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Gaurav V, Tyagi M, Grover C, Sharma S. Pruritic Trichostasis Spinulosa: A Rare Variant. Indian Dermatol Online J 2024; 15:487-491. [PMID: 38845642 PMCID: PMC11152469 DOI: 10.4103/idoj.idoj_544_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/01/2023] [Accepted: 10/06/2023] [Indexed: 06/09/2024] Open
Abstract
Trichostasis spinulosa is a disorder of hair follicles characterized by the retention of vellus telogen club hair, leading to the formation of comedo-like lesions. It usually presents over the face and is frequently asymptomatic. We report a 53-year-old female who presented with multiple itchy, discrete, bluish-black, 2-3 mm comedo-like follicular papules and pustules on her breast and lower abdomen for the past 2 years. In-vivo dermoscopy showed keratotic plugs with a tuft of hair. Extraction dermoscopy yielded a cystic structure filled with keratin and multiple vellus telogen club hairs. Histology showed a cyst lined by squamous epithelium containing abundant laminated keratinous debris and a vellus hair shaft. Truncal or breast involvement, as seen in the present case, is relatively rare, and can be pruritic, causing significant morbidity due to itching and secondary bacterial infections. Dermoscopy, especially ex-vivo extraction dermoscopy, can show diagnostic features and obviate the need for abiopsy.
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Affiliation(s)
- Vishal Gaurav
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Mehul Tyagi
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Chander Grover
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India
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Ambrogio F, Poli MA, Lospalluti L, Lettini T, Cassano N, Vena GA, Ingravallo G, Cazzato G, Foti C. Keratosis Pilaris-like Eruption during Treatment of Chronic Myeloid Leukemia with Tyrosine Kinase Inhibitors: Literature Review and Report of a Case Related to Imatinib. J Clin Med 2023; 13:32. [PMID: 38202039 PMCID: PMC10779630 DOI: 10.3390/jcm13010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
The advent of tyrosine kinase inhibitors (TKIs) blocking BCR-ABL activity has revolutionized the therapeutic management of patients with chronic myeloid leukemia (CML). Adverse cutaneous reactions (ACRs) are common nonhematologic adverse events associated with the use of BCR-ABL TKIs. A characteristic pattern of eruption resembling keratosis pilaris (KP) has been described in patients treated with these drugs, especially nilotinib and dasatinib. The pathogenesis of this ACR is still unknown. This type of reaction appears to be uncommon with imatinib. Here, we report the case of an elderly patient with an asymptomatic KP-like eruption, which appeared one month after starting treatment with imatinib for CML. The case presentation is accompanied by a review of similar reactions in patients with CML treated with BCR-ABL inhibitors, attempting to make an excursus on the molecular targets of such drugs and possible mechanisms underlying this ACR.
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Affiliation(s)
- Francesca Ambrogio
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
| | - Melita Anna Poli
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
| | - Lucia Lospalluti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
| | - Teresa Lettini
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (T.L.); (G.I.)
| | - Nicoletta Cassano
- Dermatology and Venereology Private Practice, 76121 Barletta, Italy; (N.C.); (G.A.V.)
| | - Gino Antonio Vena
- Dermatology and Venereology Private Practice, 76121 Barletta, Italy; (N.C.); (G.A.V.)
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (T.L.); (G.I.)
| | - Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (T.L.); (G.I.)
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (M.A.P.); (L.L.); (C.F.)
