Index

A management/prognosis, 332–335 Acquired and idiopathic , 79 nail findings, 329, 330 Acute cutaneous (ACLE), pathophysiology/genetics, 331–332 254, 255 Alopecia totalis, 329, 330 Allergic contact dermatitis (ACD). See also Alopecia universalis, 329 Rubber American Contact Dermatitis Society, 156 armpit , 169–171 Amoxicillin, 27 chronic rash, 172–173 Angioedema definition, 173 ACE, 68 diagnostic patch testing, 174, 175 acute and chronic angioedema, 67 fragrance series, 176–177 definition, 12 fragrance mix I and II, 175, 176 differential diagnosis, 67 ICDRG scale, 175 Hageman factor (XIIa), 68 pathophysiology, 174 idiopathic angioedema (see Idiopathic preservative angioedema) 2, 5-diazolidinylurea, 134–135 INH deficiency, 68 formaldehyde, 131–133 laboratory findings, 68–69 imidazolidinyl urea, 134 management, 69–70 MCI/MI, 135 mechanisms, 67 MDNG/phenoxyethanol, 135 vasoactive substance, 68 parabens, 135–136 without wheals, 18 quaternium-15, 133–134 Angiotensin converting enzyme (ACE) standard series , 131 angioedema, 68 prevalence, 173–174 HAE, 81 red and splotchy rash, 171–172 laryngeal , 79 Alopecia areata presenting cells (APCs), 158, 174 definition, 329 , 21–22 epidemiology, 329 , 17 hair loss Asthma differential diagnosis, 324–328 clinical presentation, 25 hypothyroidism, 327 diagnosis, 27 medical history and , differential diagnosis, 26 323, 326 follow up, 27–28 physical examination, 324, 326, 327 physical examination, 26 hair pull tests, 329 treatment, 25–26 histopathology, 332, 333 urticaria and angioedema, 26 immune-mediated disease, 329, 331 work-up, 27

339 340 Index

Atopic dermatitis B in adult, 193 Blue jean (nickel) ACD, 154 in childhood, 192 Bullous lupus, 256, 314 diagnosis, 195 Bullous pemphigoid, 314, 315 eczema differential diagnosis, 187–188 C impetiginized lesions, 188–189 Calcineurin inhibitors, 165 management and follow-up, 190–191 Candida albicans. See Recurrent vaginal medical and social history, 187 candidiasis physical examination, 187–191 C1 esterase inhibitor review of systems, 187 facial and throat swelling, 62, 63 seborrheic dermatitis, 190 HAE, 14, 19 subacute spongiotic dermatitis, 189 recurrent angioedema, 66 genetics, 193–194 Chronic cutaneous lupus erythematosus histology, 193 (CCLE), 254, 263 immunology, 194–195 Chronic dorsal foot eczema, 142–143 prevalence, 192 Chronic idiopathic angioedema, 69 rash Churg–Strauss syndrome, 226–228 autoimmune disease elimination, 186 C1-INH. See Complement 1 inhibitor differential diagnosis, 185 Clavulanic acid, 27 impetiginized lesions, 186 Cobalt , 13–14 management and follow-up, 186–187 Cold stimulation time test (CSTT), 39 medical and surgical history, 183 physical examination, 184, 185 asthma, 25–28 review of systems, 183 primary acquired (see Primary acquired risk factors, 192 cold urticaria) treatment syncopal and near-syncopal, 28–31 antibiotics, 197 Complement 1 inhibitor (C1-INH ), 76 calcineurin inhibitors, 197–198 Complement 4 (C4) level, 76 and Complete blood count (CBC) antihistamines, 197 femoral medial condyle, nail gun, 116 HEPA filter, 196 , 186 immunosuppressants, 198 urticaria treatment, 22 phototherapy, 197 Comprehensive metabolic panel (CMP), 186 Staphylococcus aureus, 196 Contact urticaria syndrome (CUS) topical corticosteroids, 196–197 atopic dermatitis, 47–48 Autoimmune blistering diseases, causative agent, 55–56 skin and mucous membranes chamber and chamber prick test, 54 desquamative gingivitis ICU, 51 BP, 314, 315 IgE–allergen interaction, 17 bullous lupus erythematosus, 314 medical history, 48–49 differential diagnosis, 312–313 NICU direct immunofluorescence, epoxy (epoxid) resins, 51, 52 313–314 vs. ICU, 52, 53 EBA, 314–316 prostaglandin metabolism inhibition, 52 medical history and medications, 312 substances, 51 MMP, 314, 316–317 nonallergic IgE–independent group, 17 ocular findings, 317–318 open test, 54 physical examination, 312 prevalence, 49–51 treatment measures, 317 radioallergosorbent test (RAST), 55 lichenoid dermatitis (see Lichenoid staging, 53, 54 dermatitis) tachyphylaxis, 55 Autoimmune progesterone dermatitis, 19 treatment-resistant hand eczema, 45–47 Azathioprine, 198 use test, 54–55 Index 341

