We have read and much appreciated the article by Wilk et al., discussing clinicopathologic aspects and management of erosive pustular dermatosis of the scalp (EDPS) [1]. We wish to share our experience with a case of EPDS, which showed an impressive response to lymecycline monotherapy. The patient was a 75-year-old Caucasian man who presented for a painful scalp eruption of two months’ duration. He suffered from type II diabetes, metabolic syndrome, hypertension and chronic heart failure. Physical examination revealed multiple confluent erosions with erythematous borders and pustules on the frontal and parietal regions as well as the vertex of the scalp (Figure 1a). Differential diagnoses included bacterial or fungal infections, Brunsting-Perry mucous membrane pemphigoid, folliculitis decalvans and erosive pustular dermatosis of the scalp (EDPS). Histopathological examination of a skin biopsy from one lesion showed absence of epidermis and a mixed dermal inflammatory infiltrate comprising neutrophils and plasma cells. Direct immunofluorescence of perilesional skin, bacterial and mycological cultures were negative. A diagnosis of EPDS was made based on the clinical and histological findings. The patient was treated with clobetasol ointment once daily for four weeks, but there was no improvement. He refused other topical medications. Systemic therapies including prednisone, acitretin or dapsone were contraindicated due to the associated comorbid diseases. He was started on lymecycline 300 mg/day, which resulted in complete healing after four weeks of treatment (Figure 1b). Lymecycline was stopped and no recurrence occurred during six months of follow-up. EPDS is a chronic inflammatory dermatosis, mostly affecting the scalp and characterized by erosions, pustules and crusts, which may eventually lead to scarring alopecia [1, 2]. Diagnosis of EPDS is often challenging and requires the exclusion of various inflammatory and neoplastic skin disorders that also affect the scalp (Table 1). Regarding the pathogenesis, a Koebner-like phenomenon has been hypothesized since EPDS often occurs following skin damage, such as trauma, skin grafting, burns or herpes zoster infection; the association with autoimmune disorders such as rheumatoid arthritis is also consistent with a possible autoimmune origin of the disease [1, 2]. Clinical Letter
{"title":"Impressive response of erosive pustular dermatosis of the scalp to lymecycline monotherapy","authors":"R. Maglie, L. Quintarelli, M. Caproni, E. Antiga","doi":"10.1111/ddg.13978","DOIUrl":"https://doi.org/10.1111/ddg.13978","url":null,"abstract":"We have read and much appreciated the article by Wilk et al., discussing clinicopathologic aspects and management of erosive pustular dermatosis of the scalp (EDPS) [1]. We wish to share our experience with a case of EPDS, which showed an impressive response to lymecycline monotherapy. The patient was a 75-year-old Caucasian man who presented for a painful scalp eruption of two months’ duration. He suffered from type II diabetes, metabolic syndrome, hypertension and chronic heart failure. Physical examination revealed multiple confluent erosions with erythematous borders and pustules on the frontal and parietal regions as well as the vertex of the scalp (Figure 1a). Differential diagnoses included bacterial or fungal infections, Brunsting-Perry mucous membrane pemphigoid, folliculitis decalvans and erosive pustular dermatosis of the scalp (EDPS). Histopathological examination of a skin biopsy from one lesion showed absence of epidermis and a mixed dermal inflammatory infiltrate comprising neutrophils and plasma cells. Direct immunofluorescence of perilesional skin, bacterial and mycological cultures were negative. A diagnosis of EPDS was made based on the clinical and histological findings. The patient was treated with clobetasol ointment once daily for four weeks, but there was no improvement. He refused other topical medications. Systemic therapies including prednisone, acitretin or dapsone were contraindicated due to the associated comorbid diseases. He was started on lymecycline 300 mg/day, which resulted in complete healing after four weeks of treatment (Figure 1b). Lymecycline was stopped and no recurrence occurred during six months of follow-up. EPDS is a chronic inflammatory dermatosis, mostly affecting the scalp and characterized by erosions, pustules and crusts, which may eventually lead to scarring alopecia [1, 2]. Diagnosis of EPDS is often challenging and requires the exclusion of various inflammatory and neoplastic skin disorders that also affect the scalp (Table 1). Regarding the pathogenesis, a Koebner-like phenomenon has been hypothesized since EPDS often occurs following skin damage, such as trauma, skin grafting, burns or herpes zoster infection; the association with autoimmune disorders such as rheumatoid arthritis is also consistent with a possible autoimmune origin of the disease [1, 2]. Clinical Letter","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84626087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emilia J. Mellerowicz, Karsten Weller, T. Zuberbier, M. Maurer, S. Altrichter
Die cholinergische Urtikaria (CholU) ist eine häufige Unterform der chronischen induzierbaren Urtikaria. Die aktuellen Leitlinien empfehlen eine symptomatische Therapie mit Antihistaminika (AH) der zweiten Generation (sgAH, second‐generation antihistamines) als Therapie der ersten Wahl. Allerdings ist wenig darüber bekannt, welche Therapien CholU‐Patienten im klinischen Alltag tatsächlich erhalten und wie sie auf diese ansprechen.
