DOCSLIB.ORG

Richtlijn Acneïforme Dermatosen

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Richtlijn Acneïforme Dermatosen Richtlijn Acneïforme dermatosen Richtlijn: Acneïforme dermatosen Colofon Richtlijn Acneïforme dermatosen © 2010, Nederlandse Vereniging voor Dermatologie en Venereologie (NVDV) Postbus 8552, 3503 RN Utrecht Telefoon: 030-2823180 E-mail: [email protected] Alle rechten voorbehouden. Niets uit deze uitgave mag worden verveelvoudigd of openbaar worden gemaakt, in enige vorm of op enige wijze, zonder voorafgaande schriftelijke toestemming van de Nederlandse Vereniging voor Dermatologie en Venereologie. Deze richtlijn is opgesteld door een daartoe geïnstalleerde werkgroep van de Nederlandse Vereniging voor Dermatologie en Venereologie. De richtlijn is vervolgens vastgesteld in de algemene ledenvergadering. De richtlijn vertegenwoordigt de geldende professionele standaard ten tijde van de opstelling van de richtlijn. De richtlijn bevat aanbevelingen van algemene aard. Het is mogelijk dat deze aanbevelingen in een individueel geval niet van toepassing zijn. De toepasbaarheid en de toepassing van de richtlijnen in de praktijk is de verantwoordelijkheid van de behandelend arts. Er kunnen zich feiten of omstandigheden voordoen waardoor het wenselijk is dat in het belang van de patiënt van de richtlijn wordt afgeweken. 1 Versie 18-06-2010 WERKGROEP Prof. dr. P.C.M. van de Kerkhof, dermatoloog, voorzitter werkgroep Mw. J.A. Boer, huidtherapeut Drs. R.J. Borgonjen, ondersteuner werkgroep Dr .J.J.E. van Everdingen, dermatoloog Mw. M.E.M. Janssen, huidtherapeut Drs. M. Kerzman, NHG/huisarts Dr. J. de Korte, dermatopsycholoog Drs. M.F.E. Leenarts, dermatoloog i.o. Drs. M.M.D. van der Linden, dermatoloog Dr. J.R. Mekkes, dermatoloog Drs. J.E. Mooij, promovendus dermatologie Drs. L. van ’t Oost, dermatoloog i.o. Dr. V. Sigurdsson, dermatoloog Mw. C. Swinkels, hidradenitis patiënten vereniging/patiëntvertegenwoordiger Drs. H.C. de Vijlder, dermatoloog i.o. Drs. H. van der Zee, dermatoloog i.o. Drs. E.J. van Zuuren, dermatoloog 2 Versie 18-06-2010 HOOFDSTUKINDELING WERKGROEP ....................................................................................................................................................... 2 HOOFDSTUKINDELING.....................................................................................................................................3 ALGEMENE INTRODUCTIE ..............................................................................................................................5 ACNE ................................................................................................................................................................... 10 I. INLEIDING............................................................................................................................................ 10 II. EPIDEMIOLOGIE................................................................................................................................. 11 III. PATHOFYSIOLOGIE EN MICROMORFOLOGIE............................................................................. 11 IV. KLINISCH BEELD................................................................................................................................ 12 V. DIAGNOSTIEK..................................................................................................................................... 12 VI. THERAPIE............................................................................................................................................. 13 ZELFZORG BIJ ACNE ......................................................................................................................... 13 ACNE EN VOEDING............................................................................................................................ 14 LOKALE THERAPIE............................................................................................................................ 17 MEDICAMENTEUZE THERAPIE......................................................................................... 17 Benzoylperoxide......................................................................................................... 17 Retinoïden .................................................................................................................. 19 Antibiotica.................................................................................................................. 21 ANDERE LOKALE THERAPIEËN ....................................................................................... 24 Lichtterapie................................................................................................................. 24 Peeling en microdermabrasie...................................................................................... 27 SYSTEMISCHE THERAPIE................................................................................................... 28 Antibiotica.................................................................................................................. 28 Retinoïden .................................................................................................................. 34 Hormonale behandeling.............................................................................................. 37 VII. SAMENVATTING EN MATRIX THERAPIEKEUZE..................................................................... 43 HIDRADENITIS SUPPURATIVA...................................................................................................................... 