Corticosteroids , 40 ACD treatment, 149, 165 Cytomegalovirus (CMV), 202 chronic dorsal foot eczema, 142 Crohn’s disease, 76 Cryopyrin, 33 D CUS. See Contact urticaria syndrome Darier’s sign Cutaneous lupus differential diagnosis, 239 bullous lupus, 256 aggregation, 240 classification, 254, 256 physical examination, 238–239 clinical presentation, 256–257 pruritic lesions, 237 DH, 256 skin biopsy, 239 histologic features, 255 Delayed , 16 pruritic rash Dermatitis herpetiformis (DH), 256 complete blood count and punch Dermatomyositis (DM), 290–291 biopsies, 260, 261 Diffuse cutaneous systemic sclerosis diagnosis, 258–260 (DcSSc), 292 skin examination, 259–260 Dimethyglyoxime (DMG) SCLE, 262–264 nickel-containing metal alloys, 164–165 SLE (see Systemic lupus peri-umbilical dermatitis, 154, 155 erythematosus) Diphenylcyclopropenone (DPCP), 335 TEN-like ACLE, 257 Doxepin, 21, 40 Cutaneous lymphocyte-associated antigen Duodenal ischemia, 76 (CLA), 194 Duodenal lymphoma/adenocarcinoma, 76 Cutaneous mastocytosis , 247 Darier’s sign E differential diagnosis, 239 EACA. See Epsilon-aminocaproic acid mast cell aggregation, 240 Eczema. See Atopic dermatitis physical examination, 238–239 Edematous and erythematous lesions pruritic lesions, 237 autoimmune progesterone dermatitis, 11 skin biopsy, 239 chronic urticaria and angioedema, 9 diagnostic evaluation, 246–247 clinical presentation, 7 histopathological analysis, 246 differential diagnosis, 10 intramuscular management and follow-up, 11 allergic reactions, 241 patient history, 10 IgE-mediated anaphylactic reaction, physical examination, 8–10 242–243 EIA. See Exercise-induced anaphylaxis medical and family history, 240 Enzyme-linked immunosorbent assays physical examination, 241 (ELISA), 218, 231 skin biopsy, 241–242 Epidermolysis bullosa acquisita, 314, 315 mediator release, symptoms, 244 Epidermolysis bullosa acquisita (EBA), 256 medical treatment, 247 Epigastric pain non-IgE-mediated mechanisms, 245–246 allergy service assessment, 76 physical examination, 246 bowel syndrome, 73 prognosis, 248 C4 level and C1-INH, 76 serum tryptase, 246 diagnosis, 77 telangiectasia macularis eruptiva perstans, medical and family history, 74 244, 245 pancreatitis, 76 transmembrane tyrosine kinase receptor, physical examination, 74–75 KIT, 243 PUD, 75–76 Cutaneous small-vessel vasculitis, 230–231 Epsilon-aminocaproic acid (EACA), 85 Cyclo-oxygenase 1(COX 1), 68 . See Toxic epidermal necrolysis Cyclooxygenase-2 inhibitor valdecoxib, 95 , 106–108, 115, 117 Cyclosporin, 191, 198 Erythrodermic psoriasis, 274 342 Index

