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Granuloma Annulare
No full textGranuloma annulare (GA) is an inflammatory dermatosis of adults and children, arranged by groups of skin‐coloured to erythematous papules in an annular distribution. Nodular lesions may be present too. Common sites of GA are the extensor surfaces of the limbs, dorsa of hands and feet; scalp and trunk are rarely affected. The aetiology of GA is unclear, but some pathological associations have been reported, such as diabetes mellitus type 1, infections, haematological and autoimmune disorders. Four main clinical variants of GA are known: localized GA (multiple or single), subcutaneous GA, generalized GA (annular or nonannular) and perforating GA. Adjunctive rare variants are papular umbilicated GA and linear GA. Clinical features are crucial for suspecting GA, but in doubtful cases biopsy and histopathology are mandatory to confirm the diagnosis. Three main microscopic patterns have been described: palisading granulomatous, interstitial histiocytic and sarcoidal. GA is usually benign and self‐limiting so clinical follow‐up represents the first‐choice therapeutic option. Other topical or systemic measures have shown controversial results
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome in childhood: a narrative review
Full text linkDespite being rare, the Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a serious, possibly fatal condition that may affect both adults and children who may be also burdened by delayed sequelae. It is an adverse drug reaction characterized by widespread skin involvement, fever, lymphadenopathy, visceral involvement, and laboratory abnormalities (eosinophilia, mononucleosis-like atypical lymphocytes). It is more frequently triggered by anticonvulsants, sulphonamides, or antibiotics, the latter being responsible for up to 30% of pediatric cases. The disease typically develops 2-8 weeks after exposure to the culprit medication, with fever and widespread skin eruption; mild viral prodromes are possible. Unfortunately, diagnosis is challenging due to the absence of a reliable test; however, a score by the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) allows to classify suspect patients into no, possible, probable, or definite DRESS cases. Moreover, rapid-onset DRESS syndrome has been described in recent years. It affects children more often than adults and differs from the most common form because it appears & LE;15 days vs. >15 days after starting the drug, it is usually triggered by antibiotics or iodinated contrast media rather than by anticonvulsants and has a higher presence of lymphadenopathy. Differential diagnosis between rapid-onset antibiotic-driven DRESS syndrome, viral exanthems, or other drug eruptions may be challenging, but it is mandatory to define it as early as possible to start adequate treatment and monitor possible complications. The present review reports the latest evidence about the diagnosis and treatment of pediatric DRESS syndrome
Alitretinoin for palmoplantar keratodermas: A novel case and review of the literature
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