45 I.INLEIDING................................................................................................................................................... 45 II. EPIDEMIOLOGIE................................................................................................................................. 46 III. PATHOFYSIOLOGIE EN HISTOLOGIE ............................................................................................ 47 IV. KLINISCH BEELD................................................................................................................................ 48 V. KWALITEIT VAN LEVEN............................................................................................................... 48 VI. DIAGNOSTIEK.................................................................................................................................. 49 VII. THERAPIE ......................................................................................................................................... 50 LOKALE THERAPIEËN....................................................................................................................... 50 Resorcinol................................................................................................................................. 50 Azelaïnezuur............................................................................................................................. 52 Clindamycine lokaal................................................................................................................. 52 SYSTEMISCHE THERAPIEËN ........................................................................................................... 53 SYSTEMISCHE ANTIBIOTICA ............................................................................................ 53 Systemische behandeling met clindamycine en rifampicine ...................................... 53 Tetracyclinen.............................................................................................................. 55 Overige antibiotica ..................................................................................................... 56 ANTI-INFLAMMATOIRE MIDDELEN ................................................................................ 56 Dapson........................................................................................................................ 56 Corticosteroïden systemisch....................................................................................... 57 Corticosteroïden intralesionaal................................................................................... 57 Ciclosporine en methotrexaat ..................................................................................... 58 ANTI-ACNE MIDDELEN....................................................................................................... 59 Isotretinoïne................................................................................................................ 59 Acitretine.................................................................................................................... 60 HORMONALE BEHANDELING ........................................................................................... 61 Finasteride .................................................................................................................. 61 Cyproteronacetaat....................................................................................................... 62 3 Versie 18-06-2010 TNF-ALPHA REMMENDE MIDDELEN .............................................................................. 63 Infliximab ................................................................................................................... 64 Adalimumab ............................................................................................................... 67 Etanercept..................................................................................................................
Load more

Recommended publications
  • Pathological Investigation of Rosacea with Particular Regard Of
    CORE Metadata, citation and similar papers at core.ac.uk Provided by White Rose E-theses Online A Clinico-Pathological Investigation of Rosacea with Particular Regard to Systemic Diseases Dr. Mustafa Hassan Marai Submitted in accordance with the requirements for the degree of Doctor of Medicine The University of Leeds School of Medicine May 2015 “I can confirm that the work submitted is my own and that appropriate credit has been given where reference has been made to the work of others” “This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement” May 2015 The University of Leeds Dr. Mustafa Hassan Marai “The right of Dr Mustafa Hassan Marai to be identified as Author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988” Acknowledgement Firstly, I would like to thank all the patients who participate in my rosacea study, giving their time and providing me with all of the important information about their disease. This is helped me to collect all of my study data which resulted in my important outcome of my study. Secondly, I would like to thank my supervisor Dr Mark Goodfield, consultant Dermatologist, for his continuous support and help through out my research study. His flexibility, understanding and his quick response to my enquiries always helped me to relive my stress and give me more strength to solve the difficulties during my research. Also, I would like to thank Dr Elizabeth Hensor, Data Analyst at Leeds Institute of Molecular Medicine, Section of Musculoskeletal Medicine, University of Leeds for her understanding the purpose of my study and her help in analysing my study data.
