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Clinical and Experimental Dermatology Feb 2022
Abrupt onset of Sweet syndrome, pityriasis rubra pilaris, pityriasis lichenoides et varioliformis acuta and erythema multiforme: unravelling a possible common trigger, the COVID-19 vaccine.
Topics: 2019-nCoV Vaccine mRNA-1273; Aged; Aged, 80 and over; BNT162 Vaccine; COVID-19; COVID-19 Vaccines; Erythema Multiforme; Female; Humans; Male; Middle Aged; Pityriasis Lichenoides; Pityriasis Rubra Pilaris; SARS-CoV-2; Sweet Syndrome
PubMed: 34617317
DOI: 10.1111/ced.14970 -
Journal of Cutaneous Pathology Mar 2022Pityriasis lichenoides (PL) is a papulosquamous disease that affects both adults and children. Previous studies have shown a subset of this entity to have clonal T-cell...
BACKGROUND
Pityriasis lichenoides (PL) is a papulosquamous disease that affects both adults and children. Previous studies have shown a subset of this entity to have clonal T-cell populations via PCR-based assays. In this study, we sought to implement next-generation sequencing (NGS) as a more sensitive and specific test to examine for T-cell clonality within the pediatric population.
METHODS
We identified 18 biopsy specimens from 12 pediatric patients with clinical and histopathologic findings compatible with PL. Patient demographics, clinical features, management, and histopathologic findings were reviewed. All specimens were analyzed for clonality with NGS of T-cell receptor beta (TRB) and gamma (TRG) genes.
RESULTS
Of the 12 patients, 9 (75%) had complete resolution of lesions at the time of data collection (mean follow-up 31 months). The remaining three patients significantly improved with methotrexate (with or without acitretin). Interestingly, 7 of 12 patients (58%) and 9 of 17 biopsy specimens (53%) showed evidence of T-cell clonality. Two patients showed matching TRB clones from different anatomic sites.
CONCLUSIONS
T-cell clonality is a common finding in PL, probably representing a "reactive clonality" rather than a true lymphoproliferative disorder. Clonality alone cannot be used as a means to distinguish PL from lymphomatoid papulosis or cutaneous lymphoma.
Topics: Adolescent; Child; Child, Preschool; Cloning, Molecular; Female; Genes, T-Cell Receptor beta; Genes, T-Cell Receptor gamma; High-Throughput Nucleotide Sequencing; Humans; Male; Pityriasis Lichenoides
PubMed: 34614220
DOI: 10.1111/cup.14143 -
Actas Dermo-sifiliograficas Dec 2022
Topics: Humans; Pityriasis Lichenoides; COVID-19; Patients
PubMed: 34602615
DOI: 10.1016/j.ad.2021.09.002 -
Journal of the American Academy of... Feb 2022
Methotrexate for pityriasis lichenoides et varioliformis acuta (Mucha-Habermann disease) and pityriasis lichenoides chronica: A retrospective case series of 33 patients with an emphasis on outcomes.
Topics: Humans; Methotrexate; Pityriasis Lichenoides; Retrospective Studies
PubMed: 34592383
DOI: 10.1016/j.jaad.2021.09.045 -
Acta Dermato-venereologica Sep 2021
Review
Topics: Humans; Papillomavirus Vaccines; Pityriasis Lichenoides
PubMed: 34515802
DOI: 10.2340/00015555-3921 -
Dermatopathology (Basel, Switzerland) Aug 2021The term "pseudomalignancy" covers a large, heterogenous group of diseases characterized by a benign cellular proliferation, hyperplasia, or infiltrate that resembles a... (Review)
Review
The term "pseudomalignancy" covers a large, heterogenous group of diseases characterized by a benign cellular proliferation, hyperplasia, or infiltrate that resembles a true malignancy clinically or histologically. Here, we (i) provide a non-exhaustive review of several inflammatory skin diseases and benign skin proliferations that can mimic a malignant neoplasm in children, (ii) give pathologists some helpful clues to guide their diagnosis, and (iii) highlight pitfalls to be avoided. The observation of clinical-pathological correlations is often important in this situation and can sometimes be the only means (along with careful monitoring of the disease's clinical course) of reaching a firm diagnosis.
