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Balazic E, Axler E, Konisky H, Khanna U, Kobets K. Pentoxifylline in dermatology. J Cosmet Dermatol 2023; 22:410-417. [PMID: 36208009 DOI: 10.1111/jocd.15445] [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: 08/14/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pentoxifylline was initially marketed for use in patients with intermittent claudication due to chronic occlusive arterial disease of the extremities but has since been shown to have several off-label uses in dermatology. AIMS The aim of this review is to increase awareness of the several applications of pentoxifylline in the field of dermatology. METHODS A comprehensive PubMed search was conducted in May 2022 using the following phrases "dermatology" AND "pentoxifylline." Our search period spanned 34 years from 1988 to 2022. All available literature was reviewed. Reference lists of identified articles were included. Studies were excluded if they were not in English and if the study was out of scope. Eighty-one articles were included in this review. RESULTS Pentoxifylline has been used to treat various dermatological conditions including peripheral vascular disease, vasculitis and vasculopathies, chilblains, pigmented purpuric dermatosis, granuloma annulare, necrobiosis, keloids, lichen sclerosis et atrophicus, scars, radiation-induced fibrosis, vitiligo, alopecia areata, leishmaniasis, and leprosy. CONCLUSIONS Pentoxifylline's use in dermatology is growing. However, there are limited larger studies and randomized control trials on the use of pentoxifylline in dermatology and more investigation is needed to evaluate its use for many dermatologic conditions. Pentoxifylline's unique mechanism of action as well as its good tolerability, cost-effectiveness, and minimal drug interactions make it a convenient primary or adjunctive option in many dermatological conditions.
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Affiliation(s)
- Eliza Balazic
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Eden Axler
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Hailey Konisky
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Urmi Khanna
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Kseniya Kobets
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
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Alkhatieb M, Mortada H. Truncal necrobiosis lipoidica diabeticorum: A first case report. Int J Surg Case Rep 2020; 77:311-313. [PMID: 33197774 PMCID: PMC7677668 DOI: 10.1016/j.ijscr.2020.11.009] [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: 10/05/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/03/2022] Open
Abstract
Necrobiosis lipoidica is a rare chronic dermatitis found in diabetic patients. These skin lesions affect 0.3–1.2% of patients with diabetes mellitus. Our patient developed necrobiosis lipoidica on the trunk, an unusual location. Treatment of necrobiosis lipoidica is difficult, related to good glycemic control.
Introduction Necrobiosis lipoidica (NL) is a known chronic rare granulomatous dermatitis. NL typically occurs in the lower extremity, there have only been previously reported cases of NL on the face, scalp, forearms, and dorsum of the hands. However, truncal NL is not a typical location. Presentation of case A 67-year-old man known to have diabetes type 2, presented with a 3-year history of painful and itchy skin lesions on the right lateral chest wall. On clinical examination, he had a red discolored patch with superficial capillaries and yellow discoloration at the center. Based on the histological examination, necrobiosis lipoidica was confirmed. Initial treatment with clobetasol propionate, tacrolimus, and topical corticosteroid cream was unsuccessful, and further NL lesions developed on the lower limb. Discussion NL rash is characterized by its location in the lower limbs and rarely involves fingers, hands, scalp, or face. It is noteworthy that the patient presented with NL skin lesions bon the trunk, which is outside the usual presentation. The prevalence of NL ranges from 0.3% to 1.2% among patients with diabetes mellitus. The treatment of NL is usually difficult. Initial management includes smoking cessation and proper diabetes control. In addition, intralesional and topical corticosteroids might be effective. In this case report, there was no improvement in NL despite the use of topical corticosteroids. Conclusion Immediate diagnosis and treatment of NL may prevent disease progression; therefore, the diagnosis of NL should be considered, even in an unusual location.
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Affiliation(s)
- Maram Alkhatieb
- Division of General Surgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Chan SA, Thomas M, Snead D, Shim TN. Penile necrobiosis lipoidica: case report and literature review. Clin Exp Dermatol 2018; 44:441-443. [PMID: 30280413 DOI: 10.1111/ced.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- S A Chan
- Department of Dermatology, University Hospital Coventry and Warwickshire, Coventry, UK
| | - M Thomas
- Department of Pathology, University Hospital Coventry and Warwickshire, Coventry, UK
| | - D Snead
- Department of Pathology, University Hospital Coventry and Warwickshire, Coventry, UK
| | - T N Shim
- Department of Dermatology, University Hospital Coventry and Warwickshire, Coventry, UK
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Mendes AL, Miot HA, Haddad V. Diabetes mellitus and the skin. An Bras Dermatol 2017; 92:8-20. [PMID: 28225950 PMCID: PMC5312172 DOI: 10.1590/abd1806-4841.20175514] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 06/29/2016] [Indexed: 11/22/2022] Open
Abstract
Several dermatoses are routinely associated with diabetes mellitus, especially in patients with chronic disease. This relationship can be easily proven in some skin disorders, but it is not so clear in others. Dermatoses such necrobiosis lipoidica, granuloma annulare, acanthosis nigricans and others are discussed in this text, with an emphasis on proven link with the diabetes or not, disease identification and treatment strategy used to control those dermatoses and diabetes.
