UV-triggered syndrome of Gougerot-Carteaud - mechanical damage or immunological reaction

Papillomatosis papulosa confluens reticulata et pigmentata is a rare dermatosis that presents clinically with pigmented, papillomatous, hyperkeratotic plaques with central confluence and reticulated peripheral pattern. The etiology remains unclear but current data points to a keratinization defect as the main pathological mechanism. There is one case report in the literature of a UV-induced Papillomatosis papulosa confluens reticulata et pigmentata. We present a 16-year old patient with clinical and histological diagnosis of confluent and reticulated papillomatosis. The characteristic lesions involved sun-exposed areas and developed after intense sun exposure. As an etiologic factor, ultraviolet light may lead to mechanical epidermal damage and further keratinization modification. On the other hand, in the setting of genetically predetermined resistance to UV-immunosuppression mechanisms, the newly formed epidermal antigens could potentially trigger an immune reaction resulting in skin eruption.Scripta Scientifica Medica 2013; 45(4): 88-91

Acute generalized exanthematous pustulosis (AGEP): a literature review

Acute generalized exanthematous pustulosis (AGEP) is a rare drug-induced pustular cutaneous reaction. The clinical course is characteristic with a sudden onset of multiple sterile pustules on an erythematous base with fever and neutrophilia, followed by a spontaneous resolution within two weeks. Drug-specific T cells play the main role in the pathogenesis, but the exact cytokine cascade and genetic background are yet to be elucidated. Timely and exact recognition is important in order to prevent confusion with infections and psoriasis and hence institution of unnecessary and wrong treatments. The diagnosis may be confirmed by typical history, identification of a culprit drug, histopathology and patch testing. The purpose of this review is to present the current knowledge on AGEP and its association with various drugs in the context of a drug allergic reaction.Scripta Scientifica Medica 2013; 45(4): 7-12

Systematized epidermolytic epidermal nevus (ichthyosis hystrix)

Ichthyosis hystrix is a term used to describe an autosomal dominant rare form of an ichthyosiform dermatosis which is characterized by hyperkeratotic spiny scales. We present a healthy 22-year-old man with lesions which clinically and histopathologically corresponded to the rare inherited disorder ichthyosis hystrix

Eruptive syringomas in association with severe periodontal disease

Introduction: Generalized eruptive syringomas is a rare clinical presentation of a benign adnexal tumor derived from the intraepidermal portion of the eccrine sweat ducts. Clinical presentation shows asymptomatic flesh-colored tumors on the anterior aspect of trunk.Material and Methods: A case of 51-year-old male with a long-standing generalized eruption of multiple brown-colored papules, associated with odorous perspiration and total loss of teeth which appeared suddenly three years ago.Results: Punch biopsy specimen revealed a normal epidermis overlying a dermis that was filled with multiple ducts embedded in a fibrous stroma. Тhe diagnosis of multiple syringomas was concluded. The perspiration odor was attributed to the presence of Gram-negative anaerobic bacteria.Conclusion: Speculations on the possible common pathogenetic background are presented