{"title":"Therapie von Patienten mit cholinergischer Urtikaria im Alltag in deutschsprachigen Ländern","authors":"Emilia J. Mellerowicz, Karsten Weller, T. Zuberbier, M. Maurer, S. Altrichter","doi":"10.1111/ddg.13979_g","DOIUrl":"https://doi.org/10.1111/ddg.13979_g","url":null,"abstract":"Die cholinergische Urtikaria (CholU) ist eine häufige Unterform der chronischen induzierbaren Urtikaria. Die aktuellen Leitlinien empfehlen eine symptomatische Therapie mit Antihistaminika (AH) der zweiten Generation (sgAH, second‐generation antihistamines) als Therapie der ersten Wahl. Allerdings ist wenig darüber bekannt, welche Therapien CholU‐Patienten im klinischen Alltag tatsächlich erhalten und wie sie auf diese ansprechen.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85022312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laudatio anlässlich der Emeritierung von Prof. Dr. Claus Garbe (Tübingen)","authors":"A. Hauschild, D. Schadendorf","doi":"10.1111/ddg.13950_g","DOIUrl":"https://doi.org/10.1111/ddg.13950_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72738529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Jäger, Johannes Kohlmann, J. Simon, Benjamin Sandner, A. Tönjes, M. Ziemer
{"title":"Hypophysitis unter Immuntherapie mit Checkpoint‐Inhibitoren","authors":"I. Jäger, Johannes Kohlmann, J. Simon, Benjamin Sandner, A. Tönjes, M. Ziemer","doi":"10.1111/ddg.13963_g","DOIUrl":"https://doi.org/10.1111/ddg.13963_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78097890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Wang, Modi Yang, Sha Lv, Nannan Xu, Yingying Zhang, Shuai Wu, Jinfeng Wang, Fuqiu Li
Phakomatosis pigmentovascularis (PPV) is a rare congenital disorder characterized by extensive cutaneous, vascular and melanocytic lesions [1]. We present a unique case of type IIb PPV in association with Klippel-Trenaunay syndrome, scleral melanosis, and rare extensive dermal melanocytosis, which manifested as bilateral nevus of Ota, bilateral nevus of Ito and ectopic Mongolian spots. A 66-year-old female Chinese patient was referred to our dermatology department for a chronic ulcer on the right lower limb that had been present for five years. In addition, several diffuse, brown and bluish-gray pigmented lesions on her face, shoulder, and back as well as diffuse, red-purple aggregated patches on her trunk and limbs had been present since birth. Her parents were both Chinese and nonconsanguineous. There was no familial history of PPV or other inherited diseases. Physical examination revealed brown, bluish-gray, and bluish-black spots as well as patches on her forehead, cheeks, and skin around both eyes. The sclera, auricle, nasal mucosa, and palatal mucosa had bluish-gray pigmented lesions bilaterally. These pigmented lesions were diagnosed clinically as bilateral nevus of Ota (Figure 1a–e). Light brown and bluish-gray pigmented lesions on her shoulders were diagnosed clinically as bilateral nevus of Ito (Figure 1f). Bluish-gray pigmented lesions scattered on her back were diagnosed clinically as ectopic Mongolian spots (Figure 1f). Diffuse, red-purple aggregated patches were observed mainly on her right trunk and limbs (Figure 1f–i). Moreover, ipsilateral hemihypertrophy was seen clearly on her right upper and lower limbs. Interestingly, subcutaneous varicosity was also noted on her right leg and abdominal wall (Figure 1f–i). A 6 cm x 4 cm chronic Clinical Letter
{"title":"Phakomatosis pigmentovascularis type IIb","authors":"B. Wang, Modi Yang, Sha Lv, Nannan Xu, Yingying Zhang, Shuai Wu, Jinfeng Wang, Fuqiu Li","doi":"10.1111/ddg.13980","DOIUrl":"https://doi.org/10.1111/ddg.13980","url":null,"abstract":"Phakomatosis pigmentovascularis (PPV) is a rare congenital disorder characterized by extensive cutaneous, vascular and melanocytic lesions [1]. We present a unique case of type IIb PPV in association with Klippel-Trenaunay syndrome, scleral melanosis, and rare extensive dermal melanocytosis, which manifested as bilateral nevus of Ota, bilateral nevus of Ito and ectopic Mongolian spots. A 66-year-old female Chinese patient was referred to our dermatology department for a chronic ulcer on the right lower limb that had been present for five years. In addition, several diffuse, brown and bluish-gray pigmented lesions on her face, shoulder, and back as well as diffuse, red-purple aggregated patches on her trunk and limbs had been present since birth. Her parents were both Chinese and nonconsanguineous. There was no familial history of PPV or other inherited diseases. Physical examination revealed brown, bluish-gray, and bluish-black spots as well as patches on her forehead, cheeks, and skin around both eyes. The sclera, auricle, nasal mucosa, and palatal mucosa had bluish-gray pigmented lesions bilaterally. These pigmented lesions were diagnosed clinically as bilateral nevus