Skin health and disease最新文献

{"title":"Amoxicillin-induced linear IgA bullous dermatosis mimicking erythema multiforme: a case report.","authors":"Marion Silagy, Priscille Carvalho, Billal Tedbirt, Clémence Tamarit, Marion Carrette, Florence Tétart, Alexis Lefebvre","doi":"10.1093/skinhd/vzae024","DOIUrl":"10.1093/skinhd/vzae024","url":null,"abstract":"<p><p>A 77-year-old man presented with a cutaneous rash of 3 days' duration. Seven days before onset, the patient reported a bronchopulmonary infection treated with amoxicillin. Physical examination revealed multiforme cutaneous lesions, involving the armpits, pubis, genitals and lower back. In the lower back area, lesions were erythematous, purplish targetoid-like with multiple concentric circles. In places, bullae and postblistering erosions could be seen. In places, a 'string of pearls' pattern could be observed. Nikolsky sign was negative. Herpes simplex virus polymerase chain reaction (PCR) on mucosal erosions was negative. Multiplex nasopharyngeal PCR was negative for influenza virus, COVID-19 and <i>Mycoplasma pneumoniae</i>. Histopathological examination revealed spontaneous subepithelial cleavage with neutrophilic -microabscesses. Direct immunofluorescence showed linear IgA deposition at the dermal-epidermal junction, confirming the diagnosis of linear IgA bullous dermatosis. Skin lesions were treated with topical clobetasol propionate cream and oral mucosa with corticosteroid mouth rinses. The disease course was marked by complete remission 7 days after amoxicillin discontinuation. There was no relapse after 4 months of follow-up.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"75-78"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of aggressive pyoderma gangrenosum with Cogan syndrome in a person with skin of colour.","authors":"Nageswary Nadarajah, Lucy Clark, Shernaz Walton","doi":"10.1093/skinhd/vzae027","DOIUrl":"10.1093/skinhd/vzae027","url":null,"abstract":"<p><p>Cogan syndrome (CS) is a rare autoimmune vasculitis affecting the audiovestibular and ocular systems. Its pathogenesis is unknown. CS was classified into typical and atypical CS in 1980 to aid its diagnosis. Its association with pyoderma gangrenosum (PG) has only been reported three times in the literature. This is also the first case of its occurrence in a person with skin of colour. CS is a diagnosis of exclusion and thus its diagnosis may present many challenges to healthcare professionals. Herein, we describe the case of a 75-year-old South Asian woman who presented acutely to the Stroke Unit following a right lacunar infarction which was treated with aspirin and clopidogrel. An enlarging nonhealing wound was noted at the site of a recent total left hip replacement. Intravenous antibiotics were started, with multiple surgical debridements performed. During admission, two new painful pustular skin lesions erupted on the chest and abdomen that ulcerated within 2 days. Painful ulcerated lesions with bluish undermined edges were also noted at the left hip wound and two pressure areas of the buttocks. A clinical diagnosis of PG was made and treatment was started with high-dose corticosteroids, which did not lead to improvement. The patient's past medical history included left eye central retinal vein occlusion with recurrent uveitis and bilateral sensorineural deafness. A diagnosis of atypical CS was made. Four pulsed cyclophosphamide infusions and hyperbaric oxygen healed the lesions. This case demonstrates the complex interplay between PG and CS, which requires further research as it can result in significant morbidity.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"79-81"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of pembrolizumab-induced bullous pemphigoid treated with dupilumab.","authors":"Agnese Rossi, Donatella Brancorsini, Helena Gioacchini, Anna Campanati","doi":"10.1093/skinhd/vzae023","DOIUrl":"10.1093/skinhd/vzae023","url":null,"abstract":"<p><p>Immune checkpoint inhibitors are a class of drugs used in cancer treatment that promote the immune system's response by blocking the inhibitor signals from tumour cells, such as programmed cell death protein 1/programmed death ligand 1 and cytotoxic T-lymphocyte associated protein 4. Despite their clinical benefit, these monoclonal antibodies unspecifically activate the immune system and can lead to the development of 'immune-related adverse events'. Cutaneous toxicities are the most frequent immune-related