BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administ...BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.展开更多
Actinic prurigo is a photodermatosis that can affect the skin, conjunctiva and lips. It is caused by an abnormal reaction to sunlight and is more common in high-altitude living people, mainly in indigenous descendants...Actinic prurigo is a photodermatosis that can affect the skin, conjunctiva and lips. It is caused by an abnormal reaction to sunlight and is more common in high-altitude living people, mainly in indigenous descendants. The diagnosis of actinic prurigo can be challenging, mainly when lip lesions are the only manifestation, which is not a common clinical presentation. The aim of this article is to report two cases of actinic prurigo showing only lip lesions. The patients were Afro-American and were unaware of possible Indian ancestry. Clinical exam, photographs, videoroscopy examination and biopsy were performed, and the diagnosis of actinic prurigo was established. Topical corticosteroid and lip balm with ultraviolet protection were prescribed with excellent results. The relevance of this report is to show that although some patients may not demonstrate the classical clinical presentation of actinic prurigo, the associated clinical and histological exams are determinants for the correct diagnosis and successful treatment of this disease.展开更多
Background: Prurigo Pigmentosa (PP) is a rare inflammatory dermatitis first discovered in 1971. Characterized by a sudden eruption of pruritic reticulated, pink-brown papules coalescing into plaques distributed symmet...Background: Prurigo Pigmentosa (PP) is a rare inflammatory dermatitis first discovered in 1971. Characterized by a sudden eruption of pruritic reticulated, pink-brown papules coalescing into plaques distributed symmetrically over shoulders, neck, chest, and back. Various triggers have been identified, including the ketogenic diet. Clinicopathological presentation looks similar to confluent and reticulated papillomatosis (CARP) which is a rare dermatosis of unknown etiology characterized by hyperkeratotic pigmented papules & peripheral reticulation involving seborrheic areas. Aim: To document a new case presentation of PP caused by a low-carbohydrate restricted diet and discuss the comparison with CARP clinically, pathologically, and treatment modalities. Case report: A 15-year-old childhood male developed PP 3 weeks after self-initiating a low carbohydrate-restricted ketogenic diet for weight management. Clinically and histopathologically the lesion looks similar to CARP, treated successfully with re-introduction of high carbohydrates in his food, a short course of systemic steroids in combination with oral doxycycline capsules for the one-month duration. Conclusion: PP & CARP have been considered a spectrum of one disease, and PP is a pruritic variant from CARP caused by a low carbohydrate-restricted diet.展开更多
Prurigo gestationis is not an uncommon disease in pregnancy. It has an estimated prevalence of 1 in 300 pregnancies. Prurigo gestationis is cnaractenzea by small, erythematous or skin-colored papules that are extreme...Prurigo gestationis is not an uncommon disease in pregnancy. It has an estimated prevalence of 1 in 300 pregnancies. Prurigo gestationis is cnaractenzea by small, erythematous or skin-colored papules that are extremely pruritic. It has usually been considered as a benign disorder that influences neither the pregnancy nor the newborn child, and recurrence in subsequent pregnancies is a rare occurrence. Pruigo gestationis associated with fetal death was rarely reported,展开更多
文摘BACKGROUND Prurigo nodularis(PN)is a chronic condition characterized by a papulonodular pruriginous eruption of unknown aetiology.Currently,there are no medications for PN that the United States Food and Drug Administration has approved,which leads to very variable practices in the prescription of off-label treatments.Treatment of PN is based on clinical experience rather than controlled trials.We present our case of generalized PN,in which we had a dramatic response with dupilumab.CASE SUMMARY A 58-year-old female patient was admitted to our clinic with severe itchy,erythematous nodular lesions that were widespread all over her body,especially on the legs and back.It was learned that the patient's complaints started 4 years ago,and there was a significant increase in the lesions in the last period.Dermatological examination revealed diffuse firm erythematous excoriated nodular lesions all over the body.In the blood tests of the patient,serum Immunoglobulin E(IgE)was measured at 9330 IU/mL.The patient was diagnosed with generalized prurigo nodularis together with clinical and histopathological findings.Due to severe clinical findings and the presence of comorbidities,dupilumab treatment was planned for the patient.In the follow-up 4 mo later,it was observed that all nodular lesions healed with postinflammatory hypopigmentation.The IgE value decreased to 1500 IU/mL after 4 mo of dupilumab treatment.CONCLUSION Dupilumab treatment stands out as an effective and safe systemic treatment agent among existing systemic treatments.
文摘Actinic prurigo is a photodermatosis that can affect the skin, conjunctiva and lips. It is caused by an abnormal reaction to sunlight and is more common in high-altitude living people, mainly in indigenous descendants. The diagnosis of actinic prurigo can be challenging, mainly when lip lesions are the only manifestation, which is not a common clinical presentation. The aim of this article is to report two cases of actinic prurigo showing only lip lesions. The patients were Afro-American and were unaware of possible Indian ancestry. Clinical exam, photographs, videoroscopy examination and biopsy were performed, and the diagnosis of actinic prurigo was established. Topical corticosteroid and lip balm with ultraviolet protection were prescribed with excellent results. The relevance of this report is to show that although some patients may not demonstrate the classical clinical presentation of actinic prurigo, the associated clinical and histological exams are determinants for the correct diagnosis and successful treatment of this disease.
文摘Background: Prurigo Pigmentosa (PP) is a rare inflammatory dermatitis first discovered in 1971. Characterized by a sudden eruption of pruritic reticulated, pink-brown papules coalescing into plaques distributed symmetrically over shoulders, neck, chest, and back. Various triggers have been identified, including the ketogenic diet. Clinicopathological presentation looks similar to confluent and reticulated papillomatosis (CARP) which is a rare dermatosis of unknown etiology characterized by hyperkeratotic pigmented papules & peripheral reticulation involving seborrheic areas. Aim: To document a new case presentation of PP caused by a low-carbohydrate restricted diet and discuss the comparison with CARP clinically, pathologically, and treatment modalities. Case report: A 15-year-old childhood male developed PP 3 weeks after self-initiating a low carbohydrate-restricted ketogenic diet for weight management. Clinically and histopathologically the lesion looks similar to CARP, treated successfully with re-introduction of high carbohydrates in his food, a short course of systemic steroids in combination with oral doxycycline capsules for the one-month duration. Conclusion: PP & CARP have been considered a spectrum of one disease, and PP is a pruritic variant from CARP caused by a low carbohydrate-restricted diet.
文摘Prurigo gestationis is not an uncommon disease in pregnancy. It has an estimated prevalence of 1 in 300 pregnancies. Prurigo gestationis is cnaractenzea by small, erythematous or skin-colored papules that are extremely pruritic. It has usually been considered as a benign disorder that influences neither the pregnancy nor the newborn child, and recurrence in subsequent pregnancies is a rare occurrence. Pruigo gestationis associated with fetal death was rarely reported,