of Ota (Figure 1a–e). Light brown and bluish-gray pigmented lesions on her shoulders were diagnosed clinically as bilateral nevus of Ito (Figure 1f). Bluish-gray pigmented lesions scattered on her back were diagnosed clinically as ectopic Mongolian spots (Figure 1f). Diffuse, red-purple aggregated patches were observed mainly on her right trunk and limbs (Figure 1f–i). Moreover, ipsilateral hemihypertrophy was seen clearly on her right upper and lower limbs. Interestingly, subcutaneous varicosity was also noted on her right leg and abdominal wall (Figure 1f–i). A 6 cm x 4 cm chronic Clinical Letter","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87547885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Von der Nessel und der Sucht beim Schwitzen","authors":"U. Lippert","doi":"10.1111/ddg.13981_g","DOIUrl":"https://doi.org/10.1111/ddg.13981_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83272058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Mahler, A. Nast, Andrea Bauer, D. Becker, J. Brasch, K. Breuer, H. Dickel, H. Drexler, P. Elsner, J. Geier, S. John, B. Kreft, A. Köllner, H. Merk, H. Ott, S. Pleschka, Maria Portisch, P. Spornraft‐Ragaller, E. Weisshaar, T. Werfel, M. Worm, A. Schnuch, W. Uter
Der diagnostische Standard zum Nachweis einer bestehenden allergischen Kontaktdermatitis ist der Epikutantest. Die vorliegende Leitlinie richtet sich an Assistenz‐ und Fachärzte der Dermatologie, Allergologie und Ärzte weiterer Fachgruppen in Klinik und Praxis, die an der Indikationsstellung oder Durchführung von Epikutantests bei Patienten mit Kontaktekzemen und weiteren Spättypallergien beteiligt sind, sowie Kooperationspartner der Ärzteschaft (Fachberufe im Gesundheitswesen, Kostenträger).
{"title":"S3‐Leitlinie: Durchführung des Epikutantests mit Kontaktallergenen und Arzneimitteln – Kurzfassung Teil 2","authors":"V. Mahler, A. Nast, Andrea Bauer, D. Becker, J. Brasch, K. Breuer, H. Dickel, H. Drexler, P. Elsner, J. Geier, S. John, B. Kreft, A. Köllner, H. Merk, H. Ott, S. Pleschka, Maria Portisch, P. Spornraft‐Ragaller, E. Weisshaar, T. Werfel, M. Worm, A. Schnuch, W. Uter","doi":"10.1111/ddg.13971_g","DOIUrl":"https://doi.org/10.1111/ddg.13971_g","url":null,"abstract":"Der diagnostische Standard zum Nachweis einer bestehenden allergischen Kontaktdermatitis ist der Epikutantest. Die vorliegende Leitlinie richtet sich an Assistenz‐ und Fachärzte der Dermatologie, Allergologie und Ärzte weiterer Fachgruppen in Klinik und Praxis, die an der Indikationsstellung oder Durchführung von Epikutantests bei Patienten mit Kontaktekzemen und weiteren Spättypallergien beteiligt sind, sowie Kooperationspartner der Ärzteschaft (Fachberufe im Gesundheitswesen, Kostenträger).","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82342817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Das Verständnis der Mechanismen, die der atopischen Dermatitis (AD) zugrunde liegen, war ein entscheidender Katalysator für die Entwicklung neuartiger Medikamente zur Behandlung dieser Krankheit. Weltweit entwickeln derzeit mehr als siebzig Pharmaunternehmen mindestens ein neues Medikament für die Behandlung der AD. Diese Übersichtsarbeit soll den aktuellen Stand der wichtigsten neuartigen Therapieansätze auf der Grundlage des heutigen Verständnisses der Pathophysiologie der AD beschreiben.
{"title":"Neuartige Therapien auf der Grundlage der Pathophysiologie der atopischen Dermatitis","authors":"T. Bieber","doi":"10.1111/ddg.13965_g","DOIUrl":"https://doi.org/10.1111/ddg.13965_g","url":null,"abstract":"Das Verständnis der Mechanismen, die der atopischen Dermatitis (AD) zugrunde liegen, war ein entscheidender Katalysator für die Entwicklung neuartiger Medikamente zur Behandlung dieser Krankheit. Weltweit entwickeln derzeit mehr als siebzig Pharmaunternehmen mindestens ein neues Medikament für die Behandlung der AD. Diese Übersichtsarbeit soll den aktuellen Stand der wichtigsten neuartigen Therapieansätze auf der Grundlage des heutigen Verständnisses der Pathophysiologie der AD beschreiben.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81172032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"EADV und ÖGDV – Partner im Zeitalter der Globalisierung","authors":"W. Aberer","doi":"10.1111/ddg.13945_g","DOIUrl":"https://doi.org/10.1111/ddg.13945_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77576706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Jäger, J. Kohlmann, J. Simon, B. Sandner, A. Tönjes, M. Ziemer
{"title":"Hypophysitis on immunotherapy with checkpoint inhibitors","authors":"I. Jäger, J. Kohlmann, J. Simon, B. Sandner, A. Tönjes, M. Ziemer","doi":"10.1111/ddg.13963","DOIUrl":"https://doi.org/10.1111/ddg.13963","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79506333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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