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3
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Oh SM, Ahn HJ, Shin MK. Clinical Characteristics of Lichen Amyloidosis Associated with Atopic Dermatitis: A Single Center, Retrospective Study. Ann Dermatol 2023; 35:432-438. [PMID: 38086357 PMCID: PMC10733083 DOI: 10.5021/ad.23.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/04/2023] [Accepted: 06/05/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Lichen amyloidosis is a chronic pruritic skin disorder associated with atopic dermatitis, however, the pathogenetic link between these two conditions remains to be elucidated. Only limited research has been performed on patients diagnosed with both pruritic dermatological conditions. OBJECTIVE This study aimed to analyze the clinical features of lichen amyloidosis associated with atopic dermatitis. METHODS We conducted a matched case-control study of incident lichen amyloidosis with atopic dermatitis between March 2020 and February 2022. Among the 2,481 patients with atopic dermatitis, 20 patients diagnosed with lichen amyloidosis and atopic dermatitis were included as case patients, and 20 patients diagnosed with atopic dermatitis were enrolled as controls. The controls were matched to cases (1:1) by age and sex. We retrospectively reviewed the medical records of the patients. RESULTS The prevalence of lichen amyloidosis associated with atopic dermatitis was approximately 0.8%, with a male:female sex ratio of 2.33:1. The recorded onset of lichen amyloidosis associated with atopic dermatitis was more common in adult patients, with moderate-to-severe atopic dermatitis. Lichen amyloidosis lesions in patients with atopic dermatitis were most commonly found on the extremities, sparing the head and neck region. The presence of lichen amyloidosis had no significant impact on severity of atopic dermatitis. CONCLUSION In patients with lichen amyloidosis associated with atopic dermatitis, the clinical manifestations of lesions are similar to those of conventional lichen amyloidosis lesions in terms of morphology and regional distribution. Further research is required to elucidate the link between the pathogenesis of these two pruritic dermatological conditions.
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Affiliation(s)
- Seung-Min Oh
- Department of Dermatology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hye-Jin Ahn
- Department of Dermatology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Min Kyung Shin
- Department of Dermatology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
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4
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Ramesh H, Somashekhar S, Kanathur S. Lichens in dermatology. Indian J Dermatol Venereol Leprol 2023; 89:908-915. [PMID: 37067120 DOI: 10.25259/ijdvl_794_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 06/29/2022] [Indexed: 03/30/2023]
Affiliation(s)
- Heera Ramesh
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Sachin Somashekhar
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Shilpa Kanathur
- Department of Dermatology, Venereology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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Li M, Bai Y, Duan Z, Yuan R, Liu X, Liu Y, Liang X, Wu H, Zhuo F. Efficacy and Safety of Long-Pulsed 755-nm Alexandrite Laser for Keratosis Pilaris: A Split-Body Randomized Clinical Trial. Dermatol Ther (Heidelb) 2022; 12:1897-1906. [PMID: 35838863 PMCID: PMC9357583 DOI: 10.1007/s13555-022-00771-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Keratosis pilaris (KP) is a disfiguring disease and is resistant to treatment. Several treatment methods are available, but the efficacy is limited. This prospective, rater-blinded, split-body comparative study investigated the efficacy and safety of long-pulsed 755-nm alexandrite laser in the treatment of KP. Methods Twenty-two patients with KP of bilateral arms were enrolled in this study. All participants were randomized and treated with a long-pulsed 755-nm alexandrite laser on the left or right arm in four sessions held 3 weeks apart. The unified moisturizing lotion was applied on both left and right arms once a day. Physicians’ assessment scores and patients’ self-assessment scores were recorded, and skin imaging changes in dermoscopy, high-frequency ultrasound, and skin biopsy were obtained at baseline and 4 weeks after the fourth treatment. Results Of the 21 patients who completed the study, 15 were women and 6 were men. At 4 weeks after the fourth treatment, the laser side showed significantly lower total (2.0 versus 4.5), roughness (1.0 versus 2.0), and redness (1.0 versus 2.0) scores according to physicians’ assessment (all P < 0.05). Furthermore, the laser side showed significantly lower total (2.0 versus 4.0), roughness (1.0 versus 2.0), and redness scores (1.0 versus 2.0) according to the patients’ self-assessment (all P < 0.05). The proportions of patients who achieved dermoscopically and ultrasonographically showed excellent improvements in follicular plugs (57.1% versus 14.3%), perifollicular erythema (52.4% versus 9.5%), perifollicular hyperpigmentation (47.6% versus 14.3%), and the number of epidermal bulges (57.1% versus 19.1%) in the laser side was significantly higher than those who achieved such improvements in the control side (all P < 0.05). Histopathology showed that the follicular plugs and inflammatory cell infiltration were improved at the final visit. Three patients exhibited reversible postinflammatory hyperpigmentation. Conclusion Long-pulsed 755-nm alexandrite laser treatment is effective and safe in treating both skin roughness and redness in KP. Trial Registration Number: ChiCTR2100054489.