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Affiliation(s)
- Adriana Lucia Mendes
- Department of Clinical Medicine - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
| | - Helio Amante Miot
- Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) -Botucatu (SP), Brazil
| | - Vidal Haddad
- Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) -Botucatu (SP), Brazil
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Mistry BD, Alavi A, Ali S, Mistry N. A systematic review of the relationship between glycemic control and necrobiosis lipoidica diabeticorum in patients with diabetes mellitus. Int J Dermatol 2017. [DOI: 10.1111/ijd.13610] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Bhavik D. Mistry
- Faculty of Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Afsaneh Alavi
- Department of Medicine (Dermatology); University of Toronto; Toronto Ontario Canada
| | - Saima Ali
- Faculty of Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Nisha Mistry
- Department of Medicine (Dermatology); University of Toronto; Toronto Ontario Canada
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Abstract
Necrobiosis lipoidica is a granulomatous condition presenting as indolent atrophic plaques, often on the lower extremities. There is a multitude of case reports suggesting possible associations and documenting different therapeutic alternatives with varied success. Important complications include ulceration and the development of squamous cell carcinoma. The disease course is often indolent and recurrent despite treatment. This article reviews the etiopathogenesis, clinical presentations, and evidence for treatment alternatives of this condition.
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Affiliation(s)
- Cathryn Sibbald
- Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada
| | - Sophia Reid
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Afsaneh Alavi
- Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada.
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Wee E, Kelly R. Pentoxifylline: An effective therapy for necrobiosis lipoidica. Australas J Dermatol 2015; 58:65-68. [PMID: 26559761 DOI: 10.1111/ajd.12420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/26/2015] [Indexed: 11/26/2022]
Abstract
Necrobiosis lipoidica (NL) is a rare chronic inflammatory granulomatous skin disorder that remains challenging to treat. Here we report three patients at different stages of disease successfully treated with pentoxifylline, a haemorrheological and anti-inflammatory agent. We demonstrate for the first time that early stage NL may be completely reversible with this treatment. Our findings are also consistent with previous isolated reports showing the effectiveness of pentoxifylline in treating ulcerative NL.
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Affiliation(s)
- Edmund Wee
- Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Robert Kelly
- Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
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8
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Badaoui A, Mugnier P, Vignon Penamen MD. [Granuloma annulare: an atypical site]. Ann Dermatol Venereol 2014; 141:810-1. [PMID: 25433939 DOI: 10.1016/j.annder.2014.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/16/2014] [Accepted: 07/24/2014] [Indexed: 10/24/2022]
Affiliation(s)
- A Badaoui
- Service d'anatomie pathologique, hôpital Saint Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - P Mugnier
- Cabinet médical, 14, rue de la République, 78370 Plaisir, France
| | - M-D Vignon Penamen
- Service d'anatomie pathologique, hôpital Saint Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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9
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Cozzani E, Rongioletti F, Ciccarese G, Drago F, Parodi A. Necrobiotic granuloma annulare of the penis: a case responding to anti-tuberculosis therapy with a review of the literature. J Eur Acad Dermatol Venereol 2014; 30:198-200. [PMID: 25201475 DOI: 10.1111/jdv.12713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E Cozzani
- IRCCS A.O.U. San Martino-IST, DISSAL - Section of Dermatology, Genoa, Italy
| | - F Rongioletti
- IRCCS A.O.U. San Martino-IST, DISSAL - Section of Dermatology, Genoa, Italy
| | - G Ciccarese
- IRCCS A.O.U. San Martino-IST, DISSAL - Section of Dermatology, Genoa, Italy
| | - F Drago
- IRCCS A.O.U. San Martino-IST, DISSAL - Section of Dermatology, Genoa, Italy
| | - A Parodi
- IRCCS A.O.U. San Martino-IST, DISSAL - Section of Dermatology, Genoa, Italy
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10
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Schofield C, Sladden MJ. Ulcerative necrobiosis lipoidica responsive to colchicine. Australas J Dermatol 2012; 53:e54-7. [DOI: 10.1111/j.1440-0960.2011.00768.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Solanki LS, Singh S. Non-healing ulcer on penis. Int J Dermatol 2012; 51:842-4. [PMID: 22715831 DOI: 10.1111/j.1365-4632.2011.05061.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Lakhan S Solanki
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
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12
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Souza FHDMD, Ribeiro CF, Pereira MAC, Mesquita L, Fabrício L. Ocorrência simultânea de necrobiose lipoídica ulcerada e granuloma anular em um paciente: relato de caso. An Bras Dermatol 2011; 86:1007-10. [DOI: 10.1590/s0365-05962011000500023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 08/28/2010] [Indexed: 11/22/2022] Open
Abstract
Ocorrência simultânea de granuloma anular e necrobiose lipoídica é rara. Sete casos dessa associação foram encontrados na literatura, sendo somente um de necrobiose lipoídica ulcerada. Relata-se caso de concomitância de granuloma anular e necrobiose lipoídica ulcerada, não associada a diabetes mellitus, em paciente masculino de 39 anos, com confirmação histopatológica.
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Abstract
The subcutaneous clinical variant of granuloma annulare (GA) is rare and tends to present more frequently in children, in locations unusual for conventional GA. Involvement of the penis is exceptional and has been rarely reported. Most cases are located in the shaft of the penis and tend to persist without spontaneous remission. Diagnosis is done only after biopsy, and surgical resection of the lesions is not unusual. We report a new case of subcutaneous GA of the penis in a 13-year-old boy with lesions persistent for the past year. Surgical excision of one of them allowed the correct diagnosis. No further treatment was done, and the condition has not remitted 1 year later. We stress the importance of clinical recognition of unusual presentations of GA to avoid overtreatment of lesions that do not need an aggressive approach.
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Forman SB, Sumfest JM, Pride HB, Ferringer TC. Penile granuloma annulare of an adolescent male--case report and review of the literature. Pediatr Dermatol 2008; 25:260-2. [PMID: 18429796 DOI: 10.1111/j.1525-1470.2008.00647.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Seth B Forman
- Dermatopathology, Geisinger Medical Center, Danville, Pennsylvania 17821, USA.
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