Cases reported "Dermatitis, Atopic"

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1/21. Septic arthritis of the hip associated with atopic dermatitis. A case report.

    We report a case of septic arthritis of the hip associated with atopic dermatitis. A 15-year female felt a pain in the right hip with unknown cause on May 11, 1998. The pain subsequently became aggravated, and she was admitted to our hospital on May 18. She has had atopic dermatitis since 4 years of age. She showed generalized dermatitis with desquamation and numerous scratch marks. A culture of both skin and joint fluid revealed staphylococcus aureus. physical examination revealed tenderness in Scarpa triangle and restricted range of motion. Immunological serology showed an increase in eosinophils and immunoglobulin e, and a decreased reaction of lymphocyte blastoid transformation. Computed tomography (CT) and MRI showed a joint effusion in the right hip. She was diagnosed as having septic arthritis of the hip. Intravenous drip of cefazolin of 2g was started on the first day of hospitalization and joint irrigation was done on the second day. CRP became negative at 4 weeks, but joint effusion was shown on CT. Additional joint irrigation with Amicamycin (200 mg) was done. As the joint fluid culture became negative, range of motion exercises were started at 6 weeks. She was discharged with a long-leg brace applied at 8 weeks. At 13 months after onset, she had complete relief of the pain and normal activities of daily living. No destructive changes in the hip were found on X-ray examination or MRI. In the present case, an abnormal immune system associated with atopic dermatitis as well as the habit of scratching eruptions may have led to hematogenous spread of skin infection, and caused septic arthritis of the hip.
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2/21. Generalized lichen nitidus successfully treated with an antituberculous agent.

    We describe a Japanese girl with generalized lichen nitidus. She had been exposed to mycobacterium tuberculosis at 6 years of age via her teacher. At 8 years of age, she developed severe contact dermatitis on sun-exposed areas after contact with Japanese lacquer trees. Shortly after, numerous tiny, shiny, flesh-coloured papules developed over the upper part of her body. At 10 years of age, she was exposed to a school outbreak of M. tuberculosis. Her eruption showed no response to topical corticosteroids or oral tranilast, but most of the papules completely disappeared after she had received oral isoniazid for 6 months.
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3/21. An AIDS patient with atopic dermatitis-like eruption responsive to systemic anti-fungal treatment.

    patients with the acquired immunodeficiency syndrome (AIDS) often develop unusual skin complications. We describe a case of a 58-year-old man with AIDS who had a history of multiple transfusions with anti-hemophilic factor A. He developed papulovesicular and lichenified skin lesions on his head, face, neck and the extensor aspects of his extremities accompanied by severe pruritus. Atopic dermatitis was suspected; however, intensive treatment with a potent topical corticosteroid and a systemic antihistamine failed. In addition to the decreased subset of CD4-positive lymphocytes characteristic of AIDS, this patient showed an elevated level of serum IgE particularly specific for candida albicans, probably because he had a chronic candidial infection of the digestive tract. Oral administration of anti-fungal agents Diflucan and Fungizone produced almost complete relief from the atopic dermatitis-like skin disease within 2 weeks.
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keywords = eruption
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4/21. A generalized reaction to thimerosal from an influenza vaccine.

    BACKGROUND: thimerosal is a preservative commonly used in ophthalmic solutions, otic drops, and vaccines because of its bactericidal property. OBJECTIVE: To report a case of a generalized reaction to thimerosal in a patient who received an influenza vaccine. methods: We describe a patient who developed a generalized maculopapular eruption after receiving a thimerosal-containing influenza vaccine. Patch testing was performed to determine if there was an allergy to thimerosal. RESULTS: Patch testing confirmed a T-cell-mediated sensitivity to thimerosal. CONCLUSIONS: physicians need to be aware that thimerosal is found in many products, including vaccinations. Clinicians should also be aware that allergic reactions occur with exposure to thimerosal even in vaccines. To our knowledge, this is the first case report in the literature of a generalized reaction to thimerosalfrom an influenza vaccine.
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5/21. Atopic dermatitis with increased severity along a line of Blaschko.

