ABSTRACT
A skin eruption consistent with subacute cutaneous lupus erythematosus (SCLE) occurred in a patient taking leflunomide for rheumatoid arthritis. The eruption resolved after discontinuation of the medication. Suppression of tumor necrosis factor (TNF)-effector mechanisms by leflunomide may have played a role in the pathogenesis of this disorder.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Isoxazoles/adverse effects , Lupus Erythematosus, Cutaneous/chemically induced , Arthritis, Rheumatoid/drug therapy , Female , Humans , Leflunomide , Middle AgedSubject(s)
Corynebacterium , Erythrasma/diagnosis , Ultraviolet Rays , Fluorescence , Humans , Male , Middle Aged , Skin/microbiology , Skin/pathologyABSTRACT
Bullous lupus erythematosus (BSLE) is a rare subset of systemic lupus erythematosus (SLE), often associated with autoimmunity to type VII collagen. Generally, patients with BSLE meet the criteria for SLE as defined by the American College of Rheumatology. We present a case of a 17-year-old adolescent girl who presented with a vesiculobullous eruption without detectable type VII collagen antibodies and without full criteria for SLE. Differential staining was characteristic for lupus erythematosus (LE), suggesting her eruption is related to LE. We review the spectrum of bullous disease in patients with LE and discuss the pathogenesis and histology of these eruptions, as well as current therapeutic options.
Subject(s)
Lupus Erythematosus, Systemic/pathology , Skin Diseases, Vesiculobullous/pathology , Adolescent , Adrenal Cortex Hormones/administration & dosage , Black or African American , Biopsy, Needle , Colchicine/administration & dosage , Dapsone/administration & dosage , Diagnosis, Differential , Drug Therapy, Combination , Female , Fluorescent Antibody Technique, Direct , Follow-Up Studies , Humans , Immunohistochemistry , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/drug therapy , Risk Assessment , Severity of Illness Index , Skin/ultrastructure , Skin Diseases, Vesiculobullous/diagnosis , Skin Diseases, Vesiculobullous/drug therapy , Treatment OutcomeABSTRACT
Psoriasis occurs with increased incidence in patients with bullous pemphigoid (BP). In this article, we describe the seventh reported English literature case in which the bullous lesions were limited to psoriatic plaques, and we discuss the pathophysiologic mechanisms that might explain this phenomenon. Treatment with acitretin quickly cleared both psoriatic and bullous lesions, suggesting a direct link between the psoriatic inflammatory process and the evolution of bullous lesions.
Subject(s)
Pemphigoid, Bullous/complications , Pemphigoid, Bullous/physiopathology , Psoriasis/etiology , Psoriasis/physiopathology , Acitretin/therapeutic use , Humans , Keratolytic Agents/therapeutic use , Male , Middle Aged , Pemphigoid, Bullous/drug therapy , Psoriasis/drug therapyABSTRACT
Palmar petechiae or purpura is an unusual finding in dermatitis herpetiformis (DH) that occurs in children but is only rarely reported in adults. We describe a 46-year-old man with DH who presented with the classic pruritic papulovesicular eruption and associated volar finger and palmar petechiae. We discuss recent advances in the pathogenesis and treatment of DH.
Subject(s)
Dermatitis Herpetiformis/complications , Hand Dermatoses/etiology , Purpura/etiology , Anti-Infective Agents/therapeutic use , Dapsone/therapeutic use , Dermatitis Herpetiformis/diagnosis , Dermatitis Herpetiformis/therapy , Diagnosis, Differential , Diet Therapy , Fluorescent Antibody Technique, Direct , Hand Dermatoses/diagnosis , Hand Dermatoses/therapy , Humans , Male , Middle Aged , Purpura/diagnosis , Purpura/therapyABSTRACT
Darier-White disease (DWD), commonly called Darier disease or keratosis follicularis, is a genodermatosis seen in clinical practice. It exists more commonly in the generalized form but can present as a localized condition. Localized DWD is a rare entity characterized by epidermal changes that are like those seen in the generalized form but that are confined to a small area of skin. This entity is postulated to result from a postzygotic mutation and has the potential to be transmitted to offspring, which may result in the severe generalized form. We report a case of localized DWD diagnosed after biopsy of a recalcitrant linear dermatitis and discuss the salient features of this condition.
