Solar Urticaria Treated with Omalizumab
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Photoaging & Skin Damage
Use_for_Revised_OFC_Only_2006_PhotoagingSkinDamage 5/21/13 9:11 AM Page 2 PEORIA (309) 674-7546 MORTON (309) 263-7546 GALESBURG (309) 344-5777 PERU (815) 224-7400 NORMAL (309) 268-9980 CLINTON, IA (563) 242-3571 DAVENPORT, IA (563) 344-7546 SoderstromSkinInstitute.comsoderstromskininstitute.com FROMFrom YOUR Your DERMATOLOGISTDermatologist [email protected]@skinnews.com PHOTOAGING & SKIN DAMAGE Before You Worship The Sun Who’s At Risk? Today, many researchers and dermatologists Skin types that burn easily and tan rarely are believe that wrinkling and aging changes of the skin much more susceptible to the ravages of the sun on the are much more related to sun damage than to age! skin than are those that tan easily, rather than burn. Many of the signs of skin damage from the sun are Light complected, blue-eyed, red-haired people such as pictured on these pages. The decrease in the ozone Swedish, Irish, and English, are usually more suscep- layer, increasing the sun’s intensity, and the increasing tible to photo damage, and their skin shows the signs sun exposure among our population – through work, of photo damage earlier in life and in a more pro- sports, sunbathing and tanning parlors – have taken a nounced manner. Dark complexions give more protec- tremendous toll on our skin. Sun damage to the skin tion from light and the sun. ranks with other serious health dangers of smoking, alcohol, and increased cholesterol, and is being seen in younger and younger people. NO TAN IS A SAFE TAN! Table of Contents Sun Damage .............................................Pg. 1 Skin Cancer..........................................Pgs. 2-3 Mohs Micrographic Surgery ......................Pg. -
61497191.Pdf
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Repositório Institucional dos Hospitais da Universidade de Coimbra Metadata of the chapter that will be visualized online Chapter Title Phototoxic Dermatitis Copyright Year 2011 Copyright Holder Springer-Verlag Berlin Heidelberg Corresponding Author Family Name Gonçalo Particle Given Name Margarida Suffix Division/Department Clinic of Dermatology, Coimbra University Hospital Organization/University University of Coimbra Street Praceta Mota Pinto Postcode P-3000-175 City Coimbra Country Portugal Phone 351.239.400420 Fax 351.239.400490 Email [email protected] Abstract • Phototoxic dermatitis from exogenous chemicals can be polymorphic. • It is not always easy to distinguish phototoxicity from photoallergy. • Phytophotodermatitis from plants containing furocoumarins is one of the main causes of phototoxic contact dermatitis. • Topical and systemic drugs are a frequent cause of photosensitivity, often with phototoxic aspects. • The main clinical pattern of acute phototoxicity is an exaggerated sunburn. • Subacute phototoxicity from systemic drugs can present as pseudoporphyria, photoonycholysis, and dyschromia. • Exposure to phototoxic drugs can enhance skin carcinogenesis. Comp. by: GDurga Stage: Proof Chapter No.: 18 Title Name: TbOSD Page Number: 0 Date:1/11/11 Time:12:55:42 1 18 Phototoxic Dermatitis 2 Margarida Gonc¸alo Au1 3 Clinic of Dermatology, Coimbra University Hospital, University of Coimbra, Coimbra, Portugal 4 Core Messages photoallergy, both photoallergic contact dermatitis and 45 5 ● Phototoxic dermatitis from exogenous chemicals can systemic photoallergy, and autoimmunity with photosen- 46 6 be polymorphic. sitivity, as in drug-induced photosensitive lupus 47 7 ● It is not always easy to distinguish phototoxicity from erythematosus in Ro-positive patients taking terbinafine, 48 8 photoallergy. -
Photodermatoses Update Knowledge and Treatment of Photodermatoses Discuss Vitamin D Levels in Photodermatoses
