ABSTRACT
Red ear syndrome has been reported in the literature to have similarities to erythromelalgia with auricular involvement; however, the distinction between the two is controversial. Red ear syndrome has previously been classified as idiopathic (primary) or secondary, with headaches being the most common association in the idiopathic or primary form. We present a case of pediatric red ear syndrome with hand and foot involvement that we believe represents auricular erythromelalgia. In this report, we propose a classification system to unify the diagnoses of red ear syndrome and erythromelalgia and review the literature on pediatric cases of red ear syndrome.
Subject(s)
Ear, External , Erythromelalgia/diagnosis , Child , Erythromelalgia/therapy , Humans , Male , SyndromeABSTRACT
Dermatitis herpetiformis is a cutaneous manifestation of celiac disease that classically presents as a symmetric pruritic vesicular eruption on extensor surfaces. Typical locations include elbows, knees, and buttocks. Facial involvement has been reported rarely. Here, we report a case of a 44-year-old woman with dermatitis herpetiformis presenting as pruritic vesicles on the face that had previously been misdiagnosed as allergic contact dermatitis. Diagnosis was confirmed with direct immunofluorescence demonstrating granular IgA in the papillary dermis. This eruption cleared with topical dapsone 5% gel and a gluten-free diet. We report this case to raise awareness of facial involvement in dermatitis herpetiformis as well as the possibility of topical dapsone as a therapeutic option.
Subject(s)
Dermatitis Herpetiformis , Forehead/pathology , Skin/pathology , Adult , Celiac Disease/complications , Celiac Disease/diagnosis , Celiac Disease/diet therapy , Dermatitis Herpetiformis/diagnosis , Dermatitis Herpetiformis/etiology , Diet, Gluten-Free , Female , Humans , Male , Middle AgedABSTRACT
Autoimmune hepatitis is a subtle diagnosis that has many diverse clinical presentations. It has been reported in the literature to occur concomitantly with pyoderma gangrenosum, a neutrophilic dermatosis. Sweet's syndrome is another neutrophilic dermatosis and has been reported to be associated with autoimmune hepatitis in only 2 previous cases: 1 idiopathic and 1 drug induced. Here we report a third case in a 24-year-old woman diagnosed with Sweet's syndrome in association with autoimmune hepatitis, documenting a possible trend between neutrophilic dermatoses and autoimmune hepatitis. The patient presented with a history of fever and tender, erythematous plaques on her legs. Skin biopsy of a plaque confirmed histiocytoid Sweet's syndrome. Initial laboratory investigations revealed elevated transaminases, and liver biopsy confirmed autoimmune hepatitis. This case suggests autoimmune hepatitis should be considered as an association when investigating a patient with Sweet's syndrome.
