Clinical photography plays a crucial role in dermatology by aiding in diagnosis, monitoring treatment progress and providing valuable visual documentation for research and patient education. This article outlines key photographic techniques, equipment options and best practices tailored for dermatologists to improve clinical outcomes through high-quality imagery.
Adult-onset Still's disease (AOSD) is a rare autoinflammatory systemic disorder classically characterised by inflammatory polyarthritis, daily fevers and a transient asymptomatic salmon-pink maculopapular rash that typically arises with the onset of fevers. We report a case of AOSD presenting with a severely pruritic urticarial eruption starting 6 weeks prior to the onset of fever and arthritis and complicated by macrophage activation syndrome. This case highlights the importance of early recognition of diverse cutaneous manifestations of AOSD to facilitate timely diagnosis and treatment to improve disease outcomes.
Eyelid allergic contact dermatitis (ACD) attributed to ophthalmic medications is often underreported, which can result in poor outcomes. Patch testing for eyelid ACD requires up-to-date knowledge of potential allergens. The aim of this study was to investigate allergens in ophthalmic medicaments in New Zealand.
We conducted a cross-sectional review of ophthalmic medicaments available in New Zealand in October 2023. Prescription and over-the-counter products were catalogued with their respective ingredient lists according to product data sheets. Products unapproved for use as per Section 29 of the Medicines Act 1981, or that were unavailable for purchase were excluded. Ingredients were classified according to their function. Allergens in the New Zealand Baseline Series Extended (NZBSE) were recorded.
Seventy-three topical ophthalmic medicaments were identified with a total of 143 formulations (brands). Twenty-eight formulations were excluded, leaving a total of 67 topical medicaments (115 formulations) for analysis. Fifty-eight per cent of formulations contained at least one NZBSE allergen. The most frequently identified NZBSE allergen was benzalkonium chloride (contained in 48% of formulations), followed by propylene glycol (6%), lanolin (4%), parabens (4%), caine anaesthetics (2%), neomycin sulphate (2%), and cetearyl alcohol (1%).
The majority of ophthalmic preparations contain known allergens. Patch test series must be based on local data and revised regularly to ensure the diagnostic accuracy of patch testing. Patch testing patient's own products is imperative.
Treatment and management outcomes or patients with atopic dermatitis has significantly improved with the inclusion of dupilumab into the pharmaceutical benefits scheme, as a safe and effective treatment. Ocular surface disease remains one of the most frequent adverse events seen with dupilumab, and impacts quality of life and can interrupt treatment. This retrospective review aims to further characterise the experience and risk factors of dupilumab-induced ocular surface disease to inform management and support long-term use for patients, improving overall treatment outcomes.
Erosive vulvovaginal lichen planus is a severe form of Lichen planus (LP) that can result in chronic scarring if not treated. It can cause narrowing of the introitus, resulting in pain, itch, dyspareunia, dysuria, and recurrent urinary tract infections caused by retention of urine. Therefore, an effective and safer therapeutic approach is required. Here, we present a case of refractory erosive vulvovaginal LP, which showed remarkable response to oral tofacitinib, a Janus kinase 1 and 3 (JAK1/3) inhibitor, which was well tolerated.
Metastatic basal cell carcinomas (mBCCs) are exceedingly rare, with an estimated variable prevalence rate between 0.003 and 0.55% among all basal cell carcinomas. Although there are hundreds of reported cases of mBCCs, a dearth of evidence exists of mBCCs in patients with Gorlin syndrome—an autosomal dominant genetic disorder. The purpose of this article was to present the first and largest case series of patients with mBCC in Gorlin. A literature review (LR) compares our data with the existing evidence base to underscore the importance of early surveillance, diagnosis and surgical intervention of suspicious lesions as distant metastases significantly reduce survival rates.
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