ABSTRACT
A 61-year-old woman with a medical history of ulcerative colitis (UC) developed an erythematous, mildly pruritic, maculopapular rash that was histologically consistent with reactive granulomatous dermatitis (RGD) with interstitial granulomatous dermatitis (IGD)-type features 1 week after vedolizumab infusion. Awareness of this complication is key to enhanced recognition and appropriate management as use of this medication becomes more prevalent.
Subject(s)
Autoimmune Diseases , Colitis, Ulcerative , Dermatitis , Antibodies, Monoclonal, Humanized/adverse effects , Colitis, Ulcerative/drug therapy , Dermatitis/diagnosis , Dermatitis/drug therapy , Dermatitis/etiology , Female , Granuloma/chemically induced , Granuloma/diagnosis , Humans , Middle AgedSubject(s)
Colitis, Ulcerative , Diarrhea , Colitis, Ulcerative/complications , Diarrhea/etiology , HumansABSTRACT
Morgellons disease is characterized by patient reports of fibers embedded in and protruding from the skin. Etiologies from infection to delusion have been endorsed, and treatment guidelines are not well-defined. The objective of this manuscript is to evaluate the existing evidence regarding the etiology and treatment of Morgellons disease in an effort to better inform clinical management. A PubMed search including key words "Morgellons," "delusional parasitosis and fibers," "delusions of parasitosis and fibers," or "delusional infestation and fibers" was completed. Original publications directly assessing etiology or treatment methods of Morgellons disease published between January, 2010 and the time of manuscript preparation were reviewed and evaluated. Sixteen articles regarding etiology were reviewed. All studies were correlative in nature with various limitations. Support for a psychiatric etiology was more widespread than support for an infectious etiology. Eleven articles regarding treatment efficacy were reviewed. Antipsychotic regimens have the most evidence of efficacy. Existing data regarding Morgellons disease suggests a psychiatric etiology and supports treatment with a low-dose antipsychotic agent once non-psychiatric causes have been excluded.
Subject(s)
Antipsychotic Agents/therapeutic use , Morgellons Disease/psychology , Borrelia Infections/complications , Borrelia burgdorferi , Delusions , Drug Therapy, Combination , Humans , Morgellons Disease/diagnosis , Morgellons Disease/drug therapy , Morgellons Disease/etiologyABSTRACT
Herpes zoster classically presents as a vesicular eruption along a single dermatome that correlates with the dorsal root ganglion in which varicella zoster virus (VZV) reactivates. Such cases most commonly involve a single thoracic dermatome, but other rare presentations of herpes zoster have been reported including multidermatomal herpes zoster. This letter reports a case of multidermatomal herpes zoster affecting cervical dermatomes C2-C5 and presents all previously published cases of multidermatomal herpes zoster in which involved dermatomes were reported to determine if this condition has a predilection for cervical dermatomes. A total of eight other cases were reviewed and involvement of cervical dermatomes was observed in 6 of 9 cases (66.7%). This suggests a propensity for multidermatomal involvement to affect cervical dermatomes beyond that encountered in classic herpes zoster. Clinicians should be aware of this presentation of herpes zoster especially in the head and neck region where the classic vesicular eruption may not be confined to a single dermatome.