    [Show full text]
  • Pathogenesis of Rosacea Anetta E
    REVIEW Pathogenesis of Rosacea Anetta E. Reszko, MD, PhD; Richard D. Granstein, MD Rosacea is a chronic, common skin disorder whose pathogenesis is incompletely understood. An inter- play of multiple factors, including genetic predisposition and environmental, neurogenic, and microbial factors, may be involved in the disease process. Rosacea subtypes, identified in the recently published standard classification system by the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea, may in fact represent different disease processes, and identifying subtypes may allow investigators to pursue more precisely focused studies. New developments in molecular biology and genetics hold promise for elucidating the interplay of the multiple factors involved in the pathogen- esis of rosacea, as well as providing the bases for potential new therapies. osacea is a common, chronic skin disorder and secondary features needed for the clinical diagnosis primarily affecting the central and con- of rosacea. Primary features include flushing (transient vex areas of COSthe face. The nose, cheeks, DERM erythema), persistent erythema, papules and pustules, chin, forehead, and glabella are the most and telangiectasias. Secondary features include burn- frequently affected sites. Less commonly ing and stinging, skin dryness, plaque formation, dry affectedR sites include the infraorbital, submental, and ret- appearance, edema, ocular symptoms, extrafacial mani- roauricular areas, the V-shaped area of the chest, and the festations, and phymatous changes. One or more of the neck, the back, and theDo scalp. Notprimary Copy features is needed for diagnosis.1 The disease has a variety of clinical manifestations, Several authors have theorized that rosacea progresses including flushing, persistent erythema, telangiecta- from one stage to another.2-4 However, recent data, sias, papules, pustules, and tissue and sebaceous gland including data on therapeutic modalities of various sub- hyperplasia.
    [Show full text]
  • Pathological Investigation of Rosacea with Particular Regard Of
    A Clinico-Pathological Investigation of Rosacea with Particular Regard to Systemic Diseases Dr. Mustafa Hassan Marai Submitted in accordance with the requirements for the degree of Doctor of Medicine The University of Leeds School of Medicine May 2015 “I can confirm that the work submitted is my own and that appropriate credit has been given where reference has been made to the work of others” “This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement” May 2015 The University of Leeds Dr. Mustafa Hassan Marai “The right of Dr Mustafa Hassan Marai to be identified as Author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988” Acknowledgement Firstly, I would like to thank all the patients who participate in my rosacea study, giving their time and providing me with all of the important information about their disease. This is helped me to collect all of my study data which resulted in my important outcome of my study. Secondly, I would like to thank my supervisor Dr Mark Goodfield, consultant Dermatologist, for his continuous support and help through out my research study. His flexibility, understanding and his quick response to my enquiries always helped me to relive my stress and give me more strength to solve the difficulties during my research. Also, I would like to thank Dr Elizabeth Hensor, Data Analyst at Leeds Institute of Molecular Medicine, Section of Musculoskeletal Medicine, University of Leeds for her understanding the purpose of my study and her help in analysing my study data.
    [Show full text]
  • A Dissertation on CLINICO EPIDEMIOLOGICAL STUDY of FACIAL DERMATOSES AMONG ADULTS
    A Dissertation on CLINICO EPIDEMIOLOGICAL STUDY OF FACIAL DERMATOSES AMONG ADULTS Dissertation submitted to THE TAMILNADU DR.M.G.R. MEDICAL UNIVERSITY CHENNAI-600032 With partial fulfillment of the requirements for the award of M.D.DEGREE IN DERMATOLOGY, VENEREOLOGY AND LEPROLOGY (BRANCH - XX) REG. No. 201730201 COIMBATORE MEDICAL COLLEGE AND HOSPITAL COIMBATORE MAY 2020 DECLARATION I Dr . MANIVANNAN . M solemnly declare that the dissertation entitled “CLINICO EPIDEMIOLOGICAL STUDY OF FACIAL DERMATOSES AMONG ADULTS ” is a bonafide work done by me at Coimbatore Medical College Hospital during the year June 2018 to May 2019 under the guidance & supervision of Dr. M. KARUNAKARAN M.D., (DERM) Professor& Head of Department, Department of Dermatology, Coimbatore Medical College & Hospital. The dissertation is submitted to Dr. MGR Medical University towards partial fulfillment of requirement for the award of MD degree branch XX Dermatology, Venereology and Leprology. PLACE: Dr. MANIVANNAN .M DATE: CERTIFICATE This is to certify that the dissertation entitled “CLINICO EPIDEMIOLOGICAL STUDY OF FACIAL DERMATOSES AMONG ADULTS” is a bonafide original work done by Dr. MANIVANNAN.M. Post graduate student in the Department of Dermatology, Venereology and Leprology, Coimbatore Medical College Hospital, Coimbatore under the guidance of Dr. M. KARUNAKARAN M.D., (DERM), Professor and HOD of Department, Department of Dermatology, Coimbatore Medical College Hospital, Coimbatore in partial fulfillment of the regulations for the Tamilnadu DR.M.G.R Medical University, Chennai towards the award of MD., degree (Branch XX.) in Dermatology, Venereology and Leprology. Date : GUIDE Dr. M. KARUNAKARAN M.D., (DERM) Professor & HOD, Department of Dermatology, Coimbatore Medical College & Hospital. Date : Dr.
