Acantholytic pityriasis rubra pilaris associated with topical use of imiquimod 5%: case report and literature review

Topical use of immune response modifiers, such as imiquimod, has increased in dermatology. Although its topical use is well tolerated, it may be associated with exacerbations of generalized cutaneous inflammatory diseases, possibly through the systemic circulation of pro-inflammatory cytokines. This report describes a case of development of pityriasis rubra pilaris, a rare erythematous-papulosquamous dermatosis, in a woman aged 60 years during treatment with imiquimod 5% cream for actinic keratosis. It evolved with erythrodermic conditions and palmoplantar keratoderma, presenting progressive clinical resolution after the introduction of methotrexate. The authors emphasize the importance of recognizing possible systemic reactions associated with the topical use of imiquimod.     

The clinics of HHV‐6 infection in COVID‐19 pandemic: Pityriasis rosea and Kawasaki disease

A new type of coronavirus family (SARS‐CoV‐2), which can be found in humans and animals, with many varieties and clinical symptoms, was first seen in Wuhan, China in late 2019, under the name novel Coronavirus Disease 2019 (COVID‐19). In the literature, cutaneous symptoms related to the disease are generally emphasized. However, it is not yet known whether this new SARS‐CoV‐2 virus, which has entered our lives, plays a role in the etiopathogenesis of dermatological diseases. The patients who were admitted to the dermatology outpatient clinic between 1 April and 15 May 2019, and on 1 April and 15 May 2020 were retrospectively analyzed by searching the hospital automation system and patient files. The reason for the same months to be included in the study was to exclude seasonal effects on the diseases. After pandemic, the number of patients with Pityriasis rosea and Kawasaki disease increased significantly in patients who applied to the dermatology outpatient clinic. Our study is the first study showing Pityriasis rosea increase during the pandemic period. We think that this increase is related to HHV‐6 reactivation. Herein, we wanted to draw attention to two diseases in which Human Herpes 6 (HHV‐6) was accused in etiopathogenesis: Kawasaki disease and Pityriasis rosea.     

单纯糠疹的诊疗进展

单纯糠疹是一种发生于儿童的局限性色素减退性疾病,有轻微鳞屑,边界不清.其发病机制尚不清楚,特应性体质、干燥及日光照射是潜在的危险因素.组织病理显示,病变区域表皮基底层黑素含量较皮损周围正常皮肤处明显减少,免疫组化显示,病变区表皮基底层黑素细胞含量与皮损周围正常皮肤差异无统计学意义.治疗中可以使用润肤剂.新近研究显示,钙调磷酸酶抑制剂等抗炎药物可以起到良好的治疗及预防复发的疗效.     

皮肤共聚焦激光扫描显微镜在儿童色素减退性疾病诊断中的应用

目的 探讨儿童常见色素减退性疾病皮肤共聚焦激光扫描显微镜(CLSM)图像的基本特征.方法 分别观察1 915例色素减退性疾病(包括白癜风、特发性滴状色素减少症、无色素痣、线状苔藓、白色糠疹及炎症后色素减退)患者的皮损,用CLSM观察皮损处、交界处及白斑周边正常皮肤的各层镜下特征.应用卡方检验和Fisher精确检验进行统计学分析.结果 1级和2级色素减少占总病例数的51.4％(984/1 915)和35.7％(684/1 915),白癜风3级色素减少的比例为77.9％(141/181),明显高于其他疾病(0～ 10.3％);815例角质层轻度角化过度,1 060例棘层灶性水肿,79例基底细胞环出现改变,1 133例真皮浅层可见稀疏炎症细胞或树枝状细胞.6种色素减退性皮肤病CLSM扫描图像色素减少程度及各层CLSM图像变化均有统计学差异(P＜0.05).CLSM特征:特发性滴状色素减少症可见色素环完全缺失;线状苔藓、白色糠疹、炎症后色素减退可见非特异性炎症改变,线状苔藓可见点灶状基底细胞液化变性;无色素痣仅为色素减少及折光变弱,白癜风白斑区色素完全缺失,且皮肤色素环缺乏完整性.结论 白癜风、特发性滴状色素减少症、无色素痣、线状苔藓、白色糠疹及炎症后色素减退皮损CLSM图像有差异,可以作为鉴别诊断的依据之一.     

