<strong>Background:</strong> Psoriasis, a chronic, systemic, inflammatory disease with prominent skin involvement, affects approximately 2% - 4% of the world population. Common variants of psoriasis are pl...<strong>Background:</strong> Psoriasis, a chronic, systemic, inflammatory disease with prominent skin involvement, affects approximately 2% - 4% of the world population. Common variants of psoriasis are plaque psoriasis, inverse psoriasis, guttate psoriasis, erythrodermic psoriasis, pustular form either palmoplantar pustular psoriasis or generalized pustular psoriasis, nail psoriasis, and psoriatic arthritis. Progressive Symmetrical Erythrokeratoderma (PSEK) is a rare genetic disorder, characterized by fixed, well-defined erythematous and hyperkeratotic plaques distributed predominantly on the elbows, knees, trunk, and dorsal surfaces of hands and feet. Clinically has the same presentation to psoriasis especially at early onset and could be confused with psoriasis but histopathological findings and progression of the psoriatic disease can differentiate between both conditions. <strong>Aim:</strong> To document a new variant of a severe, recalcitrant type of psoriasis with a history of recurrent attacks of exacerbations and partial remissions especially in lesions involving lower extremities that are clinically PSEK-like in presentation, but histopathologically consistent with psoriasis. <strong>Case report:</strong> A 12-year-old childhood male, known case of Down’s syndrome, presented to our clinic with a history of severely pruritic skin rashes involving the perioral area, corners of the mouth, bilateral elbows, dorsal hands, scrotum, and both lower extremities for 6 years duration. The rashes gradually progressed with time to form fixed lesions in the last 2 years. He was received multiple treatment modalities, including topical steroids, topical vitamin D derivatives, and narrowband UVB phototherapy without significant improvement and the lesions became more worsened over time. <strong>Conclusion:</strong> psoriasis can be presenting with a new variant of a severe, recalcitrant, and difficult to treat type in Down syndrome cases with a history of recurrent attacks of exacerbations and partial remissions especially in lesions involving lower extremities which are clinically PSEK-like in presentation, but histopathologically consistent with psoriasis. However, early diagnosis and strict management are important in controlling the severity of the condition.展开更多
Introduction Erythrokeratoderma variabilis is a rare autosomal dominant genodermatosis that usually appears within the first year of life, but may arise later in childhood. EKV was described by Mendes da Costa in 1925...Introduction Erythrokeratoderma variabilis is a rare autosomal dominant genodermatosis that usually appears within the first year of life, but may arise later in childhood. EKV was described by Mendes da Costa in 1925(1)Clinical characteristics of EKV consist of irregularly-shaped, erythematous, scaly patches and hyperkera-totic plaques.展开更多
Some patients with perioral dermatitis are not relieved despite many medications. These patients confront pain, psychological bother and social/occupational limitations. Being efficient for a wide variety of diseases ...Some patients with perioral dermatitis are not relieved despite many medications. These patients confront pain, psychological bother and social/occupational limitations. Being efficient for a wide variety of diseases including infectious inflammative degenerative or tumoral, photodynamic therapy holds a good chance to cure diseases of unknown origin, such as perioral dermatitis. This study presents the results of three women with chronic perioral dermatitis that persisted for years with partial response to medical regimen. They asked for photodynamic treatment to ease off their suffering. The duration of follow-up was up to five years. Following PDT （photodynamic therapy）, the patients discontinued medications, redness decreased and eruption disappeared. In these patients, a single PDT treatment provided prolonged relief of perioral dermatitis for up to three years. These data are encouraging but not sufficient. Further study is warranted.展开更多
文摘<strong>Background:</strong> Psoriasis, a chronic, systemic, inflammatory disease with prominent skin involvement, affects approximately 2% - 4% of the world population. Common variants of psoriasis are plaque psoriasis, inverse psoriasis, guttate psoriasis, erythrodermic psoriasis, pustular form either palmoplantar pustular psoriasis or generalized pustular psoriasis, nail psoriasis, and psoriatic arthritis. Progressive Symmetrical Erythrokeratoderma (PSEK) is a rare genetic disorder, characterized by fixed, well-defined erythematous and hyperkeratotic plaques distributed predominantly on the elbows, knees, trunk, and dorsal surfaces of hands and feet. Clinically has the same presentation to psoriasis especially at early onset and could be confused with psoriasis but histopathological findings and progression of the psoriatic disease can differentiate between both conditions. <strong>Aim:</strong> To document a new variant of a severe, recalcitrant type of psoriasis with a history of recurrent attacks of exacerbations and partial remissions especially in lesions involving lower extremities that are clinically PSEK-like in presentation, but histopathologically consistent with psoriasis. <strong>Case report:</strong> A 12-year-old childhood male, known case of Down’s syndrome, presented to our clinic with a history of severely pruritic skin rashes involving the perioral area, corners of the mouth, bilateral elbows, dorsal hands, scrotum, and both lower extremities for 6 years duration. The rashes gradually progressed with time to form fixed lesions in the last 2 years. He was received multiple treatment modalities, including topical steroids, topical vitamin D derivatives, and narrowband UVB phototherapy without significant improvement and the lesions became more worsened over time. <strong>Conclusion:</strong> psoriasis can be presenting with a new variant of a severe, recalcitrant, and difficult to treat type in Down syndrome cases with a history of recurrent attacks of exacerbations and partial remissions especially in lesions involving lower extremities which are clinically PSEK-like in presentation, but histopathologically consistent with psoriasis. However, early diagnosis and strict management are important in controlling the severity of the condition.
文摘Introduction Erythrokeratoderma variabilis is a rare autosomal dominant genodermatosis that usually appears within the first year of life, but may arise later in childhood. EKV was described by Mendes da Costa in 1925(1)Clinical characteristics of EKV consist of irregularly-shaped, erythematous, scaly patches and hyperkera-totic plaques.
文摘Some patients with perioral dermatitis are not relieved despite many medications. These patients confront pain, psychological bother and social/occupational limitations. Being efficient for a wide variety of diseases including infectious inflammative degenerative or tumoral, photodynamic therapy holds a good chance to cure diseases of unknown origin, such as perioral dermatitis. This study presents the results of three women with chronic perioral dermatitis that persisted for years with partial response to medical regimen. They asked for photodynamic treatment to ease off their suffering. The duration of follow-up was up to five years. Following PDT （photodynamic therapy）, the patients discontinued medications, redness decreased and eruption disappeared. In these patients, a single PDT treatment provided prolonged relief of perioral dermatitis for up to three years. These data are encouraging but not sufficient. Further study is warranted.
