Dermatology Reports最新文献

Dupilumab, a monoclonal antibody targeting the IL-4/13 signaling pathway, effectively treats moderate-to-severe atopic dermatitis (AD). Common side effects include injection site reactions, conjunctivitis, and respiratory infections. We report the case of a 28-year-old woman with severe AD involving the periocular and chin regions, genital areas, arms, and legs (Eczema Area and Severity Index [EASI]: 24, itch Visual Analog Scale [VAS]: 8) who showed significant improvement after initiating dupilumab therapy. However, following ketoprofen intake for headache relief, she developed a lupus-like erythematous maculopapular rash on the periocular and malar regions. Immunological tests (ANA, ENA) and photopatch testing ruled out autoimmune or allergic causes. Dupilumab was stopped, and treatment with oral prednisone and cetirizine led to complete resolution. This case highlights a potential drug interaction between dupilumab and ketoprofen, emphasizing the need for awareness of paradoxical facial erythema reactions in patients undergoing dupilumab therapy.

Dear Editor, Loxoscelism, caused by bites from Loxosceles spiders, notably Loxosceles reclusa, presents with necrotic skin lesions and, in severe cases, systemic symptoms such as hemolysis, acute renal failure, and disseminated intravascular coagulation (DIC). The venom's sphingomyelinase D (SMD) enzyme induces direct tissue damage and an inflammatory response, leading to cell death, dermal necrosis, and increased vascular permeability, which can result in hemolysis and thrombosis. [...].

Urticaria is a prevalent inflammatory dermatological condition with a global estimated lifetime prevalence of up to 20%. Yellow urticaria is not a distinct medical condition; rather, it refers to the manifestation of yellow-colored wheals that appear in certain individuals with elevated serum bilirubin levels. This excess bilirubin accumulates in various tissues, including the conjunctiva and skin. The occurrence of yellow urticaria is notably rare and uncommon. In this report, we present a case of yellow-colored urticaria in a patient diagnosed with obstructive biliary stones, complemented by a concise review of previously documented cases in the literature.

Dear Editor, Pityriasis lichenoides (PL) is an inflammatory skin disease of unknown etiology. The clinical spectrum of pityriasis lichenoides encompasses febrile ulcer-necrotic Mucha-Habermann disease (FUMHD), pityriasis lichenoides et varioliformis acuta (PLEVA), and pityriasis lichenoides chronica (PLC). Phototherapy is an effective and well-tolerated modality that is often successful for persistent PL or resistant to topical treatments. A retrospective observational study was conducted involving patients from the dermatology section of the University of Verona with a confirmed histological diagnosis of PLEVA and PLC accessed between January 2003 and June 2024. [...].

Ceftriaxone is a widely used third-generation cephalosporin antibiotic known for its efficacy and safety. However, hypersensitivity reactions, including rare cases of generalized bullous fixed drug eruption (GBFDE), have been reported. We present the case of a 68-year-old female with a history of multiple comorbidities who developed a generalized bullous drug eruption two days after initiating intravenous ceftriaxone for a suspected respiratory infection. Clinical evaluation revealed extensive bullae and erythematous patches sparing mucous membranes, with histopathology confirming drug-induced epidermal changes. Direct immunofluorescence ruled out autoimmune bullous disorders. Prompt discontinuation of ceftriaxone, systemic corticosteroids, and supportive topical treatments led to marked clinical improvement. This case underscores the importance of recognizing rare but severe cutaneous reactions to ceftriaxone. Early diagnosis and intervention are crucial to minimizing complications and ensuring favorable outcomes.

Tacrolimus is a topical immunomodulator that has been used successfully in treating vitiligo; however, recent studies suggested that combining tacrolimus with micro-needling can increase its efficacy. This systematic review aimed to assess the efficacy and safety of micro-needling combined with tacrolimus to treat localized and stable nonsegmental vitiligo. We searched Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). The risk ratio (RR) was used to represent dichotomous outcomes, whereas the odds ratio (OR) was used for adverse events. Three randomized control trials (RCTs) (n=148 participants) were deemed eligible. The pooled effect estimate showed a statistically significant higher re-pigmentation rate in all assessed body areas in favor of treatment with micro-needling combined with tacrolimus (RR=2.02, 95% CI: 1.51-2.70). Nonetheless, no significant difference was found between micro-needling combined with tacrolimus and tacrolimus monotherapy in terms of 5-grade re-pigmentation scale (RR=0.93, 95% CI: 0.53-1.62), histopathological assessment (RR=0.90, 95% CI 0.47-1.75), and adverse events (OR: 1.72, 95% CI: 0.10-29.36). The number of included studies is low, with a relatively low sample size. Micro-needling combined with tacrolimus showed a clinically and statistically substantial improvement in the re-pigmentation of vitiligo sites with acceptable tolerability and safety profile.

