1/95. Cutaneous nerve lesions in prurigo nodularis. Electron microscopic study of two patients. skin biopsies from two patients with pruirgo nodularis were studied with the electron microscope. Lesions were found in the cutaneous myelinated and unmyelinated nerves. Schwann-cell cytoplasm showed large, irregular, membrane-bound, electron-lucent vacuoles. Umyelinated axons were distended and devoid of neurotubules and neurofilaments. Myelinated nerves showed various degrees of demyelination. Onion-bulb formations with a centrally located myelinated fibre were also observed and numerous mast cells were found in the cellular infiltrate. All these findings indicate the presence of a chronic peripheral neuropathy, the etiology of which remains to be determined. ( info) |
prurigo pigmentosa is a papular pruriginous eruption that leaves a marble-like pigmentation. The majority of cases have been found in japan. Three new female. Sicilian patients with prurigo pigmentosa were studied. All of them had previously been diagnosed as having different types of dermatitis. The administration of minocycline, at a dosage of 100 mg/day for 1 month, induced the disappearance of the papular eruption and pruritus in two patients, with an improvement of the gross reticular pigmentation. The third showed no modifications of the clinical picture after 2 months of minocycline treatment, but her condition significantly improved after 1 month of treatment with diaminodiphenylsulfone, 100 mg/day. These observations allow us to suggest that prurigo pigmentosa might be relatively frequent but misdiagnosed in the Sicilian population. ( info) |
anaphylaxis to chlorhexidine is rare. We report a patient who experienced anaphylaxis during a whole body bath with chlorhexidine. Early signs of a type I allergy may have been masked because of previous concomitant treatment with corticosteroids and PUVA. ( info) |
4/95. dermatitis causada por Hylesia metabus (lepidoptera: Hemileucidae) en la region costera del Estado del Delta del Amacuro, venezuela [dermatitis caused by Hylesia metabus (lepidoptera: Hemileucidae) in the costal region of the state of Delta Amacuro, venezuela] 2 cases of acute dermatitis caused by butterfly Hylesia metabus in an area that so far has not been considered as endemic for this species were presented. The dermatitis observed in these individuals may be described as very circumscribed, pruriginous, erythematous generalized protruding papules that may be compared with urticaria, and with a variable degree oedema. Monomorphic eruption consisting in small hard papules crowned by a little vesicle was also present. The lesions of these 2 patients evolved with intensely pruriginous papules for a week and after that they healed without dermatological sequelae. ( info) |
OBJECTIVES: To describe abnormalities of F-chronodispersion in patients treated with thalidomide. methods: We retrospectively studies F-wave latency, persistence and F-chronodispersion in 12 patients on thalidomide treatment and compared them with a control group of another 12 patients with similar dermatological conditions who did not receive thalidomide. Furthermore, we prospectively performed longitudinal neurophysiological studies in 4 patients before and during thalidomide treatment. RESULTS: Seven of 12 patients in the retrospective study had abnormal F-chronodispersion while this was normal in all patients of the control group (P = 0.014). All other neurophysiological parameters were similar in the two groups. Two of the thalidomide patients with abnormal F-chronodispersion later developed sensory neuropathy. In all 4 patients in the prospective study though F-chronodispersion was normal before thalidomide it became markedly abnormal after exposure to this drug. CONCLUSIONS: thalidomide may affect smaller diameter motor nerve fibres even before changes in sural sensory nerve action potentials. F-waves and F-chronodispersion should be routinely monitored in patients on thalidomide treatment. ( info) |
strongyloides stercoralis is a parasitic nematode that develops an autoinfective life cycle within the gastrointestinal tract of its human host. The infection produces peripheral eosinophilia and cutaneous eruptions, as well as gastrointestinal or respiratory symptoms. Detection of S stercoralis is difficult through stool examination, but may be demonstrated by ELISA for IgG antibody against the parasite. We describe a patient with chronic S stercoralis infection initially presenting with generalized prurigo nodularis and lichen simplex chronicus. ( info) |
7/95. A case of prurigo and lichenified plaques successfully treated with proton pump inhibitor. A case of prurigo and lichenified plaques successfully treated with proton pump inhibitor is presented. She presented with pruritic eruptions, which showed marked lichenification and prurigo nodules, on her trunk and extremities. She had been treated with steroid ointment and H1-histamine receptor antagonist without success. Laboratory examinations revealed increased eosiophils and elevated lactate dehydrogenase. The skin biopsy specimen showed moderate acanthosis with spongiosis and lymphocytic and eosinophilic infiltration into the upper dermis. Because of vomiting and epigastralgia, endoscopical examination was performed, and an ulcer was found at the angle of her ventricle. A biopsy specimen disclosed a benign gastric mucosa with moderate inflammation within the lamina propria, and organisms consistent with helicobacter pylori. Treatment for gastric ulcer with proton pump inhibitor (omeprazole) and aluminium hydroxide gel improved her eruptions and her pruritus resolved. She was discharged with complete cure of her eruption and ventricular ulcer. Our case indicates that gastric lesions induced by helicobacter pylori infection may play an important role in dermatological diseases. proton pump inhibitors including omeprazole are one of the choices for the treatment of some dermatological diseases including prurigo and lichenified plaques. ( info) |
A case of prurigo nodularis (Hyde's prurigo) preceding by 15 years the diagnosis of celiac disease is presented. In particular, the association between the clinical course of prurigo nodularis and the compliance with gluten-free diet is reported and discussed. ( info) |
Actinic prurigo is a separate entity from the polymorphous light eruption that affects American Indians. It has been reported mainly from North and south america, with only few reported cases from Britain or asia. We report a case of actinic prurigo in a Thai girl who showed cheilitis and pruritic papules on exposed areas for three years. We were able to induce populovesicular lesions by three consecutive irradiations with 100 J/cm2 UVA and 2 minimal erythematous dose of UVB. However, three weeks after irradiation, a prurigo papule developed at the UVB irradiated site. ( info) |
We here report a patient with actinic prurigo. He had had erythematous papulovesicular eruptions on the sun-exposed sites from fall to early summer for 4 years. The lesions healed leaving atrophic scars. The histology showed epidermal necrosis and dermal dense perivascular lymphohistiocytic infiltration and edema. His minimal erythema doses to ultraviolet B (UVB) and UVA were normal and lowered, respectively. skin lesions were produced by repeated irradiation with UVA plus UVB, but not with UVA alone. Then he was diagnosed as having actinic prurigo. skin fibroblasts from the patient were hypersensitive to UVA. We believe that the hypersensitivity relates to the pathomechanisms of the photosensitivity in the case. UVA sensitivity of fibroblasts may be useful for differentiating actinic prurigo, hydroa vacciniforme, and other similar photosensitive disorders. ( info) |