Botryomycosis presenting as pruritic papules in a human immunodeficiency virus-positive patient.

Patients with human immunodeficiency virus (HIV) may present with a variety of dermatologic complaints, including reactions to medications, physiologic manifestations of their disease, numerous infectious conditions, and unusual or severe presentations of common dermatologic diseases. Botryomycosis is an uncommon infectious disorder with rare visceral involvement. The cutaneous manifestations of botryomycosis are variable and have not been well-described. We report a case of botryomycosis in an HIV-positive woman who presented with pruritic papules on her neck, trunk, and extremities.

Childhood dermatitis herpetiformis: a case report and review of the literature.

Dermatitis herpetiformis (DH) is a chronic pruritic cutaneous eruption associated with gluten-sensitive enteropathy (celiac disease [CD]) and immunoglobulin A (IgA) deposition in the skin. While the disease is not uncommon among adolescents, DH is rarely seen in prepubertal patients. Children with DH present similarly to adults; however, uncommon skin findings have been reported. Because of an increased risk for autoimmune diseases and lymphoma, accurate diagnosis and treatment are imperative. We present a case of DH in a 6-year-old Latino boy previously diagnosed with atopic dermatitis and recurrent urticaria. Our aim is to highlight the various cutaneous presentations of DH and encourage clinicians to consider this diagnosis in young patients with recalcitrant atypical skin disease.

Etiology of hand dermatitis among patients referred for patch testing.

BACKGROUND: Hand dermatitis affects many people and has numerous causes. Few reports have looked at the etiology of hand dermatitis across broad demographics. OBJECTIVES: The purposes of this investigation were to (1) determine the causes of hand dermatitis in the population patch-tested at a dermatologic referral clinic, (2) report occupations frequently associated with hand dermatitis, and (3) indicate which substances were the more common allergens among individuals evaluated by patch testing for hand dermatitis. METHODS: A retrospective analysis of patch-test data on 1,034 patients who were evaluated during an 8-year period was performed. RESULTS: Hand dermatitis affected 32% of all patients who underwent patch testing. Allergic contact dermatitis was diagnosed most often (54.4%), followed by irritant contact dermatitis (27.4%). Among women, irritant contact dermatitis of the hands peaked in the third decade and then diminished whereas allergic contact dermatitis of the hands remained fairly constant among patients between 21 and 60 years of age. In contrast, irritant contact dermatitis and allergic contact dermatitis in men peaked in the fifth decade of life. In both genders, hand dermatitis was rare among those 20 years of age or younger and among those 61 years of age or older. Fifty-six percent of hand dermatitis was related to occupation. Health care workers were most often affected by occupational hand dermatitis. The most common allergens for both occupational and non-occupational hand dermatitis were quaternium-15, formaldehyde, thiuram mix, and carba mix. CONCLUSIONS: Since more than half of hand dermatitis cases may be related to occupation, a thorough history should be taken by a knowledgeable clinician. Potentially relevant allergens in the workplace must be identified and tested. These allergens may not be contained in standard trays.