Successful treatment of combination therapy with tacalcitol lotion associated with sunscreen for localized Darier’s disease

We herein report a sporadic case of Darier’s disease localized to the bilateral side of the neck in a 39‐year‐old Japanese woman. Several clinical variants of Darier’s disease have so far been recognized including unilateral Darier’s disease, localized Darier’s disease, segmental Darier’s disease and acral Darier’s disease. Few cases of Darier’s disease, restricted to sun‐exposed areas such as the bilateral side of the neck, have been described in the published work. It remains controversial, however, whether ultraviolet exposure can induce the onset of Darier’s disease. Our patient’s skin lesions, which were resistant to previous treatment with corticosteroid, improved substantially with high‐concentration tacalcitol lotion and sunscreen. This is the first report on the efficacy of topical tacalcitol lotion associated with sunscreen for the treatment of localized Darier’s disease.     

Bacteriological aspects of Darier’s disease

Background There are no established data on the prevalence of bacterial colonization of lesional skin, nares and perineum in Darier’s disease (DD), or its contribution to the clinical manifestations of the disease. Objective To determine the prevalence of bacterial colonization of lesional skin and Staphylococcus aureus (S. aureus) in nares and perineum in 75 patients with DD, the association of these parameters with disease and patient characteristics, and the features of the bacterial skin infection in this group. Methods Medical interviews and physical examinations were performed. Bacteria were isolated from swabs taken from lesional skin, nares and perineum. Results S. aureus was isolated in 68%, 47% and 22% of lesional skin, nares and perineum cultures respectively. Subjects with positive S. aureus culture from lesional skin and/or nares had a statistically significant higher percentage of skin area affected and a more severe disease than patients with negative culture. Thirty of the 75 patients (40%) recalled bacterial skin infection, most often on the chest. Conclusions Patients with DD have high prevalence of S. aureus colonization in lesional skin and nares, with a correlation between disease severity and extent of the colonization. Further studies examining the consequences of S. aureus eradication in those sites may establish the need for S. aureus lesional skin and nares colonization screening and eradication as part of the treatment of DD exacerbations.     

Health‐related quality of life among Darier’s disease patients

Background Darier’s disease (DD) is an autosomal dominant skin disorder characterized by persistent eruption of hyperkeratotic papules. The effect of DD on quality of life (QOL) has been assessed in only one study, which found no correlation between the Dermatology Life Quality Index (DLQI) score and clinical severity of the disease. The correlation between health‐related quality of life (HRQL) and other diseases and patient characteristics has not been studied. Objectives To examine the HRQL of patients with DD and to evaluate the association between HRQL scores and disease and patient characteristics. Methods A total of 74 DD patients completed three QOL questionnaires: DLQI, EQ‐5D, and one specially designed for the study. The data reported in this study were collected as part of a larger study on the clinical characteristics of DD; the socio‐demographic and clinical data were used in the statistical analysis of the current study. Results Mean DLQI was 5.41 ± 5.57 and the mean EQ‐Visual Analogue Scale (VAS), was 70.84 ± 19.25. DLQI and EQ‐VAS were significantly associated with skin area affected, disease severity, age at onset of DD and a seborrhoeic distribution pattern of DD. Stepwise linear regression showed skin area affected to be the most significant variable in the predication of DLQI (beta = 0.183; SE = 0.04; P < 0.001), and disease severity the most significant variable in the predication of EQ‐VAS (beta = ?9.15; SE = 3.21; P < 0.006). Conclusions Darier’s disease has a negative impact on HRQL of patients and the HRQL is associated with various disease characteristics, mainly skin area affected and clinical severity.     

阿达帕林凝胶个体化治疗寻常痤疮的临床研究

目的 评价0．1％阿达帕林凝胶个体化治疗寻常痤疮的疗效和安全性。方法 81例轻、中度寻常痤疮患者，根据个体情况每日外用0．1％阿达帕林凝胶1．3次，总疗程6～8周。随机选择其中30例每周复诊，拍摄照片观察比较，指导调整治疗剂量。结果 81例和其中30例痤疮患者痊愈率(总皮损数减少≥90％)分别为44．4％和73．4％；治疗中，皮脂溢出减少发生率83．3％；不良反应发生率39．5％，未影响治疗。结论 本药个体化治疗寻常痤疮疗效良好，合理地增加日用药剂量可提高痊愈率；本药刺激性较低，患者皮肤对此药耐受性较好：疗程中阿达帕林凝胶可明显减少皮脂溢出。     