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Affiliation(s)
- Man Li
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Yue Bai
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Zhixuan Duan
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Ruofei Yuan
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Xiaoduo Liu
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Yi Liu
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Xuelei Liang
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Haixuan Wu
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China
| | - Fenglin Zhuo
- Department of Dermatology, Capital Medical University, Beijing Friendship Hospital, Beijing, 100051, China.
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Clinical and Dermoscopic Evaluation of Trichloroacetic Acid 20% Versus Long-Pulsed 1064-nm Nd-YAG Laser in the Treatment of Keratosis Pilaris. Dermatol Surg 2022; 48:838-842. [DOI: 10.1097/dss.0000000000003488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Salava A, Salo V, Remitz A. Keratosis pilaris and filaggrin loss-of-function mutations in patients with atopic dermatitis - Results of a Finnish cross-sectional study. J Dermatol 2022; 49:928-932. [PMID: 35616138 PMCID: PMC9543356 DOI: 10.1111/1346-8138.16477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022]
Abstract
Keratosis pilaris (KP) associates with epidermal barrier defects in atopic dermatitis (AD) but its role in disease severity and concomitant atopic diseases seems to vary between populations. We performed a cross‐sectional observational study with 502 randomly selected AD patients of a Finnish tertiary health care center. At a single clinical examination, disease severity (Rajka Langeland severity score and EASI), clinical signs and patient history were evaluated and total IgE levels and frequent filaggrin (FLG) loss‐of‐function mutations were investigated. There was no link with disease severity (p = 0.649, 95% CI 0.569–0.654), asthma (p = 0.230, 95% CI 0.206–0.281) or atopic sensitization (p = 0.351, 95% CI 0.309–0.392). Keratosis pilaris was significantly associated with palmar hyperlinearity (p < 0.000, 95% CI 0.000–0.006, OR 4.664, 95% CI 2.072–10.496) and the filaggrin loss‐of‐function mutation 2282del4 (p < 0.000, 95% CI 0.000–0.009, OR 4.917, 95%CI 1.961–12.330). The prevalence of KP in the cohort was generally low and KP seems to be infrequent in Finnish AD patients. This may be explained by the fact that the tested FLG loss‐of‐function mutations are rarer in the Finnish population compared for example, with central Europe or Asia. Mutations in other locations of the FLG gene or other genes of the epidermal barrier may play a more important role.
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Affiliation(s)
- Alexander Salava
- Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland
| | - Ville Salo
- Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland
| | - Anita Remitz
- Helsinki University Hospital, Skin and Allergy Hospital, Helsinki, Finland
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8
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Secco LP, Coubes C, Meyer P, Chenine L, Roubertie A, Malinge MC, Bessis D. Dermatological and genetic data in tuberous sclerosis: A prospective single-center study of 38 patients. Ann Dermatol Venereol 2022; 149:241-244. [PMID: 35527063 DOI: 10.1016/j.annder.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/20/2021] [Accepted: 02/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Tuberous sclerosis complex (TSC) is a genetic disorder involving the TSC1 or TSC2 gene. Skin signs are prominent, but dermatological data are scarce. This study aims to describe the cutaneous signs of TSC with the genotype. METHODS We studied the dermatological characteristics of 38 patients with TSC at the University Hospital of Montpellier. We collected details of genotypic features. RESULTS All the patients presented at least one cutaneous sign. The dermatological examination alone was sufficient to establish a definite diagnosis of TSC based on the diagnostic criteria for 34/38 patients. No association was found between cutaneous signs and the presence of a TSC1 or TSC2 mutation. We noted skin signs that were poorly described in the disease, namely epidermal nevus in 3 patients, vascular malformation in 2 patients, and keratosis pilaris in 9 patients. DISCUSSION While several studies demonstrate a more severe neurological phenotype in TSC2 mutated patients, skin expression does not appear to differ according to the mutated gene. Further case reports and molecular genetic studies are needed to determine the link between epidermal nevus, vascular malformations, keratosis pilaris and TSC.
