-
Asia-Pacific Journal of Clinical... Aug 2019Checkpoint inhibition is the mainstay of treatment in metastatic melanoma. More recently combined cytotoxic T-lymphocyte antigen-4 and programmed-death-1 blockade has...
Checkpoint inhibition is the mainstay of treatment in metastatic melanoma. More recently combined cytotoxic T-lymphocyte antigen-4 and programmed-death-1 blockade has resulted in improved response rates and overall survival in treatment naïve patients compared to monotherapy albeit with increased rates of adverse events. Dermatologic toxicities are an emerging consequence of the use of checkpoint inhibitors and have reportedly been more prevalent with the use of combined therapy. However, grade 3 and 4 adverse event rates are still less than 5%. Here, we report a case of a 63-year-old Caucasian male with metastatic melanoma treated with first line combined ipilimumab and nivolumab who then developed a steroid refractory, biopsy confirmed pityriasis lichenoides-like, drug related rash that resolved with cyclosporine. Time of onset was 24 days and presenting symptoms demonstrated a maculopapular rash presenting over the back and chest with pruritus. Unfortunately, the patient subsequently had multi-organ failure with acute kidney injury requiring dialysis, hypotension requiring vasopressor support, hepatic dysfunction, and bilateral lung infiltrates resulting in a fatal outcome. This case report highlights the effective use of cyclosporine as an immunomodulatory agent in the management of severe dermatological toxicity due to combination immunotherapy.
Topics: Antibodies, Monoclonal; Dermatitis; Humans; Immunotherapy; Male; Melanoma; Middle Aged; Neoplasm Grading
PubMed: 30809956
DOI: 10.1111/ajco.13136 -
Journal of Cutaneous Pathology Sep 2021Rhabdomyomatous mesenchymal hamartoma (RMH) is a rare congenital malformation of the dermis and subcutaneous tissue. Usually, RMH occurs in the midline of the face and...
Rhabdomyomatous mesenchymal hamartoma (RMH) is a rare congenital malformation of the dermis and subcutaneous tissue. Usually, RMH occurs in the midline of the face and neck region. We described a case of RMH presenting as telangiectasia in a 57-year-old man with a history of pityriasis lichenoides chronicus. Histopathological examination revealed a subepidermal haphazard proliferation of striated muscular tissue perpendicular to the epidermis. These bundles of striated muscular tissue were admixed with adnexal structures. The diagnosis was consistent with RMH. RMH is more common in the neonatal period or in young children, but we should consider it as part of a differential diagnosis in older adults as well.
Topics: Desmin; Diagnosis, Differential; Hamartoma; Humans; Male; Mesoderm; Middle Aged; Pityriasis Lichenoides; Rhabdomyoma; Soft Tissue Neoplasms; Telangiectasis; Watchful Waiting
PubMed: 33964023
DOI: 10.1111/cup.14044 -
Journal of the European Academy of... Mar 2022
Topics: BNT162 Vaccine; COVID-19; COVID-19 Vaccines; Humans; Pharmaceutical Preparations; Pityriasis Lichenoides; SARS-CoV-2
PubMed: 34751995
DOI: 10.1111/jdv.17807 -
The Australasian Journal of Dermatology Nov 2020
Topics: Antigens, CD; Humans; Lymphoproliferative Disorders; Pityriasis; Pityriasis Lichenoides
PubMed: 32309878
DOI: 10.1111/ajd.13296 -
Anais Brasileiros de Dermatologia 2024
Topics: Humans; Pityriasis Lichenoides; Dermoscopy; Pityriasis
PubMed: 37661463
DOI: 10.1016/j.abd.2022.04.017 -
Clinics in Dermatology 2023This is the second installment of a three-part contribution that highlights the achievements of Jewish dermatologists as reflected by eponyms that honor their names. It...
This is the second installment of a three-part contribution that highlights the achievements of Jewish dermatologists as reflected by eponyms that honor their names. It covers the period 1933-1945 when the Nazis took over Germany and how the lives of 14 notable Jewish physicians, mostly in Germany, were impacted during the Holocaust. Many of them fled from the persecution, bringing their academic talents to other lands such as the United States. At least one committed suicide (Fritz Juliusberg), and three others perished in the Holocaust (Abraham Buschke, Lucja Frey-Gottesman, and Karl Herxheimer). They are remembered by eponyms including Neisser-Juliusberg pityriasis lichenoides chronica, Buschke-Ollendorff syndrome, Frey syndrome, and Jarisch-Herxheimer reaction. It made little difference to the Nazis that several of the 14 physicians had converted to Christianity. All were persecuted by the Nazis and had their professional careers destroyed. Two of the 14 physicians lived outside of the Third Reich (Bruno Bloch and Emanuel Libman) and were spared the suffering endured by the other 12. This tragic account of Jewish dermatologists during the Holocaust, and the eponyms that honor them, will continue in part three of this contribution.
