Perifolliculitis Capitis Abscedens et Suffodiens Treated with Systemic Isotretinoin Monotherapy: Case Report and Review of Current Therapeutic Options

Perifolliculitis capitis abscedens et suffodiens (PCAS) is a rare, suppurative dermatosis of the scalp, the etiology of which remains unknown. It is characterized by the development of comedones, perifollicular pustules, firm or fluctuant and itchy or painful nodules and abscesses of the scalp, connected by communicating sinuses that may lead to the formation of scarring and irreversible alopecia. Treatment of PCAS is challenging, often leading to unsatisfactory results. We present a case of a 23-year-old Caucasian man with PCAS who was treated successfully with systemic isotretinoin monotherapy and we review the current therapeutic options

Topical 5% benzoyl peroxide and 3% erythromycin gel: Experience from 191 patients with inflammatory acne

Background. A dramatic increase in bacterial resistance as a result of the use of topical antibiotics in acne has been recorded over the past 20 years. Aim. In this study we investigated the efficacy and safety of the topical treatment with 5% benzoyl peroxide and 3% erythromycin gel in patients with inflammatory acne. Materials and Methods. One hundred and ninety one patients with inflammatory acne were evaluated. The patients included 54 males and 137 females with a mean average age being 22.3±8.1 years. The topical gel was applied on the face, once daily, for 3 months.Results. The mean number of non-inflammatory and inflammatory decreased. These findings were statistically significant from baseline with a mean percentage reduction of the non-inflammatory and inflammatory lesions, corresponding to 42.2% and 57.5% respectively. Conclusion. Topical 5% benzoyl peroxide and erythromycin 3% as monotherapy is efficient in the treatment of inflammatory acne

Chronic eosinophilic pneumonia associated with neurofibromatosis type 1 : an unusual complication

Neurofibromatosis type 1 (formerly known as von Recklinghausen’s disease) is an autosomal dominant disorder, which results from the proliferation of the neural crest cells, thus affecting any organ system. Several pulmonary manifestations have hitherto been reported, including chest wall deformities, diffuse lung disease, thoracic neoplasms, pulmonary arterial hypertension, central hypoventilation, diaphragmatic paralysis and meningocele. However, eosinophilic lung disorders have not been described. An unusual case of chronic eosinophilic pneumonia in a patient with neurofibromatosis type 1, is reported herein. He had a propitious outcome, following corticosteroid treatment. This is the first well-documented case of chronic eosinophilic pneumonia and neurofibromatosis type 1 in the same patient. These clinical entities might share common pathogenic mechanisms, as suggested by the present study, that could explain their co-existence

Pulmonary sarcoidosis associated with psoriasis vulgaris: coincidental occurrence or causal association? Case report

BACKGROUND: Sarcoidosis is rarely associated with a distinct disease. One disease infrequently associated with sarcoidosis is psoriasis. CASE PRESENTATION: This case study describes a 38-year-old male, who presented with chest pain, high-grade fever, arthralgias and a skin rash accompanied by bilateral hilar lymphadenopathy on his chest radiograph. Extensive investigations including fiber-optic bronchoscopy with bronchoalveolar lavage and labial and skin biopsies, demonstrated that two distinct clinical entities co-existed in the same patient: pulmonary sarcoidosis and psoriasis vulgaris. Combination therapy for both diseases was applied and the patient was greatly improved. CONCLUSION: This is the first well-documented case of sarcoidosis and psoriasis in the same patient, reported on the basis of safe and widely-used techniques that were not available until fairly recently. These disorders might share common pathogenic mechanisms that could explain their co-existence in the patient

Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gout is a common inflammatory arthritis caused by articular precipitation of monosodium urate crystals. It usually affects the first metatarsophalangeal joint of the foot and less commonly other joints, such as wrists, elbows, knees and ankles.</p> <p>Case presentation</p> <p>We report the case of a 75-year-old Caucasian man with tophaceous multiarticular gout, soft-tissue involvement and ulcerated tophi on the first metatarsophalangeal joint of the left foot, on the first interphalangeal joint of the right foot and on the left thumb.</p> <p>Conclusion</p> <p>Ulcers due to tophaceous gout are currently uncommon considering the positive effect of pharmaceutical treatment in controlling hyperuricemia. Surgical treatment is seldom required for gout and is usually reserved for cases of recurrent attacks with deformities, severe pain, infection and joint destruction.</p

The functional morphology of the skin during the appearance of drug iduced eruptions: a precursor study with light and electron microscope

