The annual incidence for pemphigus in Macedonia is 0.44 cases/100,000 inhabitants. Most common form was pemphigus vulgaris. An epidemiological peak occurred in 2001 during the local armed conflict. Macedonian Roma had a sixfold higher incidence of pemphigus compared with the overall population; ethnic Albanians had a fourfold lower incidence.
Pustulosis palmoplantaris (PPP; synonyms: pustulosis palmaris et plantaris, palmoplantar amicrobic pustulosis) is a common chronic, relapsing, pustular eruption affecting the palms and soles. The authors report the successful treatment of six therapy-experienced patients with histologically confirmed PPP with oral itraconazole (100 mg/day for 1 month, followed by a month of 100 mg/day every other day). Three of six patients showed complete clearance of pustules, significant reduction of erythema, and unnoticeable desquamation, whereas the other three patients had no new pustules appearing and had modest reduction of erythema and desquamation. All patients experienced relapses within a month of therapy cessation. Two of the three complete responders reinitiated itraconazole therapy at 100 mg/day for another 2 weeks, followed by a maintenance dose of 50 mg/day until achieving remission. As complete responses are not commonly observed in placebo treatments in placebo-controlled trials for PPP, the authors believe that the present study shows that itraconazole is an effective treatment for treatment-resistant PPP.
BACKGROUND: Angiolymphoid hyperplasia with eosinophilia is an uncommon, benign, vasoproliferative cutaneous neoplasm with uncertain origin. It preferably affects middle-aged adults, manifesting as plum-colored pruritic papules, nodules and plaques, which can persist indefinitely, relapsing over time. Different response/resistance to various therapeutic modalities and frequent recurrences impose a great therapeutic dilemma.
CASE PRESENTATION: Herein, we present a 77-year-old male patient with a 7-month-history of unrecognized cutaneous manifestations on his left shoulder and flank. Based on the investigations, the diagnosis of angiolymphoid hyperplasia with eosinophilia was established. We applied cryotherapy as a treatment of choice. The complete regression of the skin lesions and three years disease-free period was achieved.
CONCLUSION: Although surgery is the standard therapeutic approach, the disease recurs despite multiple surgical attempts. Therefore, we recommend cryotherapy as effective and safe treatment modalities for angiolymphoid hyperplasia with eosinophilia. Knowing the recurring nature of this disease, the patients with angiolymphoid hyperplasia should stay on short-term follow up in order to monitor if new lesions occur.
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