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Affiliation(s)
- L-P Secco
- Department of Dermatology, Montpellier University Hospital Center, 34295 Montpellier, France.
| | - C Coubes
- Department of Genetics, Montpellier University Hospital Center, 34295 Montpellier, France
| | - P Meyer
- Department of Pediatric Neurology, Montpellier University Hospital Center, 34295 Montpellier, France
| | - L Chenine
- Department of Nephrology, Montpellier University Hospital Center, 34295 Montpellier, France
| | - A Roubertie
- Department of Pediatric Neurology, Montpellier University Hospital Center, 34295 Montpellier, France
| | - M-C Malinge
- Department of Genetics, Angers University Hospital Center, 49100 Angers, France
| | - D Bessis
- Department of Dermatology, Montpellier University Hospital Center, 34295 Montpellier, France
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9
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Jiao Q, Zhi L, Qi Y, Yang J, Jia Y. Studies on stratum corneum metabolism: function, molecular mechanism and influencing factors. J Cosmet Dermatol 2022; 21:3256-3264. [DOI: 10.1111/jocd.15000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/19/2022] [Accepted: 04/11/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Qian Jiao
- Key Laboratory of Cosmetic of China National Light Industry College of Chemistry and Materials Engineering Beijing Technology and Business University Beijing China
| | - Leilei Zhi
- Shandong Huawutang Biological Technology Co., Ltd. Shandong China
| | - Yufeng Qi
- Shandong Huawutang Biological Technology Co., Ltd. Shandong China
| | - Jie Yang
- Shandong Huawutang Biological Technology Co., Ltd. Shandong China
| | - Yan Jia
- Key Laboratory of Cosmetic of China National Light Industry College of Chemistry and Materials Engineering Beijing Technology and Business University Beijing China
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10
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Arumilli P, Tatavarthi R, Kolalapudi S, Prasad Arumilli K, Gandikota R, Saka S. Efficacy of tacrolimus 0.1% ointment in keratosis pilaris: A prospective hospital based interventional study. JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/jmedsci.jmedsci_356_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ritter AM, Wine Lee L. Keratosis pilaris in collagen type VI-related disorders. Pediatr Dermatol 2022; 39:133-134. [PMID: 34986511 DOI: 10.1111/pde.14883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Keratosis pilaris is a common skin condition associated with a number of syndromes, including collagen type VI-related disorders. Our patient, recently diagnosed with Ullrich congenital muscular dystrophy, presented with severe keratosis pilaris, hypotonia, and velvety skin on the palms and soles. We present this case to highlight the importance of including cutaneous findings, such as keratosis pilaris, to aid in the diagnosis when evaluating patients with syndromic features.
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Affiliation(s)
- Alexandra M Ritter
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lara Wine Lee
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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12
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Fekete GL, Fekete L, Neagu N, Bacârea V, Drăgănescu M, Brihan I. Keratosis pilaris atrophicans faciei: An observational, descriptive, retrospective clinical study. Exp Ther Med 2021; 22:1331. [PMID: 34630685 DOI: 10.3892/etm.2021.10766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/05/2021] [Indexed: 11/05/2022] Open
Abstract
Keratosis pilaris atrophicans faciei (KPAF) is a hereditary follicular disorder, an atrophicans subtype of keratosis pilaris (KP) with a highly elusive diagnosis. Clinically, it presents with follicular, horny papules surrounded by an erythematous halo of the cheeks, forehead, chin and eyebrows, and it is followed by a gradual hair loss on the lateral margins of the eyebrows. The onset is as early as a few months after birth, but it is mainly diagnosed in children and adolescents and it can persist through adulthood. At present, the natural progression of the disease is poorly understood, which makes a correct diagnosis highly unlikely. The aim of the present study was to describe the clinical characteristics of KPAF in patients encountered in daily practice, in order to find common characteristics that may aid in the earlier recognition of the disease. An observational, descriptive, retrospective study was performed on 14 patients diagnosed with KPAF between January 2000 and December 2020. The mean age at diagnosis was 17.04 years and the onset of clinical symptoms appeared at a mean age of 4.85 years. The first clinical symptom was KP involving either the upper or lower limbs, or both. Then, erythema of the face appeared at a mean age of 7.21 years, keratotic papules on the face at a mean age of 8.35 years and, finally, loss of hair on the lateral margins of the eyebrows at a mean age of 14 years. The patients also had concomitant xerosis cutis, multiple mole syndrome, acne, contact dermatitis and Laugier-Hunziker syndrome. Evidence of disease progression, associations, as well as efficacious treatment measures are lacking. An earlier diagnosis potentially allows for a more efficacious, targeted treatment option. Either topical emollients, systemic retinoids or laser therapy may prove effective for each patient individually.
