ABSTRACT
Acquired epidermodysplasia verruciformis (AEV) describes epidermodysplasia verruciformis developing in an immunocompromised host. There is limited information in the literature regarding AEV in the pediatric population; of the patients reported, most patients described had HIV, with only two reported cases of children who developed AEV post-transplantation. This case series describes three pediatric patients who developed AEV on immunosuppressant therapy following cardiac transplantation. We review risk factors, treatment options, and prognosis of AEV in the pediatric population.
Subject(s)
Epidermodysplasia Verruciformis , Heart Transplantation , Child , Epidermodysplasia Verruciformis/etiology , Heart Transplantation/adverse effects , HumansSubject(s)
COVID-19/complications , Skin Diseases/etiology , Critical Illness , Hospitalization , HumansABSTRACT
Neutrophilic drug reactions are unique eruptions that can affect hospitalized patients and share a common pathophysiology with neutrophils as the key mediators of inflammation. They range in clinical presentation from papules and plaques to bullae and erosions to pustules. Although there is some overlap in presentation, each has distinguishing features that aid the clinician in differentiation from one another and from other drug hypersensitivity reactions. Much of the data on these reactions are from case reports and series or retrospective review studies. There are limited prospective observational studies dedicated to these adverse drug reactions. We review the more common and life-threatening neutrophilic drug reactions, their proposed mechanism of action, and their management.
Subject(s)
Drug Eruptions/etiology , Drug Hypersensitivity/etiology , Drug-Related Side Effects and Adverse Reactions , Neutrophils , Pharmaceutical Preparations , Drug Eruptions/diagnosis , Drug Eruptions/pathology , Drug Eruptions/therapy , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/pathology , Drug Hypersensitivity/therapy , Exanthema , Female , Halogens/adverse effects , Hidradenitis , Humans , Immunoglobulin A , Male , Neutrophils/immunology , Panniculitis , Pyoderma Gangrenosum , Skin Diseases, Vesiculobullous , Sweet SyndromeABSTRACT
Here we report a case of linear porokeratosis with recurrent malignant degeneration to squamous cell carcinoma (SCC) recurring six years after excision of initial SCC. A 79-year-old woman presented with a friable tumor located within a longstanding lesion on her posterior thigh. Six years prior, she was diagnosed with SCC arising within the same lesion, which had been surgically excised with negative margins. Physical examination revealed a 3.5 x 2.7 cm friable tumor on the left proximal posterior thigh. The tumor was located within a hyperpigmented and erythematous scaly linear plaque within a line of Blaschko, extending from the left buttock to the left distal posterior thigh. Two 4 mm punch biopsies were performed: one of the erythematous plaque on the left buttock and one from the friable tumor on the left posteromedial thigh. Histology from the left buttock revealed a cornoid lamella consistent with porokeratosis and the left posteromedial thigh revealed SCC. The patient underwent Mohs micrographic surgery with negative margins, followed by a linear repair. Porokeratosis is a disorder of epidermal keratinization that has been associated with malignant degeneration, although such cases are rare. The risk of recurrence of SCC arising within a porokeratosis is unknown. This case emphasizes the importance of ongoing monitoring for malignant degeneration within these lesions. J Drugs Dermatol. 2020;19(2)205-206. doi:10.36849/JDD.2020.4640
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Neoplasm Recurrence, Local/diagnosis , Porokeratosis/diagnosis , Skin Neoplasms/diagnosis , Aged , Carcinoma, Squamous Cell/surgery , Diagnosis, Differential , Female , Humans , Mohs Surgery , Neoplasm Recurrence, Local/surgery , Porokeratosis/surgery , Skin Neoplasms/surgery , ThighABSTRACT
BACKGROUND: Mechanisms underlying the heightened myocardial infarction risk among HIV-infected women (versus non-HIV-infected women) remain unclear. Our objectives were to assess epicardial adipose tissue (EAT) volume and its associations among asymptomatic women with and without HIV. METHODS: A total of 55 HIV-infected and 27 non-HIV-infected women without known cardiovascular disease who underwent cardiac CT and metabolic/immune phenotyping were included. EAT volume derived from CT was compared among women with and without HIV, and within-group EAT associations were assessed. Next, immune and atherosclerotic plaque parameters were compared among groups stratified by HIV serostatus and high/low EAT (defined in reference to median EAT for each serostatus group). RESULTS: Asymptomatic HIV-infected women and age-matched non-HIV-infected women with comparable mean body mass index (28 ±1 versus 29 ±1 kg/m2) had similar median (IQR) volumes of EAT (54 [41-79] versus 65 [41-78] cm3; P>0.05); however, different within-group associations were noted. Markers of monocyte activation/arterial inflammation differed by HIV serostatus/EAT volume subgroup (CXCL10 [P=0.02], sCD163 [P=0.004], sCD14 [P=0.03], Lp-PLA2 [P=0.04]; P for overall ANOVA) and were highest among HIV-infected women with excess EAT (versus HIV-infected women without excess EAT, non-HIV-infected women with excess EAT and non-HIV-infected women without excess EAT). The percentage of segments with non-calcified coronary plaque also differed by HIV serostatus/EAT volume subgroup and was highest among HIV-infected women with excess EAT. CONCLUSIONS: Asymptomatic women with and without HIV have similar volumes of EAT, but drivers of EAT may differ between groups. HIV-infected women with excess EAT have highest-level immune activation and the highest percentage of non-calcified plaque. Future studies are needed to determine whether EAT contributes pathogenetically to HIV-associated cardiovascular disease in women.
