1.One mistake, one life at stake: A case of Methotrexate Toxicity in A 57-Year old male presenting with painful plaques with erosions
Maria Franchesca S. Quinio ; Elizabeth P. Prieto
Journal of the Philippine Medical Association 2017;95(2):48-53
Introduction:
Methotrexate is being given by dermatologists in only extreme cases of skin disorders such as in severe Psoriasis Vulgaris. Strict precautionary measures are done to avoid its well-known adverse effects. An early but less common sign of its toxicity are painful erosions on plaques. Methotrexate is an effective but potentially toxic treatment for different severe dermatologic disorders such as in severe Psoriasis Vulgaris. Meticulous and complete history-taking, physical examination and laboratory work-up to come up with a correct diagnosis as well as, knowledge of indications for treatment, proper dosing, folate supplementa-tion, monitoring, proper referral and early detection of its toxicity are important in order to avoid cutaneous and systemic adverse effects including death.
Case Report
A case of a 57-year old male with a 2-day history of painful erosions on plaques on both upper and lower extremities after eleven days of taking Methotrexate 2.5mg/tablet one tablet three times a day without folate supplementation. He was then being treated by a general physician as a case of Psoriasis Vulgaris. He was subsequently admitted under the Internal Medicine service due to epigastric pain, nausea, anorexia, generalized body weakness and passage of black tarry stools. He was referred to the Department of Dermatology for the painful erosions on plaques. He expired two days after admission due to Acute Respiratory Failure. Post-mortem Skin punch biopsy was done and revealed chronic eczematous dermatitis consistent with Lichen Simplex Chronicus with superimposed drug induced hypersensitivity reaction.
Neurodermatitis
2.Comments to "Localized Darier's Disease Mimicking Lichen Simplex Chronicus on the Back".
Korean Journal of Dermatology 2015;53(10):822-823
No abstract available.
Darier Disease*
;
Lichens*
;
Neurodermatitis*
3.Epidermal Glycogen in the Diseases Showing Epidermal Hyperplasia.
In Seong JANG ; Jong Myung HYUN ; Soo Nam KIM
Korean Journal of Dermatology 1984;22(4):387-393
In order to assess the epidermal glycogen in the epidermal hyperplastic disease, PAS(Periodic Acid Schiff) stain with or without diastase is used. Epidermal PAS positive reaction is significantly increased in psoriasis (90. 0%), verruca vulgaris (100%) and lichen simplex chronicus (100%) than control group (12, 5%) Epidermal PAS positive reaction is relatively increased in prurigo nodularis(66. 7 %) and chronic contact dermatitis (75%) Strong PAS positive reaction is noticed in 3 of 5 cases (60%) with verruca vulgaris, but none of 22 cases with psoriasis. It is suggested that epidermal glycogen epidermal hyperplasia and that the more glycogen accumulated. than control group (12. 5%) in 3 of 5 cases (60%) with verruca vulaccumulation is accompanied with the hyperplastic the epidermis is, the more glycogen accumulated.
Amylases
;
Dermatitis, Contact
;
Epidermis
;
Glycogen*
;
Hyperplasia*
;
Neurodermatitis
;
Prurigo
;
Psoriasis
;
Warts
4.Autoerythrocyte sensitization syndrome presenting with general neurodermatitis
In Young OH ; Eun Jung KO ; Kapsok LI
Asia Pacific Allergy 2013;3(3):204-206
Autoerythrocyte sensitization syndrome (AES) was first described by Gardner and Diamond in 1955, when four women with painful bruising were depicted. Patients with AES typically present with the development of recurrent, spontaneous, painful ecchymosis, frequently preceded by a prodrome of pain or itching of the skin. The patients are sensitive to their own red blood cells injected intradermally, and underlying coagulopathies are thought to be absent. We introduce a 70-year-old woman presenting with recurrent episodes of painful bruising on the trunk and extremities.
Aged
;
Diamond
;
Ecchymosis
;
Erythrocytes
;
Extremities
;
Female
;
Humans
;
Neurodermatitis
;
Pruritus
;
Skin
5.Focused ultrasound therapy for reducing recurrence of vulvar lichen simplex chronicus in rats: efficacy and mechanism.
Yao LIU ; Yijin FAN ; Chengzhi LI
Journal of Southern Medical University 2019;39(12):1487-1493
OBJECTIVE:
To explore the changes of collagen fibrosis in the vulva skin of SD rats with lichen simplex chronicus (LSC) after focused ultrasound therapy and explore the mechanism by which focused ultrasound reduces the recurrence of vulvar LSC.
METHODS:
Fifty female SD rat models of vulvar LSC were established and randomly divided into the treatment group and the control group (=25) for treatment with focused ultrasound and sham treatment, respectively. Before and after the treatment, vulvar skin tissues were sampled to observe the pathological changes with HE staining and assess the density of collagen fibers using Masson staining. The ultrastructure of the collagen fibers in the superficial dermis was observed using transmission electron microscopy. The expressions of notch1 and c-fos in the vulvar tissue were detected by immunohistochemistry and Western blotting.
