Subject(s)
Adrenal Cortex Hormones/administration & dosage , PUVA Therapy/methods , Retinoids/administration & dosage , Scleromyxedema/diagnosis , Scleromyxedema/drug therapy , Thalidomide/therapeutic use , Adolescent , Adult , Combined Modality Therapy/methods , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
We herein report a 12-year-old boy with amoxicillin-induced, recurrent, site-specific, symmetrical, sharply demarcated reddish plaques on the buttocks and the major flexural and intertriginous areas. The lesions resolved with topical corticosteroids, leaving hyperpigmentation. Histopathology showed nonspecific features of inflammation and dermal melanophages. Amoxicillin was the probable inducer based on oral provocation test with Amoksina(®) tablet, however patch testing with amoxicillin on previously affected and unaffected skin remained negative. The diagnosis was challenging because of the overlapping features of symmetrical drug-related intertriginous and flexural exanthema and fixed drug eruption. This one represents a unique and challenging one with overlapping clinical features of symmetrical drug-related intertriginous and flexural exanthem (SDRIFE) and fixed drug eruption (FDE). We discuss the possible immunopathogenetic mechanisms leading to the simultaneous occurrence of different phenotypes of drug eruption in the same patient.
Subject(s)
Amoxicillin/adverse effects , Drug Eruptions/diagnosis , Exanthema/diagnosis , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/therapeutic use , Buttocks , Child , Drug Eruptions/drug therapy , Humans , Hyperpigmentation/etiology , Male , Patch Tests , Treatment OutcomeABSTRACT
Allergic contact stomatitis (ACS) can occur with variable clinical presentations such as erythematous, erosive, and lichenoid forms. Burning mouth symptoms may also be a result of allergic contact stomatitis. Additionally, gingival hyperplasia has been reported in exceptional cases of ACS caused by dental metals. Here, two rare cases are presented of nickel-induced oral mucosal hyperplasia with gingival and upper palatal involvement from metal-porcelain crowns and metal-acrylic upper denture, respectively. In both cases the diagnosis was made on the basis of the positive patch test results to nickel sulfate and the regression of the lesions after removing the nickel containing dental materials. Nickel-induced ACS should be borne in mind in every case of oral mucosal hyperplasia appearing after dental procedures, especially in the presence of previous allergies and sensitization risks such as ear piercing. It might be further suggested to include this variant within the clinical forms of ACS.
Subject(s)
Dermatitis, Allergic Contact/pathology , Mouth Mucosa/pathology , Nickel/adverse effects , Rare Diseases/pathology , Stomatitis/chemically induced , Stomatitis/pathology , Adult , Crowns/adverse effects , Dentures/adverse effects , Female , Gingiva/pathology , Humans , Hyperplasia , Palate/pathologyABSTRACT
Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous and elastolytic skin disease of unknown pathogenesis. Therapy for AEGCG is controversial. The data about the effectiveness of chloroquine in the treatment of AEGCG are also variable. Here, we report a case of AEGCG with significant improvement after a total treatment period of 22 weeks with hydroxychloroquine. Although a possibility of spontaneous remission cannot be ruled out, we think that chloroquine can be considered as an effective treatment of this chronic disorder.
