RESUMO
It has been reported that there are a range of causative drugs related to symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). The causative drugs reported so far include the following: antibiotics, intravenous immunoglobulin, chemotherapeutic agents, and biologics. In this study, we report two cases of SDRIFE and a review of the previous literature. We believe that our study makes a significant contribution to the literature because it demonstrates that intradermal injection of the Chinese herbal ball, and not its topical application, elicited a reaction that predicted the occurrence of SDRIFE. This finding is important for the diagnosis of SDRIFE in future studies. Our findings also provide evidence for a SDRIFE reaction after exposure to ranitidine and mosapride.
Assuntos
Humanos , Antibacterianos , Povo Asiático , Produtos Biológicos , Diagnóstico , Exantema , Imunoglobulinas , Injeções Intradérmicas , RanitidinaRESUMO
La enfermedad de Hailey-Hailey (EHH) también conocida como pénfigo crónico familiar benigno (PCFB), es una genodermatosis muy infrecuente sin predilección de sexos; se caracteriza por ampollas y vesículas fláccidas, pruriginosas y dolorosas, localizadas en áreas intertriginosas. El diagnóstico suele tardarse debido a la diversidad de su presentación clínica. Presentamos el caso atípico de un paciente de 86 años de edad, que presentaba hace seis meses vesículas dolorosas erosionadas en cuello, axilas, ingles y mucosa oral; tratado anteriormente con corticoides, sin cambios, motivo por el que se hace biopsia de las lesiones, siendo la histopatología compatible con la enfermedad de Hailey-Hailey.
Hailey-Hailey disease or familial benign chronic pemphigus, is a very rare genodermatosis, autosomal dominant inheritance, has no sex and race predilection. It is caused by mutations in the ATP2C1 gene, which causes dysfunction calcium channel, key in regulating epidermal differentiation and processing desmosomal proteins involved in cell adhesion, as a result there is a defect in adherence of keratinocytes and acantholysis occurs and generating alterations in the epidermis. It´s clinical manifestations are characterized by flaccid, pruritic and painful ampules and vesicles located in intertriginous areas and rarely in mucosas; chronic and recurrent evolution. We report the unusual case of a male patient aged 86, presenting six months ago eroded and painful vesicles on the neck, armpits, groin and oral mucosa; previously treated with corticosteroids, unimproved, whereby lesions are biopsied, being histopathology compatible with Hailey-Hailey disease.
RESUMO
Familial hypercholesterolemia is an autosomal dominant inherited metabolic disease characterized by high serum low-density lipoprotein (LDL) cholesterol concentrations, and xanthoma formation. There are multiple types of xanthomas, such as eruptive, tendinous, tuberous, and planar. Intertriginous xanthomas are rare, but, if present, are typically associated with familial homozygous hypercholesterolemia. We here report on a 15-month-old infant who presented with multiple yellowish linear patches and plaques on the intertriginous areas. Serum lipoprotein electrophoresis showed a marked increase in beta-fraction, suggesting type IIa hyperlipoproteinemia. Histopathology showed numerous aggregates of foam cells in the dermis. We performed DNA analysis and revealed the presence of an LDL receptor gene mutation. In summary, we here report an interesting case of an infant with intertriginous xanthoma. This condition is so rare that it has not been reported in the Korean dermatologic literature before.
Assuntos
Humanos , Lactente , Colesterol , Derme , DNA , Eletroforese , Células Espumosas , Hipercolesterolemia , Hiperlipoproteinemia Tipo II , Lipoproteínas , Doenças Metabólicas , Receptores de LDL , XantomatoseRESUMO
Objective: To review baboon syndrome (BS). Data Sources: Date sources were obtained from PubMed and Google Scholar: Photographs of baboon syndrome were obtained from our patient. Study Selections: PubMed and Google Scholar were searched up to June 30, 2010. The search terms were “baboon syndrome”, “SDRIFE” and “thimerosal allergy”. Reverse references from relevant articles and Google Scholar were also used. As BS is a classical disease and cases of offending agents were relatively old, some references were more than five years old. In order to gather as many cases of offending agents as possible, more than 50 references were collected. Results and Conclusion: We divided BS into as 4 groups; classical baboon syndrome, topical drug-induced baboon syndrome, systemic drug-induced baboon syndrome and symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). The pathomechanism of BS is still unknown. A delayed type of hypersensitivity reaction, a recall phenomenon, pharmacologic interaction with immune-receptors and anatomical factors may be involved in the causation of BS.
RESUMO
Lichen planus pigmentosus-inversus is a rare variant of lichen planus pigmentosus. The eruption of lichen planus pigmentosus-inversus occurs mainly in the flexural regions and presents with brownish macules and patches. Here we describe the case of a 31-year-old Korean woman who presented with hyperpigmented lesions over her antecubital and popliteal area and groin. Physical examination revealed multiple brownish macules and patches on the intertriginous area without pruritis, and histologic findings showed a regressive pattern of lichen planus. These clinical and histological findings were consistent with a diagnosis of lichen planus pigmentosus-inversus.
Assuntos
Adulto , Feminino , Humanos , Virilha , Líquen Plano , Líquens , Exame Físico , PruridoRESUMO
Intertriginous granular parakeratosis is a condition presenting with erythematous hyperkeratotic papules and plaques localized to the intertriginous areas such as axilla, groin and perianal area. Although the etiology of granular parakeratosis remains obscure, it is probably caused by a defect in conversion of profilaggrin to filaggrin. The defect results in a failure to degrade keratohyaline granules and to aggregate keratin filaments during cornification. We report a 59-year-old man who presented with erythematous fissured patches on the perianal area for 1 year. Histopathologic examination revealed mild acanthosis and severe parakeratosis with prominent keratohyaline granules in the epidermis and vascular proliferation and RBC extravasation in the dermis.
Assuntos
Humanos , Pessoa de Meia-Idade , Axila , Derme , Epiderme , Virilha , ParaceratoseRESUMO
Granuloma gluteale infantum is a granulomatous lesion in the diaper area of infants. Athough usually seen in infants, it has been described in incontinent elderly patients. The causes of granuloma gluteale infantum are not clear, although child care equipment(ditergents1, diapers2, and starch3), corticosteroids2,4,5,6, candidial infection3 urine and feces7 have been postulated for its etiology. We report a case of granuloma gluteale infantum in a 5-month-old boy. He was healthy except for an asymtomatic 1.5×1.5cm sized, round, Rat-topped brownish and firm nodule on the perianal area, and two, 1×3cm and 1×6cm sized brownish plaques on the intertriginous area of the neck. The lesions were resistant to the treatment of systemic antibiotics. These nodules completely resolved in the three months after we tried to keep the diaper area clean without using any corticosteroids or other ointments and after changing from plastic diapers to cotton o A histological examination of the nodule on the perianal area showed mild hyperkeratosis, spongiosis, and focal infiltration of neutrophils in the epidermis. In the dermis, an inflammatory infiltrate composed of many lymphocytes, eosinophils, plasma cells, and histiocytes was