Excited skin syndrome (ESS), 173, 175 I Exercise-induced anaphylaxis (EIA), 17 ICDRG. See International Contact Dermatitis Research Group ICU. See Immunologic contact urticaria F Idiopathic angioedema Familial atypical cold urticaria (FACU), 32–33 facial and throat swelling Familial cold auto-inflammatory syndrome acquired angioedema, 63–64 (FCAS), 32–33 C1 esterase inhibitor, 62, 63 Familial delayed cold urticaria, 32–33 diagnostic testing, 60–62 Filaggrin (FLG) gene, 194 differential diagnosis, 62 , 63 HAE, 63 G IM epinephrine, 59–60 Ganser syndrome, 223 medical history, 60 Gastric antral vascular ectasia (GAVE), induced angioedema, 63 289–290 physical examination and Gold allergy, 160 medications, 60 Guillain-Barre syndrome, 222 review of system, 60 Guttate psoriasis, 274–275 treatment planning, 61 recurrent angioedema acquired angioedema, 66 H comprehensive laboratory evaluation, 66 HAE. See differential diagnosis and testing, 65 Hair loss. See Alopecia areata doxepin, 64 , 16 drug allergy, 64 Henoch-Schonlein purpura, 114 HAE type III, 66 Hereditary angioedema (HAE) medical history, 64 abdominal exacerbations, 83 medication induced angioedema, 66–67 C1 esterase inhibitor, 14, 19 physical examination, 65 epigastric pain (see Epigastric pain) review of system, 64 , 83 treatment planning, 65 facial and throat swelling, 63 TSH, 66 gastrointestinal tract, 81–82 IGDA. See Interstitial granulomatous laryngeal edema, 77–80 dermatitis with arthritis management and treatment IgE receptors, 14, 68 danazol androgen and EACA, 85 IgE-specific enzyme-linked immunosorbent ecallantide (DX-88), 86 assay, 204 fresh frozen plasma, 85 IL-17 cytokine, 159 Rhucin, 85 Immediate pressure urticaria, 15 short-and long-term prophylaxis, 84–85 Immunologic contact urticaria (ICU), 51, 148 pathophysiology, 83 Interferon-gamma (IFN-g? cytokine, 160, 194 recurrent cramping/colicky abdominal International Contact Dermatitis Research pain, 83 Group (ICDRG) subcutaneous/submucosal swelling, 80 armpit rash, 170 type I, II & III, 80 atopic dermatitis, 48 Hereditary C1 inhibitor (INH), 68 chronic rash, 172 Herpes simplex virus (HSV), 202 dermatitis, 155 Hevea brasiliensis, 143 patch test scoring, 175 High efficiency particulate air (HEPA) filter, 196 red and splotchy rash, 171 Histocompatibility Complex Type II Receptor treatment-resistant hand eczema, 46 (MHC II), 136 Interstitial granulomatous dermatitis with Human papilloma virus (HPV), 202 arthritis (IGDA), 233–234 Human seminal plasma (HSP), 205–207 Intracellular adhesion molecule 1 (ICAM-1), 100 Hypothyroidism, 326–328 Inverse psoriasis, 276 Index 343