adverse events, reported in approximately 30-50% of patients treated with immunotherapy; the most common dermatological toxicities are represented by rash, vitiligo, pruritus and lichenoid reactions. Usually, these reactions are mild and it is not necessary to suspend immunotherapy. Potentially life-threatening skin toxicities, such as immunobullous eruption, are rare and may appear in approximately 1% of patients. In this report we describe a case of bullous pemphigoid, the most frequent bullous disease, that developed after treatment with pembrolizumab for a metastatic melanoma. The diagnosis, first suspected by the referring clinic, was confirmed by performing serology and biopsy with direct immunofluorescence. The patient was first treated with high doses of systemic corticosteroids, without suspending the immunotherapy treatment. Subsequently, due to the continuous relapses, we decided to suspend pembrolizumab and systemic corticosteroid and to begin off-label treatment with dupilumab. The following case gives cause for reflection about the management of a drug-induced disease in an immunocompromised patient, while exploring the therapeutic options.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut barrier integrity disruption in atopic dermatitis: truth or myth-a case-control study.","authors":"Naglaa M El Sayed, Merna A Riad, Raghda S Z Taleb, Eman H El Morsy","doi":"10.1093/skinhd/vzaf001","DOIUrl":"10.1093/skinhd/vzaf001","url":null,"abstract":"<p><strong>Background: </strong>Gut dysbiosis has been linked to the onset and progression of various diseases, including atopic dermatitis, by disrupting the intestinal barrier integrity. In turn, it allows the translocation of microbes and toxins into the systemic circulation, which triggers an immune response.</p><p><strong>Objectives: </strong>To measure serum levels of the gut integrity markers claudin 3 and intestinal fatty acid-binding protein in patients with atopic dermatitis.</p><p><strong>Methods: </strong>This prospective study was conducted on 43 patients with atopic dermatitis. Healthy volunteers (<i>n</i> = 35) served as controls. The serum level of claudin 3 and intestinal fatty acid-binding protein were measured using an enzyme-linked immunosorbent assay for all participants.</p><p><strong>Results: </strong>There were no significant differences in serum levels of claudin 3 and intestinal fatty acid-binding protein between patients with atopic dermatitis and the control group (<i>P</i> = 0.61 and 0.81, respectively). In addition, there was no significant correlation between the two markers, and different clinical and laboratory parameters (onset of disease, eczema area severity index, other allergic manifestations and serum IgE).</p><p><strong>Conclusion: </strong>Alterations in the intestinal barrier may be absent in the ethnically distinct group of patients with atopic dermatitis included in our study. Nevertheless, our findings might have been influenced by factors such as the duration of the disease, diet and characteristics of the study population. Further studies are needed to investigate additional biomarkers or mechanisms that may be involved in atopic dermatitis pathogenesis, especially those related to the gut-skin axis.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"31-36"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>In vitro</i> and <i>in vivo</i> efficacy of the Active Oligo Skin complex™, a new active ingredient processed from seawater, on multiple parameters of atopic skin.","authors":"Nicolas Lebonvallet, Chloé Catovic, Marc Feuilloley, Raphael Leschiera, Alexia Reux, Matthieu Talagas, Ianis Cousin, Laurent Misery, Emilie Simon, Sylvie Chopin, Johan Gardères","doi":"10.1093/skinhd/vzae029","DOIUrl":"10.1093/skinhd/vzae029","url":null,"abstract":"<p><strong>Background: </strong>Different symptoms are associated with atopic skin, including dryness, pruritus and pain, and affect patients' quality of life. The environment, microbiota, epidermis, immune and nerve cells are all implicated in the pathogenesis of atopic skin. <i>Staphylococcus aureus</i> is the focus of particular attention. Epidermis is implicated at multiple levels: inflammatory process, barrier, control of moisture and water loss. Sensory neurons that participate in cutaneous neurogenic inflammation and pruritus are seen as a potential new target. Specific management strategies and new treatments for adults and children are needed to help in more refractory cases. As a baseline of management, guidelines recommend a treatment to moisturize the skin and maintain the skin barrier function, such as an emollient.