Adult-onset Still’s disease (AOSD) presents with fever, systemic symptoms and rash. Atypical presentations are increasingly described. Uncommonly, viral-associated AOSD occurs. We report AOSD presenting in a 30-year-old male with waterexacerbated pruritus, a subsequent flagellate eruption, and associated influenza A virus infection.
{"title":"Water-exacerbated Pruritus and a Flagellate Eruption: Adultonset Still’s Disease Occurring in Association with Influenza A Virus Infection","authors":"Jonathan D Ho","doi":"10.23880/cdoaj-16000245","DOIUrl":"https://doi.org/10.23880/cdoaj-16000245","url":null,"abstract":"Adult-onset Still’s disease (AOSD) presents with fever, systemic symptoms and rash. Atypical presentations are increasingly described. Uncommonly, viral-associated AOSD occurs. We report AOSD presenting in a 30-year-old male with waterexacerbated pruritus, a subsequent flagellate eruption, and associated influenza A virus infection.","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124284209","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":"A Paget's disease Case of Breast without Underlying Carcinoma","authors":"H. Ayvaz","doi":"10.23880/cdoaj-16000176","DOIUrl":"https://doi.org/10.23880/cdoaj-16000176","url":null,"abstract":"","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117170741","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}
Lichen planus pigmentosus is considered a rare variant of lichen planus. It is characterized by acquired dark brown to gray macular pigmentation localized on sun-exposed areas. As lichen planus pigmentosus, ashy dermatosis is also characterized by pigmented lesion and is commonly found in dark-skinned patients. It can be difficult to distinguish lichen planus pigmentosus from ashy dermatosis by the naked eye (1). Dermoscopy can be applied to skin lesions, revealing additional features that can be highly valuable for correct diagnosis. Skin lesions were evaluated via polarized dermoscopy. On dermoscopy, a brownish background with brownish – blackish globules and dots with a linear distribution were found in lichen planus pigmentosus. A bluish background with small bluish dots and globules and white areas were seen in ashy dermatosis. Dermoscopy could provide valuable information for the diagnosis of LPP and aids in differentiating it from ashy dermatosis.
{"title":"Diagnostic Usefulness of Dermoscopy in Differentiating Lichen Planus Pigmentosus from Ashy Dermatosis","authors":"El Kadiri S","doi":"10.23880/cdoaj-16000240","DOIUrl":"https://doi.org/10.23880/cdoaj-16000240","url":null,"abstract":"Lichen planus pigmentosus is considered a rare variant of lichen planus. It is characterized by acquired dark brown to gray macular pigmentation localized on sun-exposed areas. As lichen planus pigmentosus, ashy dermatosis is also characterized by pigmented lesion and is commonly found in dark-skinned patients. It can be difficult to distinguish lichen planus pigmentosus from ashy dermatosis by the naked eye (1). Dermoscopy can be applied to skin lesions, revealing additional features that can be highly valuable for correct diagnosis. Skin lesions were evaluated via polarized dermoscopy. On dermoscopy, a brownish background with brownish – blackish globules and dots with a linear distribution were found in lichen planus pigmentosus. A bluish background with small bluish dots and globules and white areas were seen in ashy dermatosis. Dermoscopy could provide valuable information for the diagnosis of LPP and aids in differentiating it from ashy dermatosis.","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125420670","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}
Eosinophilic Pustular Folliculitis (EPF) or papulooerythroderma of Ofuji (PEO) is a rare dermatosis that presents with recurrent pruritic follicular papules and pustules that can involve the entire skin surface sparing the skin folds. This can be accompanied with elevated IgE levels and eosinophils. Diagnosis has been challenging due to its ability to mimic several common dermatologic disorders, such as acne and contact dermatitis. Literature has described the first line of therapy to be oral and topical indomethacin, however, success has been variable, and reports have been anecdotal. Until this day, there is yet to be standard guidelines for approach to diagnosis and management of this condition. In this article, we report a case of a 29 year-old female of Chinese descent who presented with papules on bilateral malar and nasal areas recalcitrant to topical corticosteroids. She demonstrated success with the use of a monthly regimen of isotretinoin after a perplexing diagnostic dilemma.
