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Dermatology Practical & Conceptual Apr 2023
PubMed: 37196286
DOI: 10.5826/dpc.1302a103 -
New Microbes and New Infections Jun 2023The tick is the main vector of and tick-borne encephalitis virus in Switzerland Spotted fever group Rickettsiae (SFG) and have been detected in Swiss ticks, however,...
BACKGROUND
The tick is the main vector of and tick-borne encephalitis virus in Switzerland Spotted fever group Rickettsiae (SFG) and have been detected in Swiss ticks, however, information about the extent and clinical presentation of these infections in humans is scant.
METHODS
Indirect fluorescent antibody tests for SFG rickettsiae and were performed on serum samples of 121 seropositive patients with and without Lyme disease and 43 negative controls.
RESULTS
Out of 121 seropositive individuals, 65 (53.7%) were seropositive for IgG and 15 (12.4%) for IgM antibodies to SFG rickettsiae. IgM antibodies were detected more frequently in early-than in late-stage of Lyme disease (12 out of 51 and 2 out of 49; respectively; p = 0.0078). Significantly higher IgG antibody titers against SFG rickettsiae were found in patients with late-stage compared to patients with early-stage Lyme disease (mean titer 1:261 and 1:129, respectively; p = 0.038). This difference was even more pronounced in patients with acrodermatitis chronica atrophicans compared to patients with early stage of Lyme disease (mean titer 1:337 and 1:129, respectively; p = 0.009).In patients presenting with fatigue, headache and myalgia, the prevalence of IgG antibodies against SFG rickettsiae was significantly higher (7 out of 11; 63.6%) than in seropositive individuals without clinical illness (1 out of 10; 10%; p = 0.024). IgG antibodies to were detected in 12 out of 121 individuals (9.9%), no IgM antibodies were found.
CONCLUSION
Infections with SFG rickettsiae and are underdiagnosed and should be ruled out after a tick bite. Further studies are needed to elucidate the possible causative role of SFG rickettsiae for myalgia, headache and long-lasting fatigue after a tick bite and to determine the necessity for an antibiotic treatment.
PubMed: 37168237
DOI: 10.1016/j.nmni.2023.101139 -
Indian Dermatology Online Journal 2023
PubMed: 37089830
DOI: 10.4103/idoj.idoj_249_21 -
Clinical Case Reports Apr 2023A second-born breastfed infant presented with zinc deficiency. His mother had a novel heterozygous mutation in . A previous baby did not have zinc deficiency but the...
A second-born breastfed infant presented with zinc deficiency. His mother had a novel heterozygous mutation in . A previous baby did not have zinc deficiency but the mother had taken a proton pump inhibitor (PPI) during the second pregnancy. Antenatal PPI exposure may plausibly contribute to transient infantile zinc deficiency.
PubMed: 37082517
DOI: 10.1002/ccr3.7213 -
SAGE Open Medical Case Reports 2023Gianotti-Crosti syndrome, also known as papular acrodermatitis of childhood, is a common, self-limiting dermatosis often seen in children with triggers including viral...
Gianotti-Crosti syndrome, also known as papular acrodermatitis of childhood, is a common, self-limiting dermatosis often seen in children with triggers including viral and bacterial infections along with immunizations. Lesions are generally described as asymptomatic, skin colored to erythematous papules and papulovesicles that often spontaneously resolve within weeks. Here, we will discuss Gianotti-Crosti syndrome and present a rare case of chronic Gianotti-Crosti syndrome in an otherwise healthy 3-year-old male persisting for over 20 months. From this report, we aim to better educate the dermatologic community on the extremes of the Gianotti-Crosti syndrome disease course to improve diagnosis and treatment of symptomatic patients.
PubMed: 37077806
DOI: 10.1177/2050313X231164250 -
Clinical, Cosmetic and Investigational... 2023Acrodermatitis continua of Hallopeau (ACH) is a rare variant of pustular psoriasis that presents as a sterile pustular eruption of the periungual and subungual regions....
Acrodermatitis continua of Hallopeau (ACH) is a rare variant of pustular psoriasis that presents as a sterile pustular eruption of the periungual and subungual regions. It affects the skin and nail bed and can lead to distal phalangeal destruction as the disease progresses. ACH is an incurable disease that requires long-term maintenance therapy to prevent any complications. Because ACH is a variant of pustular psoriasis, it is commonly treated with anti-psoriatic therapies. Unfortunately, it is resistant to many available anti-psoriatic therapies, and there are no clinical guidelines for it; the treatment is therefore highly challenging. Current treatment strategies are mostly based on a few case reports and case series. In this study, we present a case of ACH in a 24-year-old man with a long history of severe skin lesions and overt onychodystrophy, successfully treated with Ustekinumab. In this patient, we observed rapid improvement in skin lesions and symptoms. Ustekinumab can considerably improve other symptoms besides plaque psoriasis. The treatment and excellent outcomes of Ustekinumab may provide clinical benefits to more patients and serve as a reference for other dermatologists.
PubMed: 37051587
DOI: 10.2147/CCID.S404860 -
SAGE Open Medical Case Reports 2023Acrodermatitis continua of Hallopeau is a rare variant of localized pustular psoriasis characterized by the recurrent eruption of sterile pustules involving the distal...
Acrodermatitis continua of Hallopeau is a rare variant of localized pustular psoriasis characterized by the recurrent eruption of sterile pustules involving the distal portions of the fingers and toes that can lead to the destruction of the nail apparatus. Acrodermatitis continua of Hallopeau is a chronic, relapsing condition that is resistant to most topical and systemic psoriasis therapies, making it notoriously difficult to manage. Interleukin-36 and interleukin-17 are thought to play a pivotal role in the pathophysiology of pustular psoriasis, and evidence suggests that interleukin-17 inhibition can be an effective therapy for pustular psoriasis variants, including acrodermatitis continua of Hallopeau. Bimekizumab, a monoclonal antibody that inhibits the interleukin-17 pathway, may be a safe and effective treatment option for patients with acrodermatitis continua of Hallopeau. We present the first documented case of a patient with acrodermatitis continua of Hallopeau of the bilateral thumbnails who experienced an excellent response to bimekizumab treatment.
PubMed: 36968989
DOI: 10.1177/2050313X231160937 -
BMJ Case Reports Feb 2023An immunocompetent male in his 70s was diagnosed with psoriatic arthritis based on dactylitis, onycholysis of the nails and scalp psoriasis. He was treated with...
An immunocompetent male in his 70s was diagnosed with psoriatic arthritis based on dactylitis, onycholysis of the nails and scalp psoriasis. He was treated with corticosteroids, methotrexate and local corticosteroid injections without improvements in his symptoms. When tumor necrosis factor-alpha inhibitor treatment was introduced, the symptoms worsened and dactylitis of all digits and a bluish-red rash were observed on the extensor side of the left hand and arm. At this point, a skin biopsy was performed showing histopathological changes compatible with Lyme borreliosis and serum contained IgG antibodies against It was concluded that he was suffering from acrodermatitis chronica atrophicans (ACA) and Lyme dactylitis. Ten days of phenoxymethylpenicillin treatment was initiated, and after 2 weeks, the dactylitis and ACA had regressed substantially. After 6 months, both had resolved. This case emphasises the need for clinical reassessment, when treatment is not effective.
Topics: Humans; Male; Exanthema; Lyme Disease; Borrelia burgdorferi; Arthritis, Psoriatic; Hand
PubMed: 36805866
DOI: 10.1136/bcr-2022-253182 -
Indian Dermatology Online Journal 2023
PubMed: 36776177
DOI: 10.4103/idoj.idoj_312_22