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Affiliation(s)
- Gyula László Fekete
- Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureș, Romania
| | - László Fekete
- Department of Dermatology, Mureș County Hospital, 540015 Târgu Mures, Romania
| | - Nicoleta Neagu
- Department of Dermatology, Mureș County Hospital, 540015 Târgu Mures, Romania
| | - Vladimir Bacârea
- Department of Medical Research Methodology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureș, Romania
| | - Miruna Drăgănescu
- Faculty of Medicine and Pharmacy, Medical Department, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Ilarie Brihan
- Department of Dermatology, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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Sánchez-Cárdenas CD, Vega-Memije ME, Flores-Gavilán P, Romero M, Arenas R, Sánchez RL. Disseminated and recurrent infundibulofolliculitis in children in Mexico. Pediatr Dermatol 2021; 38:1233-1236. [PMID: 34515382 DOI: 10.1111/pde.14803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Disseminated and recurrent infundibulofolliculitis is an uncommon non-infectious skin eruption characterized by recurrent, sometimes pruritic, follicular papules commonly seen on the trunk and proximal extremities. We describe the clinical, dermoscopic, and histopathologic characteristics of disseminated and recurrent infundibulofolliculitis in three young pediatric patients from the tropical regions of Mexico, Guerrero, and Chiapas.
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Affiliation(s)
- Carlos Daniel Sánchez-Cárdenas
- Departamento de Dermatología, Intituto Mexicano del Seguro Social, Centro Médico Nacional "La Raza", Ciudad de Mexico, Mexico
| | - María Elisa Vega-Memije
- Sección de Dermatopatología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Paola Flores-Gavilán
- Sección de Dermatopatología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Marina Romero
- Sección de Micología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Roberto Arenas
- Sección de Micología, Hospital General "Dr. Manuel Gea González", Ciudad de Mexico, Mexico
| | - Ramon L Sánchez
- Dermopath.Laboratories LLC, Galveston Dermatology, PA, Galveston, TX, USA
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Acne in the first three decades of life: An update of a disorder with profound implications for all decades of life. Dis Mon 2020; 67:101103. [PMID: 33041056 DOI: 10.1016/j.disamonth.2020.101103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular. Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne.
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Maghfour J, Ly S, Haidari W, Taylor SL, Feldman SR. Treatment of keratosis pilaris and its variants: a systematic review. J DERMATOL TREAT 2020; 33:1231-1242. [PMID: 32886029 DOI: 10.1080/09546634.2020.1818678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Keratosis pilaris (KP) is a common, benign skin condition of follicular hyperkeratosis. Although KP is asymptomatic, the cosmetic appearance of KP can lead to psychosocial distress among patients. New emerging treatments are increasingly being utilized. Yet, there is little to no summative data on the treatments of KP and its subtypes. OBJECTIVE To summarize existing literature on treatments for KP and its subtypes. METHODS A comprehensive search was performed using Pubmed/MEDLINE, Embase and Web of Science databases. The search identified 1150 non-duplicated articles, and 47 articles were included in the review. The primary outcomes measured were KP treatment type and the degree of improvement following therapy. FINDINGS Our findings demonstrate that the most supported form of treatment for KP is laser therapy, particularly the QS:Nd YAG laser. Topical treatments - including Mineral Oil-Hydrophil Petrolat, tacrolimus, azelaic acid, and salicylic acid - are also effective at least for improving the appearance of KP. CONCLUSION While the measured treatment outcomes varied among studies, laser therapy appears to be the most effective form of treatment. Use of topicals also improved KP lesions.