In our study 25 patients clinically diagnosed as having cutaneous drug reactions were examined with light microscopy and 11 of them with both light and electron microscopy. The results are summarized into the following: 1. Clinical criteria are not sufficient enough to establish the diagnosis of drug eruptions. In our study, only 23 out of 25 patients (92%) were proved to manifest drug eruptions. 2. The cutaneous adverse drug reactions are not encountered in female group as far as 14 patients were men (60,86%) and 9 women (39,13%). Our findings were not in agreement with the majority of literature. 3. The mean age of our patients with drug eruptions was 49,47 (15-80) years. The mean age of the male patients was 46,42 (15-78) years while of the female patients, 54,22 (17-80) years. 4. Regarding the distribution, drug eruptions were either of generalized type (13,04%) or of patchy type (17,39%) or were localized on face - scalp (21,73%), arms (34,78%), trunk (56,52%), buttocks (4,3%) and legs (30,43%). 5. The incriminating drugs of our study were: antibiotics (39,13%), non-steroidal anti-inflammatory agents (13,04%), chemotherapeutic agents (13,04%), anticonvulsants (8,6%), systemic corticosteroids (8,6%), antifungal agents (4,3%), anticoagulants (4,3%) heavy metals (4,3%) and allopourinol (4,3%). 6. The clinical patterns of drug eruptions seen in our study, were the following: maculopapular or morbilliform eruptions (17,39%), acneiform or pustular eruptions (13,04%), fixed drug eruption (13,04%), psoriasiform eruptions (8,6%), vasculitis (8,6%), urticaria (4,3%), lichenoid eruptions (4,3%), vesicular or bullous eruptions (4,3%), eczematous reactions (4,3%), purpura (4,3%), drug-induced alopecia (4,3%), Stevens-Johnson syndrome (4,3%) and toxic epidermal necrolysis (4,3%). 7. Histopathological examination of our study’s drug eruptions showed similar histologic findings to the skin diseases that they resemble clinically. Light microscopy histological features of each case were assessed and classified in relation with the degree of probability of drug eruptions’ histological diagnosis, into the following categories: a) definite (13,04%), b) probable (13,04%), c) possible (13,04%), d) diagnosis of skin disease with no findings compatible to drug aetiology (26,08%), and e) non-specific findings (34,78%).Τα συμπεράσματα τα οποία προέκυψαν από την μελέτη 25 ασθενών μας με εξανθήματα που θεωρήθηκαν φαρμακευτικής αιτιολογίας και εξετάσθηκαν με οπτικό μικροσκόπιο και οι 11 εξ΄αυτών με οπτικό και ηλεκτρονικό μικροσκόπιο, συνοψίζονται στα εξής: 1. Τα κλινικά κριτήρια δεν επαρκούν για τη διάγνωση των φαρμακευτικών εξανθημάτων γιατί ενώ βάσει αυτών επιλέχθηκαν 25 ασθενείς, μόνο στους 23 (ποσοστό 92,0%) πιστοποιήθηκε τελικά η διάγνωση του φαρμακευτικού εξανθήματος. 2. Η συχνότητα εμφάνισης των φαρμακευτικών εξανθημάτων δεν εξαρτάται από το φύλο, αφού από το σύνολο των 23 ασθενών μας με φαρμακευτικό εξάνθημα, οι 14 ήταν άνδρες (60,86%) και οι 9 θήλεις (39,13%), ευρήματα που δεν είναι σε συμφωνία με την πλειονότητα της βιβλιογραφίας. 3. Ο μέσος όρος της ηλικίας των ασθενών μας με φαρμακευτικό εξάνθημα ήταν 49,47 (15-80) έτη. Οι άρρενες ασθενείς είχαν μέσο όρο ηλικίας τα 46,42 (15-78) έτη ενώ τα θήλεα 54,22 (17-80) έτη. 4. Η νόσος είχε γενικευμένη μορφή (13,04%) ή διάσπαρτη μορφή (17,39%), ή ήταν δυνατό να εντοπίζεται στο πρόσωπο και το τριχωτό της κεφαλής (21,73%), στα άνω άκρα (34,78%), στον κορμό (56,52%), τους γλουτούς (4,3%) και τα κάτω άκρα (30,43%). 5. Τα φάρμακα που θεωρήθηκαν υπεύθυνα για την πρόκληση των φαρμακευτι-κών εξανθημάτων στην μελέτη μας ήταν τα αντιβιοτικά (39,13%), τα ανοσοκατασταλτικά (13,04%), τα μη-στεροειδή αντιφλεγμονώδη (13,04%), τα αντιεπιληπτικά (8,6%), τα συστηματικά κορτικο-ειδή (8,6%), τα αντιμυκητιασικά (4,3%), τα αντιπηκτικά (4,3%), τα σκευάσματα σιδήρου (4,3%) και η αλλοπουρινόλη (4,3%). 6. Οι κλινικές εικόνες με τις οποίες εκδηλώθηκαν τα φαρμακευτικά εξανθήματα των ασθενών μας ήταν: τα κηλιδοβλατιδώδη ή ιλαροειδή εξανθήματα (17,39%), τα ακμοειδή ή φλυκταινώδη εξανθήματα (13,04%), το σταθερό φαρμακευτικό εξάνθημα (13,04%), το ψωριασιόμορφο εξάνθημα (8,6%), η αγγειίτιδα (8,6%), η κνίδωση (4,3%), το λειχηνοειδές φαρμακευτικό εξάνθημα (4,3%), το φυσαλιδο-πομφολυγώδες εξάνθημα (4,3%), το εκζεματικό φαρμακευτικό εξάνθημα (4,3%), η πορφύρα (4,3%), η φαρμακογενής διάχυτη αλωπεκία (4,3%), το σύνδρομο Stevens-Johnson (4,3%), η ερυθροδερμία (4,3%) και η ΤΕΝ (4,3%)