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The Medical Journal of Malaysia Jun 2018Ultraviolet phototherapies are important treatment modalities for a wide range of dermatological conditions. We aim to describe the utilization of phototherapy in the...
INTRODUCTION
Ultraviolet phototherapies are important treatment modalities for a wide range of dermatological conditions. We aim to describe the utilization of phototherapy in the Department of Dermatology Hospital Kuala Lumpur.
METHODS
This is a 5-year retrospective audit on patients who underwent phototherapy between 2011 and 2015.
RESULTS
There were 892 patients, M:F=1.08:1, aged from 4- 88 years, with a median age of 38.8 years who underwent phototherapy. Majority (58.9%) had skin phototype IV, followed by type III (37.7%) and type II (0.7%). There were 697(78.1%) who underwent NBUVB, 136 (15.2%) had topical PUVA, 22(2.5%) had oral PUVA, 12(1.4%) had UVA1 and 23(2.6%) had NBUVB with topical or oral PUVA/UVA1 at different time periods. The indications were psoriasis (46.6%), vitiligo (26.7%), atopic eczema (9.8%), pityriasis lichenoides chronica (5.3%), mycosis fungoides (3.9%), lichen planus (2.5%), nodular prurigo (2.2%), scleroderma (1.2%), alopecia areata (0.7%) and others. The median number of session received were 27 (range 1-252) for NBUVB, 30 (range 1-330) for topical PUVA, 30 (range 3-190) for oral PUVA and 24.5 (range 2-161) for UVA1. The acute adverse effects experienced by patients were erythema (18%), pruritus (16.3%), warmth (3.3%), blister formation (3.1%), cutaneous pain (2.4%), and xerosis (0.8%), skin swelling (0.7%) and phototoxicity (0.2%).
CONCLUSION
Narrow-band UVB was the most frequently prescribed phototherapy modality in our center. The most common indication for phototherapy in our setting was psoriasis. Acute adverse events occurred in a third of patients, although these side effects were mild.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Dermatology; Female; Hospital Departments; Humans; Malaysia; Male; Middle Aged; PUVA Therapy; Phototherapy; Retrospective Studies; Skin Diseases; Young Adult
PubMed: 29962494
DOI: No ID Found -
Gaceta Medica de Mexico 2018T-cell lymphoid dyscrasia is a group of different, infrequent, epitheliotropic inflammatory dermatosis that precede cutaneous T-cell lymphomas. Treatment with...
INTRODUCTION
T-cell lymphoid dyscrasia is a group of different, infrequent, epitheliotropic inflammatory dermatosis that precede cutaneous T-cell lymphomas. Treatment with ultraviolet radiation is safe and efficacious.
OBJECTIVE
To describe responses to treatment, secondary effects and complications.
METHOD
Eleven patients with different T-cell lymphoid dyscrasias were treated. Two received psoralens plus ultraviolet A radiation (PUVA) and nine narrow band ultraviolet B radiation (NB-UVB).
RESULTS
Seven women and four men from 5 to 30 years-old and phototypes III and IV were included. They had hypopigmented epitheliotropic lymphoid dyscrasia, chronic pityriasis lichenoides, hypopigmented parapsoriasis and pigmented purpuric dermatoses. Two received PUVA and 9 NB-UVB. Eight achieved complete response and three partial response with 10 to 119 sessions. Any patient presented neither relapse nor progression to cutaneous T-cell lymphoma during treatment or in the follow up period after 34 to 247 sessions. Secondary effects were xerosis and mild pruritus.
CONCLUSIONS
The majority of patients with T-cell lymphoid dyscrasias can be successfully and safely treated with minimal secondary effects after a variable number of sessions and periods of time with ultraviolet radiation.
Topics: Adolescent; Adult; Child; Child, Preschool; Disease Progression; Female; Follow-Up Studies; Humans; Lymphoma, T-Cell, Cutaneous; Male; Middle Aged; PUVA Therapy; Precancerous Conditions; Skin Neoplasms; T-Lymphocytes; Treatment Outcome; Ultraviolet Therapy; Young Adult
PubMed: 30532114
DOI: 10.24875/GMM.18004577 -
Acta Dermato-venereologica 2008Febrile ulceronecrotic Mucha-Habermann disease is a severe variant of pityriasis lichenoides et varioliformis acuta characterized by the sudden onset of ulceronecrotic... (Review)
Review
Febrile ulceronecrotic Mucha-Habermann disease is a severe variant of pityriasis lichenoides et varioliformis acuta characterized by the sudden onset of ulceronecrotic skin lesions and associated with high fever and systemic symptoms. We report here a case of a 20-year-old woman in whom the disease started as pityriasis lichenoides et varioliformis acuta and evolved to febrile ulceronecrotic Mucha-Habermann disease. Almost 90% of the body surface was involved, together with high fever and malaise. Steroids alone proved to be an insufficient therapeutic procedure. The remission achieved was attributed to the use of methotrexate. To our knowledge, only 39 cases of febrile ulceronecrotic Mucha-Habermann disease have been reported in the literature to date.
Topics: Adult; Female; Fever; Humans; Methotrexate; Necrosis; Pityriasis; Pityriasis Lichenoides; Ulcer
PubMed: 18709304
DOI: 10.2340/00015555-0441 -
Acta Dermato-venereologica Apr 2023Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare fulminant variant of pityriasis lichenoides et varioliformis acuta (PLEVA) that is characterized by a... (Review)
Review
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare fulminant variant of pityriasis lichenoides et varioliformis acuta (PLEVA) that is characterized by a large ulceronecrotic appearance with high fever and a variety of systemic symptoms. We report here a case of FUMHD in a 17-year-old male Chinese patient who was treated successfully with a combination therapy of methotrexate, methylprednisolone, and intravenous immunoglobulin. In addition, a literature review was conducted to summarize the key characteristics of paediatric FUMHD cases.
