Over the past 27 years in my functional medicine clinical practice, I have had 10 or more patients present with chronic and acute cases of eczema. After taking a thorough history, ordering blood tests and food intolerance panels, all of them were positive for signs and symptoms of intestinal permeability and positive IgA markers to predominantly; gliadin, agglutinins and casein, as well as a plethora of other food proteins, due to the nature of molecular mimicry. After placing patients on an antigen free food plan for 3-6 months, prescribing demulcent herbals, L-glutamine, anti-inflammatory supplements, and counseling them on stress reducing strategies, there was a resolution of the eczema and a healing of the intestinal lining. There is a misconception in traditional allopathic medicine that the problem resides at the dermis, where the symptomatology is observed and expressed. However, the skin is just a reflection and extension of the inflammatory cascade occurring at the intestinal lining which leads to the erosion of the tight junctions of the microvilli, which causes intestinal permeability [1,2]. These erosions open the door to undigested proteins which end up in the enteric blood vessels, subsequently triggering white blood cells to tag these proteins with antibodies. These proteins are almost identical to body tissues (molecular mimicry) , leading to autoimmune reactivity. Eczema is a direct expression of this immune system response and loss of oral and self-tolerance. The road to healing the tight junctions begins with an elimination food plan that excludes all the proteins which have become antigens. I have found it necessary to prescribe demulcent herbs such as; slippery elm, aloe vera gel, marshmallow root, deglycyrrhizinated licorice, rhubarb, immunoglobulin compounds, turmeric, vitamin D3/K2, glutathione, resveratrol and omega 3’s, as well as counseling patients on stress reduction strategies, given that production of high levels of cortisol and norepinephrine contribute to erosion of tight junctions [3]. The more a patient unburdens their body from causative factors, the faster the transformation and quicker the necessary scaffolding is built, to provide significant symptom relief and restoration of functional physiological processes that render a vital healthy human being, who is capable of developing immune and chemical tolerance to living in this “modern” hectic world. We live in a world where we spend 80% of our daily lives running from the “tyrannical lion(ness)” inside our busy monkey minds. In “flight or fight mode”, we are running tons of adrenaline epinephrine, norepinephrine, putting out fires, disasters, unknowns, daily to-do lists, answering phone calls, typing on the computer, driving around freeways, and encountering angry, impatient beings along the way. We are also near-constantly bombarded by lights, sounds, smells, EMF’s, microwaves, 4G and now the 5G radiation grid, toxins, infections, and stressors of all kinds
{"title":"Observed Causal Relationship Between Eczema and Inflammatory Bowel Diseases","authors":"","doi":"10.46889/jdr.2023.42014","DOIUrl":"https://doi.org/10.46889/jdr.2023.42014","url":null,"abstract":"Over the past 27 years in my functional medicine clinical practice, I have had 10 or more patients present with chronic and acute cases of eczema. After taking a thorough history, ordering blood tests and food intolerance panels, all of them were positive for signs and symptoms of intestinal permeability and positive IgA markers to predominantly; gliadin, agglutinins and casein, as well as a plethora of other food proteins, due to the nature of molecular mimicry. After placing patients on an antigen free food plan for 3-6 months, prescribing demulcent herbals, L-glutamine, anti-inflammatory supplements, and counseling them on stress reducing strategies, there was a resolution of the eczema and a healing of the intestinal lining. There is a misconception in traditional allopathic medicine that the problem resides at the dermis, where the symptomatology is observed and expressed. However, the skin is just a reflection and extension of the inflammatory cascade occurring at the intestinal lining which leads to the erosion of the tight junctions of the microvilli, which causes intestinal permeability [1,2]. These erosions open the door to undigested proteins which end up in the enteric blood vessels, subsequently triggering white blood cells to tag these proteins with antibodies. These proteins are almost identical to body tissues (molecular mimicry) , leading to autoimmune reactivity. Eczema is a direct expression of this immune system response and loss of oral and self-tolerance. The road to healing the tight junctions begins with an elimination food plan that excludes all the proteins which have become antigens. I have found it necessary to prescribe demulcent herbs such as; slippery elm, aloe vera gel, marshmallow root, deglycyrrhizinated licorice, rhubarb, immunoglobulin compounds, turmeric, vitamin D3/K2, glutathione, resveratrol and omega 3’s, as well as counseling patients on stress reduction strategies, given that production of high levels of cortisol and norepinephrine contribute to erosion of tight junctions [3]. The more a patient unburdens their body from causative factors, the faster the transformation and quicker the necessary scaffolding is built, to provide significant symptom relief and restoration of functional physiological processes that render a vital healthy human being, who is capable of developing immune and chemical tolerance to living in this “modern” hectic world. We live in a world where we spend 80% of our daily lives running from the “tyrannical lion(ness)” inside our busy monkey minds. In “flight or fight mode”, we are running tons of adrenaline epinephrine, norepinephrine, putting out fires, disasters, unknowns, daily to-do lists, answering phone calls, typing on the computer, driving around freeways, and encountering angry, impatient beings along the way. We are also near-constantly bombarded by lights, sounds, smells, EMF’s, microwaves, 4G and now the 5G radiation grid, toxins, infections, and stressors of all kinds ","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76812676","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}
Transient eosinophilic nodulomatosis is an uncommon disease characterized by multiple nodules in different parts of the body, with spontaneous resolution in an average of 3 weeks. Histological examination shows perivascular dermatitis with an inflammatory infiltrate with predominance of eosinophils. The etiopathogenesis has not been well clarified. In this paper we present two new cases of transient eosinophilic nodulomatosis.
