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JAAD Case Reports May 2023
PubMed: 37078017
DOI: 10.1016/j.jdcr.2023.02.006 -
Dermatology Reports Mar 2023Erosive pustular dermatosis of the scalp (EPD) is a rare condition that affects predominantly the adult population and occurs on a previously photo-damaged bald scalp....
Erosive pustular dermatosis of the scalp (EPD) is a rare condition that affects predominantly the adult population and occurs on a previously photo-damaged bald scalp. The physical examination is presented with large erythematous, erosive and crusted patches with granulation on an atrophic skin. The problem in patients with erosive pustular dermatosis of the scalp arises from the non-specific clinical and histopathological findings, which can be misleading. Biopsy followed by careful histopathological verification is mandatory, although the finding is nonspecific. The histopathology findings are characterized by superficial erosions with mild neutrophil infiltrate, mainly intravascular and focally with neutrophil exocytosis; focal parakeratosis, smoothed rete ridges without pronounced interface changes; pronounced lymphoplasmacytic infiltrate with focal distribution in the dermis and giant cell reaction with the formation of a "foreign body" granuloma.. We report a 58-year-old male patient with a 1-year-old lesion, suspected for skin cancer, later diagnosed with EPDS, which was successfully treated with topical clobetasol proprionate after 3-5weeks.
PubMed: 37063403
DOI: 10.4081/dr.2022.9556 -
International Journal of Surgical... Feb 2024Duchenne muscular dystrophy (DMD) is characterized by progressive systemic muscle wasting, leading to respiratory paralysis and early death. This X-linked disease is...
Duchenne muscular dystrophy (DMD) is characterized by progressive systemic muscle wasting, leading to respiratory paralysis and early death. This X-linked disease is caused by mutations, encoding dystrophin. There is little information regarding gastrointestinal abnormalities in patients with DMD. However, since the esophageal wall includes smooth and skeletal muscle it is also vulnerable to suffering the effects of muscle wasting in patients with DMD. After finding dyskeratosis and parakeratosis restricted to the proximal and middle esophagus with distal sparing in an 18-year-old patient with DMD, we performed an archive search of a large academic hospital and identified four additional patients with DMD who had also undergone esophageal biopsy. The patients consisted of five boys, ranging from 7 to 19 years of age. Esophageal injury was present in two patients, consisting of mild esophagitis in one, and spongiosis with dyskeratosis and parakeratosis in another. These patients were both older and had been diagnosed with DMD for greater than 15 years, while the three patients with histologically normal biopsies were younger and been diagnosed with DMD for 7, 9, and 13 years, respectively. Although the data is limited and the changes are subtle, they can be explained by the underlying muscular dystrophy pathophysiology.
Topics: Adolescent; Humans; Male; Esophagus; Muscle, Skeletal; Muscular Dystrophy, Duchenne; Mutation; Parakeratosis; Child; Young Adult
PubMed: 37063046
DOI: 10.1177/10668969231167532 -
Photodiagnosis and Photodynamic Therapy Jun 2023Granular parakeratosis is characterized by variably hyperkeratotic brownish papules or plaques, mostly found on flexures. Different treatments have been suggested with...
Granular parakeratosis is characterized by variably hyperkeratotic brownish papules or plaques, mostly found on flexures. Different treatments have been suggested with variable results. We present a series of 3 cases successfully treated with one session of methyl-aminolevulinate photodynamic therapy, showing resolution of the lesions and symptoms within less than 2 weeks, as a potentially new, safe and effective therapeutic option.
Topics: Humans; Parakeratosis; Photochemotherapy; Photosensitizing Agents; Aminolevulinic Acid
PubMed: 37037402
DOI: 10.1016/j.pdpdt.2023.103562 -
Clinical, Cosmetic and Investigational... 2023Granular parakeratosis is a rare dermatosis characterized by erythematous scaly patches or papules, and plaques, often involving intertriginous areas. In this work, a...