    [Show full text]
  • The Great Mimickers of Rosacea
    The Great Mimickers of Rosacea Jeannette Olazagasti, BS; Peter Lynch, MD; Nasim Fazel, MD, DDS Practice Points Rosacea is characterized by frequent flushing; persistent erythema (ie, lasting for at least 3 months); telangiectasia; and interspersed episodes of inflammation with swelling, papules, and pustules. Rosacea is most commonly seen in adults older than 30 years and is considered to have a strong hereditary component, as it is more commonly seen in individuals of Celtic and Northern European descent as well as those with fair skin. Although rosacea is one of the most common Rosacea Characteristics conditions treated by dermatologists, it also is Rosacea is a chroniccopy disorder affecting the central one of the most misunderstood. It is a chronic dis- parts of the face that is characterized by frequent order affecting the central parts of the face and flushing; persistent erythema (ie, lasting for at least is characterized by frequent flushing; persistent 3 months); telangiectasia; and interspersed epi- erythema (ie, lasting for at least 3 months); tel- sodes of inflammation with swelling, papules, and angiectasia; and interspersed episodes of inflam- pustules.not2 It is most commonly seen in adults older mation with swelling, papules, and pustules. than 30 years and is considered to have a strong Understanding the clinical variants and disease hereditary component, as it is more commonly seen course of rosacea is important to differentiateDo in individuals of Celtic and Northern European this entity from other conditions that can mimic descent as well as those with fair skin. Furthermore, rosacea. Herein we present several mimickers of approximately 30% to 40% of patients report a fam- rosacea that physicians should consider when ily member with the condition.2 diagnosing this condition.
    [Show full text]
  • Abscess, 600, 601F, 602 Apocrine Sweat Gland, 14–16
    3038r_ind_1023-1041 4/11/01 2:14 PM Page 1023 INDEX A Allergic phytodermatitis (APD), 26–28, Abscess, 600, 601f, 602 28f–29f apocrine sweat gland, 14–16, 15f, 17f Allopurinol, drug reaction to, 554 tuberculosis, metastatic, 661–662, 664, 666 ALM (acral lentiginous melanoma), 295–296, Acantholytic dermatosis, transient, 112, 113f 297f Acanthosis nigricans (AN), 82–83, 83f Alopecia classification, 82 nonscarring, 928–940 malignant, 82–83, 493, 493f–494f alopecia areata, 928–930, 929f, 931f ACD. See Allergic contact dermatitis alopecia totalis, 928 ACDRs (adverse cutaneous drug reactions). alopecia universalis, 928, 931f See Drug reactions anagen effluvium, 940, 940f ACE (angiotensin-converting enzyme) inhib- androgenetic alopecia, 932–936, 933f, itors, reactions to, 556 935f–936f Acetowhitening, 1015 neoplastica, 482 Acne keloidalis, 941, 945f telogen effluvium, 937–939, 938t–939t, Acne rosacea. See Rosacea 939f Acne vulgaris, 2–6, 3f, 5f, 7f scarring, 941, 942f–945f, 942t acne conglobata, 4 α1 antitrypsin-deficiency panniculitis, 146 acne fulminans, 4 Amiodarone-induced pigmentation, 566, 567f recalcitrant acne, 4 Amoxicillin drug reaction, 554 Acneform drug eruptions, 548 Ampicillin drug reaction, 553f, 554 Acral lentiginous melanoma (ALM), 295–296, Amyloidosis, systemic, 334–336, 335f, 337f 297f acquired, 334–336, 335f, 337f Acrochordon, 209f secondary, 334, 336 Acrodermatitis continua of Hallopeau, 69 AN. See Acanthosis nigricans Acrodermatitis enteropathica, 430–431, 432f Anagen effluvium, 940, 940f Acrosclerosis, 375f Anaphylaxis and anaphylactoid reactions, 547, ACTH-induced pigmentation, 568 556, 558 Actinic keratosis, 217, 219, 220f Angioedema and urticaria, 338–344, 339f, Actinic prurigo, 230, 234 341f–343f, 344t, 345f Acute febrile neutrophilic dermatosis. See drug reaction, 547, 556–558, 559f Sweet’s syndrome urticaria perstans, 393–394, 394f Acute retroviral syndrome (ARS), 912–915, urticarial vasculitis, 393–394, 394f 915f, 915t Angiokeratoma, 183f AD.