{"title":"Transient Eosinophilic Nodulomatosis: A Report of Two Cases","authors":"E. G. Aldás","doi":"10.46889/jdr.2023.42013","DOIUrl":"https://doi.org/10.46889/jdr.2023.42013","url":null,"abstract":"Transient eosinophilic nodulomatosis is an uncommon disease characterized by multiple nodules in different parts of the body, with spontaneous resolution in an average of 3 weeks. Histological examination shows perivascular dermatitis with an inflammatory infiltrate with predominance of eosinophils. The etiopathogenesis has not been well clarified. In this paper we present two new cases of transient eosinophilic nodulomatosis.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80981941","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}
ORF nodule is a disease caused by a parapoxvirus ovis with epithelial tropism which is transmitted to humans from sick animals, sheep and goats, suffering from contagious ovine pustular dermatosis ecthyma [1]. Common complications of ORF infection have been reported, including secondary bacterial infection, lymphadenopathy, lymphangitis, more rarely erythema multiforme and bullous pemphigoid [2]. We describe here two cases of ORF nodule with secondary erythema multiforme.
{"title":"ORF Nodule Complicated by Erythema Multiforme: About 2 Cases","authors":"Boularbah Siham","doi":"10.46889/jdr.2023.42012","DOIUrl":"https://doi.org/10.46889/jdr.2023.42012","url":null,"abstract":"ORF nodule is a disease caused by a parapoxvirus ovis with epithelial tropism which is transmitted to humans from sick animals, sheep and goats, suffering from contagious ovine pustular dermatosis ecthyma [1]. Common complications of ORF infection have been reported, including secondary bacterial infection, lymphadenopathy, lymphangitis, more rarely erythema multiforme and bullous pemphigoid [2]. We describe here two cases of ORF nodule with secondary erythema multiforme.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77027140","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}
Erythema Nodosum Leprosum (ENL) is considered a distinct entity from the reaction state of leprosy, it is a complication observed during lepromatous leprosy, its occurrence before any antibacillary treatment is possible, but relatively rare in our practice [1].
{"title":"Erythema Nodosum Leprosum and Thalidomide: How Effective?","authors":"Siham Boularbah","doi":"10.46889/jdr.2023.42011","DOIUrl":"https://doi.org/10.46889/jdr.2023.42011","url":null,"abstract":"Erythema Nodosum Leprosum (ENL) is considered a distinct entity from the reaction state of leprosy, it is a complication observed during lepromatous leprosy, its occurrence before any antibacillary treatment is possible, but relatively rare in our practice [1].","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84880589","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}
Background: Toxic Epidermal Necrolysis (TEN) is a serious adverse drug reaction causing a potentially fatal mucocutaneous bullous rash and epithelial detachment. It is increasingly recognized that survivors may develop late sequelae, some of which may be associated with significant morbidity. Few studies have mentioned autoimmune diseases as late complications of TEN. Case report: We report the case of a patient hospitalized for TEN who developed long-term Hashimoto’s thyroiditis and Sjögren’s syndrome. Conclusion: Toxic epidermal necrolysis has a major impact on long-term quality of life. A prolonged multidisciplinary follow-up including a social follow-up is necessary.