{"title":"A Recalcitrant Case of Eosinophilic Pustular Folliculitis","authors":"Kathryn Jayne Tan","doi":"10.23880/cdoaj-16000289","DOIUrl":"https://doi.org/10.23880/cdoaj-16000289","url":null,"abstract":"Eosinophilic Pustular Folliculitis (EPF) or papulooerythroderma of Ofuji (PEO) is a rare dermatosis that presents with recurrent pruritic follicular papules and pustules that can involve the entire skin surface sparing the skin folds. This can be accompanied with elevated IgE levels and eosinophils. Diagnosis has been challenging due to its ability to mimic several common dermatologic disorders, such as acne and contact dermatitis. Literature has described the first line of therapy to be oral and topical indomethacin, however, success has been variable, and reports have been anecdotal. Until this day, there is yet to be standard guidelines for approach to diagnosis and management of this condition. In this article, we report a case of a 29 year-old female of Chinese descent who presented with papules on bilateral malar and nasal areas recalcitrant to topical corticosteroids. She demonstrated success with the use of a monthly regimen of isotretinoin after a perplexing diagnostic dilemma.","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"341 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115474003","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}
Merkel cell carcinomas (MCC) are highly aggressive skin malignancies, resulting in death of more than one-third of patients with increasing incidences over the past decades. The carcinogenesis is associated with Merkel cell polyomavirus (MCPyV) infection and/or ultraviolet-induced DNA mutations. Diagnosis is made by histology and specific immunohistochemical stains. Among them, cytokeratin 20 (CK20) expression represents indeed the most important marker. The treatment consists of either wide local excision to achieve clear margins accompanied by nodal dissection or radiation therapy. In advanced stage diseases, survival rates still remain low, but immunotherapy with PD-L1 and PD-1 inhibitors are promising. The increasing incidence, the rapidly and aggressive clinical course as well as some unsolved diagnostic and therapeutic challenges underline the need for a better understanding of MCC. Therefore, the aim of this short review was to present an overview of the current literature regarding diagnosis and treatment of MCC patients.
{"title":"Merkel Cell Carcinoma: Diagnostic and Therapeutic Workup from a Head and Neck Surgeon Perspective","authors":"Erovic Bm","doi":"10.23880/cdoaj-16000251","DOIUrl":"https://doi.org/10.23880/cdoaj-16000251","url":null,"abstract":"Merkel cell carcinomas (MCC) are highly aggressive skin malignancies, resulting in death of more than one-third of patients with increasing incidences over the past decades. The carcinogenesis is associated with Merkel cell polyomavirus (MCPyV) infection and/or ultraviolet-induced DNA mutations. Diagnosis is made by histology and specific immunohistochemical stains. Among them, cytokeratin 20 (CK20) expression represents indeed the most important marker. The treatment consists of either wide local excision to achieve clear margins accompanied by nodal dissection or radiation therapy. In advanced stage diseases, survival rates still remain low, but immunotherapy with PD-L1 and PD-1 inhibitors are promising. The increasing incidence, the rapidly and aggressive clinical course as well as some unsolved diagnostic and therapeutic challenges underline the need for a better understanding of MCC. Therefore, the aim of this short review was to present an overview of the current literature regarding diagnosis and treatment of MCC patients.","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122813232","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":"Dysbiosis of Gut Microbiota and Acne Vulgaris: The Role of ShortChain Fatty Acids Gut in Pathogenesis","authors":"Hitosugi N","doi":"10.23880/cdoaj-16000218","DOIUrl":"https://doi.org/10.23880/cdoaj-16000218","url":null,"abstract":"","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128205061","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":"Keratoacanthoma: A Diagnostic and Therapeutic Conundrum","authors":"G. Pise","doi":"10.23880/cdoaj-16000283","DOIUrl":"https://doi.org/10.23880/cdoaj-16000283","url":null,"abstract":"","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128777976","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}