Ashley Feneran, DO Jenifer Lloyd, DO University Hospitals Regional Hospitals AMERICAN OSTEOPATHIC COLLEGE OF DERMATOLOGY Objectives Review key points of several photodermatoses Update knowledge and treatment of photodermatoses Discuss vitamin D levels in photodermatoses Types of photodermatoses Immunologically mediated disorders Defective DNA repair disorders Photoaggravated dermatoses Chemical- and drug-induced photosensitivity Types of photodermatoses Immunologically mediated disorders Polymorphous light eruption Actinic prurigo Hydroa vacciniforme Chronic actinic dermatitis Solar urticaria Polymorphous light eruption (PMLE) Most common form of idiopathic photodermatitis Possibly due to delayed-type hypersensitivity reaction to an endogenous cutaneous photo- induced antigen Presents within minutes to hours of UV exposure and lasts several days Pathology Superficial and deep lymphocytic infiltrate Marked papillary dermal edema PMLE Treatment Topical or oral corticosteroids High SPF Restriction of UV exposure Hardening – natural, NBUVB, PUVA Antimalarial PMLE updates Study suggests topical vitamin D analogue used prophylactically may provide therapeutic benefit in PMLE Gruber-Wackernagel A, Bambach FJ, Legat A, et al. Br J Dermatol, 2011. PMLE updates Study seeks to further elucidate the pathogenesis of PMLE Found a decrease in Langerhans cells and an increase in mast cell density in lesional skin Wolf P, Gruber-Wackernagel A, Bambach I, et al. Exp Dermatol, 2014. Actinic prurigo Similar to PMLE Common in native -
Urticaria from Wikipedia, the Free Encyclopedia Jump To: Navigation, Search "Hives" Redirects Here
Urticaria From Wikipedia, the free encyclopedia Jump to: navigation, search "Hives" redirects here. For other uses, see Hive. Urticaria Classification and external resourcesICD-10L50.ICD- 9708DiseasesDB13606MedlinePlus000845eMedicineemerg/628 MeSHD014581Urtic aria (or hives) is a skin condition, commonly caused by an allergic reaction, that is characterized by raised red skin wheals (welts). It is also known as nettle rash or uredo. Wheals from urticaria can appear anywhere on the body, including the face, lips, tongue, throat, and ears. The wheals may vary in size from about 5 mm (0.2 inches) in diameter to the size of a dinner plate; they typically itch severely, sting, or burn, and often have a pale border. Urticaria is generally caused by direct contact with an allergenic substance, or an immune response to food or some other allergen, but can also appear for other reasons, notably emotional stress. The rash can be triggered by quite innocent events, such as mere rubbing or exposure to cold. Contents [hide] * 1 Pathophysiology * 2 Differential diagnosis * 3 Types * 4 Related conditions * 5 Treatment and management o 5.1 Histamine antagonists o 5.2 Other o 5.3 Dietary * 6 See also * 7 References * 8 External links [edit] Pathophysiology Allergic urticaria on the shin induced by an antibiotic The skin lesions of urticarial disease are caused by an inflammatory reaction in the skin, causing leakage of capillaries in the dermis, and resulting in an edema which persists until the interstitial fluid is absorbed into the surrounding cells. Urticarial disease is thought to be caused by the release of histamine and other mediators of inflammation (cytokines) from cells in the skin. -
Dear Editor, Photo-Onycholysis Due to Tetracyclines
Dear EditOr, Photo-onycholysis Due to Tetracyclines: a Case Report (Tetrasiklin Kulammma Baglz Fotoonikolizis: Olgu Sunumu) Mehmet Kose Assist. Prof.1 M.D. Department of Pediatrics Erciyes University Medical Faculty Photo-onycholysis refers to separation of the nail plate from the nail bed after [email protected] exposure to ultraviolet light. Drug induced photo-onycholysis is seen most commonly with tetracycline. Harun Y1lmaz M.D. Department of Pediatrics A-12-years old boy was admitted to our pediatric department because of fever and Erciyes University Medical Faculty arthralgia. He was diagnosed as Brucellosis and treated with rifampin (20 mglkg/24hr) Kaz•m Ozum and tetracycline (30mg/kg/24hr in 3 divided oral doses). Seven days later pinkish Prof., M.D. purple discoloration and onycholysis developed on his fingernails. Two weeks later Department of Pediatrics Erciyes University Medical Faculty his fingernails darkened to a purple-black color and onycholysis became evident [email protected] (Picture 1). He was admitted again. Toenails were normal. Tetracycline was discontinued after 14 days of treatment and trimethoprim- sulfamethoxizole was Selim Kurtoglu Prof., M.D. added to therapy. Two months later, the nail changes resolved spontaneously. Department of Pedi atrics Erciyes University Medica l Facu lty Photosensitivity is a well-recognized complication of tetracyclines. Photo-onycholysis selimk@e rciyes.edu.tr has been observed with many of the tetracyclines usually appearing more than 2 weeks commencing drug administration (I, 2). It was first described by Segal as photosensitivity fo llowed by discoloration of the nails and onycholysis (3). Tetracyclines were reported to cause pseudoporphyria, cutaneous pigmentation, erythema multiforme, toxic epidermal necrolysis, Steven-Johnson Syndrome, fixed drug eruptions, pruritis, urticaria and vasculitis (2, 4). -