Topics: Humans; United States; Jews; Dermatologists; Eponyms; Holocaust; Physicians; Germany
PubMed: 37777142
DOI: 10.1016/j.clindermatol.2023.09.006 -
Clinics in Dermatology 2019White diseases are a heterogenous group characterized by hypopigmentation or depigmentation. Skin and eye color are determined by the number and size of melanosomes...
White diseases are a heterogenous group characterized by hypopigmentation or depigmentation. Skin and eye color are determined by the number and size of melanosomes present. Melanin is produced by melanosomes in the melanocytes present within the epidermis of the skin, uvea, and retinal pigmented epithelium (RPE). Conditions altering the number of melanocytes or concentration of melanin result in a lack of pigmentation, appearing as "white diseases" ranging from the well-known albinism and vitiligo to more esoteric white hand syndrome and Degos disease.
Topics: Albinism; Color; Cosmetics; Diagnosis, Differential; Humans; Hypopigmentation; Inflammation; Lichen Sclerosus et Atrophicus; Malignant Atrophic Papulosis; Mucous Membrane; Nail Diseases; Nevus, Halo; Pityriasis Lichenoides; Prognosis; Skin Lightening Preparations; Tinea Versicolor; Vibration; Vitiligo; Waardenburg Syndrome
PubMed: 31896410
DOI: 10.1016/j.clindermatol.2019.07.018 -
Dermatologic Therapy Jun 2022
Topics: COVID-19; Humans; Pityriasis Lichenoides; RNA, Messenger; Vaccination
PubMed: 35286000
DOI: 10.1111/dth.15445 -
The American Journal of Surgical... Aug 2019Papular mycosis fungoides (PMF) is a rare variant of mycosis fungoides (MF). The exact nosology and prognosis of PMF are still unclear. We retrospectively identified...
Papular mycosis fungoides (PMF) is a rare variant of mycosis fungoides (MF). The exact nosology and prognosis of PMF are still unclear. We retrospectively identified cases of PMF from the files of the Department of Dermatology of the Medical University of Graz, Austria, and checked the follow-up data. The patients comprised 13 men and 5 women (median age: 57.5 y; range 13 to 77 y). In 4 patients, an initial clinicopathologic diagnosis of atypical pityriasis lichenoides was made; these cases were subsequently reclassified as PMF due to the onset of conventional patches of MF during follow-up. Follow-up data of our cases showed that 2 patients died of disease progression 50 and 199 months after the first presentation, respectively. Two patients are alive with progressive disease after 215 and 300 months, respectively. Ten patients are alive with stable disease (median: 70 mo). Four patients were in complete remission at last follow-up visit (median: 215 mo; 2 of them died of unrelated causes). Our data confirm that PMF represents a clinicopathologic variant of early MF with prognosis similar to conventional presentations of the disease. Familiarity with PMF and distinction from other cutaneous papular lymphoid proliferations is necessary for a precise diagnosis and management of these patients.
Topics: Adolescent; Adult; Aged; Austria; Biomarkers, Tumor; Disease Progression; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mycosis Fungoides; Retrospective Studies; Skin Neoplasms; Time Factors; Treatment Outcome
PubMed: 30969178
DOI: 10.1097/PAS.0000000000001256 -
Case Reports in Dermatology 2023The febrile ulceronecrotic Mucha-Habermann disease is a rare and potentially lethal variant of pityriasis lichenoides et varioliformis acuta (PLEVA). It is characterized...
The febrile ulceronecrotic Mucha-Habermann disease is a rare and potentially lethal variant of pityriasis lichenoides et varioliformis acuta (PLEVA). It is characterized by a sudden onset of ulceronecrotic skin lesions associated with high fever and systemic symptoms. Herein, we report a 23-year-old male, not known to have any medical illnesses, presented with a month-long history of persistent fever of unknown origin associated with a sudden onset of progressive diffuse necrotic ulcers and widespread papulosquamous lesions. Pan CT showed enlarged lymph nodes in the cervix, chest, and abdomen. Unfortunately, a skin biopsy was done late, showing features consistent with PLEVA. Few days after admission, despite being on intravenous methylprednisolone, our patient rapidly deteriorated by showing severe acute respiratory symptoms and consequently died. In spite of the continuous addition of new case reports to the literature, no definite diagnostic criteria have been established, leading to late or missed cases, and an optimum treatment is still waiting.
PubMed: 36686043
DOI: 10.1159/000528500