Febrile Ulceronecrotic Mucha‐Habermann’s Disease with Pulmonary Involvement

Abstract: We report a case of febrile ulceronecrotic Mucha‐Habermann disease (FUMHD) in a 12‐year‐old boy. After 1 week of typical cutaneous appearance of pityriasis lichenoides et varioliformis acuta (PLEVA), he was given a percutaneous injection of measles virus vaccine, and then extensive polymorphous, papular, and ulcerohemorrhagic skin lesions developed along with intermittent high temperature, hepatic dysfunction, and hypoalbuminemia. Thoracic CT scan showed parenchymal nodular infiltration at the tip of vascular structures. Skin biopsy showed a combination of the classic features of PLEVA and an allergic vasculitis. We treated him with prednisolone and methotrexate (MTX) successfully. The evolution in our patient suggests that FUMHD may have been triggered by virus vaccination. We also emphasize that FUMHD in children may be successfully treated with a combination of systemic MTX and high‐dose corticosteroids.     

Successful Treatment of Bowen's Disease with Topical Maxacalcitol

Abstract is missing (Letter).     

Successful Treatment of Vitiligo Associated with Vogt–Koyanagi–Harada Disease

Vogt–Koyanagi–Harada disease (VKH) is a rare multisystem disorder with cutaneous, ophthalmic, neurologic, and auditory manifestations. There is a paucity of published literature regarding the management of cutaneous features in VKH. We report a case of VKH‐associated vitiligo responsive to topical corticosteroids and topical calcineurin inhibitors.     

Cutaneous Crohn’s Disease in the Pediatric Population

Abstract: Three healthy children with an anogenital skin eruption, all of whom had undergone extensive medical evaluation and treatment, had undetected intestinal Crohn’s disease. Biopsy of the skin showed noncaseating granulomas consistent with cutaneous Crohn’s disease. Inflammatory bowel disease should be in the differential diagnosis of persistent nontender, erythematous papules, nodules, and plaques in the anogenital region.     

阿达帕林凝胶联合过氧苯甲酰凝胶治疗寻常痤疮的多中心随机对照研究

目的评价阿达帕林凝胶联合过氧苯甲酰凝胶治疗轻中度寻常痤疮的疗效和安全性。方法随机、多中心、开放、平行对照研究。按照痤疮严重程度国际改良标准入选轻、中度寻常痤疮患者。试验组早晨外用5%过氧苯甲酰凝胶1次,晚睡前外用0.1%阿达帕林凝胶1次;对照组仅晚睡前外用0.1%阿达帕林凝胶1次。共用药12周,在基线、2、4、8和12周时记录炎性皮损、非炎性皮损和总皮损数,皮肤局部刺激反应如红斑、脱屑、干燥、烧灼/刺痛的评分,以及其他不良反应。结果3个中心共入选150例患者。试验组、对照组的总有效率在第8周分别为74.6%和56.7%(P<0.05);在第12周时分别为81.3%和68.9%(P>0.05)。局部刺激反应评分除烧灼/刺痛在第4、8周时两组间的差异有显著性外,其余差异均无显著性。另外,两组各有2例发生接触性皮炎。结论0.1%阿达帕林凝胶合用5%过氧苯甲酰治疗轻中度寻常痤疮较0.1%阿达帕林凝胶单用疗效显著,见效快,病程短,未增加不良反应。     

阿维A联合阿达帕林凝胶治疗融合性网状乳头瘤病2例

目的观察阿维A联合阿达帕林凝胶治疗融合性网状乳头瘤病2例的疗效。方法口服阿维A30mg/d联合阿达帕林凝胶外用,皮损明显消退后,停用阿维A,继续外用阿达帕林凝胶至皮损全部消退。结果分别于联合治疗3周和5周后皮损明显消退,总疗程2～4个月,口服阿维A疗程7～9周。结论联合疗法可缩短阿维A的疗程,减轻不良反应,复发程度较初诊时轻微,再次治疗仍有效。     