Module Test № 1 on Dermatology
THE MINISTRY OF HEALTHCARE OF THE RUSSIAN FEDERATION FEDERAL STATE BUDGETARY EDUCATIONAL INSTITUTION OF HIGHER PROFESSIONAL EDUCATION PIROGOV RUSSIAN NATIONAL RESEARCH MEDICAL UNIVERSITY DEPARTMENT OF DERMATOVENEROLOGY Gaydina T.A., Dvornikov A.S., Skripkina P.A., Nazhmutdinova D.K., Heydar S.A., Arutunyan G.B., Pashinyan A.G. MODULE TEST №1 ON DERMATOLOGY FOR STUDENTS OF INSTITUTES OF HIGHER MEDICAL EDUCATION ON SPECIALTY THERAPEUTIC FACULTY DEPARTMENT OF DERMATOVENEROLOGY Moscow 2016 ISBN УДК ББК A21 Module test №1 on Dermatology for students of institutes of high medical education on specialty «Therapeutic faculty» department of dermatovenerology: manual for students for self-training//FSBEI HPE “Pirogov RNRMU” of the ministry of healthcare of the russian federation, M.: (publisher) 2016, 144 p. The manual is a part of teaching-methods on Dermatovenerology. It contains tests on Dermatology on the topics of practical sessions requiring single or multiple choice anser. The manual can be used to develop skills of students during practical sessions. It also can be used in the electronic version at testing for knowledge. The manual is compiled according to FSES on specialty “therapeutic faculty”, working programs on dermatovenerology. The manual is intended for foreign students of 3-4 courses on specialty “therapeutic faculty” and physicians for professional retraining. Authors: Gaydina T.A. – candidate of medical science, assistant of dermatovenerology department of therapeutic faculty Pirogov RNRMU Dvornikov A.S. – M.D., professor of dermatovenerology department of therapeutic faculty Pirogov RNRMU Skripkina P.A. – candidate of medical science, assistant professor of dermatovenerology department of therapeutic faculty Pirogov RNRMU Nazhmutdinova D.K. – candidate of medical science, assistant professor of dermatovenerology department of therapeutic faculty Pirogov RNRMU Heydar S.A. -
Etiology, Classification, and Treatment of Urticaria
CONTINUING MEDICAL EDUCATION Etiology, Classification, and Treatment of Urticaria Kjetil Kristoffer Guldbakke, MD; Amor Khachemoune, MD, CWS GOAL To understand urticaria to better manage patients with the condition OBJECTIVES Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Discuss the clinical classification of urticaria. 2. Recognize how to diagnose urticaria. 3. Identify treatment options. CME Test on page 50. This article has been peer reviewed and approved Einstein College of Medicine is accredited by by Michael Fisher, MD, Professor of Medicine, the ACCME to provide continuing medical edu- Albert Einstein College of Medicine. Review date: cation for physicians. December 2006. Albert Einstein College of Medicine designates This activity has been planned and imple- this educational activity for a maximum of 1 AMA mented in accordance with the Essential Areas PRA Category 1 CreditTM. Physicians should only and Policies of the Accreditation Council for claim credit commensurate with the extent of their Continuing Medical Education through the participation in the activity. joint sponsorship of Albert Einstein College of This activity has been planned and produced in Medicine and Quadrant HealthCom, Inc. Albert accordance with ACCME Essentials. Drs. Guldbakke and Khachemoune report no conflict of interest. The authors discuss off-label use of colchi- cine, cyclophosphamide, cyclosporine, dapsone, intravenous immunoglobulin, methotrexate, montelukast sodium, nifedipine, plasmapheresis, rofecoxib, sulfasalazine, tacrolimus, thyroxine, and zafirlukast. Dr. Fisher reports no conflict of interest. Urticaria is among the most common skin dis- autoimmune mechanisms are now recognized as a eases. It can be acute, chronic, mediated by a cause of chronic urticaria. A search of the PubMed physical stimulus, or related to contact with an database (US National Library of Medicine) for urticant. -
Local Heat Urticaria