{"title":"Autoimmune Diseases a Late Complication of Toxic Epidermal Necrolysis: A Case Report","authors":"I. Couissi","doi":"10.46889/jdr.2023.4207","DOIUrl":"https://doi.org/10.46889/jdr.2023.4207","url":null,"abstract":"Background: Toxic Epidermal Necrolysis (TEN) is a serious adverse drug reaction causing a potentially fatal mucocutaneous bullous rash and epithelial detachment.\u0000\u0000It is increasingly recognized that survivors may develop late sequelae, some of which may be associated with significant morbidity.\u0000\u0000Few studies have mentioned autoimmune diseases as late complications of TEN.\u0000\u0000Case report: We report the case of a patient hospitalized for TEN who developed long-term Hashimoto’s thyroiditis and Sjögren’s syndrome.\u0000\u0000Conclusion: Toxic epidermal necrolysis has a major impact on long-term quality of life. A prolonged multidisciplinary follow-up including a social follow-up is necessary.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90875531","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}
Neutrophilic Sebaceous Adenitis (NSA) is a rare disorder of unknown cause, characterized by circinate plaques on the face and histologically by neutrophilic inflammation of the sebaceous glands accompanied by necrotic sebocytes, together with a superficial and deep perivascular infiltrated composed mainly of lymphocytes. Even though there are few cases reported of NSA, in this paper we present two new cases with optimal response to dapsone.
{"title":"Neutrophilic Sebaceous Adenitis A Challenger Diagnosis with Favorable Response to Dapsone, Contribution of Two News Cases","authors":"Eduardo Garzón Aldás","doi":"10.46889/jdr.2023.4206","DOIUrl":"https://doi.org/10.46889/jdr.2023.4206","url":null,"abstract":"Neutrophilic Sebaceous Adenitis (NSA) is a rare disorder of unknown cause, characterized by circinate plaques on the face and histologically by neutrophilic inflammation of the sebaceous glands accompanied by necrotic sebocytes, together with a superficial and deep perivascular infiltrated composed mainly of lymphocytes. Even though there are few cases reported of NSA, in this paper we present two new cases with optimal response to dapsone.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83314638","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}
Mycosis fungoides is fairly common type of cutaneous T-cell lymphoma with prolonged indolent course. Early-stage MF patch/plaque stage disease (T1/T2) can be treated safely and effectively by Phototherapy. Systemic PUVA and Narrowband UVB widely used with considerable result in MF. Topical PUVA is rarely considered as a phototherapy line in MF. We represent in our patient complete clearance of MF plaque after topical PUVA phototherapy without relapse.
{"title":"Successful Treatment of Early-Stage Mycosis Fungoides With Topical PUVA in Adult Patient: Case Report","authors":"I. Almasry","doi":"10.46889/jdr.2023.4205","DOIUrl":"https://doi.org/10.46889/jdr.2023.4205","url":null,"abstract":"Mycosis fungoides is fairly common type of cutaneous T-cell lymphoma with prolonged indolent course. Early-stage MF patch/plaque stage disease (T1/T2) can be treated safely and effectively by Phototherapy. Systemic PUVA and Narrowband UVB widely used with considerable result in MF. Topical PUVA is rarely considered as a phototherapy line in MF. We represent in our patient complete clearance of MF plaque after topical PUVA phototherapy without relapse.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88247661","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}
Background: The Affordable Care Act (ACA) role in changing the insurance composition of patients diagnosed with many dermatological conditions, such as Kaposi Sarcoma (KS), has not been assessed. Methods: The Surveillance, Epidemiology and End Results (SEER) Program, which captures cancer data from nearly 40% of cases in the US was used to extract cases. Cases were subgrouped by Medicaid expansion and non-expansion states. Standard mean differences were used as the statistical measure with P-value <0.05 used for statistical significance. Results: 2,465 patients met the inclusion criteria. In patients newly diagnosed with Kaposi sarcoma nationally before and after ACA implementation, the analysis showed there was no significant difference in the percentage of uninsured patients, Medicaid-insured patients, or privately insured patients. Pre- and post-ACA sub-analysis of patients newly diagnosed with Kaposi sarcoma in states that expanded Medicaid showed: (1) significant decrease in the percentage of uninsured patients (-5.81% difference, 95% CI -9.58% to -2.04%, P <.05); (2) significant increase in the percentage of Medicaid-insured patients (+9.36% difference, 95% CI +0.35% to +18.37%, P <.05) and (3) no significant difference in the percent of privately insured patients (-3.54% difference, 95% CI -13.74% to +6.64%). Sub-analysis in non-expansion states showed no difference between the insurance subtypes. Conclusion: Medicaid expansion played the largest role in reducing the percentage of uninsured patients newly diagnosed with KS. In states without Medicaid expansion, it is important that public health forces ensure adequate access to medications with services like the Ryan White HIV/AIDS Program
