Distinctive exudative discoid and lichenoid chronic dermatosis (Sulzberger and Garbe) re-examined–1978

Abstract

The dermatosis described over 40 years ago by Sulzberger and Garbe is still beiig seen and is still withotjt known cause, aetiology or pathogenctic mechanism. Its kaleidoscopic changes in clinical appearance cause it to mimic many other dermatoses. But in typical cases it can be recognized by an assemblage of clinical and histopathological characteristics and distinguished from other known dermatoses. Modern techniques may shed light upon its causal mechanism and either establish it as an entity or place it in nosological perspective.

A 6-year-old boy with Sulzberger and Garbe dermatosis: a and literature review

“…Additional tests may show eosinophilia in the peripheral blood, while in histopathological examination, presence of mild endothelial oedema and perivascular infiltrations mainly consisting of lymphocytes, granulocytes, eosinophiles and plasmatic cells is frequent. The author also mentioned that before establishing the diagnosis in the diagnostic process other more frequent diseases should be considered [1]. Other features, which were not described by Sulzberger definitely include the occurrence of severe pruritus and good therapeutic reaction to systemic corticosteroids [2].…”

“…Sulzberger emphasized that pruritus experienced by patients he described seemed the most severe one he had ever observed. The patients were often qualified as nervous and easily falling in the depressive mood, which obviously can be explained by the occurrence of severe pruritus [1]. …”

“…Typically, mild endothelium swelling and perivascular infiltrations consisting mainly of lymphocytes, granulocytes, eosinophils and plasmatic cells have been observed in microscopic examination of the skin lesions [1]. Spongiosis and parakeratosis have also been quite frequently visualized [2].…”

“…Typically, the Sulzberger and Garbe dermatosis patients responded well to the treatment even with small doses of systemic corticosteroids, in most cases administered orally [1]. In the child hospitalized at the Department of Dermatology, Paediatric Dermatology and Dermatological Oncology, a prolonged-release corticosteroid was applied intramuscularly, as a result of which the severity of pruritus and size of skin lesions decreased.…”

“…Doctor Sulzberger observed the first cases of the disease in 1927, while practising in Zurich at a department managed by professor Bruno Bloch, and then in 1929 in Wrocław – at a department ran at that time by professor Joseph Jadasson. Observations of other patients with similar skin disorders were performed together with doctor Garbe in New York [1]. …”