Volume 23 Number 12 | December 2017 Dermatology Online Journal || Case Presentation DOJ 23 (12): 10 Local heat urticaria Forrest White MD, Gabriela Cobos MD, and Nicholas A Soter MD Affiliations: 1 New York University Langone Health, New York Abstract PHYSICAL EXAMINATION: A brisk, mechanical stroke elicited a linear wheal. Five minutes after exposure We present a 38-year-old woman with local heat to hot water, she developed well-demarcated, urticaria confirmed by heat provocation testing. Heat erythematous blanching wheals that covered the urticaria is a rare form of physical urticaria that is distal forearm and entire hand. triggered by exposure to a heat source, such as hot water or sunlight. Although it is commonly localized Conclusion and immediate, generalized and delayed onset forms Physical or inducible urticarias are a group of exist. Treatment options include antihistamines urticarias that are triggered by various external and heat desensitization. A brisk, mechanical stroke physical stimuli, such as mechanical stimuli, pressure, elicited a linear wheal. Five minutes after exposure cold, light, or temperature change. Urticarias due to hot water, she developed well-demarcated, to temperature change include heat urticaria (HU), erythematous blanching wheals that covered the cholinergic urticaria, and cold urticaria. distal forearm and entire hand. HU is a rare form of chronic inducible urticaria, with Keywords: urticaria, local heat urticaria, physical approximately 60 reported cases [1]. In HU, contact urticaria with a heat source such as hot water, sunlight, hot air, radiant heat, or hot objects results in wheal formation Introduction HISTORY: A 38-year-old woman presented to the Skin and Cancer Unit for the evaluation of recurrent, intensely pruritic eruptions that were precipitated by exposure to heat, which included hot water and sunlight. -
How Not to Miss Autoinflammatory Diseases Masquerading As Urticaria
Allergy REVIEW ARTICLE How not to miss autoinflammatory diseases masquerading as urticaria K. Krause1,2, C. E. Grattan3, C. Bindslev-Jensen4, M. Gattorno5, T. Kallinich1,6, H. D. de Koning7,8, H. J. Lachmann9, D. Lipsker10, A. A. Navarini11, A. Simon7, C. Traidl-Hoffmann12,13 & M. Maurer1,2 1Autoinflammation Reference Center Charite´ , Charite´ -Universita¨tsmedizin Berlin, Berlin, Germany; 2Department of Dermatology and Allergy, Charite´-Universita¨tsmedizin Berlin, Berlin, Germany; 3St John’s Institute of Dermatology, St Thomas’ Hospital, London, UK; 4Department of Dermatology and Allergy Center, Odense University Hospital, Odense, Denmark; 5UO Pediatria II, G. Gaslini Institute, Genova, Italy; 6Pediatric Pneumology and Immunology, Charite´ -Universita¨tsmedizin Berlin, Berlin, Germany; 7Department of General Internal Medicine, Nijmegen Institute for Infection, Inflammation and Immunology (N4i), Centre for Immunodeficiency and Autoinflammation (NCIA), Radboud University Nijmegen Medical Centre; 8Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 9National Amyloidosis Centre, University College London Medical School, London, UK; 10Faculte´ de Me´ decine, Hoˆ pitaux universitaires de Strasbourg, Universite´ de Strasbourg et Clinique Dermatologique, Strasbourg, France; 11Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland; 12Department of Dermatology and Allergy Biederstein, Technische Universita¨t, Munich, Germany; 13ZAUM – Center for Allergy and Environment, Technische -
ALLCHRONIC URTICARIA About ANGIOEDEMA
ALLCHRONIC URTICARIA about& ANGIOEDEMA WHAT IS CHRONIC URTICARIA? may be a result of an immune system disorder. In very rare cases, The term chronic urticaria (CU) is another term for “chronic CU/angioedema can be identified as a reaction to a medication, hives.” Hives are an inflammation of the skin that results from cells food, insect or infection. Even when the cause cannot be identified, in your body releasing histamine and other allergic chemicals into there are common stimuli that may worsen or exacerbate the condi- the bloodstream. They appear as clusters of raised, red or white tion such as: welts that tend to be very itchy. Chronic hives are defined as hives • allergies (food, environmental) • medications that last more than six weeks, or may briefly go away, but often • temperatures (hot and cold) • illnesses recur frequently. About 40% of people with chronic urticaria often • pressure • sun exposure have another condition known as angioedema. There are several subtypes of CU, including cold urticaria, pressure urticaria, and HOW IS CU/ANGIOEDEMA DIAGNOSED? cholinergic urticaria. CU occurs in about 1% of the US population. The diagnosis of CU is based mostly on history of symptoms and physical exam that is done by either your pediatrician or an WHAT ARE THE SYMPTOMS OF CU? allergist. Although there are not specific laboratory tests that can be done to diagnose this condition, there are blood tests and allergy CU presents as hives - small or large patches that may be round, tests that can be done to identify triggers or rule out other condi- irregular shaped, rings, or may change shape throughout the day. -