    [Show full text]
  • Otophyma: About a Case
    ACNE, ROSACEA, AND RELATED DISORDERS (INCLUDING HIDRADENITIS SUPPURATIVA) OTOPHYMA: ABOUT A CASE N Maya (1) - E Tababa (1) - Na Vashi (1) Boston University School Of Medicine, Department Of Dermatology, Boston, United States (1) Background: Phyma, a slowly progressive and disfiguring disorder of the face and ears, is generally considered to be an advanced form of rosacea. Interestingly, it may occur in patients with no other signs or symptoms of rosacea. It is caused by sebaceous gland hyperplasia and hypertrophy with surrounding fibrous tissue proliferation. Phyma typically affects the nose (rhinophyma); however, equivalent presentations can occur on the chin (gnatophyma), forehead (metophyma), ears (otophyma), and eyelids (blepharophyma). Although rhinophyma is ubiquitously seen in clinical practice, otophyma (rosaceous lymphedema of the ear) is much more rare and uncommonly reported in the literature. It presents as either unilateral or bilateral edematous ear involvement with or without coexisting facial rosacea. Observation: A 58-year-old Hispanic man presented for evaluation of a one-month history of asymptomatic enlarged ears. He denied any triggers or history of repeated trauma to the affected area. His past medical history was non-contributory and notably negative for thyroid disease, dermatomyositis, systemic lupus erythematosus, angioedema or sarcoidosis. Physical examination was notable for bilateral diffuse auricular enlargement with mild- moderate edema and without associated overlying erythema, scale, erosion or induration. No paresthesia or dysesthesia was noted. His facial skin was devoid of any other dermatologic conditions. Importantly, he had no other signs of rosacea. The differential diagnosis included leprosy, sarcoidosis and malignancy, particularly angiosarcoma. A punch biopsy of the right ear lobule was notable for a superficial perivascular and perifollicular lymphoplasmacytic infiltrate and papillary dermal edema, consistent with rosacea.
