Cutaneous Features (cutaneous + feature)

Distribution by Scientific Domains

Selected Abstracts

Cutaneous manifestations of chikungunya fever: observations made during a recent outbreak in south India

Arun C. Inamadar MD
Background, Chikungunya fever is an Aedes mosquito-borne Arbo viral illness with significant morbidity. Methods, In a recent outbreak of the disease in south India, the dermatologic manifestations of 145 patients attending a tertiary care hospital were recorded. Results, All age groups were affected, including newborns. Some of the cutaneous features were observed during the acute stage of the illness, and others during convalescence or thereafter. Pigmentary changes were found to be the most common cutaneous finding (42%), followed by maculopapular eruption (33%) and intertriginous aphthous-like ulcers (21.37%). Lesions with significant morbidity were generalized vesiculobullous eruptions (2.75%), found only in infants, lymphedema, and intertriginous aphthous-like ulcers. Exacerbation of existing dermatoses, such as psoriasis, and unmasking of undiagnosed Hansen's disease were observed. A perivascular lymphocytic infiltrate was a consistent histopathologic finding in all types of skin lesions. All patients responded well to symptomatic, conservative treatment. Conclusions, The cutaneous findings hitherto not reported may be the result of the African genotype of the virus detected during this outbreak in India. [source]

Cutaneous manifestations of dengue viral infection in Punjab (north India)

Emy Aby Thomas MBBS
Background, Dengue infection is emerging as a public health problem in India. Despite numerous studies, there is a paucity of literature regarding the cutaneous manifestations of dengue. This study was performed to investigate the prevalence and type of cutaneous manifestations in dengue viral infection. Methods, Two hundred and fifty-six patients with febrile illness, admitted to the Christian Medical College and Hospital, Ludhiana, India, were studied. On the basis of the clinical criteria and laboratory tests, 124 patients were diagnosed with dengue viral infection, and these patients were investigated in detail. Serologic tests were attempted in only 84 patients, and all of these samples tested positive for anti-dengue immunoglobulin M (IgM) antibodies. Results, Of the 124 patients with dengue infection, 41 (23.1%) were classified with dengue fever (DF) and 83 (66.9%) with dengue hemorrhagic fever (DHF), four (3.2%) of whom had dengue shock syndrome (DSS). Cutaneous involvement was seen in 46.8% of patients, the most common symptom being maculopapular/morbilliform eruption (48.3%), followed by ecchymotic (27.6%), petechial (13.8%), and macular/scarlatiniform (10.3%) eruption. Maculopapular eruption was observed more in DF, whereas petechiae, ecchymosis, and mucosal involvement were seen more in DHF; 72.4% of patients with cutaneous manifestations were asymptomatic, and 27.6% had pruritus. Involvement was generalized in 48.3% of patients, with the limbs and trunk involved in 32.8% and 18.9% of patients, respectively. Mucosal involvement was seen in 29.8% of patients, with conjunctival involvement being the most common (20.9%), followed by the lips (4.8%), palate (2.4%), and tongue (1.6%). Conclusions, This study describes the variety of cutaneous features associated with dengue viral infection which may evolve during the course of the disease. As a significant proportion of patients showed cutaneous features, these manifestations, together with simple laboratory tests, will be helpful in the early diagnosis of dengue viral infection. [source]

Ichthyosis follicularis, alopecia and photophobia (IFAP) syndrome treated with acitretin

S Khandpur
ABSTRACT We describe a 3-year-old male patient with the ichthyosis follicularis, alopecia and photophobia (IFAP) syndrome, who developed cutaneous and ocular involvement in infancy. In addition, he had growth retardation and borderline intelligence; no other systemic involvement was found on detailed investigation. A moderate response to acitretin therapy (1 mg/kg) administered for 6 months was observed, with improvement in cutaneous features and corneal erosions and no change in alopecia or photophobia. [source]

Attitudes of dermatologists toward the Chapel Hill Consensus Conference nomenclature and classification

T. Kawakami
Summary This study was designed to explore the attitudes of dermatologists towards the Chapel Hill Consensus Conference (CHCC) nomenclature and classification. We developed a questionnaire to determine the views of chief assistant dermatological professors at 61 Japanese university hospitals. A ,2 analysis of the responses found a close relationship between dermatological facilities that based their evaluations on the CHCC and their likelihood of taking confirmatory skin biopsies from patients with suspected microscopic polyangiitis with cutaneous features. In those facilities, the physicians and pathologists tended to consider cutaneous polyarteritis nodosa and cutaneous leucocytoclastic angiitis as independent disease conditions. We believe that it would be beneficial for dermatologists to take advantage of the CHCC, through which an appropriate early diagnosis of vasculitis can be realized. The present investigation provides a picture of current practices of Japanese dermatologists with reference to the management of vasculitis, including the extent to which biopsies are used to establish the diagnosis. [source]

Unusual cutaneous features of syphilis in patients positive for human immunodeficiency virus

S. Shimizu
Summary Dermatologists commonly find it difficult to diagnose syphilis, because of its protean clinical features. In cases of co-infection with human immunodeficiency virus (HIV) syphilis may present particularly unusual clinical features, further confounding the diagnosis. We report two cases of syphilis/HIV co-infection in Japanese patients showing uncommon skin features that made the diagnosis of syphilis difficult. These cases underline the need for dermatologists to be more aware of atypical cutaneous features of syphilis in patients positive for HIV. [source]

Hypereosinophilic syndrome with various skin lesions and juvenile temporal arteritis

K. Ito
Summary Hypereosinophilic syndrome (HES) is a multisystem disease with a high mortality rate. It is characterized by peripheral blood eosinophilia and eosinophilic infiltration of the skin and many other organs. The commonest cutaneous features include erythematous pruritic maculopapules and nodules, angio-oedema or urticarial plaques. However, some case reports have indicated that eosinophilic cellulitis, cutaneous necrotizing eosinophilic vasculitis, Raynaud's phenomenon and digital gangrene may also occur as cutaneous features of HES. Juvenile temporal arteritis (JTA) of unknown cause is characterized by an asymptomatic nodule in the temporal artery area in young adults. Histologically, the lesion is characterized by a significant intimal thickening with moderate eosinophilic infiltrates, constriction or occlusion of the vascular lumen and absence of giant cells. We report a patient with HES presenting with eosinophilic cellulitis, Raynaud's phenomenon, digital gangrene and JTA. JTA may also be one of the features of HES. [source]

Cryopyrin-associated periodic syndromes and autoinflammation

K. Shinkai
Summary Autoinflammatory syndromes are a distinct class of inherited diseases of cytokine dysregulation with important cutaneous features. Several disorders, including familial cold autoinflammatory syndrome (FCAS), Muckle,Wells syndrome and neonatal onset multisystem inflammatory disorder (NOMID), are associated with mutations in a common gene, CIAS-1. These disorders are now believed to represent related conditions along a spectrum of disease severity, in which FCAS is the mildest and NOMID is the most severe phenotype. Patients typically present with lifelong atypical urticaria with systemic symptoms, with potential for developing end-organ damage due to chronic inflammation. Advances in the understanding of the genetic basis of these syndromes have also revealed cytokine signalling molecules that are critical to normal regulation of inflammatory pathways. The dramatic response of these syndromes to anakinra, an interleukin (IL)-1 antagonist, highlights the important role of IL-1 cytokine signalling in the pathogenesis of this rare but fascinating class of diseases. [source]