    Several primarily symmetric skin diseases may, on rare occasions, manifest themselves more prominently along the embryonic migration pathways of cutaneous cell clones. loss of heterozygosity along these lines of Blaschko resulting in hemizygosity or homozygosity of alleles predisposing for the disease is the most likely explanation for this phenomenon. Here, we report a case of severe Blaschko linear atopic dermatitis superimposed on a milder symmetric eruption of atopic eczema in a 36-year-old man with personal and familial history of allergy. Continuous transition of linear atopic eczema to linear vesicular (dyshidrotic) plantar eczema demonstrates the relationship between these two entities. Individuals such as our patient offer an opportunity to identify intraindividual genetic variations marking loci involved in the pathogenesis of atopy and atopic eczema.
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6/21. Aggressive CD30 large cell lymphoma after cyclosporine given for putative atopic dermatitis.

    Atopic dermatitis (AD) is not regarded as a predisposing condition for cutaneous T cell lymphoma. cyclosporine (CsA) is an efficient therapy in AD, and its side effects, including lymphocytic proliferation, are rare at the low dose used in such cases. So far 3 cases of patients who developed cutaneous T cell lymphoma under CsA treatment for atopy have been described. An adult patient with a history of AD received CsA therapy because of an atypical flare-up of his eruption. He rapidly developed papular atypical lesions, then followed by the onset of a voluminous cutaneous tumor leading to the diagnosis of mycosis fungoides (MF) transformed in CD30 large cell lymphoma with nodal and blood involvement. No improvement occurred after withdrawing of CsA, and he required a polychemotherapy and an allograft. This case illustrates the dramatic evolution of an MF under CsA given in the hypothesis of AD. It stresses the fact that skin biopsies should be taken in case of atypical AD to rule out MF and avoid such an aggressive evolution under immunosuppressive therapy.
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7/21. Autoimmune progesterone dermatitis.

    Seven patients had autoimmune progesterone dermatitis. The morphological findings illustrate the polymorphous nature of the disease in which urticaria, erythema multiforme, and dyshidrosiform lesions were seen. recurrence of the eruption five to ten days prior to the menses with spontaneous resolution following the menses was present in all cases. Intradermal skin testing to progesterone was done to confirm the diagnosis. Six of the seven patients has a history of use of artificial progestational hormones prior to the beginning of their eruption. It is postulated that the artificial progesterones may have been the trigger for the development of their autosensitivity. Treatment with conjugated estrogens resulted in remission of the disease in five of the seven cases reported.
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keywords = eruption
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8/21. Cutaneous dissemination of herpes simplex virus in individuals fifteen years of age and older.

    We have reported the case histories of two individuals with underlying atopic dermatitis who developed extensive vesicular eruptions. In both cases herpes simplex virus type l was isolated from skin lesions and both individuals ultimately recovered. These two cases represent only the third and fourth instances of this syndrome proven to be caused by herpes simplex virus type l that have been reported in older individuals. In addition we have reviewed the literature relative to cutaneous disseminated herpes simplex virus infections occurring in individuals over the age of 15 and have presented a comprehensive overview of this disease.
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9/21. Atopic dermatitis provoked by AL721 in a patient with acquired immunodeficiency syndrome.

    A 40-year-old patient with acquired immunodeficiency syndrome (AIDS) had an atopic dermatitis-like skin eruption and elevated serum IgE levels after therapy with AL721. This agent is a mixture of egg yolk lipids used for the treatment of AIDS. The relationship between the drug and the eruption has been based on circumstantial evidence and confirmed by the positive results of skin tests. Although an almost unlimited amount of materials have been reported to be responsible for atopic manifestations, cases of drug-induced atopic dermatitis are rare. AL721, however, can be regarded as a food product; therefore, the appearance of the eruption following intake of this agent should not be considered exceptional.
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keywords = eruption
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10/21. Infantile acropustulosis.

    Infantile acropustulosis (IA) is a well-recognised syndrome described primarily among black male infants, which may also occur among white and East Asian children. The eruption occurs mainly on the distal areas of the extremities and is characterised by recurrent crops of 1 to 2 mm pruritic papules and pustules in infants from 2 to 10 months of age. We report one patient with infantile acropustulosis and a history of atopic dermatitis and abnormally high IgE serum value. Immunofluorescent studies of involved skin gave negative results. Infantile acropustulosis has been reported by several authors within recent years. The clinical and histological features and differential diagnosis of infantile acropustulosis are discussed. This disease is uncommon but not rare, and persists for about two years.
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