背景:平价医疗法案(ACA)在改变被诊断患有许多皮肤病(如卡波西肉瘤(KS))的患者的保险构成方面的作用尚未得到评估。方法:监测、流行病学和最终结果(SEER)项目收集了美国近40%病例的癌症数据，用于提取病例。病例按医疗补助扩张州和非扩张州分组。统计学方法以标准差为标准，p值<0.05为差异有统计学意义。结果:2465例患者符合纳入标准。在ACA实施前后，在全国范围内新诊断的卡波西肉瘤患者中，分析显示未参保患者、医疗补助参保患者和私人参保患者的百分比没有显著差异。在扩大医疗补助的州，对新诊断的卡波西肉瘤患者进行aca前和aca后的亚分析显示:(1)未参保患者的百分比显著下降(差异为-5.81%，95% CI为-9.58%至-2.04%，P < 0.05);(2)参保患者比例显著增加(差异为+9.36%，95% CI +0.35% ~ +18.37%， P < 0.05);(3)自费参保患者比例无显著差异(差异为-3.54%，95% CI -13.74% ~ +6.64%)。在非扩张状态的亚分析中，保险亚型之间没有差异。结论:扩大医疗补助在降低未参保的新诊断为KS的患者比例方面发挥了最大作用。在没有扩大医疗补助的州，重要的是公共卫生力量要确保通过瑞安·怀特艾滋病毒/艾滋病项目等服务获得足够的药物
{"title":"Impact of the Affordable Care Act on Insurance Status of Patients Newly Diagnosed With Kaposi Sarcoma","authors":"V. Ramachandran","doi":"10.46889/jdr.2023.4204","DOIUrl":"https://doi.org/10.46889/jdr.2023.4204","url":null,"abstract":"Background: The Affordable Care Act (ACA) role in changing the insurance composition of patients diagnosed with many dermatological conditions, such as Kaposi Sarcoma (KS), has not been assessed.\u0000\u0000Methods: The Surveillance, Epidemiology and End Results (SEER) Program, which captures cancer data from nearly 40% of cases in the US was used to extract cases. Cases were subgrouped by Medicaid expansion and non-expansion states. Standard mean differences were used as the statistical measure with P-value <0.05 used for statistical significance.\u0000\u0000Results: 2,465 patients met the inclusion criteria. In patients newly diagnosed with Kaposi sarcoma nationally before and after ACA implementation, the analysis showed there was no significant difference in the percentage of uninsured patients, Medicaid-insured patients, or privately insured patients. Pre- and post-ACA sub-analysis of patients newly diagnosed with Kaposi sarcoma in states that expanded Medicaid showed: (1) significant decrease in the percentage of uninsured patients (-5.81% difference, 95% CI -9.58% to -2.04%, P <.05); (2) significant increase in the percentage of Medicaid-insured patients (+9.36% difference, 95% CI +0.35% to +18.37%, P <.05) and (3) no significant difference in the percent of privately insured patients (-3.54% difference, 95% CI -13.74% to +6.64%). Sub-analysis in non-expansion states showed no difference between the insurance subtypes.\u0000\u0000Conclusion: Medicaid expansion played the largest role in reducing the percentage of uninsured patients newly diagnosed with KS. In states without Medicaid expansion, it is important that public health forces ensure adequate access to medications with services like the Ryan White HIV/AIDS Program","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78605975","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}
Objective: For clinical scenarios where patients have moderate to severe psoriasis and nail psoriasis, knowing whether skin response is correlated with nail response would provide insight into the relationship between psoriatic skin and nail unit inflammation. The primary objective of this study was to determine if improvement in skin and nail psoriasis across a range of systemic therapies are correlated. Methods: Relevant publications pertaining to systemic therapies approved in the US for psoriasis were identified via PubMed search. Only studies with placebo controls were included. The paired point estimates of the PASI 75 response treatment effect [i.e., the placebo-adjusted PASI 75 response rate] (independent variable) and mean percentage NAPSI improvement for target fingernail treatment effect [also placebo-adjusted] (dependent variable) were calculated for each therapy. Simple linear regression analysis weighted by the standard errors for the independent and dependent variables was performed. Results: Ten paired treatment effects for 4 systemic therapies (apremilast, adalimumab, etanercept, and guselkumab) were obtained. Guselkumab and adalimumab were associated with the greatest nail improvement, and guselkumab was associated with the greatest skin response rate. PASI 75 response rate and mean percentage improvement target fingernail NAPSI were positively correlated (p=0.03), with an R2 value of 0.48. Conclusions: There is significant positive correlation across different therapies between the magnitude of improvement in psoriatic skin and nail disease among patients with moderate-severe psoriasis and clinically significant nail disease.