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Affiliation(s)
- Jalal Maghfour
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sophia Ly
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Wasim Haidari
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sarah L Taylor
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Departments of Pathology and Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Ravipati A, Pradeep T. Seasonal variability in public searches of keratosis pilaris: How the internet can illuminate a pattern in public interest. Dermatol Ther 2020; 33:e13957. [PMID: 32621629 DOI: 10.1111/dth.13957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022]
Abstract
In this study, we examine keratosis pilaris search patterns using Google Trends to determine any seasonality. Monthly searches were collected from January 2004 to January 2020 using "keratosis pilaris" as the search term in the Google Trends database. The US search data were compared to monthly temperatures and tested for correlation. Worldwide search interest was also acquired and, along with the US data, a two-model analysis was performed to determine any seasonal patterns. Peaks in search interest closely overlapped with higher temperatures in the United States and showed correlation (.44; P < .0001). The US and worldwide search interest also exhibited seasonality, which was confirmed with a sinusoidal regression being the best-fit model (R2 = .867 and .895). These results show higher search volume during warmer months in the United States and a clear cyclical pattern in searches worldwide and in the United States. Examination of these trends could elucidate peaks that health care providers may not have been aware of yielding improved resource allocation and preparedness for larger volume periods. This information in conjunction with clinical data could also shed more light in the future on potential peak seasons of incidence and prevalence.
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Affiliation(s)
- Advaitaa Ravipati
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tejus Pradeep
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Sobhi RM, Adawy NAH, Zaky IS. “Comparative study between the efficacy of fractional CO2 laser, Q-switched Nd:YAG laser (1064 nm), and both types in treatment of keratosis pilaris”. Lasers Med Sci 2020; 35:1367-1376. [DOI: 10.1007/s10103-020-02956-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/02/2020] [Indexed: 01/09/2023]
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Maitriwong P, Tangkijngamvong N, Asawanonda P. Innovative 1064-nm Nd:YAG Laser Significantly Improves Keratosis Pilaris, A Randomized, Double-Blind, Sham-Irradiation-Controlled Trial. Lasers Surg Med 2019; 52:509-514. [PMID: 31713266 DOI: 10.1002/lsm.23184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVE Keratosis pilaris (KP) is a common follicular disorder for which various topical agents and energy-based devices have been used with some efficacy. To evaluate the efficacy of a novel 1064-nm Nd:YAG laser for the reduction of skin roughness, erythema, and hyperpigmentation in KP subjects. STUDY DESIGN/MATERIALS AND METHODS Twenty-three subjects with untreated KP on the upper outer arms participated in a randomized, single-blind fashion. One arm of each subject was divided into upper and lower parts. One part was randomized to be treated with an innovative 1064-nm Nd:YAG laser, while the other part received sham irradiation. Subjects received four consecutive treatments at 4-week intervals. Antera3D was used to measure skin roughness, erythema, and hyperpigmentation at baseline and 4 weeks after the last treatment. Moreover, clinical outcomes were also evaluated by subjects' Global Improvement Score (GIS) and subjects' satisfaction grading scores. RESULTS Twenty-three subjects completed the study. There was statistically significant reduction of skin roughness measured by Antera3D compared with control group (P < 0.001). There were statistically significant improvements of skin roughness, erythema, hyperpigmentation, and overall appearances graded by subjects' Global Improvement Score (P < 0.001 all). Subjects' satisfaction scores were graded significantly better in treatment parts (P < 0.001). No adverse events including burning, bulla, erosion, post-inflammatory hyper/hypopigmentation, and scar formation developed in any subjects throughout the study period. CONCLUSION This innovative 1064-nm Nd:YAG laser has proved to significantly and safely reduce skin roughness in Thai KP subjects compared with control after four sessions. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Praewvanid Maitriwong
- Department of Medicine, Division of Dermatology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Natsinee Tangkijngamvong
- Department of Medicine, Division of Dermatology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Pravit Asawanonda
- Department of Medicine, Division of Dermatology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