The endocannabinoid system (ECS), discovered in the 1990s, is a system involved with maintaining cellular homoeostasis by down-regulating the damaging inflammatory responses and upregulating regenerative processes. Tetrahydrocannabinol (THC), Cannabidiol (CBD), tetrahydrocannabivarin (THCV) and cannabidivarin (CBDV) are all phytocannabinoids that have novel therapeutic effects on hair growth through the ECS receptors on hair follicles. These cannabinoids are fat-soluble and poorly absorbed past the epidermis, but topical application easily reaches hair follicles where CBDV, THCV and CBD act as partial or full CB1 antagonists and agonists of vanilloid receptor-1 (TRPV1) and vanilloid receptor-4 (TRPV4). All these ECS receptors relate to hair follicle function. THC on the other hand has the opposite effects decreasing hair shaft elongation and matrix production. A summary of the pre-clinical and clinical cannabinoid research is reviewed. The studies confirm that for androgenetic alopecia (AGA) the method of action is different from and synergistic with current hair regrowth therapies. Blocking the CB1 receptor on the hair follicle has been shown to result in hair shaft elongation and matrix production via keratinocytes, in addition, the hair follicle cycle (anagen, catagen, and telogen phases) is controlled by TRPV1. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase via a different receptor known as TRPV4. CBD has also been shown to increase Wnt signaling, which causes dermal progenitor cells to differentiate into new hair follicles and maintains anagen phase of the hair cycle. Two recent six-month duration clinical trials of adults with androgenetic alopecia (AGA) have revealed an average 93.5% increased hair count with CBD alone, and 164% increased hair count with hemp extract high in CBD, THCV, CBDV and menthol. A current study is underway to look at punch biopsies of the areas of hair regrowth in patients treated with a combination of CBD, THCV isolate, menthol and caffeine. Another study is underway looking at using hexahydrocannabinol (HHC) a hydrogenated version of THC to decrease facial hair growth as a cosmetic effect
{"title":"A Summary of Pre-Clinical and Clinical Evidence for Cannabinoid Hair Follicle Effects","authors":"Gregory L. Smith","doi":"10.23880/cdoaj-16000290","DOIUrl":"https://doi.org/10.23880/cdoaj-16000290","url":null,"abstract":"The endocannabinoid system (ECS), discovered in the 1990s, is a system involved with maintaining cellular homoeostasis by down-regulating the damaging inflammatory responses and upregulating regenerative processes. Tetrahydrocannabinol (THC), Cannabidiol (CBD), tetrahydrocannabivarin (THCV) and cannabidivarin (CBDV) are all phytocannabinoids that have novel therapeutic effects on hair growth through the ECS receptors on hair follicles. These cannabinoids are fat-soluble and poorly absorbed past the epidermis, but topical application easily reaches hair follicles where CBDV, THCV and CBD act as partial or full CB1 antagonists and agonists of vanilloid receptor-1 (TRPV1) and vanilloid receptor-4 (TRPV4). All these ECS receptors relate to hair follicle function. THC on the other hand has the opposite effects decreasing hair shaft elongation and matrix production. A summary of the pre-clinical and clinical cannabinoid research is reviewed. The studies confirm that for androgenetic alopecia (AGA) the method of action is different from and synergistic with current hair regrowth therapies. Blocking the CB1 receptor on the hair follicle has been shown to result in hair shaft elongation and matrix production via keratinocytes, in addition, the hair follicle cycle (anagen, catagen, and telogen phases) is controlled by TRPV1. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase via a different receptor known as TRPV4. CBD has also been shown to increase Wnt signaling, which causes dermal progenitor cells to differentiate into new hair follicles and maintains anagen phase of the hair cycle. Two recent six-month duration clinical trials of adults with androgenetic alopecia (AGA) have revealed an average 93.5% increased hair count with CBD alone, and 164% increased hair count with hemp extract high in CBD, THCV, CBDV and menthol. A current study is underway to look at punch biopsies of the areas of hair regrowth in patients treated with a combination of CBD, THCV isolate, menthol and caffeine. Another study is underway looking at using hexahydrocannabinol (HHC) a hydrogenated version of THC to decrease facial hair growth as a cosmetic effect","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128381507","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":"A Humectant-Rich Moisturizer Reduces Xerosis in Diabetic Feet and Susceptibility to an Irritant in Healthy Skin","authors":"M. Lóden","doi":"10.23880/cdoaj-16000260","DOIUrl":"https://doi.org/10.23880/cdoaj-16000260","url":null,"abstract":"","PeriodicalId":164845,"journal":{"name":"Clinical Dermatology Open Access Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129011231","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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