夫西地酸乳膏联合阿达帕林凝胶治疗寻常痤疮的临床观察

目的评价2%夫西地酸软膏联合0.1%阿达帕林凝胶治疗轻、中度寻常痤疮的临床疗效及安全性。方法寻常痤疮246例,随机分为3组,治疗组98例,采用2%夫西地酸软膏联合0.1%阿达帕林凝胶治疗;对照A组81例,采用1%克林霉素磷酸酯凝胶联合0.1%阿达帕林治疗;对照B组67例,单独使用0.1%阿达帕林凝胶治疗。均连用8周,分别在治疗后第2,4,8周末观察疗效并评价安全性。结果在治疗后第8周,治疗组有效率93.88%,与对照A组(81.48%)相比差异有统计学意义(P=0.010);治疗组Ⅲ级痤疮的有效率93.02%,与对照A组(69.70%)相比差异有统计学意义(P=0.007);疗程结束后,治疗组复发5例,复发率5.10%,远低于2个对照组。单独外用阿达帕林疗效均欠佳,且复发率较高。在治疗过程中,3组均未见明显不良反应。结论 2%夫西地酸软膏联合0.1%阿达帕林凝胶治疗轻、中度寻常痤疮具有疗效较好、复发率低、不良反应少等优点,是较理想的治疗方案。     

阿达帕林在治疗皮肤角化异常中的应用

阿达帕林具有较强的抗炎、抗增生和调节表皮细胞分化的能力 ,笔者就阿达帕林的药理学特性、药代动力学特性、临床应用及安全性进行了综述。阿达帕林外用除对痤疮有较好的疗效外 ,还可用于治疗其它角化异常性皮肤病。     

Sterile Folliculitis as an Important Diagnostic Clue to Crohn’s Disease

Abstract: Sterile folliculitis is known to be one of the rare cutaneous manifestations of Crohn’s disease (CD). To our knowledge it has never been emphasized as a marker of significant diagnostic value, perhaps maybe even more significant than more common cutaneous manifestations such as erythema nodosum (EN).     

Chilblains and Microgeodic Disease Diagnosed Concurrently in a Child’s Toe

Abstract: Microgeodic disease, similar to chilblains (pernio), is characterized by painful, erythematous swelling, as well as small, punched‐out erosions found in affected phalanges. Although they share a similar appearance and proposed pathogenesis, chilblains has rarely been diagnosed in children with microgeodic disease, and in those cases has not been confirmed on skin biopsy. This article details a child in Connecticut diagnosed during the winter with chilblains and microgeodic disease of his toe, as supported by biopsy and imaging. These findings further indicate that the two diseases are interrelated, imply a similar pathogenesis, and lead us to suggest similar treatment for problematic forms of both diseases.     

The Efficacy of Topical 0.1% Adapalene Gel for Use in the Treatment of Childhood Acanthosis Nigricans: A Pilot Study

Background:

Vitiligo is one of the disorder that has social impact. Both skin and mucous membrane show depigmentation in vitiligo. Depigmentation in oral cavity can be more easily observed and the patient can be given awareness regarding the condition if they are unaware of vitiligo elsewhere in their body and can be guided for treatment.

Aim and objectives:

The aim of this study is to determine the frequency of occurrence of oral mucosal vitiligo in vitiligo patients and to determine the most commonly involved oral mucosal site.

Materials and methods:

The study sample included 100 vitiligo patients. The patients of all age groups and both genders were included. Vitiligo patients associated with systemic conditions such as thyroid disorders, juvenile diabetes mellitus, pernicious anemia, Addison''s disease were excluded in this study.

Results:

Out of 100 vitiligo patients 44 % male and 56% were female. The oral presentation of vitiligo in this study showed depigmentation of buccal mucosa in 5% of patients, labial mucosa in 5% of patients, palate in 8% of patients, gingiva in 2% of patients and alveolar mucosa 1%. Depigmentation of lip was seen in 42% of patients. Lip involvement refers to depigmentation of both the lips or either lip. Also vermilion border involvement was noted in majority of cases. In some cases, the depigmentation of lip extended to the facial skin also.

Conclusion:

In this study 55 patients out of 100 patients showed depigmentation in the oral cavity. Lip involvement was most common in this study showing about 42% of patients. Intraoral mucosal involvement was found in 21% of patients. Among intraoral mucosal site palate was common followed by buccal and labial mucosa, gingiva. Two patients had lip pigmentation as the only manifestation without any depigmentation in the skin.     

内服中药联合外用0.1%阿达帕林凝胶治疗扁平疣疗效观察

目的　观察中西医结合治疗扁平疣的疗效。方法　 14 4例患者随机分组 ,治疗组 (C组 ) 5 0例采用中药煎液内服联合 0 .1%阿达帕林凝胶外涂 ,对照组 (A组 ) 46例采用单纯中药煎液内服 ,(B组 ) 48例单纯 0 .1%阿达帕林凝胶外用。结果　C组有效率明显高于A、B组 (P均 <0 .0 1)。结论　中西医结合治疗扁平疣 ,标本同治 ,治愈率高。