Even though infections are the most common cause of erythema nodosum (EN), only certain microorganisms take the great interest such as streptococci in knowledge. Our aim was to examine the frequency and type of infections in EN, to determine the characteristics of patients with an infectious etiology, and to discuss the role of these microbes in EN pathology in the context of their interactions with humans. Charts of 81 patients with EN who were seen between 2003 and 2017 were retrospectively reviewed. Identified etiological factors were classified into three groups: infectious, noninfectious, and idiopathic. While there were no significant demographic and clinical differences between the infectious and idiopathic groups, systemic symptoms (p = 0.034) and the number of EN lesions (p = 0.016) were significantly lower; the mean erythrocyte sedimentation rate was significantly higher (p = 0.049), but the mean aspartate aminotransferase value was significantly lower in the infectious group compared to the noninfectious group (p = 0.019). Besides streptococci, many other microbes, including the ones living on and inside us, were identified in the etiology of EN. There is a need for large-scale prospective studies involving control groups for a better understanding of the microbial immunopathology of EN.
Purpose: Patients with cutaneous inflammatory diseases often present with more aggressive and refractory clinical course in the presence of accompanying human immunodeficiency virus (HIV) infection. Therefore, biologic therapies may be needed to improve outcomes of these patients. The use of biologic agents in HIV positive patients is conflicting because such treatment can lead to increase the risk of infection and malignancy in already immunocompromised patients. On the other hand, some researchers have recommended that HIV management should also include the blockade of tumour necrosis factor-alpha (TNF-α). We discuss the reliability and effectiveness of biologic therapies for patients with cutaneous inflammatory diseases and accompanying HIV infection. Methods: The Medline literature database search through PubMed using the key words 'human immunodeficiency virus', 'cutaneous inflammatory diseases', 'TNF-α inhibitor', 'biologic therapy', 'biologic treatment', 'adalimumab', 'etanercept', 'infliximab,' 'ustekinumab', and 'rituximab' was performed. Literature data associated with biologic therapies of cutaneous inflammatory diseases in HIV-positive patients were evaluated. Results: The literature search identified a total of 17 patients with HIV infection receiving biologic therapy for cutaneous inflammatory diseases (psoriasis, psoriatic arthritis, hidradenitis suppurativa and pemphigus vulgaris) from two case series and 12 case reports. Conclusion: In HIV-infected patients with severe and refractory cutaneous inflammatory diseases, biologic therapies should only be reserved for those whom HIV status is stable at baseline. Screening for tuberculosis prior to treatment and close monitoring for potential side effects are mandatory. Further multicentre randomised controlled trials about the use of biologic agents in these patient groups are necessary.
We present 9-year-old fraternal twins from a family with piebaldism, having congenital depigmented macules and meeting the diagnostic criteria for neurofibromatosis type 1 ( NF1 ) due to the multiple café-au-lait macules (CALMs) and intertriginous freckling at the same time. It's still a debatable issue that CALMs and intertriginous freckling may be seen in the clinical spectrum of piebaldism or these patients should be regarded as coexistence of piebaldism and NF1 . However, based on recent literature and our patients' findings, we suggest that this rare phenotypic variant of piebaldism may not need the careful clinical follow-up and molecular testing for NF1 . Besides, it may be suitable that these individuals with piebaldism showing NF1 -like clinical phenotypes should be further tested for KIT and SPRED1 gene mutations.