K Mucous membrane pemphigoid (MMP) Ketotifen, 40 diagnosis, 319 vs. EBA, 316 epiligrin, 318, 319 L mucosal–submucosal junction, 314 Langerhan cells (LCs), 158–159, 174 ocular findings, 317 Laryngeal edema patient management, 316 ACE inhibitors, 79 treatment measures, 317 differential diagnosis, 78–80 MWS. See Muckle−Wells syndrome food allergy, 79 hypothyroidism, 79 ibuprofen, 77 N penicillin allergy, 77 NACDRG. See North American Contact physical examination, 77–78 Dermatitis Research Group Leukocytoclasis, 254 Necrotizing sialometaplasia, 224–225 Lichenoid dermatitis Nephrogenic systemic fibrosis (NSF), 290 allergic contact dermatitis, 304 Nickel and metal-based allergic contact bullous pemphigoid, 305 dermatitis erythema multiforme, 304–305 clinical presentation, 161–162 IgG deposition, 306, 307 cobalt, 160–161 medical and family history, 303 dermatitis, 154–155 medical treatment, 306–309 diagnosis and treatment paraneoplastic pemphigus (see Pemphigus) calcineurin inhibitors, 165 pemphigus vulgaris, 305 DMG test, 164 physical examination, 304 NACDRG standard patch series, review of systems, 304 162–164 skin biopsies, 305–306 non-chelating barrier creams, 165 Stevens–Johnson syndrome, 305 European Union (EU), 157 suprabasilar acantholysis, 306 gold, 160 Lymphocytes and eosinophils, 105 immunology and pathophysiology, 158–159 palladium, 161 patient factors impact, 157 M peri-umbilical dermatitis (eczema), 153–154 Methylchloroisothiazolinone/methylisothiaz- positive patch test, 156 olinone (MCI/MI), 135 transitional metals, 156 Methyldibromoglutaronitrile (MDNG)/ Nifedipine, 22 phenoxyethanol, 135 Nonimmunologic contact urticaria (NICU) MMP. See Mucous membrane pemphigoid epoxy (epoxid) resins, 51, 52 Muckle−Wells syndrome (MWS), 18 vs. ICU, 52, 53 Mucosal surface allergy prostaglandin metabolism inhibition, 52 HSP substances, 51 clinical evaluation, 203 Non-steroidal anti-inflammatory drugs definition, 205 (NSAIDs), 79 differential diagnosis, 202 North American Contact Dermatitis Research ELISA inhibition, 204 Group (NACDRG), 142, 143 gel filtration chromatography, 203–204 armpit rash, 170 HPV DNA probe, 202 atomic dermatitis, 48 IgE-mediated response, 206 chronic rash, 171 immunotherapy, 207 dermatitis, 155 SDS-PAGE, 205 formaldehyde, 131 skin prick and serologic test, 206 MCI/MI and MDNG/phenoxyethanol, 135 symptoms, 201–202, 205 parabens, 136 recurrent vaginal candidiasis (see patch test, 162–164 Recurrent vaginal candidiasis) quaternium-17, 133 344 Index

North American Contact Dermatitis Research Primary acquired cold urticaria (ACU) Group (NACDRG) (cont.) clinical manifestations, 34 red and splotchy rash, 171 definition, 31 treatment-resistant hand eczema, 46 differential diagnosis, 32–33 history and physical examination cold stimulation time test (CSTT), 39 O signs and symptoms, 38–39 Oral antihistamines, 46, 149 pathophysiology, 34 Oral contraceptive pills (OCP), 11 treatment Ordinary urticaria, 14–15 aquatic activities, 40–41 cyproheptadine and doxepin, 40 steroid, 41 P Prostate specific antigen (PSA), 203, 205 Palisaded neutrophilic and granulomatous Provocative use testing (PUT), 171 dermatitis (PNGD), 233 Pruritic urticarial papules and plaques of Papulo-vesiculation, 161 pregnancy (PUPPP), 18–19 Paraben paradox, 136 Pseudoephedrine, 105 Parakeratosis, 193 Psoriasis Pemphigus Auspitz’s sign, 276 desmogleins, 310 Bowen’s disease, 279 diagnosis, 310 classification, 271 paraneoplastic pemphigus comorbidities, 276–277 chronic lymphocytic leukemia, 311 differential diagnosis, 277–278 computed tomography scan, 308 erythrocyte sedimentation rate, 279 murine bladder epithelium, 308, 310 erythrodermic psoriasis, 274 non-Hodgkins lymphoma, 311 guttate psoriasis, 274–275 suprabasilar acantholysis, 307 intermittent irritating skin patch, 267–269 tissue bound antibodies, 310 inverse psoriasis, 276 Peptic ulcer disease (PUD), 75–76 medical treatment, 280–281 Phenytoin (dilantin), 187 pathophysiology . See also Cold urticaria genetics, 272–273 challenge test, 20 molecular pathogenesis, 271–272 , 15 type I and II, 271 delayed pressure urticaria, 16 plaque psoriasis, 273–274 dermographism, 15 psoriatic arthritis, 276 heat urticaria, 16 pustular psoriasis, 275 Pimecrolimus, 183, 187 Reiter’s syndrome, 279 Preservatives scaly and flaky skin patch, 269–270 chronic recurrent dermatitis, 127–128 skin biopsy, 278 cosmetic ingredient review, 130 total body examination, 278 definition, 130 VDRL lab test, 280 diagnostic procedures, 136–137 Psoriatic arthritis, 276 intermittent hand eczema, 129–130 Pustular psoriasis, 275 pathophysiology, 136 types 2, 5-diazolidinylurea, 134–135 R formaldehyde, 131–133 Rash imidazolidinyl urea, 134 allergic contact dermatitis (ACD) MCI/MI, 135 armpit, 169–171 MDNG/phenoxyethanol, 135 chronic, 172–173 parabens, 135–136 red and splotchy, 171–172 quaternium-15, 133–134 atopic dermatitis United States Food and Drug autoimmune disease elimination, 186 Administration (FDA), 130 differential diagnosis, 185 Index 345

