The article description and significance to dermatologists: bleomycin flagellate dermatitis is a rare cutaneous manifestation, believed to be due to the lack of bleomycin hydrolase enzyme in the skin, which inactivates bleomycin, resulting in its accumulation. This is thought to be a dose-dependent reaction, and doses over 200 U and higher may increase risk. This case describes a male developing a pruritic, erythematous linear flagellated dermatitis to the lower back after his third cycle of bleomycin, etoposide and cisplatin for a stage 3 seminoma. Pruritis resolved and erythema improved with the treatment of bilastine and desoximetasone cream. It is important to recognize this condition because untreated pruritis may lead to increased impairment of the skin barrier in already immunocompromised patient populations. This may also give further evidence to having ongoing and continuing collaboration between Dermatology and Medical Oncology for any patients presenting with a new rash undergoing chemotherapy treatments.
A 47-year-old man with a 25-year history of small plaque psoriasis treated with betamethasone dipropionate cream presented with well-demarcated areas of skin atrophy, confined to his back ( Figure 1). The atrophic areas were mildly erythematous and showed slight scaling (Figure 2). Skin scrapings from these areas were examined microscopically using 15% potassium hydroxide with Parker blue-black ink. Thick fungal hyphae and grape-like bunches of spores were seen, consistent with Malassezia yeast.Although pityriasis (tinea) versicolor is common, the atrophic form is unusual, with the first case reported in 1971.1 The atrophy is limited to the area affected by the pityriasis versicolor. Case reports have suggested an association with the use of topical corticosteroids. The fungus, which is confined to the stratum corneum and follicles, is thought to disrupt the skin barrier, allowing better absorption of the steroid, which induces atrophy. Corticosteroid-induced atrophy is usually associated with epidermal atrophy and telangiectasis. Our patient did not have this feature.In a case series involving 12 patients with atrophying pityriasis versicolor, long-term topical corticosteroid use was reported for only one patient.2 In these cases, the atrophy was thought to have been induced directly by Malassezia yeast, which produce diffusible products that enhance dermal elastolysis, possibly by activating tissue histiocytes. Degeneration of elastic fibres has been noted on skin biopsies. Following treatment of Malassezia, the atrophy usually resolves. Our patient had a complete recovery following treatment with systemic ketoconazole.The presence of fine scaling overlying the atrophy allows clinicians to distinguish this form of cutaneous atrophy from other causes of skin atrophy, especially anetoderma. Examination using potassium hydroxide confirms the diagnosis. References
We present a case of clinically suspected atrichia with papular lesions in an 8-year-old male presenting with alopecia universalis and keratotic papules. We review the literature available on this rare genodermatosis.
Human papillomavirus (HPV) remains the most common sexually transmitted infection with a lifetime incidence of over 75%. Based on US data from the Centers for Disease Control and Prevention (CDC), 64% of invasive HPV-associated cancers are attributable to HPV 16 or 18 (65% for females; 63% males) and may be prevented by vaccination with either the quadrivalent or nonavalent HPV vaccine. Public HPV vaccination programs are now the norm for women aged 9-45 years and men aged 9-26 years in Canada. Yet, only recently have guidelines begun to consider vaccination of men older than 26 years of age. There now exist compelling reasons to recommend vaccination against HPV amongst males >26 years of age. Recognizing that the risks posed by HPV infection persist beyond 26 years of age, that the vaccination of men aged 26-45 years with HPV vaccine confers immunogenicity at levels demonstrably efficacious against HPV-related diseases, and that the Food and Drug Administration recently expanded the HPV vaccination to include older men, it is argued that HPV vaccination in men older than 26 years of age should be routinely recommended.
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.