儿童白色糠疹与血微量元素的相关性探讨

目的：探讨儿童白色糠疹与血微量元素的相关性。方法：用比色法及原子吸收法测定208例白色糠疹患儿血清微量元素情况，并以747例健康儿童作为对照。结果：白色糠疹患儿缺锌、缺钙者比例明显高于健康对照组，差异有统计学意义（X^2值分别为4．45、6．38，P值均〈0．05）；白色糠疹患儿血清中锌、钙水平明显低于健康对照组，差异有统计学意义（t值分别为2．29、3．59，P值均〈0．05），而镁、铁、铜、铅及25羟基维生素D水平与健康对照组相比，差异均无统计学意义（P值均〉0．05）。结论：白色糠疹患儿体内存在缺锌、缺钙情况，临床上应注意早期干预、早期治疗。     

玫瑰疹病毒属与玫瑰糠疹发病的相关性研究现况

玫瑰糠疹是一种病因尚未明确的炎症性、自限性红斑鳞屑性皮肤病，至今病因尚未明确。近年来，关于玫瑰糠疹与玫瑰疹病毒属人疱疹病毒6、7型的研究较为深入，本文对相关文献进行了综述。     

Examen mycologique en dermatologie

Dermatomycoses are dermatological infections very commonly encountered in private dermatological practice since they affect up to one third of the population. However, the symptoms are very often shared by other skin infections and disorders and may be highly atypical. It is thus impossible to make a diagnosis with any certainty on clinical grounds alone. For this reason, mycological diagnosis is essential to either confirm or rule out dermatomycosis, and is unavoidable when antifungal therapy is required for the treatment of ringworm of the scalp or beard, or for onychomycosis. It is also vital where therapy guided by the clinical appearance of lesions has failed or in the event of recurring skin lesions. Confirmation of mycosis enables antifungals to be initiated and a negative test warrants investigation for other underlying causes for the lesions seen. However, regardless of the mycological diagnostic technique employed, the quality of the results depends chiefly on the quality of sampling of the infected site, but also on the expertise of the microbiologist. Standard mycological testing remains the most informative, the least expensive and the sole examination capable of isolating the causative fungus irrespective of the type of mycosis, such as dermatophytosis, scytalidiosis, mould-induced ungual infection, candidiasis, or infections due to Malassezia sp. This is the only examination able to identify epidemiological variations. All other more recent techniques are either based upon simple demonstration of the fungal elements involved, without identification of the fungal species in question, or else they are reliant upon a fungal database that is generally highly incomplete.     

盐酸伐昔洛韦联合复方甘草酸苷治疗玫瑰糠疹的临床观察

目的:观察盐酸伐昔洛韦联合复方甘草酸苷治疗玫瑰糠疹的临床疗效和安全性。方法:将107例玫瑰糠疹患者随机分为对照组(志愿者,n=37)、观察组(n=35)和研究组(n=35)。对照组患者不给予用药治疗,等待自愈;观察组患者给予复方甘草酸苷3片,口服,每日3次;研究组患者在观察组治疗的基础上给予盐酸伐昔洛韦250 mg,口服,每日3次。3组患者均观察2周。观察3组患者未用药或用药1周、2周后疗效,并记录不良反应发生情况。结果:治疗1周后,研究组患者总有效率>观察组>对照组,3组比较差异有统计学意义(P<0.05);治疗2周后,研究组与观察组患者总有效率均显著高于对照组,差异均有统计学意义(P<0.05),但研究组与观察组比较差异无统计学意义(P>0.05)。3组患者观察期间均未见明显不良反应发生。结论:盐酸伐昔洛韦联合复方甘草酸苷治疗玫瑰糠疹较单用复方甘草酸苷或未用药物疗效较好、起效较快,安全性相似。