181 research outputs found
[Motor complications during Herpes zoster of the ophtalmic branch of the trigeminal nerve. Electromyographic study of 7 cases (author's transl)]
Central nervous system dysmyelination in PIBI(D)S syndrome: A further case
none2noneBATTISTELLA PA; A. PESERICO STECCHINI NEGRI DE SALVIBattistella, PIER ANTONIO; PESERICO STECCHINI NEGRI DE SALVI, Andre
Kobner phenomenon in psoriasis induced by Mantoux test
The Koebner phenomenon refers to the appearance of a dermatosis
at sites of trauma or other cutaneous injuries. We describe a case of psoriatic flare-up developing from the site of the Mantoux test and
subsequently spread to the entire body surface, with development
of pustular lesions.
A 58-year-old man presented with a 37-year history of severe
plaque-type psoriasis. The patient was also affected by marked
hypercholesterolemia, chronic gastritis and hypertension. Over
time, he had been treated with multiple therapies including
phototherapy with narrowband UVB, systemic corticosteroids
and cyclosporine. Cyclosporine at 350 mg/day was the only
effective approach, but it had to be discontinued after 1 month
because of the uncontrolled worsening of hypertension. At
presentation, the patient showed multiple plaques, well defined,
characterized by mild infiltration, moderate erythema and coarse
scaling, covering approximately 20% of body surface area, with a
Psoriasis Area Severity Index (PASI) score of 14.6 and a Nail
Psoriasis Severity Index of 6. Since the patient suffered from
several comorbidities and he had previously shown to be
unresponsive to narrowband UVB phototherapy, we considered a
biologic therapy. We thus collected personal history and performed
physical examination, laboratory tests and a screening for tuberculosis.
The chest radiography was negative. A Mantoux test
performed on his left forearm revealed a positive reaction (> 10 mm).
Two days after, the patient developed a psoriatic plaque at the site
of the Mantoux test (Fig. 1). One week after the Mantoux test, the
patient showed a severe worsening of psoriasis on the entire body
surface. Suddenly, the previously observed lesions enlarged and
new psoriatic plaques developed on healthy skin sites resulting in
an almost generalized involvement of body surface area (Fig. 2).
The lesions were deeply infiltrated and severely erythematous.
PASI score was 32.6 and BSA was 80%. Within some of these
plaques, scattered pustules were detected. The patient denied to
have ever suffered from pustular psoriasis
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