</p><p><strong>Objectives: </strong>To evaluate a new product <i>in vitro</i> and <i>in vivo</i> in order to validate the potential of its use in people with atopic skin or dry skin.</p><p><strong>Methods: </strong>A specific mineral composition, Active Oligo Skin complex™, from seawater was developed and included in a balm. The effects of a solution and balm containing the complex were evaluated <i>in vitro</i> on the growth and biofilm formation of <i>Staphylococcus aureus</i> and <i>Staphylococcus epidermidis</i> in different skin models, and <i>in vivo</i> in adult and young volunteers.</p><p><strong>Results: </strong><i>In vitro</i>, the complex modulated bacterial biofilm formation and growth, decreased cytokine [interleukin (IL)-1, IL-6, IL-4] and neuropeptide (substance P) release, and increased the expression of CL1 and CL4. On volunteers with dry skin, the complex had a moisturizing effect after 1 h of application. Dryness and roughness were also reduced in young participants with atopic skin. The balm decreased erythema and pruritus after 21 days of topical application on 60 young participants. On 22 adult participants, stinging score was decreased after -application.</p><p><strong>Conclusions: </strong>The Active Oligo Skin complex™ appears to display potent antipruritic and anti-inflammatory activities, both <i>in vitro</i> and <i>in vivo</i>.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"22-30"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locally advanced basal cell carcinoma treated with sonidegib: <i>in vivo</i> monitoring with line-field confocal optical coherence tomography.","authors":"Simone Cappilli, Maria Mannino, Gerardo Palmisano, Enrico Bocchino, Alfredo Piccerillo, Andrea Paradisi, Alessandro Di Stefani, Ketty Peris","doi":"10.1093/skinhd/vzae025","DOIUrl":"10.1093/skinhd/vzae025","url":null,"abstract":"<p><strong>Background: </strong>Hedgehog pathway inhibitors, including sonidegib and vismodegib, represent the treatment strategy for 'difficult-to-treat' basal cell carcinoma (BCC), encompassing, among others, locally advanced (laBCC) and metastatic BCC. Assessment of therapy response is challenging due to the presence of telangiectasia and scar tissue at the area of the BCC lesion. Line-field confocal optical coherence tomography (LC-OCT) is a new noninvasive imaging technique that provides high-resolution visualization of skin structures.</p><p><strong>Objectives: </strong>To investigate the value of LC-OCT for the assessment of laBCC response to sonidegib therapy.</p><p><strong>Methods: </strong>We retrospectively included patients with laBCC treated with sonidegib in the period from May 2020 to May 2023. Patients with laBCC underwent LC-OCT at baseline before starting sonidegib, and after sonidegib discontinuation when clinical complete response (CR) was reached. A subset of patients underwent LC-OCT assessment during sonidegib therapy to assess tumour persistence.</p><p><strong>Results: </strong>Twenty laBCCs in 20 patients [4 women, 16 men; mean (SD) age 76 (18) years] treated with oral sonidegib 200 mg daily were included in the study. Ten patients obtained an apparent clinical CR; LC-OCT imaging confirmed CR in 7/10 patients (70%), while in the remaining patients (3/10, 30%) LC-OCT revealed findings indicative of BCC non-CR. Ten patients were continuing sonidegib treatment: in this group LC-OCT revealed findings suggestive of BCC persistence in all 10 patients (100%).</p><p><strong>Conclusions: </strong>In this study we provide preliminary results of the beneficial use of LC-OCT in the management of patients with laBCC treated with sonidegib therapy.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"37-40"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amitriptyline for the prevention of post herpetic neuralgia: study protocol for the ATHENA study.","authors":"Sian Wells, Stephanie J MacNeill, Yumeng Liu, Anna Gilbertson, Hazel Everitt, Oliver van Hecke, Jonathan Banks, Sophie Rees, Rebecca Kandiyali, Kirsty Garfield, Lorelei Hunt, Ioana Fodor, Vikki Wylde, Robert Johnson, Alastair D Hay, Anthony E Pickering, Matthew J Ridd","doi":"10.1093/skinhd/vzaf002","DOIUrl":"10.1093/skinhd/vzaf002","url":null,"abstract":"<p><strong>Background: </strong>Post herpetic neuralgia (PHN) is the most common complication of herpes zoster, also known as shingles. Amitriptyline has been postulated to prevent PHN. The objective is to determine whether prophylactic low-dose amitriptyline prevents PHN in patients newly diagnosed with shingles.