PubMed: 34449607
DOI: 10.3390/dermatopathology8030042 -
Postepy Dermatologii I Alergologii Feb 2021Keratinization means cytodifferentiation of keratinocytes turning into corneocytes in the stratum corneum. Disorders of keratinization (hyperkeratosis, parakeratosis and... (Review)
Review
Keratinization means cytodifferentiation of keratinocytes turning into corneocytes in the stratum corneum. Disorders of keratinization (hyperkeratosis, parakeratosis and dyskeratosis) are causing many dermatological diseases, including various types of ichthyoses, pachyonychia congenita, pityriasis rubra pilaris, all subtypes of psoriasis, pityriasis lichenoides, dyskeratosis congenita, leukoplakia and keratosis follicularis, which apart from skin lesions may affect the eye's adnexae causing ectropion, entropion, blepharitis, madarosis, and trichiasis, the ocular surface causing keratitis, conjunctivitis, corneal ulceration and episcleritis, which in turn cause uveitis and various fundoscopic changes (proliferative retinopathy, retinal vasculopathy, macular oedema and birdshot chorioretinopathy). Knowledge of ocular symtoms associated with pathological keratinization is crucial, preventing sight-threatening complications such as corneal perforation, lagophthalmus, phthisis bulbi, retinal neovascularization, retinal vasculopathy and optic nerve atrophy. This review encourages dermatologists to monitor patients for ocular symptoms and encourage ophthalmologists to monitor patients for dermatological symptoms.
PubMed: 34408561
DOI: 10.5114/ada.2021.104272 -
International Journal of Dermatology Apr 2022Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare inflammatory dermatological disease. A case of a 13-year-old boy with FUMHD possibly triggered by... (Review)
Review
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare inflammatory dermatological disease. A case of a 13-year-old boy with FUMHD possibly triggered by mycoplasma infection is presented. Based on FUMHD cases identified in a MEDLINE literature search, demographic, treatment, and outcome data were analyzed. An FUMHD mortality risk score is proposed based on the likelihood ratios of risk factors for a fatal outcome. Our FUMHD case had marked leukopenia and thrombocytopenia at admission. He recovered without systemic immunosuppressive treatment. Literature review revealed 119 FUMHD cases. Overall lethality was 14/119 (12%, CI 6-17%), and lethality in children was lower (1/54, 2%, CI 0-6%) compared to adults (13/65, 20%, CI 11-31%). Risk factors for a fatal outcome (likelihood ratio; P) were sepsis (24.97, P < 0.001), adult vs. pediatric patient age (11.19; P = 0.001), systemic involvement (19.97, P < 0.001), and mucosal involvement (4.58; P = 0.032). The proposed FUMHD mortality risk score = Age/10 + 4 + 4 (if systemic involvement) + 1 (if mucosal involvement) was discriminative (sensitivity 93%, specificity 77%). In FUMHD, immune-suppressive treatment intensity should be balanced against the mortality risk, as infectious complications are a frequent cause of death.
Topics: Adolescent; Adult; Child; Herpes Simplex; Humans; Immunosuppressive Agents; Male; Middle Aged; Pityriasis Lichenoides; Risk Factors; Thrombocytopenia; Young Adult
PubMed: 34287852
DOI: 10.1111/ijd.15770 -
Italian Journal of Dermatology and... Jun 2022
Topics: China; Humans; Pityriasis Lichenoides; Skin
PubMed: 34282864
DOI: 10.23736/S2784-8671.21.07060-2 -
Clinical, Cosmetic and Investigational... 2021Syphilis is a complex, systemic infectious disease caused by subspecies . Herein, we report a rare case of secondary syphilis with probable neurosyphilis that was...
Syphilis is a complex, systemic infectious disease caused by subspecies . Herein, we report a rare case of secondary syphilis with probable neurosyphilis that was misdiagnosed as (PLEVA) in a 12-year-old human immunodeficiency virus (HIV) negative patient. A female patient presented to our hospital with a four-month history of relapsed systemic rash, accompanied by hair loss, arthralgia and fatigue. Based on physical examination and skin biopsy, she was initially diagnosed as PLEVA and treated both locally and systemically but failed to present a dermatologic improvement. The diagnosis of secondary syphilis with probable neurosyphilis was made based on serologic and cerebrospinal fluid tests. After neurosyphilis therapy, the clinical manifestations of the patient were significantly improved. Physicians should be alert for the possibility of syphilis when encountering cases with unusual clinical manifestations.
PubMed: 34262318
DOI: 10.2147/CCID.S315235