Systemic contact dermatitis related to alcoholic beverage consumption.

Systemic contact dermatitis is a rash secondary to systemic exposure to allergens after sensitization. Numerous agents are implicated including Balsam of Peru, a plant-derived compound often used for flavoring and fragrance. Alcoholic beverages can contain many possible allergens, including cinnamon, vanilla, citrus peels, and Balsam of Peru. Herein, we describe two patients presenting with recurrent, diffuse, erythematous, and pruritic cutaneous eruptions suspicious for contact dermatitis. Based on clinical history, exam, and formal and at-home patch testing results, we believe the most likely etiology was Balsam of Peru within the alcohol beverages leading to systemic contact dermatitis. Both patients markedly improved after avoidance of their alcoholic beverages. Overall, systemic contact dermatitis secondary to alcohol consumption is a rare phenomenon, whereas Balsam of Peru is a relatively common allergen. Suspicion must be high to identify possible allergens (including Balsam of Peru) exposure within alcoholic beverages such as artificial flavorings, aromas, and mixtures.

Corrigendum: Systemic contact dermatitis related to alcoholic beverage consumption.

The original article was published on September 15, 2019 and corrected on November 15, 2019.The revised version of the article adds a missing author. This change appears in the revised online PDF copy of this article.

Actinic lichen nitidus.

Actinic lichen nitidus is a unique photoinduced lichenoid eruption that displays histologic features of classic lichen nitidus, with some clinical similarity. It is seen most commonly in deeply pigmented patients (Fitzpatrick skin types V and VI), in photodistributed areas, and during the summer months. Sun avoidance and topical corticosteroids are the mainstay of therapy; however, seasonal recurrences are common. Actinic lichen nitidus has unique properties that differentiate it from classic lichen nitidus. Confusion exists in the literature regarding the nomenclature of this entity, and it appears to be an underrecognized disease in the United States.

Lichen planus-like atopic dermatitis: expanding the differential diagnosis of spongiotic dermatitis.

Spongiotic dermatitis represents a commonly encountered histopathological pattern seen by dermatopathologists. The differential diagnosis of lymphocyte predominant acute spongiotic dermatitis typically entails atopic dermatitis (AD), contact dermatitis, nummular dermatitis, pityriasis rosea and seborrheic dermatitis. Recently, our group has characterized a distinct subtype of spongiotic dermatitis occurring exclusively in heavily pigmented patients. Clinically, lesions of this subtype are nearly indistinguishable from lichen planus. However, the histology is contradistinctive to classic lichen planus. The purpose of this report is to raise awareness among dermatopathologists of this variant as a possible diagnosis in spongiotic dermatitis specimens submitted as lichen planus.

Glucocorticoid-induced bone loss in dermatologic patients: an update.

OBJECTIVE: To raise awareness of the new treatment options and current recommendations among dermatologists treating patients with systemic corticosteroids. DATA SOURCES: MEDLINE peer-reviewed publications. STUDY SELECTION: English language and clinical pertinence to corticosteroid-induced osteoporosis. DATA EXTRACTION: Pertinent information on pathophysiologic, epidemiologic, clinical trial, cost-effectiveness, and treatment option data regarding corticosteroid-induced osteoporosis. DATA SYNTHESIS: Comprehensive summary of published data on the pathophysiologic, epidemiologic, clinical, and treatment data and current practice guidelines regarding corticosteroid-induced osteoporosis; creation of an algorithmic management approach for patients treated with long-term oral corticosteroids. CONCLUSIONS: Glucocorticoid-induced bone loss is the most predictable and debilitating complication of prolonged administration of systemic corticosteroids. Every dermatologist prescribing systemic corticosteroids must be aware of corticosteroid-induced osteoporosis and ensure that every patient is receiving general measures to prevent it. Despite efficacious preventive and therapeutic options, actual implementation of these strategies remains unacceptably low. Based on currently available evidence, the first choice for prevention and treatment of glucocorticoid-induced osteoporosis should be a potent oral bisphosphonate such as alendronate (70 mg/wk) or risedronate sodium (35 mg/wk). For patients with severe osteoporosis or patients with active osteoporotic fractures, the anabolic agent teriparatide (recombinant fragmented parathyroid hormone) should be considered as a first-line option for up to 2 years.

Pharmacologic advances in the systemic treatment of itch.

Itch is propagated by complex mechanisms located both peripherally and within the central nervous system. For decades, novel treatments of itch have been slow to emerge, with the majority of focus on antagonism of histamine. Recently, with a new understanding of the pathophysiology of itch transmission, new treatment strategies have been elucidated. Opiate receptor antagonists, antidepressants, antiepileptics, and thalidomide are currently available therapeutic options that have benefited many patients with variegated sources of itch. In addition, research focused on the neuromediators of itch transmission has led to the development of novel targets for itch reduction and great potential for future therapies.

Tissue transglutaminase localization and activity regulation in the extracellular matrix of articular cartilage.

Tissue transglutaminase (tTG) catalyzes a Ca2+-dependent transglutaminase (TGase) activity which cross-links proteins and stabilizes many tissues [C.S. Greenberg et al. FASEB J. 5 (1991) 3071]. Because cartilage is subjected to great stress in vivo, an enzyme that strengthens and stabilizes tissue could play an integral role in maintaining cartilage integrity. The purpose of this study was to determine if active tTG is present in the extracellular matrix (ECM) of adult human osteoarthritic articular cartilage. Using a TGase activity assay along with immunolabeling for tTG of cartilage sections, TGase activity and tTG immunoreactivity were localized in the ECM in cartilage sections, predominantly in the superficial layer. Previous in vitro studies have demonstrated that the Mg-GTP complex inhibits the TGase activity of tTG [T.S. Lai et al. J. Biol. Chem. 273 (1998) 1776]. To investigate the in situ regulation of the TGase activity of tTG, a TGase activity assay was done with a dose response of GTP, measuring incorporation of fluorescein cadaverine. TGase activity was inhibited by GTP in a similar manner as in vitro. These results not only confirm tTG presence in the ECM. but also indicate tTG as the major TGase activity of the ECM. Secondly, the study provides a possible mechanism by which extracellular tTG is regulated in vivo.