Granular parakeratosis is a rare dermatosis characterized by erythematous scaly patches or papules, and plaques, often involving intertriginous areas. In this work, a 73-year-old Chinese male patient presented with a 6-month history of pruritic verrucous papules on the bilateral groin. A skin biopsy was performed and revealed the following: the horny layer showed highly compact hyperkeratosis and parakeratosis with basophilic granules; the epidermis showed obvious acanthosis with psoriasiform hyperplasia. The final diagnosis was verrucous granular parakeratosis. We also reviewed the progress in nomenclature, etiology, clinical manifestations, differential diagnosis and treatment. Different clinical manifestations may represent different clinical entities. Dermatologists should differentiate it from other diseases to make a correct diagnosis. Treatment options should be based on the variable etiologies and clinical manifestations.
PubMed: 37033787
DOI: 10.2147/CCID.S401799 -
International Journal of Surgery Case... Apr 2023Nevus comedonicus (NC) is a rare cutaneous disorder thought to be caused by hamartomatous pilosebaceous tissue proliferation that was first described in 1895. Clinically...
INTRODUCTION
Nevus comedonicus (NC) is a rare cutaneous disorder thought to be caused by hamartomatous pilosebaceous tissue proliferation that was first described in 1895. Clinically NC appears as a group of elevated follicular openings often linearly arrayed, giving the appearance of comedones. NC usually manifests at birth but can also present later during adolescence and rarely in adulthood.
CASE PRESENTATION
A 21-year-old medically healthy single male presented with right-sided chest black papules in comedo distribution with areas of superficial ulcerations and suppurations in periareolar distribution since the age of 16. Histopathological examination showed dilated follicular ostia filled with keratin plug, devoid of the hair shaft, and lined by stratified squamous epithelium with compact hyperkeratosis, focal parakeratosis, and patchy atrophy and acanthosis.
CLINICAL DISCUSSION
Nevus comedonicus often responds effectively to conservative treatment, however some cases need surgery intervention. The patient failed conservative medical and topical treatment, and he was treated by surgical-wide local excision and primary closure of the affected skin with free nipple grafting.
CONCLUSION
Nevus comedonicus (NC) is a rare cutaneous pathology secondary to pilosebaceous apparatus developmental defect that usually manifests at birth and can affect any area of skin; they typically manifest as black papules in comedo distribution. They can present as an isolated cutaneous pathology or as a component of nevus comedonicus syndrome. Different therapeutic approaches were described, including topical retinoids, keratolytic agents, oral retinoids, antibiotic therapy, manual extraction of comedos, dermabrasion, and surgical resection of the lesion.
PubMed: 37001367
DOI: 10.1016/j.ijscr.2023.108021 -
Tropical Animal Health and Production Mar 2023This study aimed to investigate the effect of rumen pH-adjusting additives in the high-concentrated diet on functional traits, nutrient digestion, some meat parameters,...
Comparison of the effect of Saccharomyces cerevisiae-Megasphaera elsdenii and buffer on growth performance, digestibility, ruminal histomorphometry, and carcass characteristics of fattening lambs in high concentrate diet.
This study aimed to investigate the effect of rumen pH-adjusting additives in the high-concentrated diet on functional traits, nutrient digestion, some meat parameters, and histomorphometry, and rumen histopathology. Twenty-four Arabia male lambs with 3 to 4 months old and initial body weight of 23.9 ± 3.15 kg were used in a completely randomized design with three treatments and eight replicates. The study was 77 days, including 14 days of the adaptation period and 63 days of the record taking and sampling period. The experimental treatments consisted of a control diet, control diet + sodium bicarbonate buffer, control diet + Megasphaera elsdenii, and Saccharomyces cerevisiae (bacterial-yeast). Rumen fluid was taken by stomach tube at 3 h after morning feeding to measure pH. The lambs were weighed every 3 weeks during the period, and the body weight changes, average daily gain, and total weight gain were measured, and the feed conversion ratio was calculated. At the end of the experiment, the lambs were slaughtered, and the longissimus dorsi muscle was prepared to determine the meat parameters. For histological studies, the abdominal rumen sac was sampled. There were no differences among treatments in dry matter intake (DMI), daily weight gain (ADG), and feed conversion ratio (P > 0.05). Propionate concentration was higher in the bacteria-yeast treatment than other treatments (P < 0.05). Protein digestibility was higher in control and bacteria-yeast treatments than buffer treatment (P < 0.05). The percentage of meat protein, carcass weight, and dressing percentage in bacterial-yeast treatment was higher than other treatments (P < 0.05). Rumen wall thickness in the buffer and bacterial-yeast receiving treatments was greater than the control treatment and was significant in the buffer treatment compared to the control treatment (P < 0.05). The thickness of rumen epithelial tissue in the buffer and bacterial-yeast recipient treatments was less than the control treatment (P < 0.05). Rumen papillae thickness was higher in the control treatment than other treatments (P < 0.05). Hydropic degeneration and parakeratosis were less in pH-regulating treatments than in control. The results showed that the use of Megasphaera elsdenii could be an effective way to modulate the ruminal fermentation conditions of lambs fed with high concentrate diets. In addition, to increaseing dressing percentage and meat protein, it can also reduce tissue damage and improve ruminal tissue structure.
