Monkeypox (mpox) is a disease caused by a double-stranded DNA orthopoxvirus discovered in 1958. In 2022 an outbreak on an unprecedented scale marked its transition from neglected, zoonotic disease circulating almost exclusively within African borders to sexually transmitted infection (STI) of international concern. Although phylogenetic evidence suggests progressive evolution from the strain associated with the 2018 outbreak in Nigeria, epidemiological links with previous cases are still incompletely elucidated. Clinically, mpox presents with systemic symptoms, such as fever, headache, malaise, and a characteristic cutaneous eruption, similar to that of cognate viruses (e.g., smallpox). Mpox pseudo-pustules evolve through several stages, including umbilication and crusting, and resolve in the span of 2-3 weeks. Disproportionate affection of men that have sex with men, an often localized cutaneous picture and a significant burden in terms of concomitant STIs were the hallmarks setting the 2022 outbreak apart from classic mpox. Investigations into the disease pathogenesis, related immune response, clinical and dermoscopic features, as well as studies aimed at defining novel management strategies, have advanced mpox knowledge considerably. Herein, recent findings on mpox are reviewed, with a keen focus on dermatological manifestations and their implications in the current diagnostic scenario, reinforcing the pivotal role of dermatologists in managing suspect cases and preventing further spread of the contagion.
Background Brunsting-Perry pemphigoid (BPP) is a rare, autoimmune bullous skin disorder classified within the spectrum of mucous membrane pemphigoid (MMP). Materials and Methods An a priori protocol was designed based on PRISMA guidelines.PubMed and Scopus databases were searched for English-language articles concerning BPP published between 1950 and July 2021.Results Thirty-six articles including 63 BPP patients were analyzed. The mean age at diagnosis was 62.9 years (range: 27-86). BPP was shown to be characterized by vesiculobullous lesions (46/63, 73.0%) on an erythematous base, erosions or ulcerations (27/63, 42.9%), atrophic scars (49/63, 77.8%), and milia (4/63, 6.3%). Exclusive oral mucosal involvement was documented in 22.2% of cases, usually manifesting after the cutaneous onset of the disease. Subepidermal blistering was a constant finding, often with an eosinophil-rich inflammatory infiltrate (21/58, 36.2%). Positive direct immunofluorescence was found in 92.0% of patients, almost always with linear IgG AE C3 deposits along the basement membrane (43/46, 93.5%). BP180 (12/15, 80.0%), BP230 (5/ 15, 33.3%), and laminin 332 (3/15, 20.0%) were the most frequently identified target antigens.Conclusions BPP nosologic position remains uncertain, given the overlap with other autoimmune bullous diseases, such as MMP, bullous pemphigoid, and epidermolysis bullosa acquisita, particularly in its BPP-like variant. Nonpredominant oral mucosal lesions may appear during the course of the disease, generally after cutaneous manifestations.Positivity of DIF and anti-BP180/230 autoantibodies detected on ELISA/immunoblotting in the absence of anticollagen VII antibodies may provide guidance in diagnosing BPP.
(1) Background: Onychopapilloma is a benign tumor of the nail bed and distal matrix. which usually manifests as monodactylous longitudinal eryhtronychia associated with subungual hyperkeratosis. The impossibility to rule out a malignant neoplasm is an indication for surgical excision and histological examination. Our aim is to report and describe the ultrasonographic features of onychopapilloma. (2) Methods: we conducted a retrospective analysis of patients with a histological diagnosis of onychopapilloma who underwent ultrasonographic examination in our Dermatology Unit from January 2019 to December 2021. (3) Results: Six patients were enrolled. Erythronychia, melanonychia, and splinter hemorrhages were the main dermoscopical findings. Ultrasonography detected nail bed dishomogeneity in three patients (50%) and a distal hyperechoic mass (5 patients, 83.3%). Color Doppler imaging did not show vascular flow in any of the cases. (4) Conclusions: the detection of a subungual distal non-vascularized hyperechoic mass by US, together with classical onychopapilloma clinical features, supports the diagnosis, especially in those patients who were unable to perform excisional biopsy.
over several weeks to months. 4 Additionally, response to antibiotics has been described in HKFE cases without associated BAK exposure. 1 For completeness, patch testing could have been considered to rule-out BAK allergic contact dermatitis; however, as the clinical features were characteristic for HKFE and our patients responded rapidly to initial therapy with amoxicillin-clavulanic acid, we did not pursue this.This observation in a mother-daughter pair, while not sufficiently robust to claim genetic aetiology, raises the possibility of genetic factors contributing to HKFE/GP, as also suggested by Robinson et al. (2019). 4 The microbiome and skin barrier function are genetically influenced and both are involved in HKFE pathogenesis. 3,4 The reversal of dysbiosis with antibiotics is an effective treatment strategy in conditions including erythrasma, confluent and reticulated papillomatosis, and also HKFE. 2 Positive bacterial cultures have been occasionally reported in HKFE, such as in Case 1, with organisms including Klebsiella pneumoniae, Streptococcus milleri and Coagulase-negative Staphylococci. 1,5 These organisms are normal skin commensals, and we believe the positive cultures reflect the state of dysbiosis rather than bacterial infection. However, further studies are required to characterise the altered microbiome of these patients, which may help determine the pathogenicity of organisms in HKFE.
Background occasional case reports have described the appearance of Kaposi’s sarcoma (KS) on previously unaffected skin after incidental or accidental injury, but the association is probably under-reported. Objectives to present a large case series of patients suffering from Koebner phenomenon (KP) in KS and describe their main epidemiological, clinical, and therapeutic features. Methods we have retrospectively analyzed our clinical and photographic records of 524 patients who had been diagnosed with KS between 2009 and 2021. Results 31 of 524 (6%) KS patients developed KP. Among these 31 patients, 24 (77%) had KS lesions after surgery, 4 (13%) after electrochemotherapy, laser therapy and cryotherapy, and 3 (10%) on areas affected by bullous diseases. Conclusions trauma, including surgery or other medical procedures, can trigger KS, underlying the importance of treatment options which cause the least injury to the skin.
We describe a patient with psoriasis who developed pyoderma gangrenosum while on treatment with brodalumab, an anti-interleukin (IL)-17 receptor monoclonal antibody. Genetic analyses revealed heterozygous polymorphisms within the promoter region of the IL-6 (promoter polymorphism –174 G/C) and IL-10 genes (promoter polymorphism –1082 A/G).
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.