impetiginized lesions, 186 Riley-Day syndrome, 11 management and follow-up, 186–187 Rubber allergies medical and surgical history, 183 chronic dorsal foot eczema, 142–143 physical examination, 184, 185 clinical manifestations, 147–148 review of systems, 183 diagnosis and treatment, 149 bullous and erythematous Hevea brasiliensis, 143 clobazam, 99 IgE-mediated allergy, 144 cutaneous eruption, 97 immunology and pathophysiology, 145–146 cytotoxic T lymphocytes, 100 latex-accelerator complex and exposure, 144 epidermal necrosis, 98–99 phospholipoprotein matrix, 144 immunological mechanism, 100 prevalence, 144–145 photo-Koebner phenomenon, 99 recalcitrant hand eczema, 141–142 physical examination, 97 complete blood count (CBC), 186 pruritic S complete blood count and punch , 19 biopsies, 260, 261 Scleroderma diagnosis, 258–260 classification and prevalence, 298, 299 skin examination, 259–260 clinical presentation, 298–299 Raynaud’s phenomenon (RP) deep tissue skin biopsy, 296–298 DcSSc, 292 definition, 298 diagnostic testing, 288 dermal and subcutaneous septal sclerosis, differential diagnosis 297, 298 chronic graft vs. host disease, 292 differential diagnosis, 297 DM, 290–291 histological findings, 299 NSF, 290 medical treatment, 300 scleredema adultorum, 291–292 pathogenesis, 299–300 systemic lupus erythematous, 290 physical and skin examination, 296, 297 GAVE, 289–290 RP physical examination, 288 DcSSc, 292 social and environmental history, 288 diagnostic testing, 288 SSc differential diagnosis, 290–292 CREST, 293 GAVE, 289–290 digital ulceration and renal physical examination, 288 involvement, 293 social and environmental history, 288 Doppler echocardiography, 294 SSc, 292–294 gastrointestinal involvement, 293 symptoms, 296 medical treatment, 294 Scleroderma renal crisis (SRC), 293 microchimerism, 292 Seminal plasma sensitizing proteins pathogenesis, 292 ELISA inhibition, 204 pulmonary involvement, 293–294 gel filtration chromatography, 203–204 Recurrent vaginal candidiasis IgE-specific enzyme-linked allergen immunotherapy, 210 immunosorbent assay, 204 antifungal agents, 208 SDS-PAGE and western chronic vulvovaginal hypersensitivity, immunoblotting, 205 210–212 Serum sickness differential diagnosis, 209 femoral medial condyle, nail gun IgE measurement, 209 characteristics, 118–119 positive KOH preps, 208 complete blood counts, 116, 117

prostaglandin E2 (PGE2) inhibition, 210 differential diagnosis, 117 risk factors, 209 drug allergies, 116 skin prick testing, 209 intravenous solu-medrol, 117 treatment response, 212 intravenous vancomycin, 115 Rheumatic juvenile arthritis, 114 medical history, 116 346 Index

