11/95. Use of topical cyclosporin for conjunctival manifestations of actinic prurigo. PURPOSE: To report the successful treatment of conjunctival manifestations of actinic prurigo with topical cyclosporin. methods: A 12-year-old female with extensive limbal lesions and chronic conjunctivitis secondary to actinic prurigo was treated with topical cyclosporin, and a rapid clinical response was observed. RESULTS: The patient had the limbal lesions surgically excised. The lesions completely recurred over the first 2 postoperative months. Treatment with topical steroids and vitamin a ointment was unsuccessful. The patient was then treated with cyclosporine 2% drops and a dramatic improvement occurred. Over a 3-month period, the lesions completely resolved. CONCLUSION: cyclosporine eyedrops may be an effective treatment for the conjunctival manifestations of actinic prurigo. ( info) |
12/95. The successful treatment of prurigo pigmentosa with macrolide antibiotics. Recent studies have demonstrated that macrolide antibiotics have anti-inflammatory as well as antibacterial effects. Therefore, macrolide antibiotics have been successfully used to treat patients with various inflammatory diseases. We evaluated the effect of macrolide antibiotics in 4 patients with prurigo pigmentosa who were treated with either 400 mg of clarithromycin or 300 mg of roxythromycin daily. Eruption and pruritus disappeared within a week in all the patients while those symptoms were unresponsive to other drugs. Although the mechanism of this effect remains unclear in patients with prurigo pigmentosa, macrolide antibiotics can be considered as an alternative treatment for prurigo pigmentosa. ( info) |
13/95. prurigo pigmentosa from contact allergy to chrome in detergent. prurigo pigmentosa is a recurrent inflammatory dermatosis characterized by pruritic erythematous papules and reticulate hyperpigmentation that occurs most frequently in spring and summer. The etiology of prurigo pigmentosa remains unknown. Numerous authors have suggested that various contact allergens may be pathogenic or triggering factors, but nearly all attempts to identify an allergen have been unsuccessful. We report a case of prurigo pigmentosa induced by contact allergy to chrome in detergent, supporting the conclusion that contact allergens such as chrome may play a role in inducing prurigo pigmentosa. ( info) |
14/95. Grouping prurigo: report of cases. Grouping prurigo was reported as a new clinical entity by Ofuji et al. in 1977 and 1988. No further cases have been reported since. Herein we report four cases of grouping prurigo and discuss the possible relationship between this condition and other diseases in the prurigo group, including chronic pruritic papular dermatitis in adult men, which was reported by Chang et al. in 1999. Since grouping prurigo and chronic pruritic papular dermatitis in adult men share approximately the same characteristics in both clinical and histopathological findings, we concluded that these two disorders may be the same entity, characterized by grouped pruritic solid papules on the trunk. ( info) |
15/95. Disseminated superficial actinic porokeratosis with both typical and prurigo nodularis-like lesions. We report a 50-year-old Korean patient who developed a disseminated superficial actinic porokeratosis (DSAP) with two types of lesions. One was a typical DSAP lesion clinically and histopathologically. The other was clinically similar to prurigo nodularis, but histologic examination showed the findings of porokeratosis such as cornoid lamellae and loss of the granular layer in addition to those of chronic lichenified dermatitis, so it could be described as prurigo nodularis-like porokeratosis. The nodular lesions seemed to develop on preexisting typical lesions of DSAP mainly during the summer by the aggravation of pruritic symptoms and scratching associated with sun exposure. Although we could not find any published reports describing lesions like those of our case, we think that such prurigo nodularis-like porokeratosis can develop in patients with DSAP in some situations involving pruritus and scratching. ( info) |
| Although chronic widespread dermatophyte infection is reported widely in the literature, neither a uniform nomenclature, nor even a clear definition of this syndrome have been established so far. Thus, we suggest trichophyton rubrum syndrome (TRS) for denomination and define the following obligatory clinical and mycological criteria for TRS. (A) skin lesions at the following four sites: (1) feet, often involving soles; (2) hands, often involving palms; (3) nails; and (4) at least one lesion in another location than (1) (2) or (3), except for groins. (B) Positive microscopic analyses of potassium hydroxide preparations of skin scrapings in all four locations. (C) Identification of trichophyton rubrum by cell culture at three of the four locations at least. For diagnosis of TRS the criteria (A) and (B) and (C) have to be fulfilled. This standardization is a prerequisite for further investigations of underlying mechanisms of this disease. The typical clinical pattern of TRS is illustrated by the presentation of two paradigmatic cases. ( info) |
17/95. A case of severe actinic prurigo successfully treated with thalidomide. Actinic prurigo is an uncommon and usually persistent idiopathic photodermatosis with typical human leukocyte antigen (HLA) associations (HLA-DR4, particularly subtypes DRB1*0407 and DRB1*0401). Although its mechanism of action is not clearly understood, thalidomide has been shown to be particularly efficacious in treating actinic prurigo, among other conditions. A 31-year-old Australian woman who had suffered actinic prurigo for most of her life was treated with two courses of thalidomide (50-100 mg nocte) over consecutive summers. Remission was observed after cessation of the second course of thalidomide and had continued 4 years later. Abnormalities in the cutaneous response to ultraviolet radiation at the time of diagnosis, detected by monochromator phototesting, reverted to normal following treatment. ( info) |
18/95. Squamous cell carcinoma complicating prurigo nodularis. Squamous cell carcinoma complicating ulcerative prurigo nodularis is described in 2 patients who were having prurigo nodularis on dorsum of the feet for duration of many years. biopsy specimens from the ulcerating nodules showed features of squamous cell carcinoma. This finding has not been previously reported. Squamous cell carcinoma should be considered in the evaluation of long standing ulcerative lesion of prurigo nodularis especially when not responding to conventional therapy. ( info) |
19/95. Vesicular prurigo pigmentosa cured by minocycline. We present a case of prurigo pigmentosa associated with vesicles that we call 'vesicular prurigo pigmentosa'. The subject was treated using minocycline with good results and no recurrence of the lesions over a 2-year period. ( info) |
20/95. Synchronous rectal and esophageal cancer associated with prurigo chronica multiformis: report of a case. The skin lesions that appear in association with internal malignancies are called dermadromes or paraneoplastic cutaneous disorders. These skin changes characteristically develop with progression of the internal malignancy. A 75-year-old Japanese man who had been diagnosed as having prurigo chronica multiformis, a form of dermadrome, 5 years previously was referred to our hospital for further investigation. On admission, numerous itchy red papules were present on the right side of the abdomen and the inner aspect of both thighs. Intensive screening for internal malignancies revealed advanced rectal cancer and early esophageal cancer. After surgical resection, the skin lesions improved without any treatment. To the best of our knowledge, this is the first case of synchronous double cancers associated with prurigo chronica multiformis. ( info) |