A 19-year-old female with severe hidradenitis suppurativa (HS), treated with adalimumab for 10 months, developed facial erysipelas following an episode of pharyngitis. The infection presented with fever, severe cough, and a rapidly progressing erythematous plaque with edema on the left cheek, forehead, and periocular region. Laboratory tests confirmed a streptococcal infection. Due to allergies and intolerance to first-line antibiotics, azithromycin was administered, leading to complete resolution. This case highlights the increased risk of severe infections in immunosuppressed patients and underscores the importance of careful antibiotic selection and close monitoring for infections in patients receiving TNF-α inhibitors.

Unusual skin infection localization represents a challenge to physicians regarding presentation and mode of acquisition, all of which might influence the diagnosis. At the same time, the administration of incorrect drugs due to a misdiagnosis might have a negative impact on the disease course. This article presents two case reports detailing the unusual presentation of larva migrans and scabies mites infection in two Italian patients, highlighting the importance of clinical vigilance and comprehensive evaluation of patients. These cases suggest how an accurate diagnosis requires a high index of suspicion and appropriate diagnostic tools, such as dermoscopy, for the prompt recognition of skin infections and the consequent optimal patient outcome.

Vismodegib and sonidegib are smoothened (SMO) inhibitors approved for the treatment of advanced basal cell carcinoma (aBCC). This study investigates the real-world experiences and outcomes associated with these therapies across multiple Italian centers. A retrospective, observational, multicenter study was conducted. Medical records of patients with local advanced basal cell carcinoma (laBCC) treated with SMO inhibitors outside of clinical trials from July 2019 to April 2024 were analyzed. A total of 57 patients were included in the study, with 19 (33.3%) receiving vismodegib and 38 (66.7%) receiving sonidegib. Vismodegib demonstrated a complete response (CR) in 31.6% of cases and a partial response (PR) in 26.3%. Sonidegib achieved a CR of 47.4% and a PR of 36.8%. The median treatment duration was 8 months for vismodegib and 12 months for sonidegib. Adverse events were more frequently reported with vismodegib. Treatment interruption due to adverse events occurred in 47.4% of vismodegib recipients and in 13.2% of those receiving sonidegib. The progression of the disease under treatment occurred in 7.9% of cases of patients under sonidegib and in 26.3% of cases under vismodegib. *************************************************************** *Appendix Authors list Valentina Benzecry Mancin,1 Veronica Benzi,2 Matteo Bianco,2,3 Alessandra Bulotta,4 Antonio Costanzo,2,3 Giuseppe Damiano,5 Nerina Denaro,6 Laura Eibenschutz,7 Barbara Merelli,8 Giulia Murgia,1 Alessandra Narcisi,3 Emanuela Passoni,1 Francesco Piscazzi,2,3 Vincenzo Russo5 1Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; 2Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan; 3Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan; 4Department of Oncology, IRCCS San Raffaele, Milan; 5Unit of Immuno-Biotherapy of Melanoma and Solid Tumors, IRCCS Ospedale San Raffaele, Milan; 6Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; 7Oncologic and Preventive Dermatology Unit, IFO-San Gallicano Dermatological Institute IRCCS, Rome; 8Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy.

Our patient presented with a 5-year history of chronic, asymptomatic papulonodular lesions on the extremities. The lesions spread to the face and earlobes, with new ulcerative lesions on both legs for the past 8 months. Skin biopsy was compatible with lepromatous leprosy with Lucio phenomenon. Lucio phenomenon is a rare type of leprosy reaction found mostly in neglected lepromatous leprosy cases. Unfortunately, the patient developed pulmonary embolism and passed away. This case report focuses on the clinicopathological characteristics and management of Lucio phenomenon, which is an unusual form of leprosy reaction that often carries a poorer prognosis. Importantly, physicians should be able to differentiate Lucio phenomenon from other types of leprosy reactions for prompt management.