{"title":"Improvements in Skin and Nail Psoriasis are Positively Correlated across Systemic Psoriasis Therapies","authors":"M. Okun","doi":"10.46889/jdr.2023.4203","DOIUrl":"https://doi.org/10.46889/jdr.2023.4203","url":null,"abstract":"Objective: For clinical scenarios where patients have moderate to severe psoriasis and nail psoriasis, knowing whether skin response is correlated with nail response would provide insight into the relationship between psoriatic skin and nail unit inflammation. The primary objective of this study was to determine if improvement in skin and nail psoriasis across a range of systemic therapies are correlated.\u0000\u0000Methods: Relevant publications pertaining to systemic therapies approved in the US for psoriasis were identified via PubMed search. Only studies with placebo controls were included. The paired point estimates of the PASI 75 response treatment effect [i.e., the placebo-adjusted PASI 75 response rate] (independent variable) and mean percentage NAPSI improvement for target fingernail treatment effect [also placebo-adjusted] (dependent variable) were calculated for each therapy. Simple linear regression analysis weighted by the standard errors for the independent and dependent variables was performed.\u0000\u0000Results: Ten paired treatment effects for 4 systemic therapies (apremilast, adalimumab, etanercept, and guselkumab) were obtained. Guselkumab and adalimumab were associated with the greatest nail improvement, and guselkumab was associated with the greatest skin response rate. PASI 75 response rate and mean percentage improvement target fingernail NAPSI were positively correlated (p=0.03), with an R2 value of 0.48.\u0000\u0000Conclusions: There is significant positive correlation across different therapies between the magnitude of improvement in psoriatic skin and nail disease among patients with moderate-severe psoriasis and clinically significant nail disease.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79684710","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}
Introduction: Loxoscelism is an under-diagnosed condition due to lack of awareness among practitioners. It is a serious form of araneism that can be strictly cutaneous with variable clinical aspects that can be deadly. Materials and methods: Five cases were collected over a period of 3 years presenting with envenomation by a supposed spider bite highly suggestive of cutaneous loxoscelism. Results: We collected five cases of post-spider bite envenomation with an average age of 45 years, predominantly female, of rural origin. The bite occurred in the summer in all cases. The average time to consultation was 2 days. Four patients had felt and located the spider nearby. Two patients had an erysipéloïde placard centred by a necrotic ulceration, while one had post-bite erythema multiforme, one had acute exanthematous pustulosis and one had acute urticaria. Biological tests were normal in all cases. Antihistamines and dermocorticoids were prescribed. Discussion: This type of envenomation is common in the summer months and in rural areas, with a clear female predominance. It is generally induced by the venom of spiders of the sicariidae family and of the Loxosceles genus. The diagnosis is based on a combination of epidemiological, clinical and biological evidence. Conclusion: Envenomation by spider bites has been little reported in Morocco until now. This rare cause of necrosis, skin rash deserves to be known by practitioners for an adequate management.
{"title":"Cutaneous Loxoscelism On 5 Moroccan Cases","authors":"S. Chhiti","doi":"10.46889/jdr.2023.4202","DOIUrl":"https://doi.org/10.46889/jdr.2023.4202","url":null,"abstract":"Introduction: Loxoscelism is an under-diagnosed condition due to lack of awareness among practitioners. It is a serious form of araneism that can be strictly cutaneous with variable clinical aspects that can be deadly.\u0000\u0000Materials and methods: Five cases were collected over a period of 3 years presenting with envenomation by a supposed spider bite highly suggestive of cutaneous loxoscelism.\u0000\u0000Results: We collected five cases of post-spider bite envenomation with an average age of 45 years, predominantly female, of rural origin. The bite occurred in the summer in all cases. The average time to consultation was 2 days. Four patients had felt and located the spider nearby. Two patients had an erysipéloïde placard centred by a necrotic ulceration, while one had post-bite erythema multiforme, one had acute exanthematous pustulosis and one had acute urticaria. Biological tests were normal in all cases. Antihistamines and dermocorticoids were prescribed.\u0000\u0000Discussion: This type of envenomation is common in the summer months and in rural areas, with a clear female predominance. It is generally induced by the venom of spiders of the sicariidae family and of the Loxosceles genus. The diagnosis is based on a combination of epidemiological, clinical and biological evidence.\u0000\u0000Conclusion: Envenomation by spider bites has been little reported in Morocco until now. This rare cause of necrosis, skin rash deserves to be known by practitioners for an adequate management.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77721633","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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