Psychiatric Sequelae of Chronic Pruritic Dermatoses

This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chronic urticaria, and prurigo nodularis. Highlighting the complex, reciprocal relationship between pruritus and psychiatric conditions such as depression, anxiety, and sleep disturbances, this paper elucidates the comprehensive impact of dermatological disorders on the skin in addition to the far-reaching effects on an individual’s psychological well-being. By evaluating the efficacy of integrated psychodermatological interventions, including cognitive behavioral therapy, mindfulness practices, pharmacological treatments, and innovative telepsychiatry and digital health solutions, this review aims to lay the foundation for a more holistic approach to treatment of concurrent dermatological and psychiatric conditions. Future research endeavors should delve deeper into the mechanistic foundation of the pruritus-psychiatry interface, the refinement of tailored treatment strategies, and the evaluation of long-term patient outcomes. In doing so, this review seeks to contribute to the optimization of patient care and well-being, underscoring the pivotal role of addressing both dermatological and psychological needs in achieving comprehensive health outcomes.

Intestinal-borne dermatoses significantly improved by oral application of Escherichia coli Nissle 1917

AIM: To evaluate the effect of oral Escherichia coli (E. coli) Nissle application on the outcome of intestinal-borne dermatoses.METHODS: In a randomized, controlled, non-blinded prospective clinical trial 82 patients with intestinal-borne facial dermatoses characterized by an erythematous papular-pustular rash were screened. At the initiation visit 37 patients entered the experimental arm and 20 patients constituted the control arm. All 57 patients were treated with a vegetarian diet and conventional topical therapy of the dermatoses with ointments containing tetracycline, steroids and retinoids. In the experimental arm patients received a one month therapy with oral E. coli Nissle at a maintenance dose of 2 capsules daily. The experimental group was compared to a non-treatment group only receiving the diet and topical therapy. The primary outcome parameter was improvement of the dermatoses, secondary parameters included life quality and adverse events. In addition the immunological reaction profile (IgA, interleucin-8 and interferon-α) was determined. Furthermore the changes of stool consistency and the microbiota composition over the time of intervention were recorded.RESULTS: Eighty-nine percent of the patients with acne, papular-pustular rosacea and seborrhoic dermatitis responded to E. coli Nissle therapy with significant amelioration or complete recovery in contrast to 56% in the control arm (P < 0.01). Accordingly, in the E. coli Nissle treated patients life quality improved significantly (P < 0.01), and adverse events were not recorded. The clinical improvement was associated with a significant increase of IgA levels to normal values in serum as well as suppression of the proinflammatory cytokine IL-8 (P < 0.01 for both parameters). In the E. coli Nissle treated group a shift towards a protective microbiota with predominance of bifidobacteria and lactobacteria (> 107 CFU/g stool) was observed in 79% and 63% of the patients, respectively (P < 0.01), compared to no change in the control group without E. coli Nissle. Moreover, the detection rate of a pathogenic flora dropped from 73% to 14 % of the patients in the experimental arm (P < 0.01) with no significant change in the control arm (accounting 80% before and 70% after the observation period, P > 0.05). Accordingly, stool consistency, color and smell normalized in the E. coli Nissle treated patients.CONCLUSION: E. coli Nissle protects the mucus barrier by overgrowth of a favorable gut microbiota with less immunoreactive potential which finally leads to clinical improvement of intestinal borne dermatoses.

Esophagitis dissecans superficialis and autoimmune bullous dermatoses: A review

Esophagitis dissecans superficialis(EDS)is a rare and severe endoscopic finding characterized by sloughing of large fragments of esophageal mucosal lining.Although EDS has been reported in association with serious illnesses and certain medications,the pathophysiological association of autoimmune bullous dermatoses with EDS has gained remarkable attention.Among these dermatoses,pemphigus vulgaris and pemphigoid frequently present with various types of esophageal involvement including EDS.We review the pathophysiology and clinical features of this involvement with the presentation of our experiences.The importance of endoscopic evaluation of this entity is discussed.

