Cases reported "Hand Dermatoses"

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1/8. A case of pre-sezary syndrome preceded by hand lesions.

    Pre-sezary syndrome is an erythroderma with a chronic course, clinical findings of sezary syndrome, lymphocytic subepidermal band infiltration at times, and repeated cycles of circulating Sezary cells of less than 1,000 cells/mm3. Duration of the pre-existing skin diseases preceding pre-Sezary erythroderma varies from a few weeks to 20 years. Before the erythroderma develops, these patients are diagnosed with contact dermatitis, neurodermatitis, chronic dermatitis, atopic dermatitis, or asteatotic eczema. hand lesion also precedes the pre-Sezary erythroderma. This condition has been controlled by three cycles of chemotherapy consisting of vincristine, cytoxan, doxorubicin, and prednisolone. We describe a case of pre-sezary syndrome preceded by hand lesion and treated with chemotherapy.
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keywords = skin disease
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2/8. Atypical varicella with palm and sole involvement.

    Varicella is a common disease characterized by a typical presentation. We report a case of an atypical presentation of varicella with a centrifugal distribution, eruption with many vesicles, no pustular stage in evolution and distal involvement. There were none of the known modifying factors (immunosuppression, skin disease, injury or sun exposure). To explain the distal involvement we suggest intraepidermic lesions caused by a pre-existing B1 coxsackie infection.
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keywords = skin disease
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3/8. Allergic contact dermatitis in dental professionals: effective diagnosis and treatment.

    BACKGROUND: Like other health care workers, dental professionals are at risk of developing allergic contact dermatitis, or ACD, after exposure to allergenic chemicals. Common allergens include antimicrobials, preservatives, rubber additives and methacrylates. CASE DESCRIPTION: The authors describe an orthodontic assistant with severe skin disease, whose symptoms included redness, cracking and bleeding that persisted for 10 years. The patient had previously received an incomplete diagnosis. After performing patch testing, assessing symptoms and evaluating the patient's medical history, the authors diagnosed ACD resulting from exposure to several dental allergens. The patient received appropriate treatment and counseling to better manage her allergies; this resulted in resolution of all symptoms and averted permanent occupational disability. CLINICAL IMPLICATIONS: Not all skin reactions are related to gloves or natural rubber latex. Dental professionals should be aware of common chemical allergens, symptoms of ACD and the appropriate treatment of occupational skin disease.
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keywords = skin disease
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4/8. The relationship between neutrophilic dermatosis of the dorsal hands and sweet syndrome: report of 9 cases and comparison to atypical pyoderma gangrenosum.

    BACKGROUND: Neutrophilic dermatoses are a collection of diseases with varying presentation unified by clinical and histologic features. Neutrophilic dermatosis of the dorsal hands is a recently described clinical entity and an evolving disease concept. Its relationship to acute febrile neutrophilic dermatosis (sweet syndrome), pyoderma gangrenosum, and a primary vasculitis has been debated. OBSERVATIONS: We present 9 cases (8 women and 1 man) of neutrophilic dermatosis of the dorsal hands, all with consistent histologic features. Two cases had histologic evidence of vasculitis, and 3 had clinical extension of lesions onto the forearms. Most showed fever, leukocytosis, and/or elevated erythrocyte sedimentation rate. Individual cases were associated with leukemia, lung carcinoma, and inflammatory bowel disease. All 9 patients responded to systemic corticosteroid therapy, with additional response to dapsone, methotrexate, and potassium iodide therapies in several cases. Of the 9 patients, 5 showed complete resolution of their skin disease, whereas 4 required ongoing therapy. We assessed the 43 cases previously reported in the literature. CONCLUSION: The clinical presentation, laboratory data, histologic features, and response to corticosteroid therapy offer strong evidence that neutrophilic dermatosis of the dorsal hands is a localized variant of sweet syndrome and is also identical to atypical pyoderma gangrenosum when that condition presents on the hands.
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keywords = skin disease
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5/8. Medicolegal aspects of occupational skin diseases.

    skin diseases, including chemical burns, are the most frequently reported of all occupational illnesses. More than 90 per cent of work-related dermatologic problems are contact dermatitis, and there is rarely anything about the location and appearance of these lesions to differentiate clearly from a dermatitis of nonoccupational origin. A complete and time-consuming history must therefore be taken, including documentation of nonwork activities.
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keywords = skin disease
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6/8. Paraproteinaemia in erythema elevatum diutinum.

    Paraproteinaemia (IgGkappa) was observed in a 68 year-old patient with erythema elevatum diutinum. The association of this skin disease with paraproteinaemia as already reported by other authors may indicate a pathogenetic relationship.
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7/8. Occupational irritant contact dermatitis and fungal infection in construction workers.

    We have examined 6 construction workers who developed chronic skin diseases on their hands over a period of 15 years (1970-1985). 4 developed a trichophyton rubrum infection, and the other 2 an irritant contact dermatitis. All of them carried out jobs which caused traumatization of the skin, due to the presence of ethylene glycol and mineral oils during operation of pneumatic hammers in winter. They also suffered other types of skin trauma during their work. Construction workers may be at risk of developing an occupational skin disease involving fungal infection.
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keywords = skin disease
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8/8. Occupational dermatoses in cheese makers: frequent association of irritant, allergic and protein contact dermatitis.

    BACKGROUND: Few data are available on occupational dermatoses in cheese makers. OBJECTIVE: The purpose of the present study was to investigate occupationally related skin diseases in cheese makers. METHOD: In a retrospective study we analyzed 400 patients with occupational dermatoses which presented for expert opinion evaluation at our institution (1990-1995). RESULTS: Four patients with hand eczema acquired in cheese dairies were identified. All patients had a decreased alkali resistance. Atopy was a further risk factor in 2 patients. Three out of 4 patients were patch test positive for occupationally related substances and demonstrated also immediate skin test reactions to various milk products. Therefore, these patients had concurrent allergic contact and protein contact dermatitis. CONCLUSION: The diagnosis of concurrent allergic and protein contact dermatitis has to be considered in occupational dermatoses related to cheese making.
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keywords = skin disease
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