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Ismail S, Omar SS. Clinical and dermoscopic evaluation of fractional carbon dioxide laser in management of keratosis pilaris in Egyptian type skin. J Cosmet Dermatol 2019; 19:1110-1120. [DOI: 10.1111/jocd.13140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/27/2019] [Accepted: 08/15/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Shaimaa Ismail
- Department of Dermatology, Venereology & Andrology Faculty of Medicine Alexandria University Alexandria Egypt
| | - Salma Samir Omar
- Department of Dermatology, Venereology & Andrology Faculty of Medicine Alexandria University Alexandria Egypt
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Sechi A, Guglielmo A, Patrizi A, Savoia F, Cocchi G, Leuzzi M, Chessa MA. Disseminate Recurrent Folliculitis and Hidradenitis Suppurativa Are Associated Conditions: Results From a Retrospective Study of 131 Patients With Down Syndrome and a Cohort of 12,351 Pediatric Controls. Dermatol Pract Concept 2019; 9:187-194. [PMID: 31384491 DOI: 10.5826/dpc.0903a03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent skin disease of the pilosebaceous unit characterized by protean manifestations. Several studies have found an increased incidence and earlier presentation of this disease in patients carrying trisomy 21. Patients with Down syndrome (DS) have a higher risk of developing a wide range of cutaneous manifestations, including HS and chronic folliculitis. Recently, disseminate recurrent folliculitis (DRF) has been reported as an atypical monosymptomatic feature of HS at its onset. Objective To assess the prevalence of HS and DRF by comparing a cohort of patients carrying trisomy 21 vs pediatric controls. Methods A retrospective 2-year monocentric clinical study was performed by collecting clinical data of 131 patients with DS, aged 4-36 years, followed at the Dermatology Unit and Down Syndrome Regional Center of Bologna University. Data were matched with those coming from 12,351 pediatric controls. Results In DS patients, DRF and HS showed a prevalence of, respectively, 6.8% and 24.4%, while 5.3% of patients presented both diseases. In the control group the prevalence for HS+ and DRF+ was 0.5% and 1.2%, respectively, with a 0.14% of overlap cases. The association between HS and DRF proved to be statistically significant in both groups (P < 0.05). In the DS cohort the mean age of symptoms onset was 15.67 (SD: 2.29) years for HS and 13.11 (SD: 4.93) years for DRF. Buttocks were the most frequently affected body area for DRF followed by the inguinocrural area, while in HS buttocks were less frequently involved than groins and upper thighs. Conclusions Because of the later onset of HS, patients with DRF at an early age should be monitored for the possible onset of HS in the apocrine-bearing areas.
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Affiliation(s)
- Andrea Sechi
- Division of Dermatology, Sant'Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Alba Guglielmo
- Division of Dermatology, Sant'Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Sant'Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Francesco Savoia
- Division of Dermatology, Sant'Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Guido Cocchi
- Neonatology Unit, Sant'Orsola-Malpighi Polyclinic, Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Miriam Leuzzi
- Division of Dermatology, Sant'Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Marco A Chessa
- Division of Dermatology, Sant'Orsola-Malpighi Polyclinic, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
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Dermatologic Problems Commonly Seen by the Allergist/Immunologist. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:102-112. [PMID: 31351991 DOI: 10.1016/j.jaip.2019.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/23/2022]
Abstract
Allergists/immunologists see a variety of skin disorders, some of which have a known immunologic basis whereas others do not. We review the prevalence, etiology, clinical presentation, and effective and low-cost care of common dermatologic conditions seen in outpatient practices. Conditions discussed include pityriasis alba, seborrheic dermatitis, rosacea, acne, tinea infections, intertrigo, lichen planus, tinea versicolor, lichen simplex chronicus, scabies, pityriasis rosea, keratosis pilaris, and seborrheic keratosis. An understanding of frequently encountered cutaneous diseases and their therapies will help provide immediate access to treatment and improve the experience for both the affected patient and the clinician.
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Comment on: Keratosis Pilaris and Its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options. Am J Clin Dermatol 2019; 20:165. [PMID: 30506428 DOI: 10.1007/s40257-018-0411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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