    [Show full text]
  • Inhoudsopgave ­Officiële Orgaan Van De Nederlandse Vereniging Voor Dermatologie En Venereologie
    NEDERLANDS TIJDSCHRIFT VOOR DERMATOLOGIE EN VENEREOLOGIE | VOLUME 21 | NUMMER 02 | FEBRUARI 2011 61 Het Nederlands Tijdschrift voor Dermatologie en Venereologie is het InhoudsoPgave officiële orgaan van de Nederlandse Vereniging voor Dermatologie en Venereologie. Het NTvDV is vanaf 1 januari 2008 geïndiceerd in NVDV NASCHOLING - DERMATOLOGENDAGEN 2011 EMBase, de internationale wetenschappelijke database Programma 24 en 25 maart 2011 62 van Elsevier Science. Psoriasis genetics and clinical implications 68 Hoofdredactie Dr. P.G.M. van der Valk, hoofdredacteur Is psoriasis een afwijking van het verworven immuunsysteem? 70 79 artiKeLeN Psoriasis: een ziekte veroorzaakt door onze innate immuniteit? Dr. R.C. Beljaards, dr. J.J.E. van Everdingen, dr. C.J.W. van Ginkel, Psoriasis: een huidbarrièreziekte? 82 dr. M.J. Korstanje, prof. dr. A.P. Oranje, dr. R.I.F. van der Waal Kritische blik op psoriasis en cardiovasculaire ziekten 87 Leerzame zieKtegescHiedeNisseN Dr. R. van Doorn, dr. S. van Ruth, dr. M. Seyger, Stress, cortisol en psoriasis: als stress onder de huid gaat… 89 dr. J. Toonstra, dr. M. Vermeer Juveniele psoriasis 92 rubrieK dermatocHirurgie Een kritische beschouwing over de beschikbare behandelingen A.M. van Rengen, dr. J.V. Smit , dr. R.I.F. van der Waal van psoriasis 96 rubrieK referaat Dr. W.P. Arnold, dr. A.Y. Goedkoop, dr. E.M. van der Snoek, Kliniek, epidemiologie en pathogenese van acneïforme dr. T.J. Stoof, dr. H.B. Thio, dermatosen 101 rubrieK vereNigiNg Klinische presentaties en histopathologische kenmerken Dr. M.B. Crijns, dr. J.J.E. van Everdingen van acne vulgaris 102 rubrieK oNderzoeK vaN eigeN bodem Dr. H.J.
    [Show full text]
  • Dermatology 101: from Acne to Zebras and the Pearls in Between
    Dermatology 101: From Acne to Zebras and the Pearls in Between Dr Kyle Cullingham, BA, BSc, MSc, MD, FRCPC Dermatologist Skinsense Dermatology, Saskatoon,SK Assistant Professor University of Saskatchewan Disclosures Speaker: Dr Kyle Cullingham Relationships with commercial interests: Speakers Bureau/Honoraria: Abbvie, Allergan, Celgene, LEO Consulting Fees: Abbvie, Celgene, Galderma, Janssen, LEO, Novartis Conflict of Interest Declaration: Nothing to Disclose Presenter: Dr. Kyle Cullingham Title of Presentation:Dermatology for GPs I have no financial or personal relationship related to this presentation to disclose. Objectives Discuss some common dermatological concerns – focus on recognition, management, what’s new and pearls. Acne Clinical pearls Rosacea Psoriasis Eczema Interspersed with interesting real Dermatology cases with common pitfalls, red flags, or learning points. Time for questions/comments Acne disorder of the pilosebaceous unit affects certain areas of the body: face > trunk >> buttocks manifests during adolescence, but can occur at any stage of life comedones, papulopustules, nodules, cysts scarring can follow Epidemiology acne affects approximately 85% of adolescents onset during puberty (10-19 y/o); may appear after age 25 more severe in men higher incidence in caucasians and indigenous population inheritance: multifactorial; most patients with cystic acne have parental history of severe acne Pathogenesis Corneocyte Sebum Propionibacterium acnes Inflammatory cell Drugs Diet Recent JAAD review
    [Show full text]
  • Kazlouskaya V
    MINISTRY OF HEALTH OF REPUBLIC OF BELARUS GOMEL STATE MEDICAL UNIVERSITY V. V. Kazlouskaya SELECTED LECTURES ON DERMATOLOGY Manual for foreign medical students Gomel GSMU 2008 УДК 616.5 (075.8)=20 ББК 55.8 К 59 Рецензеты: заведующий кафедрой дерматовенерологии УО «Витебский государственный медицинский университет», доктор медицинских наук, профессор В. П. Адаскевич; заведующий кафедрой поликлинической терапии и общеврачебной практики с курсом дерматовенерологии УО «Гомельский государственный медицинский университет», кандидат медицинских наук, доцент Э. Н. Платошкин. Козловская, В. В. К 59 Курс лекций по дерматологии: учеб.