Epidemiological and Clinical Aspects of Neonatal Dermatoses at the National Teaching Hospital HKM of Cotonou Benin

Neonatal dermatoses (NND) are frequent, varied and of variable prognosis. The objective of this work was to study the epidemiological and clinical aspects of NND at the NTH-HKM. Methods: This was a cross-sectional descriptive and analytical study from December 1, 2014 to February 28, 2015. All newborns received in the Department of Pediatrics and Medical Genetics and with dermatosis were included. The diagnosis of dermatoses was clinical. Results: During the study period, 355 newborns had at least one NND on a total of 580 newborns received, a prevalence of 61.2%. The sex ratio was 1.54 and the average age was 3.11 days. Transient dermatoses were more frequent (80%), dominated by desquamation + xerosis (33.75%). Congenital melanocytic nevi (40.74%) and malformations and vascular tumors (18.52%) were the most noted pathological neonatal dermatoses. Only age was statistically associated with NND. Conclusion: DNH is common in newborns at the NTH-HKM. They were mostly transitory. Pathological conditions should be treated where appropriate.

Purpura annularis telangiectodes of Majocchi:A case report

BACKGROUND Purpura annularis telangiectodes of Majocchi(PATM),also known as Majocchi,is a rare subclass of pigmented purpuric dermatoses.The etiology of PATM is unknown,but it seems more common in children and young women.The skin lesions are mostly symmetrical ring-shaped reddish-brown macules on the lower limbs.CASE SUMMARY A 9-year-old girl,who has received treated in our department,presented with reddish-brown ring-shaped rash on both lower limbs that had been present for 6 mo.These lesions,red brownish annular or petaloid patches,were mostly found on ankles and lower limber,which do not fade when adding pressure and no feel of infiltration and no atrophy when touching those lesions.Pathological examination showed deposition of hemosiderin in papillary dermis.However,dermoscopy showed the pigmentation in the center as well as the lavender patches on the edge of lesion.The child was thus diagnosed with PATM.After diagnosis,we suggested the patient avoid strenuous exercise.she was given vitamin C tablets for oral and mometasone furoate cream for external use.Followup examinations and treatment continue to support the clinical diagnosis to date.CONCLUSION This is the first report of investigating PATM using dermoscopy,which can differentiate PATM from other diseases due to its unique microscopic feature under dermoscopy.Although PATM is harmless,it still requires long-term follow-up.Moreover,dermoscopy technique can be applied for observation of multi-site lesions and correlated with histopathology.Thus,we believe this approach could be generalized for future diagnosis of PATM.

Dermatosis as the initial presentation of gastric cancer: two cases

Paraneoplastic dermatoses are known to be certain dermatosis related with tumor. The common paraneoplastic dermatoses are acanthosis nigricans, acquired ichthyosis, dermatomyositis, erythroderma, and so on. Here we report two cases of paraneoplastic dermatoses associated with gastric cancer. One case was a 57-year-old man with dermatomyositis and proved to be associated with gastric cancer through stomachoscopy. The other was a 66-year-old man with erythroderma and proved to be associated with gastric cancer through stomachoscopy. Both cases were treated with radical total gastrectomy with lymphadenectomy（D2） and esophagojejunostomy of Roux-en-Y. The skin symptom of both cases had improved a lot but still existed after operation. Paraneoplastic dermatoses can be seen as the early manifestation of visceral carcinomas. As a result, gastric cancers should be excluded in the patients with paraneoplastic dermatoses.

Epidemio-Clinical Profile of Skin Conditions in Pediatric Dermatology Consultation of the University Hospital of Treichville

Introduction: Dermatoses are common in the pediatric population. They have certain particularities such as the prevalence of the diaper dermatitis and genetic disorders. Paediatric dermatological problems are common, with some conditions requiring specialist consultation. Often appropriate diagnosis and therapy are sometime delayed in certain countries. Few studies have focused on pediatric aspects of skin diseases in C&ocirc;te d’Ivoire. We initiated this work to contribute to a better knowledge of pediatric skin conditions in our work context. Material and Methods: This is a cross-sectional prospective, descriptive and analytical study carried out in the Dermatology Department of the University Hospital of Treichville from January 2015 to December 2017. Data from the study were collected on a survey card that included socio-demographic characteristics and clinical aspects. All children with cutaneous and mucosal disease seen in pediatric dermatology consultation have been taken into account in the study. Results: 11,487 patients were seen in dermatology consultation during the period of our study with only 302 children, a prevalence of 2.6%. The sex ratio was 0.9. The main reason for consultation was pruritus (22.65%). In 63.9% of the cases the child was referred by a family member whereas more than 1/3 of the children (39.07%) had previously been consulted by a pediatrician. Among children referred with a skin diagnosis, the half had a correct diagnosis The most prevalent disorders by category were dermatitis (57.9%) and infections (29.5%). Multiple diagnosis were made in 9.27% of the patients. The most common pathologies encountered were prurigo (23.2%), scabies (12.9%) and atopic dermatitis (9.6%). The lesions were mainly located on the head (23.31%) and the lower limbs (20.51%). In almost all cases (99.3%), the diagnosis was essentially clinical. Conclusion: Pediatric dermatoses are numerous and varied. They are dominated by Prurigo and Scabies. This study invites for close collaboration between pediatricians and dermatologists in order to optimize their therapeutic management. The knowledge of this spectrum of pediatric skin diseases would be useful for future health planning in order to reduce disease burden.