DRUG-INDUCED PHOTOSENSITIVITY (Part 1 of 4)
DRUG-INDUCED PHOTOSENSITIVITY (Part 1 of 4) DEFINITION AND CLASSIFICATION Drug-induced photosensitivity: cutaneous adverse events due to exposure to a drug and either ultraviolet (UV) or visible radiation. Reactions can be classified as either photoallergic or phototoxic drug eruptions, though distinguishing between the two reactions can be difficult and usually does not affect management. The following criteria must be met to be considered as a photosensitive drug eruption: • Occurs only in the context of radiation • Drug or one of its metabolites must be present in the skin at the time of exposure to radiation • Drug and/or its metabolites must be able to absorb either visible or UV radiation Photoallergic drug eruption Phototoxic drug eruption Description Immune-mediated mechanism of action. Response is not dose-related. More frequent and result from direct cellular damage. May be dose- Occurs after repeated exposure to the drug dependent. Reaction can be seen with initial exposure to the drug Incidence Low High Pathophysiology Type IV hypersensitivity reaction Direct tissue injury Onset >24hrs <24hrs Clinical appearance Eczematous Exaggerated sunburn reaction with erythema, itching, and burning Localization May spread outside exposed areas Only exposed areas Pigmentary changes Unusual Frequent Histology Epidermal spongiosis, exocytosis of lymphocytes and a perivascular Necrotic keratinocytes, predominantly lymphocytic and neutrophilic inflammatory infiltrate dermal infiltrate DIAGNOSIS Most cases of drug-induced photosensitivity can be diagnosed based on physical examination, detailed clinical history, and knowledge of drug classes typically implicated in photosensitive reactions. Specialized testing is not necessary to make the diagnosis for most patients. However, in cases where there is no prior literature to support a photosensitive reaction to a given drug, or where the diagnosis itself is in question, implementing phototesting, photopatch testing, or rechallenge testing can be useful. -
Follicular Eruption As a Cutaneous Manifestation in COVID-19 Retno Danarti ,1 Aries Budiarso,2 Dionisia Lintang Unggul Rini,1 Hardyanto Soebono1
Case report BMJ Case Rep: first published as 10.1136/bcr-2020-238182 on 29 October 2020. Downloaded from Follicular eruption as a cutaneous manifestation in COVID-19 Retno Danarti ,1 Aries Budiarso,2 Dionisia Lintang Unggul Rini,1 Hardyanto Soebono1 1Department of Dermatology SUMMARY entered a red area known for COVID-19 trans- and Venereology, Faculty of A 50-year -old man presented to our dermatology mission and was rapid tested with positive result. Medicine, Public Health, and clinic with itchy skin rash. The rash began 5 days after He did self- quarantine at home, while waiting for Nursing, Universitas Gadjah systemic symptoms appeared such as mild fever and mild confirmation of COVID-19 from the results of Mada, Yogyakarta, Indonesia dyspnoea. The rashes were a characteristic of follicular the nasopharyngeal swab testing used in reverse 2Department of Dermatology transcription PCR (RT- PCR) examination. On day and Venereology, Setjonegoro eruption, which started on his stomach and spread District Hospital, Wonosobo, all over his body. After a thorough evaluation, he was 5 after systemic symptoms, he experienced skin Central Java, Indonesia diagnosed with COVID-19 and was started on COVID-19 lesions which included itchy, stinging feelings, with regimens. Skin lesions disappeared on the ninth day a burning sensation. The skin lesions that started Correspondence to of treatment. Our findings contribute to the growing on his stomach spread all over his body, extremi- Dr Retno Danarti; awareness of dermatological manifestations in patients ties, neck and face. The clinical manifestation was danarti@ ugm. ac. id with COVID-19. suggestive of follicular eruption (figure 1A–C).