-метод. пособие для студентов- медиков = Selected Lectures on Dermatology: manual for foreign medical students / В. В. Козловская. — Гомель: Учреждение образования «Го- мельский государственный медицинский университет», 2008. — 160 с. ISBN 978-985-506-210-4 Учебно-методическое пособие «Selected Lectures on Dermatology» представляет собой курс лекций по дерматологии, предназначенный для иностранных студентов 3 курса, обучающихся на английском языке. Лекции составлены в соответствии с типовой учебной программой и содержат основные разделы цикла дерматология. Утверждено и рекомендовано к изданию Центральным учебным научно- методическим советом учреждения образования «Гомельский государственный медицинский университет» 20 ноября 2008 г., протокол № 11. УДК 616.5 (075.8) ББК 55.8 ISBN 978-985-506-210-4 © Учреждение образования «Гомельский государственный медицинский университет», 2008 2 Abbreviations Used in the Book AA
    [Show full text]
  • UC Davis Dermatology Online Journal
    UC Davis Dermatology Online Journal Title Otophyma: a rare benign clinical entity mimicking leprosy Permalink https://escholarship.org/uc/item/41p4q5xq Journal Dermatology Online Journal, 21(3) Authors Shuster, Marina McWilliams, Ashley Giambrone, Danielle et al. Publication Date 2015 DOI 10.5070/D3213024280 Supplemental Material https://escholarship.org/uc/item/41p4q5xq#supplemental License https://creativecommons.org/licenses/by-nc-nd/4.0/ 4.0 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Volume 21 Number March 2015 Photo vignette Otophyma: a rare benign clinical entity mimicking leprosy Marina Shuster BA1, Ashley McWilliams BS2, Danielle Giambrone BS3, Omar Noor MD3, Jisun Cha MD3 Dermatology Online Journal 21 (3): 22 1Harvard Medical School 2Virginia Commonwealth University School of Medicine 3Rutgers- Robert Wood Johnson Medical School Correspondence: Danielle Giambrone Department of Dermatology Rutgers- Robert Wood Johnson Medical School 1 World’s Fair Drive Somerset, NJ 08873 Email: [email protected] Phone: 609-220-7710 Abstract Otophyma is a rare condition characterized by edematous deformation of the ear that is considered to be the end-stage of an inflammatory process such as rosacea and eczema. This report illustrates a case in an elderly male, originally thought to have leprosy. Biopsy revealed a nodular infiltration of inflammatory cells around adnexal structures and an intraepidermal cyst. No acid-fast organisms were identified. We present a patient who is of a different ethnic group than usually seen with this disease and provide a review of the clinical presentation, histopathological features, and management of this rare condition. Keywords: Otophyma, Leprosy, Rhinophyma, Rosacea Case synopsis A 62-year-old Filipino male presented for evaluation of his grossly enlarged ears.
    [Show full text]
  • The Treatment of Rosacea Anetta E
    Review The Treatment of Rosacea Anetta E. Reszko MD, PhD; Diane Berson MD Rosacea is a chronic condition affecting the facial and frequently ocular tissues. It is historically underdi- agnosed and affects people of all ethnicities, with higher overall prevalence in people of Celtic descent. The exact pathophysiology of rosacea is poorly understood. A variety of medical therapies, depending on the subtype, are available to treat the various signs and symptoms of rosacea. osacea is a common, chronic skin disorder differentiated from chronic sun damage and photoder- that frequently affects light-skinned white matitis. Papulopustular rosacea must be distinguished population. Overall prevalence of rosacea from acne vulgaris, seborrheic dermatitis, lupus miliaris ranges from less than 1% up to 10%. The disseminates faciei, collagen vascular diseases, perioral nose, cheeks, chin, forehead, and glabella dermatitis, and Demodex folliculitis. Differential diag- areR the most frequently affected sites. The disease has a nosis of ocular rosacea includes allergic conjunctivitis variety of clinical manifestations ranging from flushing, and blepharitis. persistent COSerythema, telangiectasias, papules, pustules, DERM Therapy of rosacea is centered on symptomatic and sebaceous gland hyperplasia. Significant psycho- improvement, including reduction of facial erythema logical stress and perceived diminished quality of life and number of inflammatory lesions; decrease in the often accompany this condition.1 The pathogenesis is number, duration and intensity
    [Show full text]