Neutrophilic Panniculitis Associated With Myelodysplastic Syndrome/Myeloproliferative Neoplasm:A Case Report and Literature Review

Introduction:Neutrophilic panniculitis(NP)is a rare subtype of neutrophilic dermatosis,a group of neutrophilrich inflammatory skin disorders that can present in association with myeloid neoplasms.NP is defined by the presence of a neutrophilic infiltrate in the fat lobules of the subcutis in the absence of either infection or vasculitis.We herein describe a 65-year-old woman with a recent diagnosis of myelodysplastic syndrome/myeloproliferative neoplasm overlap syndrome(MDS/MPN)who abruptly developed painful,pruritic nodules consistent with NP.Case presentation:A 65-year-old woman with MDS/MPN presented for evaluation of painful and pruritic nodules on her upper and lower extremities.A biopsy revealed a lobular neutrophilic infiltrate in the subcutis without evidence of microorganisms or vasculitis.The patient was diagnosed with NP and treated with oral prednisone.Within 1 month of treatment,she reported complete resolution of the nodules.Discussion:Similar to other neutrophilic dermatoses,NP may arise in association with hematologic malignancies of myeloid origin,such as MDS/MPN.A literature review revealed that most cases of NP associated with MDS occur after the onset of MDS and respond to systemic corticosteroids,not antibiotics.Infection should be ruled out before initiating treatment with systemic steroids.Conclusion:Although the mechanism is still unknown,it is important for clinicians to be aware that NP is associated with MDS;thus,hematological malignancies should be investigated on diagnosis of NP.Once diagnosed,NP is easily treated and has an excellent response to systemic corticosteroids.

Treatment of 43 Cases of Lateral Femoral Cutaneous Neuritis with Pricking and Cupping Therapy

Lateral femoral cutaneous neuritis, also named asmeralgia paresthetica or Roth syndrome, is markedby cutaneous pain or paresthesia such asformication or numbness in one or both thighs,which can be aggravated by prolonged standing orwalking; it is also characterized by hypoesthesia orskin sensibility without muscular atrophy ordyskinesia. Forty-three cases of lateral femoralcutaneous neuritis have been treated by pricking andcupping therapy since 1996. Now it was reported asfollows.

Ets-2 deletion in myeloid cells attenuates IL-1α-mediated inflammatory disease caused by a Ptpn6 point mutation

The SHP-1 protein encoded by the Ptpn6 gene has been extensively studied in hematopoietic cells in the context of inflammation.A point mutation in this gene(Ptpn6spin)causes spontaneous inflammation in mice,which has a striking similarity to neutrophilic dermatoses in humans.Recent findings highlighted the role of signaling adapters and kinases in promoting inflammation in Ptpn6spin mice;however,the underlying transcriptional regulation is poorly understood.Here,we report that SYK is important for driving neutrophil infiltration and initiating wound healing responses in Ptpn6spin mice.Moreover,we found that deletion of the transcription factor Ets2 in myeloid cells ameliorates cutaneous inflammatory disease in Ptpn6spin mice through transcriptional regulation of its target inflammatory genes.Furthermore,Ets-2 drives IL-1α-mediated inflammatory signaling in neutrophils of Ptpn6spin mice.Overall,in addition to its well-known role in driving inflammation in cancer,Ets-2 plays a major role in regulating IL-1α-driven Ptpn6spin-mediated neutrophilic dermatoses.