Serum sickness (cont.) drug dosage, 5 necrotic keratinocyte, 117, 118 management and follow-up, 6 physical examination, 116 physical examination, 4–5 Rocephin, 115 punch biopsy, 5 vasculitis, 117 Telangiectasia macularis eruptiva perstans, immune complex detection, 120 244, 245 management/treatment, 120, 121 Toxic epidermal necrolysis pathophysiology, 119–120 bullous and erythematous rash vs. serum sickness like-reactions, 121 clobazam, 99 symptoms, 119 cutaneous eruption, 97 type III hypersensitivity reaction, 119 cytotoxic T lymphocytes, 100 upper respiratory infections epidermal necrosis, 98–99 augmentin (amoxicillin/clavulanate) immunological mechanism, 100 antibiotic therapy, 111, 115 photo-Koebner phenomenon, 99 bilateral knee joint effusion, 114 physical examination, 97 differential diagnosis and testing, erythema 113–114 causative agent and corticosteroids, 96 keflex (cephalexin), 112 diagnosis, 93–94 medical history and physical etiologic categories, 95 examination, 112 herpes virus, 96 work-up, 114 mucosal pseudomembrane formation, 94 Sodium dodecyl sulphate–polyacrylamide gel multiple keratinocyte, 95 electrophoresis (SDS-PAGE), 205 prognosis, 96 , 17 satellite cell necrosis, 92 Spina bifida/spinal dysraphism, 144, 148–149 SCORTEN, 95 Stevens–Johnson syndrome, 117, 252–253. targetoid lesions, 94 See also Toxic epidermal necrolysis viral diseases, 95 Subacute cutaneous lupus erythematosus erythema multiforme (SCLE), 262–264 diagnosis, 106–108 Sulfasalazine, 22 varicella vaccine, 106 Sweet’s syndrome, 6 maculopapular eruption, 104–105 Syncopal and near-syncopal upper respiratory infection cold environment exposure, 29 ampicillin-sulbactam, 100 diagnosis, 31 epidermolytic exotoxin, 102 differential diagnosis, 30 intravenous immunoglobulin physical stimuli, 28–29 therapy, 103 symptoms, 28 keratinocyte apoptosis, 103 treatment, 29 laboratory evaluations, 100–102 work-up, 30–31 Nikolsky sign, 100 Systemic lupus erythematosus (SLE) SCORTEN, 102, 103 clinical data, 253 Toxic epidermal necrolysis (TEN), 256–257 diagnosis, 253–254 Triamcinolone acetonide, 142 physical examination, 253 Type IV delayed-type hypersensitivity skin biopsy, 254, 255 reaction, 174 Stevens–Johnson Syndrome, 252–253 symptoms, 251 U Urticaria T angioedema without wheals, 18 Tacrolimus, 165 autoimmune progesterone dermatitis, 19 Targetoid lesion clinical manifestation, 14 biochemical analysis, 6 contact urticaria, 17 clinical presentation, 3–4 definition, 12 differential diagnosis, 5 diagnostics, 19–20 Index 347

history, 12 imaging studies, 224 mechanical stimuli minor salivary gland tumors, 225 aquagenic urticaria, 17 necrotizing inflammatory process, 224 cold urticaria, 16 primary systemic vasculitides, 220, 221 delayed pressure urticaria, 16 pulmonary radiographic abnormalities, 220 dermographism, 15 recurrent palpable purpura and cutaneous exercise-induced anaphylaxis (EIA), 17 ulcers heat urticaria, 16 biopsy, 228–229 immediate pressure urticaria, 15 complete blood cell count, 228 solar urticaria, 17 hemorrhagic crusts, 228 , 16 histopathology, 229 Muckle–Wells syndrome, 18 IgG deposits, 229–230 ordinary urticaria, 14–15 immune-complex deposition, 230 pathophysiology, 13–14 pemphigus, 230–231 physical urticaria, 15 renal histology characteristics, 220 PUPP, 18–19 Riley–Day syndrome, 222–223 Schnitzler syndrome, 19 skin-colored papules treatment, 21–22 diagnosis, 232–233 vasculitis, 18 IGD, 233–234 US Food and Drug Administration, 85 medical history, 231 perivascular and interstitial infiltrate lymphocytes, 232 V vessel damage mechanisms, 220, 222 Vasculitis Vibratory angioedema, 16 allergic rhinitis, chronic sinusitis and asthma, 226–228 and joint swelling W Alice in Wonderland syndrome, 219 Wegener’s granulomatosis brain MRI, 219–220 Alice in Wonderland syndrome, 218–219 imaging studies, 218 arthralgias and joint swelling, 218 migraine, 218 cyclophosphamide, 221–222 cyclophosphamide, 221–222 diagnosis, 220 Ganser syndrome, 223 glucocorticoids, 221 glucocorticoids, 221 midline ulceration, 223 granulomatous vasculitis, 220 necrotizing sialometaplasia, 225 Guillain–Barre syndrome, 222 Whole seminal plasma (WSP) proteins, 204 midline ulceration and palatal mucosa mucocele biopsy, 223, 224 Z clinical manifestation, 225 Zollinger–Ellison syndrome, 75–76