Papuloerythroderma, described by Ofuji in 1984, is characterized by the occurrence of polygonal, erythematous-brown papules, covering the entire skin surface, except skin folds; these changes are accompanied by pruritus and eosinophilia. We report a case of a 41-year-old female patient with melanoerythroderma that has been intensifying since August 2010. The patient's personal and family history for atopy were negative. No triggering factors were identified in the course of hospitalizations. Preceding infections and neoplasms were excluded. The diagnosis of papuloerythroderma of Ofuji was established on the basis of major and minor criteria proposed by Torchia et al. The patient met all the five major criteria: 1) erythroderma-like eruption formed by coalescence of flat-topped, red-to-brown papules with a cobblestone-like appearance, 2) itch, 3) sparing of skin folds and creases, 4) histopathological exclusion of cutaneous lymphoma and other skin diseases, 5) absence of the causative factors such as tumors, infections, drugs and atopy. Regarding the 5 minor criteria, the patient met the following three: 1) peripheral (33.8%) and tissue eosinophilia, 2) elevated level of the total serum IgE (10935 IU/ml), 3) lymphopenia (6.6%). The patient went into remission after 9-month treatment with cyclosporine at a dose of 3 mg/kg.
Introduction: Longitudinal melanonychia presents with pigmented longitudinal streaks of the nail plate. It results from an increased activity of melanocytes or melanocytic hyperplasia in the nail matrix or nail bed and is associated with increased melanin deposition in the nail plate. Distal onycholysis is characterized by separation of the distal part of the nail plate from the nail bed. Objective: To present a case of longitudinal melanonychia and distal onycholysis associated with 5-fluorouracil/adriamycin/cyclophosphamide chemotherapy. Case report: A 66-year-old woman, who received 5-fluorouracil/adriamycin/cyclophosphamide for breast cancer developed longitudinal melanonychia and distal onycholysis. After discontinuation of chemotherapy, nail changes improved significantly. Conclusions: Drug-induced longitudinal melanonychia and distal onycholysis are common adverse effects of breast cancer chemotherapy. This case shows that lesions may resolve after discontinuation of therapy.
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Human hair follicles (HFs) express the olfactory receptor OR2AT4, whose specific stimulation ex vivo by the synthetic sandalwood-like odorant, Sandalore Ò , prolongs anagen, and suppresses apoptosis by up-regulating intra-follicular IGF-1 mediated signalling. To study whether this effect of Sandalore Ò is clinically relevant, we conducted a double-blinded, placebo-controlled trial involving 60 female volunteers affected by telogen effluvium. 30 patients were randomly assigned to a verum group applying once daily a solution containing 1% Sandalore Ò , and 30 patients were included in a placebo group that applied natural sandalwood oil, which has the same odor as Sandalore Ò but does not stimulate OR2AT4. The trial lasted 24 weeks. The read-out parameters were the degree of hair shedding, hair density, anagen/catagen-telogen ratio, hair mass index (hair volume), hair thickness, and patient selfassessment questionnaire. Sandalore Ò 1% reduced hair shedding, increased hair volume and increased the percentage of anagen HFs significantly more than placebo. Hair thickness and density were not affected. Most effects were seen after 8 weeks and maintained at week 24. Subjectively, individuals in the treatment group were "more satisfied" than in the placebo group regarding hair appearance and overall results. This clinical trial confirmed the anagenmaintaining effects of Sandalore Ò seen ex vivo and provides the first evidence that a cosmetic odorant can positively impact on human hair growth in vivo, encouraging the use of topical "olfactotherapy" with Sandalore Ò as adjunct therapy of hair disorders characterized by excessive hair shedding.
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