</p><p><strong>Methods: </strong>This is a multicentre, individually randomized, pragmatic, placebo-controlled superiority trial with health economic analysis and nested qualitative study. Patients with new-onset shingles are screened by treating clinicians in participating general practitioner surgeries. Key eligibility criteria are age ≥50 years, ≤6 days since rash onset and not already taking (and no contraindication to) amitriptyline. Participants are randomized 1:1 to amitriptyline 10 mg or matched placebo tablets (dose escalated as tolerated to a maximum of three tablets daily for 70 days). Resource-use data (including health, social and informal care, personal expenses and usual activities) are collected from electronic medical records and participant questionnaires. A sample of recruitment conversations are audio-recorded and interviews conducted with recruiters and patients, including those who decline to participate or who withdraw from the trial.</p><p><strong>Discussion: </strong>The primary outcome is the presence of PHN (≥3/10 worst pain on Zoster Brief Pain Inventory) at 90 days after rash onset. Primary health economic analyses will present cost per case of PHN prevented and cost per quality-adjusted life year. Qualitative data will be analysed to optimize trial delivery and to aid interpretation and implementation of the trial findings. This is the largest trial to date to evaluate the clinical/cost-effectiveness and acceptability of prophylactic low-dose amitriptyline for the prevention of PHN.</p><p><strong>Protocol registration: </strong>EudraCT 2021-001101-78 and ISRCTN14490832.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxic epidermal necrolysis induced by axitinib in a patient with advanced lung adenocarcinoma.","authors":"Na Wang, Dongkai Li, Huaiwu He, Yun Long, Dawei Liu","doi":"10.1093/skinhd/vzae028","DOIUrl":"10.1093/skinhd/vzae028","url":null,"abstract":"<p><p>Patients taking oral EGFR inhibitors should be alert to the risk of TEN if they suddenly develop widespread rash.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"86-87"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the challenges of mycetoma: a case series highlighting diagnostic dilemmas and therapeutic triumphs.","authors":"Mahesh Mathur, Neha Thakur, Sunil Jaiswal, Sandhya Regmi, Supriya Paudel","doi":"10.1093/skinhd/vzae017","DOIUrl":"10.1093/skinhd/vzae017","url":null,"abstract":"<p><p>Mycetoma is a chronic suppurative granulomatous infection of the deep dermis and subcutaneous tissue prevalent in tropical and subtropical regions and is caused by filamentous aerobic bacteria (actinomycetoma) or true fungi (eumycetoma), representing 60% and 40% of cases worldwide, respectively. The causative organism enters into the subcutaneous tissue, usually of the foot, from contaminated soil or vegetative material through inoculation from a thorn prick, or repeated trauma. It commonly affects men, farmers and field workers. Differentiating eumycetoma from actinomycetoma can be challenging but is required before starting prolonged treatment. One of our patients presented with lesions on the thigh and in a sporotrichoid pattern that is atypical, while the other two patients were treated with antifungal medication for eumycetoma for years without proper investigation and improvement. Early diagnosis of actinomycetoma is mandatory to prevent tissue destruction, bone invasion and ultimate loss of function by proper investigative workup, histopathology and direct microscopy of discharge. We here report three cases of actinomycetoma with clinical and microbiology profiles treated successfully with tablets of trimethoprim-sulfamethoxazoleand amoxicillin-clavulanic acid along with folic acid as proposed by the Cochrane systemic review protocol 2018.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: The Development and Validation of a Decision Aid to Enhance Shared Decision-Making for the Management of Actinic Keratosis.","authors":"","doi":"10.1093/skinhd/vzaf003","DOIUrl":"https://doi.org/10.1093/skinhd/vzaf003","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1002/ski2.388.].</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"5 1","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}