RESULTS:
After 4 weeks of focused ultrasound therapy, 16% (4/25) of the rats in the treatment group showed lesion progression to LSIL, 4% (1/25) still had LSC, and 80% (20/25) showed normal vulvar skin. In the control group, progression to LSIL occurred in 19 (76%) rats, 3 (12%) rats still showed LSC, and only 3 (12%) had normal vulvar skin. The difference in the cure rate differed significantly between the two groups ( < 0.05). The density of collagen fibers in the superficial dermis and the expressions of notch1 and c-fos in the vulvar skin were significantly lower in the treatment group than in the control group ( < 0.05).
CONCLUSIONS
Focused ultrasound therapy can inhibit superficial collagen fibrosis of the dermis by lowering the expressions of notch1 and c-fos in the vulvar skin to reduce the recurrence of vulvar LSC in rats.
Animals
;
Female
;
Neurodermatitis
;
Rats
;
Rats, Sprague-Dawley
;
Recurrence
;
Vulvar Diseases
6.Observation on the therapeutic effect of a red-hot needle therapy combined with blood-letting puncture and cupping for treatment of neurodermatitis.
Yan ZHANG ; Jian-Wei ZHOU ; Shu HUANG ; Chun-Tao CHEN ; Yi DENG ; Yu-Hua HUANG
Chinese Acupuncture & Moxibustion 2007;27(4):252-254
OBJECTIVETo search for an effective therapy for neurodermatitis.
METHODSNinety-six cases were divided into 2 groups by random number table. The treatment group (n = 54) were treated by hot-red needle therapy combined with blood-letting puncturing and cupping at skin-injured area, and the control group (n = 42) were treated with external smearing of halometasone cream.
RESULTSThe cured rate and the total effective rate were 51.9% and 96.3% in the treatment group, and 28.6% and 81.0% in the control group, respectively, with a significant difference between the two groups in the therapeutic effect (P < 0.05).
CONCLUSIONRed-hot needle therapy combined with blood-letting puncture and cupping has a definite therapeutic effect on neurodermatitis, without toxic and adverse effects.
Acupuncture Therapy ; methods ; Adolescent ; Adult ; Aged ; Bloodletting ; methods ; Female ; Humans ; Male ; Middle Aged ; Neurodermatitis ; therapy
7.Observation on clinical therapeutic effect of Yang's cotton moxibustion on neurodermatitis.
Can-yang DIAO ; Yun-kuan YANG ; Yong-hong LU ; Zhan WANG ; Xiao-rui YAN ; Yan WANG
Chinese Acupuncture & Moxibustion 2007;27(3):176-178
OBJECTIVETo compare the difference of the therapeutic effects between Yang's cotton moxibustion and hormonotherapy on neurodermatitis.
METHODSSixty cases of neurodermatitis were divided into a treatment group and a control group according to random number table. The treatment group were treated with Yang's cotton moxibustion and the control group with triamcinolone and urea cream. After treatment for one week, the therapeutic effect was start to be observed. After the treatment was given for 4 weeks, the therapeutic effect was evaluated.
RESULTSThe total effective rate was 93.3% in the treatment group and 80.0% in the control group, with a significant difference between the two groups (P < 0.05).
CONCLUSIONYang's cotton moxibustion has an obvious therapeutic effect on neurodermatitis with a good safety.
Adolescent ; Adult ; Aged ; Female ; Gossypium ; Humans ; Male ; Middle Aged ; Moxibustion ; methods ; Neurodermatitis ; therapy
9.Two Cases of Lacalized Cutaneous Amyloidosis Associated with Neurodermatitis.
Hwan Pyo JEON ; Ae Young LEE ; Jai Il YOUN ; Yoo Shin LEE
Korean Journal of Dermatology 1988;26(6):910-915
We report herein two cases of localized curaneous amyloidosis (LCA) associated with neurodermatitis. Both patients suffered from persistent pruritus during several years and had small brown discrete lichenoid papules or neurodermatitis like lesion. Biopsy specimen taken from lichehoid papules revealed amyloid deposition in the papillary dermis. In histologic examination of the neurodermatitis like lesion, hematoxylin eosin stain revealed only chronic eczematous changes but special stain and election microscopic examination revealed amyloid deposition in the papillary dermis. Although neurodermatitis and LCA may be able to develop concomitantly in one patient, it was suggested that neurodermatitis may transfrom into LCA.
Amyloidosis*
;
Biopsy
;
Dermis
;
Eosine Yellowish-(YS)
;
Hematoxylin
;
Humans
;
Neurodermatitis*
;
Plaque, Amyloid
;
Pruritus
10.Two Cases of Linear Lichen Simplex Chronicus.
Kyung Sool KWON ; Eul Hee HAN ; Tae Ahn CHUNG
Korean Journal of Dermatology 1982;20(3):449-453
We present two cases of linear lichen simplex chronicus. One is a 44-year-old male patient who had a linear licbenified patch on the left upper extremity, and the other is a 45-year-old female patient who had linear pruriginous nodules on the right lower extremity. The one is coincidental with localized lichen simplex chronicus, the other is coincidental with prurigo nodularis histopathologically.
Adult
;
Female
;
Humans
;
Lichens*
;
Lower Extremity
;
Male
;
Middle Aged
;
Neurodermatitis*
;
Prurigo
;
Upper Extremity