Topics: Sheep; Animals; Male; Saccharomyces cerevisiae; Megasphaera elsdenii; Rumen; Diet; Sheep, Domestic; Fermentation; Meat Proteins; Body Weight; Animal Feed; Digestion
PubMed: 36977895
DOI: 10.1007/s11250-023-03532-4 -
European Journal of Pharmacology May 2023Psoriasis is an enduring, pruritic and papulosquamous skin ailment that poses a significant burden on public health. It is mainly characterized by hyperkeratosis,... (Review)
Review
Psoriasis is an enduring, pruritic and papulosquamous skin ailment that poses a significant burden on public health. It is mainly characterized by hyperkeratosis, acanthosis, parakeratosis, scaly and erythematous plaques. Biomarkers like interleukin-17, interleukin-12 and -23 and tumor necrosis factor-α serve as key drivers of psoriatic pathogenesis. Triggered release of pro-inflammatory cytokines from various up-regulated pathways leads to psoriatic inflammation. Several target moieties like biologics, small molecules and herbal moieties play a fundamental role in the repression of pathogenesis of psoriasis. Biologics and small molecules engaged in the management of psoriasis have been emphasized in detail. An insight into nano-carrier interventions on herbal moieties and clinical aspects of psoriasis are also highlighted. This review emphasizes various pathological targets involved in psoriasis.
Topics: Humans; Cytokines; Biological Products; Psoriasis; Skin; Inflammation
PubMed: 36958476
DOI: 10.1016/j.ejphar.2023.175668 -
Explore (New York, N.Y.) 2023Immune checkpoint inhibitors (ICIs) have emerged as a revolutionary therapy in advanced squamous non-small cell lung cancer (sqNSCLC) and ushered a new era of... (Review)
Review
BACKGROUND
Immune checkpoint inhibitors (ICIs) have emerged as a revolutionary therapy in advanced squamous non-small cell lung cancer (sqNSCLC) and ushered a new era of immunotherapy. Despite of remarkable outcomes, a wide spectrum of immune-related adverse events (irAEs) was reported, among which cutaneous reactions were the most common. Cutaneous irAEs were mainly managed by glucocorticoids, whereas prolonged use of glucocorticoids may cuase kinds of side effects, especially in elderly paitients, and diminish the anti-tumor efficacy of ICIs, thus finding a safe and effective alternative approach to managing cutaneous irAEs is imperative.
CASE SUMMARY
A 71-year-old man who was diagnosed with advanced sqNSCLC suffered from sporadic maculopapulars one week later after the fifth cycle of sintilimab treatment, and the skin lesions had been deteriorating rapidly. Skin biopsy revealed epidermal parakeratosis with a dense band-like lymphocytic infiltrate and acanthosis, indicating a diagnosis of immune-induced lichenoid dermatitis. Oral administration of traditional Chinese herbal formula modified Weiling decoction significantly alleviated the symptoms of the patient. The dosage of Weiling decoction were maintained for about three months without recurrence of cutaneous adverse reactions and any other side effects. The patient refused to receive further anti-tumor medication and stayed alive without disease progression at follow up.
CONCLUSION
We present modified Weiling decoction successfully ameliorates immune-induced lichenoid dermatitis in a patient with sqNSCLC for the first time. This report indicates that Weiling decoction may be an effective and safe complementary or alternative approach for the treatment of cutaneous irAEs. Further investigation of the underling mechanism is required in the future.
Topics: Male; Humans; Aged; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Antineoplastic Agents, Immunological; Skin; Drug-Related Side Effects and Adverse Reactions; Dermatitis; Retrospective Studies
PubMed: 36878772
DOI: 10.1016/j.explore.2023.02.008