ABSTRACT
Granular parakeratosis is an acquired, idiopathic disorder of keratinization typified by retention hyperkeratosis. It usually occurs in women at intertriginous sites. There have been only 2 reports of infants with granular parakeratosis to our knowledge. We describe 3 additional infants with granular parakeratosis. We demonstrate that infantile granular parakeratosis exhibits 2 clinical patterns: bilateral linear plaques in the inguinal folds; and erythematous geometric plaques underlying pressure points from the diaper. A thick, flakelike scale is present in both forms and is characteristic. Diaper wearing appears to play an important role in the genesis of infantile granular parakeratosis but the mechanisms are unclear. Therapeutic responsiveness to topical agents is ambiguous, however, spontaneous clearance after months to 1 year appears to be the rule.
Subject(s)
Parakeratosis/diagnosis , Skin/pathology , Biopsy , Diagnosis, Differential , Diaper Rash/diagnosis , Diapers, Infant , Female , Groin , Humans , Infant , Male , Parakeratosis/etiology , Parakeratosis/pathologySubject(s)
Dermatitis, Contact/etiology , Urticaria/chemically induced , Allergens/adverse effects , Anesthetics, Local/adverse effects , Anti-Infective Agents, Local/adverse effects , Bandages/adverse effects , Botulinum Toxins, Type A/adverse effects , Collagen/adverse effects , Dermatologic Agents/adverse effects , Detergents/adverse effects , Humans , Hypersensitivity/etiology , Latex Hypersensitivity/chemically induced , Mastic Resin , Plant Extracts/adverse effects , Resins, Plant/adverse effects , Styrax , Surgery, Plastic , Tissue Adhesives/adverse effects , Urticaria/immunologyABSTRACT
Initial symptoms of Rocky Mountain spotted fever (RMSF), a tick-borne illness caused by Rickettsia rickettsii, are nonspecific and include headache, gastrointestinal disturbances, malaise, and myalgias, followed by fever and rash. The classic triad of fever, rash, and history of tick exposure is uncommon at presentation. Clinical manifestations of RMSF range from virtually asymptomatic to severe. Because of the potentially fatal outcome of RMSF, presumptive clinical diagnosis and empiric antimicrobial therapy can be critical. We present the case of a 3-year-old girl from New York State who presented with fever and rash.
Subject(s)
Doxycycline/administration & dosage , Rocky Mountain Spotted Fever/diagnosis , Rocky Mountain Spotted Fever/drug therapy , Child, Preschool , Dose-Response Relationship, Drug , Drug Administration Schedule , Exanthema/diagnosis , Female , Fever/diagnosis , Follow-Up Studies , Humans , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
A case is presented of a 55-year old woman who developed an eruption suggestive of contact dermatitis on repeated occasions after receiving anesthesia for dermatologic procedures. Patch testing revealed a positive reaction to lidocaine. Basic structures of anesthetics are reviewed, and the classification of immunologically-mediated allergic reactions is discussed. The presence of cutaneous lidocaine allergy has profound implications for the field of dermatology.