ÖzetPoliozis, hipopigmente veya depigmente kıllardan oluşan lokalize alanı tanımlamak için kullanılan bir terimdir. Bu tablonun foliküler melanositlerin inflamatuvar veya otoimmün bir mekanizmayla yıkımı sonucu oluştuğuna inanılmaktadır. Poliozis bazı herediter sendromlarla birlikte görülebileceği gibi inflamasyon, irradyasyon veya infeksiyonu takiben ve bazı ilaçlarla edinsel olarak da oluşabilir. Ayrıca bazı nevüsler, melanom ve nörofibrom gibi bazı benin ve malin lezyonlar üzerinde de gelişebileceği bildirilmiştir. Ancak literatürde T hücre aracılı otoimmün inflamatuvar bir hastalık olan psoriasis ile poliozis ilişkisine dair bir veri bulunmamaktadır. Burada saçlı derideki psoriasis plağı üzerinde poliozis gelişen 11 yaşında bir kız olgu sunulmaktadır. Sum maryPoliosis is the term used to describe a localized area of hypopigmented or depigmented hairs. It is believed that this condition is a result of the destruction of follicular melanocytes by an inflammatory or autoimmune mechanism. Poliosis can occur in several hereditary syndromes or is acquired after inflammation, irradiation or infection and some medications. Additionally, it has also been reported that it can overlie some benign and malignant lesions, including some nevi, melanoma and neurofibroma. On the other hand, there has been no prior data of an association between psoriasis, which is a T-cell-mediated autoimmune inflammatory disease, and poliosis in the literature. Here, we describe an 11-year-old female with poliosis of the scalp overlying a plaque of psoriasis. (Turkderm 2013; 47: 69-71 Psoriasis üzerinde poliozis Poliosis overlying psoriasis GirişPoliozis, bazı kıl foliküllerindeki melanin azalması veya kaybına bağlı olarak grimsi beyaz renkli hipopigmente veya depigmente kıllardan oluşan lokalize alanı tanımlamak için kullanılan bir terimdir. Çoğu olguda kozmetik kaygı dışında herhangi bir sorun yaratmayan bu dermatoz çeşitli hastalıklar veya ilaçlarla ilişkili olabilir 1-14 . Poliozisin patogenezi tam olarak bilinmemekle birlikte in amatuvar veya otoimmün bir mekanizma sonucunda foliküler melanositlerin yıkımı ile meydana geldiği düşünülmektedir 2-12 . Her ne kadar bazı in amatuvar ve otoimmün hastalıklarla ilişkilendirilmiş olsa da, T hücre aracılı otoimmün in amatuvar bir hastalık olan psoriasis ile poliozis ilişkisine dair bir veriye rastlanmamıştır 15,16 . Burada saçlı derisinde psoriasis ile uyumlu eritemli, skuamlı plak üzerini örten kıllarda poliozis gelişmiş 11 yaşında bir kız olgu sunulmaktadır. OlguSaçlı derideki pullanan kızarık kabarıklık ve saçlardaki beyazlama yakınması ile başvuran 11 yaşındaki kız olgu bu yakınmalarının yaklaşık bir yıl önce ense bölgesindeki saçlı deride pullanan kızarıklık şeklinde başladığını ifade etmiştir. Bu kızarıklığın zaman içinde daha kabarık hale
Psoriasis is a chronic, immune-mediated disease resulting from interactions of genetic background with environmental triggering factors, such as trauma, infections and drugs. Dendritic cells, activated T-cells toward a Th1 and Th17 response and inflammatory cytokines [tumor necrosis factor (TNF)-alpha, are the key factors in psoriasis pathogenesis. Patients diagnosed with psoriasis are at increased risk of infection due to the nature of disease and immunosuppressive therapies. Vaccination is recommended to prevent infections in patients with psoriasis. Additionally, vaccines such as Mycobacterium vaccae, live attenuated varicella zoster virus and Leishmania amastigotes have been reported to induce improvement in psoriasis patients. It has been suggested that vaccines, targeting molecules in the immunopathogenesis of psoriasis, may be a new treatment option for psoriasis patients without any serious side effects. However, induction or worsening of the psoriasis and psoriatic arthritis followed by some vaccines (e.g., influenza, rubella, tetanus, BCG) has also been reported in the literature. In this review, we focus on the vaccines in psoriasis in terms of their both triggering and therapeutic effects.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.