Dermatology online journal最新文献

Silver sulfadiazine, a topical antimicrobial that releases silver ions to disrupt bacterial cell membranes, is primarily used for second- and third-degree burns owing to its broad-spectrum activity against bacteria, fungi, and certain viruses. Beyond burns, silver sulfadiazine can be used off-label for conditions such as diabetic and pressure ulcers, atopic dermatitis, and radiation dermatitis. The literature suggests it may reduce bacterial load, accelerate healing, and address challenges such as multidrug-resistant Staphylococcus aureus. Rare side effects, including localized reactions and systemic toxicity with extensive use, necessitate cautious application, especially in vulnerable populations. Despite these limitations, silver sulfadiazine remains a cornerstone of dermatological wound care. Continued research is needed to optimize its use alongside emerging therapies.

Kaposi sarcoma (KS) is a vascular tumor caused by human herpesvirus-8 (HHV-8), most often associated with human immunodeficiency virus (HIV)-positive individuals. However, KS can also occur in HIV-negative patients, though less commonly. We report a rare case of classic KS in an HIV-negative man with no history of male-to-male sexual activity, who experienced rapid progression to stage IV disease within 3 months. To our knowledge, this is the first documented case of classic KS in Vietnam, highlighting the potential for aggressive KS presentations in immunocompetent Asian individuals. This case underscores the importance of considering KS in the differential diagnosis of rapidly advancing skin lesions, even in patients without traditional risk factors, to ensure timely diagnosis and appropriate management.

Pretibial epidermolysis bullosa (PEB) is a rare subtype of dystrophic epidermolysis bullosa (DEB), characterized by trauma-induced blistering and scarring limited to the pretibial area. DEB results from monoallelic or biallelic variants in the COL7A1 gene, which encodes type VII collagen. PEB generally presents with milder symptoms than other DEB forms. We report a 50-year-old man with a 30-year history of asymptomatic erythematous patches and tense blisters on the pretibial areas, triggered by construction work and improving during vacations. Physical examination revealed bilateral erythematous plaques, tense bullae, crusted erosions, and nail dystrophy of the feet. Histology and EM showed subepidermal blisters and defects in anchoring fibrils. Genetic testing identified presumptive compound heterozygosity for 2 likely pathogenic COL7A1 variants: a previously reported missense variant (c.151C>G; p.Arg51Gly) and a novel frameshift variant (c.1752del; p.Ser585Valfs*30). Symptomatically management included protective dressings. The specific combination of variants in this patient has not been previously documented. This case underscores the relevance of diagnosing PEB and identifying novel COL7A1 variants, emphasizing the need for further research to understand genotype-phenotype correlations and explore treatment options.

Harlequin syndrome is a rare condition characterized by asymmetric facial flushing and sweating in reaction to heat, exercise, or emotional circumstances. It results from a defect of the autonomic nervous system. The syndrome can arise from structural defects or iatrogenic factors or can be primary (idiopathic) and have a benign course. We report a 4-year-old boy who experienced sweating and flushing on the left side of the face after exercise. He had no noteworthy medical or birth history. Neurological and ophthalmological examinations revealed no additional abnormalities. Magnetic resonance imaging of the cervicothoracic spinal cord and cerebrum showed no anomalies. A diagnosis of idiopathic harlequin syndrome was made.

Purpose To review published literature on the clinical efficacy, use, and accuracy of the 31-gene expression profiling (31-GEP) test for prognostic information in invasive melanoma. Methods A comprehensive literature search used keywords "31-gene expression profiling," "melanoma," "prognosis," "clinical efficacy," and "clinical utility." A panel of 10 dermatologists with expertise in melanoma management reviewed the articles and created consensus statements. A modified Delphi process approved each statement, requiring supermajority approval through multiple rounds of real-time voting, with strength of recommendation assigned. Results The search produced 150 articles; 26 met inclusion criteria. The panel unanimously voted to adopt 9 consensus statements and recommendations regarding 31-GEP testing: 8 with strength "A" and 1 with strength "C." Conclusion The panel agreed there is strong support for using 31-GEP testing to provide prognostic information for invasive melanoma. The test provides prognostic information when thickness and other traditional factors are unknown, improves prognosis assessment when added to American Joint Committee on Cancer 8th edition staging system, and is associated with improved melanoma-specific mortality and overall survival. The panel concluded that the robust existing literature strongly supports its use as a best practice for appropriate patients with melanoma.

Purpuric and pigmented lichenoid dermatitis of Gougerot and Blum is a form of purpuric pigmented dermatosis. These entities are rarely described, but are likely underdiagnosed. Herein, we present a patient with this condition that is unusual in is its diffuse nature and its delayed diagnosis after twenty years of evolution.

Serratia marcescens is an uncommon cause of cutaneous infections, especially in immunocompetent individuals. We present a 31-year-old woman with a chronic erythematous nodule on the nasal supratip, three years post-rhinoplasty. Initial treatments, including intralesional corticosteroids, oral doxycycline, and topical metronidazole, failed to resolve the infection. Initially thought to be a contaminant, repeat tissue culture confirmed the presence of S. marcescens. The patient's abscess resolved following a course of levofloxacin but surgery was required to remove remnant scar tissue. This case underscores the importance of considering atypical pathogens in chronic cutaneous infections following cosmetic procedures, even in immunocompetent patients. Increased awareness among clinicians can aid in prompt diagnosis and targeted therapy.