1/10. Type III and type IV hypersensitivity reactions due to mitomycin C.A 71-year-old man developed an exfoliative dermatitis of the palms of the hands and soles of the feet, and a generalized itch, during treatment with intravesical instillations of mitomycin C for an undifferentiated carcinoma of the bladder. patch tests with mitomycin C 0.03%, 0.1% and 0.3% aq. were positive. Because of the serious consequences of this finding, the patient was retested with mitomycin C in pet. (same concentrations), a more stable preparation. This showed clear positive reactions. During this last series of patch tests, he developed palpable purpura on the legs. We postulated that this reaction was an immune-complex-mediated reaction, caused by the 2nd series of patch tests with mitomycin C. To prove this, we performed histopathological and immunofluorescence investigations, and these showed the reaction to be consistent with Henoch-Schonlein-type purpura. We therefore conclude that this patient developed systemic reactions to mitomycin C, characterized by an eczematous dermatitis as well as purpuric reactions. The intravesical installations with mitomycin C have been stopped. The patient's skin problems (the purpura as well as the eczema) have completely resolved and have not recurred.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
2/10. Nargile (Hubble-Bubble) smoking-induced hand eczema.A 65-year-old retired man with hand eczema presented to the dermatology clinic in October of 2001. He complained of scaly, fissured plaque-type lesions over the radial margin of his right index finger and thumb (Fig. 1). He first noticed these changes 2 years ago.There was no history of irritation from his occupation. None of the other family members were affected. There was no history of atopy or psoriasis. The physical examination was remarkable for scaly, fissured, hyperkeratotic patches on the palms and palmar surfaces of the finger tips of the right hand. No nail changes were noted. The other fingers were free from lesions.There were no changes on the feet or soles. A diagnosis of eczema was suspected. hobbies and repeated trauma to the hands were investigated. He had a habit of "nargile" smoking,starting at 35 years of age and he was using this apparatus more than 2 h a day. We performed patch tests with European standart test serial and they were negative. Yeast examination using KOH was negative. The diagnosis of Nargile (Hubble-bubble) eczema was made. It was advised that he stop smoking. Mild topical corticosteroids and emollient with urea were started. Clinical evaluation demonstrated resolution of the lesions after 2 weeks of therapy.- - - - - - - - - - ranking = 2keywords = palm (Clic here for more details about this article) |
3/10. Papillon-Lefevre syndrome: a report of two cases.Papillon-Lefevre syndrome is a rare disease characterized by skin lesions caused by palmar-plantar hyperkeratosis, and severe periodontal destruction involving both the primary and permanent dentitions. It is transmitted as an autosomal recessive condition and consanguinity of parents is evident in about one-third of cases. This paper describes two preschool children who presented at the Paediatric dentistry Department, Sheffield, UK, with progressively loosening teeth and discomfort during eating. The medical history revealed scaling on the hands and feet, which had been medically diagnosed as eczema. Papillon-Lefevre syndrome was diagnosed in both cases.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
4/10. Severe eczematous skin reaction after high-dose intravenous immunoglobulin infusion: report of 4 cases and review of the literature.BACKGROUND: High-dose intravenous immunoglobulins (IVIGs) are increasingly used to treat inflammatory and/or autoimmune disorders. In dermatology, they provide therapeutic benefit in Kawasaki disease and certain cases of dermatomyositis. While most adverse effects following IVIG treatment are not severe, occasionally more severe adverse effects occur, including anaphylactic reactions and acute, usually transient, renal failure. OBSERVATIONS: We report 4 cases of a characteristic severe extensive eczematous reaction that occurred approximately 10 days after IVIG infusion for polyradiculoneuritis. In all cases, onset was characterized by dyshidrotic lesions on the palms, rapidly followed by pruriginous maculopapular lesions involving the whole body. All patients were treated with topical and/or systemic steroids, and complete resolution of skin lesions was observed within 1 month. To date, 33 cases of cutaneous rash following IVIG infusion have been reported in the literature, mostly in neurology journals, and the features are identical to those reported herein. CONCLUSIONS: Severe eczematous skin reaction with a characteristic initial localization to the palms and/or soles that then extends to the rest of the body is a rare but characteristic adverse effect of high-dose IVIG therapy. Although the precise mechanism of this cutaneous eruption remains to be elucidated, its occurrence within days of IVIG infusion, its characteristic distribution at onset, and its clinical course should be recognized by dermatologists.- - - - - - - - - - ranking = 2keywords = palm (Clic here for more details about this article) |