Topics: Male; Humans; Child; Adolescent; Pityriasis Lichenoides; Herpes Simplex; Methotrexate; Methylprednisolone
PubMed: 37073962
DOI: 10.2340/actadv.v103.4806 -
Dermatology Reports Nov 2022Febrile Ulceronecrotic Mucha- Habermann Disease (FUMHD) is a variant of Pityriasis Lichenoides Et Varioliformis Acuta (PLEVA). Although rare, the condition may progress...
Febrile Ulceronecrotic Mucha- Habermann Disease (FUMHD) is a variant of Pityriasis Lichenoides Et Varioliformis Acuta (PLEVA). Although rare, the condition may progress to involve serious complications and even lead to fatal outcomes if diagnosis and appropriate treatment is delayed. A PubMed search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMSA) guidelines was performed to find cases of FUMHD from the earliest records to October 2021. Treatments, complications, and patient outcomes were extracted from the literature and summarized, while a review of quality was also performed. A total of 63 publications with 68 patients were found. Successful treatment modalities for FUMHD included antibiotics, antivirals, systemic steroids, Methotrexate (MTX), cyclophosphamide, Cyclosporine (CYA), Intravenous Immunoglobulins (IVIG), pentoxifylline, and ultraviolet B phototherapy. Out of 68 patients, 55 patients had their condition fully resolved and 13 cases were fatal. Increased age, systemic involvement, and monoclonal T-cell receptor rearrangement were associated with worst prognosis, but mucosal involvement did not affect mortality risk. Overall, the publications had low risk of bias, but most lacked adequate follow-up periods. FUMHD is a diagnostic and therapeutic challenge due to the lack of clearly defined diagnostic criteria and optimum treatment. Further studies with larger patient populations and longer follow-up periods may lead to refinement of diagnostic criteria, establish an optimum treatment regimen, and better estimate the likelihood of recurrence.
PubMed: 36483219
DOI: 10.4081/dr.2022.9492 -
Case Reports in Dermatological Medicine 2015We present a 74-year-old female patient who developed a pityriasis lichenoides chronica (PLC) during etanercept therapy. This association is not described in the...
We present a 74-year-old female patient who developed a pityriasis lichenoides chronica (PLC) during etanercept therapy. This association is not described in the literature and might be considered in the spectrum of cutaneous adverse reactions of etanercept.
PubMed: 25789178
DOI: 10.1155/2015/168063 -
Dermatology Online Journal Dec 2005We report a case of febrile ulceronecrotic Mucha-Habermann disease (FUMHD) in a 27-year-old woman. After 20 days of a mild eruption, extensive polymorphous, papular and... (Review)
Review
We report a case of febrile ulceronecrotic Mucha-Habermann disease (FUMHD) in a 27-year-old woman. After 20 days of a mild eruption, extensive polymorphous, papular and ulcerohemorrhagic skin lesions gradually developed, associated with intermittent high temperature, and constitutional symptoms. The initial treatment with acyclovir was not successful, the skin lesions still progressed distally and individual lesions evolved from necrotic papules and bullae to erosions and ulcers. Skin biopsies showed the typical histopathological changes of PLEVA. The patient was treated with systemic prednisolone but dosage was limited in order to avoid sepsis. Despite corticosteroid therapy and supportive therapy, the fulminating course led to death. Including this present case, only 31 cases of FUMHD have been reported in English literature. Our case is the second report from Turkey.
Topics: Adult; Female; Fever; Humans; Pityriasis Lichenoides; Skin Ulcer
PubMed: 16409927
DOI: No ID Found -
Proceedings of the Royal Society of... Aug 1932
PubMed: 19988934
DOI: No ID Found -
Annals of Dermatology Feb 2021
PubMed: 33911821
DOI: 10.5021/ad.2021.33.1.94 -
Dermatology (Basel, Switzerland) 2012Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare subtype of pityriasis lichenoides et varioliformis acuta, characterized by an acute onset of... (Review)
Review
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare subtype of pityriasis lichenoides et varioliformis acuta, characterized by an acute onset of ulceronecrotic papules, rapidly coalescing into large ulcers with necrotic crusts, associated with high fever and severe systemic symptoms. We report a case of a 65-year-old woman with a resistant form of FUMHD successfully treated with a tumor necrosis factor-α (TNFα) inhibitor (infliximab). After 1 year of treatment, because of the recurrence of lesions and -occurrence of severe sepsis, we decided to change the therapeutic procedure by introducing intravenous immunoglobulin witch induced a spectacular improvement. Only few cases of FUMHD treated with intravenous immunoglobulin have been reported to date. In our case, we describe the first utilization of TNFα inhibitors in the treatment of FUMHD: TNFα inhibitors may be useful, particularly in resistant cases. Further reports are required to confirm this potential therapeutic option.
Topics: Aged; Antibodies, Monoclonal; Dermatologic Agents; Drug Therapy, Combination; Female; Herpes Simplex; Humans; Immunoglobulins, Intravenous; Infliximab; Pityriasis Lichenoides; Time Factors; Treatment Outcome; Tumor Necrosis Factor-alpha
PubMed: 23391565
DOI: 10.1159/000346245