODS@#This is a cross-sectional study wherein the cutaneous surfaces (except the mucosa and genitalia) of residents of Barangay Doña Imelda, Quezon City were examined for the presence of warts. Information on individual, family, school, public, and occupational risk factors was obtained from the respondents themselves, parents or guardian using a data extraction sheet. A PRR of > 1.0 was interpreted as a positive association. Chi-square and Fisher’s exact tests were used to test for significance. A p-value of < 0.05 was considered significant.@*RESULTS@#The prevalence of common warts among 315 residents was 7.6 %. The presence of family (PRR = 6.41, 1.91), school (PRR = 1.68), and occupational (PRR = 1.50) factors increased the risk of developing warts. In contrast, a personal history of warts and public factors were not associated with the development of warts.@*CONCLUSION@#The prevalence of common warts is 7.6%, compatible with the results of previous studies. Having a family member with warts, large family size (more than five family members), having at least one closest school friend with warts, and occupation (fish or meat or poultry vendor) increase the risk of developing warts.
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Introduction@#Bullous pemphigoid (BP) is an acquired autoimmune subepidermal bullous disease characterized by linear depo- sition of IgG and C3 along the basement membrane. It rarely occurs in childhood, especially in adolescence, with only 14 cases identified in literature. Treatment of choice is systemic corticosteroids but other treatment options such as anti-inflammatory antibacterials and methotrexate are available.@*Case report@#A 16-year-old Filipino girl presented with a three-month history of generalized vesicles and bullae. Nikolsky and Asboe-Hansen signs were negative. Histopathology and direct immunofluorescence were consistent with BP. ELISA to BP180 au- toantibody levels was elevated at 135 IU (normal <9 IU). Complete blood count showed leukocytosis with increase in neutrophils. Chest x-ray revealed pulmonary tuberculosis. The patient was given quadruple anti-Koch’s medication (pyrazinamide, rifampi- cin, ethambutol, isoniazid), prednisone, oral erythromycin and topical clobetasol propionate. Complete remission was attained at 10 months and is sustained at the time of writing.@*Conclusion@#To establish a definitive diagnosis and appropriate management, BP requires clinical, histopathologic, and immuno- logical correlation. Childhood BP has good prognosis and rapid treatment response, with rare relapses.
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Penfigoide BolhosoRESUMO
INTRODUCTION@#Interdigital pilonidal sinus is an acquired condition secondary to penetration of hair fragments into the skin of the web spaces of the hands commonly observed in hairdressers, and occasionally, among pet groomers. Local literature reports or guidelines to ensure practice of protective measures for this population of workers are currently lacking.@*CASE SUMMARY@#A 24-year old pet groomer consulted due to occasional white hair strands emerging from two openings in the third interdigital space of his dominant hand. Histopathologic examination of the sinus tract showed an acanthotic, hyperplastic epidermis with scale crust, and nodular dermal infiltrates composed of epithelioid histiocytes, plasma cells, lymphocytes, and eosinophils. Transepidermal extrusion of polarizable hair cortical material was also evident establishing the diagnosis of an interdigital pilonidal sinus. Sinusectomy and debridement with healing by secondary intention resulted in an optimal wound closure and full motion of the affected hand after one week and minimal scarring with no recurrence after seven months.@*CONCLUSION@#Surgical excision followed by proper wound care is essential to avoid recurrence. In conclusion, since interdigital pilonidal disease is a rare condition, awareness among physicians would lead to accurate diagnosis, optimal treatment, and proper patient education.