5/10. 5. Allergy and the skin: eczema and chronic urticaria.eczema is common, occurring in 15%-20% of infants and young children. For some infants it can be a severe chronic illness with a major impact on the child's general health and on the family. A minority of children will continue to have eczema as adults. The exact cause of eczema is not clear, but precipitating or aggravating factors may include food allergens (most commonly, egg) or environmental allergens/irritants, climatic conditions, stress and genetic predisposition. Management of eczema consists of education; avoidance of triggers and allergens; liberal use of emollients or topical steroids to control inflammation; use of antihistamines to reduce itch; and treatment of infection if present. Treatment with systemic agents may be required in severe cases, but must be supervised by an immunologist. urticaria ("hives") may affect up to a quarter of people at some time in their lives. Acute urticaria is more common in children, while chronic urticaria is more common in adults. Chronic urticaria is not life-threatening, but the associated pruritus and unsightly weals can cause patients much distress and significantly affect their daily lives. angioedema coexists with urticaria in about 50% of patients. It typically affects the lips, eyelids, palms, soles and genitalia. Management of urticaria is through education; avoidance of triggers and allergens (where relevant); use of antihistamines to reduce itch; and short-term use of corticosteroids when antihistamine therapy is ineffective. Referral is indicated for patients with resistant disease.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
6/10. Dyshidrotic eczema associated with piroxicam photosensitivity.piroxicam has been reported to cause photosensitivity in several patients. Two patients with an unusual variant involving a dyshidrotic eruption of the palms are described herein.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
7/10. Allergic contact dermatitis from anaerobic acrylic sealants.Three patients employed in electronic assembly operations had allergic contact dermatitis to polyethylene glycol (PEG) dimethacrylate, found in an anaerobic sealant. Clinical features in all three cases consisted of eczema localized predominantly on the distal parts of the fingers and the palmar aspects of fingertips; onycholysis developed in one patient. No cross reactions to methyl methacrylate were observed on patch testing. guinea pig maximization testing with both the commercially available sealant and the active resin demonstrated that PEG dimethacrylate is a moderate skin sensitizer.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
8/10. Nevoid basal cell carcinoma syndrome. Multiple basal cell carcinomas of the palms after radiation therapy.A patient with the nevoid basal cell carcinoma syndrome had been treated with radiation therapy to the hands at 5 years of age. Multiple basal cell carcinomas of the palms and dorsa of the hands developed when the patient was 28 years of age. It is proposed that the radiation therapy induced tumors in palmar pits that seem to represent a forme fruste of basal cell carcinoma. radiation therapy should be avoided in individuals with the nevoid basal cell carcinoma syndrome.- - - - - - - - - - ranking = 6keywords = palm (Clic here for more details about this article) |
9/10. Knuckle pads--a forgotten skin condition: report of a case and review of the literature.A 12-year-old boy presented with knuckle pads, palmar keratoderma, and hand eczema. Since Morginson's description of knuckle pads associated with other dermatoses almost forty years ago, little attention has been given to this disorder. We describe a case and review some of the clinical aspects of this disorder.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
10/10. wrist dermatitis: contact allergy to neoprene in a keyboard wrist rest.A case of allergic contact dermatitis to a keyboard wrist rest containing neoprene is reported. The patient, who had a history of sensitivity to rubber products, developed an acute vesicular reaction of the palmar aspects of her distal wrists, followed by eczematous patches of her extremities and face. Treatment with prednisone, a 3-week tapering dose (60, 40, 20 mg), cleared the dermatitis. The widespread uses of neoprene are discussed and suggest that neoprene will become a common source of contact dermatitis as the potential sources of exposure increase.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
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