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

No abstract available.
Darier Disease* ; Lichens* ; Neurodermatitis*

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

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

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

Some of chronic benign recurrent dermatoses are markedly recalcitrant to the ordinary dermatological treatments. The author studied the therapeutic effect of beta ray on those of 30 patients including 6 cases of psoriasis, 3 of lichen simplex chronicus, 9 of nummular eczema, 8 of pustulosis palmaris et plantaris, and 4 of chronic eczema of the finger. All of the above were promptly recurred with ordinary treatments. Strontium 90 applicator was used as the source of beta ray and the total irradiation doses to each sites were ranged from 600 to 1500 rads in divided doses(usually weekly) over 2 to 3 weeks. The results were as follows, 1. In psoriasis patients with papular type were cleared by strontium 90, however, with chronic localized plaque type were poorly responded. The relapses of the cleared papular type were noticed between 13 to 24 days intervals, and it appeared that the larger doses did not influence significantly the clinical results. 2. Almost all of the chronic eczematous dermatoses including lichen simplex chronicus, nummular eczema, pustulosis Palmaris et plantaris, and chronic eczema of the finger, which were irradiated by beta rays following clearance with preliminary corticosteroid therapy, were recurred between 2 to 4 weeks intervals. However, larger doses resulted in prolonged recurrence intervals in a few patients. 3. No noticeable eariy hazards of irradiation were detected except for the mild hyperpigmentation on the irradiated skin.
Beta Particles ; Eczema ; Fingers ; Humans ; Hyperpigmentation ; Neurodermatitis ; Psoriasis ; Recurrence ; Skin ; Skin Diseases* ; Strontium*

Puraotix-C(0.1% Clocortolone Picalats Cream) is a new di-halogenated topical corticosteroid, and used in trial for treating several kinds of dermatoses. We treated 30 patients with Purantix-C who had one of the following dermatoses; atopic dermatitis, neurodermatitis, pustulosis palmaris et plantsris, seborrheic dermatitis, pityriasis rosea, nummular eczema, psoriasis vulgaris, pruritus ani and pompolyx. Among these 30 patients, Purantix-C showed excellent or good result (66.7%) either unoccluded or occluded application, 2~3 times daily for 7~10 days. Comparing with Lidex(0.05% fluorocinonide cream) and purantix-C, both of them had similar effect on eczema and psoriatic groups but Lidex was more effective than Purantix-C for treating the patients with the pustulosis palmaris et plantaris. Purantix-C without containing perfume and coloring substapce was less irritative.
Dermatitis, Atopic ; Dermatitis, Seborrheic ; Eczema ; Fluocinonide ; Humans ; Neurodermatitis ; Perfume ; Pityriasis Rosea ; Pruritus Ani ; Psoriasis ; Skin Diseases

Lidex(Fluacinonide) 0.05% in FAPG base is a new fluorinated topical corticosteroid. 30 patients with different steroid responsive dermatoaes were treated with 0. 05% Lidex. The diagnosis included atopic dermatitis, contact dermatitis, neurodermatitis, seborheic dermatitis, nummular eczema, psoriasis vulgaris, chronic eczema and pustulosis pahmaris et plantaris. In the majority of cases Lidex cream produced excellent to good result(70%) after unoccluded application 3 times daily for 10 days. Two patients complained burning or itching sensation after the initial application of Lidex. 0.05% Lidex was compared with 0. 25% Desoxymethasone cream and 0. 25% Fluocortolone cream and was found slightly more effective in Lidex.
Burns ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Desoximetasone ; Diagnosis ; Eczema ; Fluocinonide* ; Fluocortolone ; Humans ; Neurodermatitis ; Pruritus ; Psoriasis ; Sensation

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

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