Long-term Control of Papular Dermatitis (“Dermal Hypersensitivity Reaction”) With Mycophenolate Mofetil

Flugman, Scott L.

doi:10.1001/archderm.142.11.1512

Cited by 11 publications

(7 citation statements)

References 5 publications

(5 reference statements)

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“…Several diagnostic names, such as papular dermatitis, urticarial papulosis, urticarial dermatitis, and "itchy red bump" disease have been ascribed to the spectrum of prurigo reactions (1)(2)(3)(4)(5)(6), although the cutaneous symptoms associated with these reactions are not necessarily identical, and their morphology and pathoetiology appear to be heterogenous. In general, prurigo, particularly its subacute and chronic forms, is difficult to treat with conventional therapies, including H1 receptor antagonists and topical corticosteroids; thus, recurrence is common.…”

mentioning

confidence: 99%

“…Prurigo lesions are also commonly observed in atopic dermatitis (11)(12)(13). Although certain types of prurigo, such as prurigo nodularis (Hyde), may be just a secondary skin change resulting from severe scratching due to persistent itch (14), prurigo is also considered a subtype of dermal hypersensitivity reactions (3)(4)(5). Prurigo lesions are histopathologically characterized by lymphocyte and eosinophil infiltration, with dermal edema and/or exudates.…”

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confidence: 99%

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Protective Role of STAT6 in Basophil-Dependent Prurigo-like Allergic Skin Inflammation

Hashimoto

Satoh

Yokozeki

2015

The Journal of Immunology

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Prurigo is a common, but treatment-resistant, skin disease characterized by persistent papules/nodules and severe itching. Prurigo occurs in association with various underlying diseases, such as diabetes, chronic renal failure, and internal malignancies. Atopic dermatitis is occasionally complicated by prurigo lesions. However, the pathology of prurigo is completely undefined. We demonstrate that repeated intradermal administration of Ag to IgE-transgenic mice causes persistent and pruritic papulonodular skin lesions mimicking prurigo. Skin lesions were histopathologically characterized by irregular acanthosis and dermal cellular infiltrates comprising eosinophils, mononuclear cells, and basophils, with epidermal nerve fiber sprouting. In vivo depletion of basophils alleviated skin reactions, indicating that the inflammation is basophil dependent. Unexpectedly, STAT6 signaling was unnecessary for skin lesion development if IgE was present. Moreover, the absence of STAT6 signaling exacerbated the inflammation, apparently as the result of impaired generation of an M2-type anti-inflammatory macrophage response. These results provide novel insights into the pathologic mechanisms underlying prurigo. Although basophils are indispensable for prurigo-like inflammation, Th2 immunity mediated by STAT6 appears to play a protective role, and therapies targeting Th2-type cytokines may risk aggravating the inflammation.

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confidence: 99%

mentioning

confidence: 99%

Protective Role of STAT6 in Basophil-Dependent Prurigo-like Allergic Skin Inflammation

Hashimoto

Satoh

Yokozeki

2015

The Journal of Immunology

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“…Almost all cases improved with conventional therapies, namely topical and oral steroids, antihistamines, and phototherapy (narrow-band ultraviolet B, full ultraviolet). Unlike previous reports, none of the patients required aggressive treatment with systemic immunosuppressants [7, 8]. …”

Section: Discussionmentioning

confidence: 79%

“…The term idiopathic papular dermatitis was coined 25 years ago [4, 5] and has since been hardly mentioned in the literature [7, 8]. …”

Section: Discussionmentioning

confidence: 99%

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Idiopathic Papular Dermatitis in the Spectrum of Chronic Papular Eruptions (Subacute Prurigo): Reappraisal and Diagnostic Algorithm

et al. 2019

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Background: The clinical diagnosis of papular eruptions is common but poorly characterized in the literature and the etiology is often unknown. Objective: To characterize the entity of idiopathic papular dermatitis in the spectrum of chronic papular eruptions. Methods: The cohort consisted of patients who presented at a tertiary medical center in 2005–2014 with a papular eruption of at least 4 months’ duration. Findings on histological analysis and thorough clinical investigation, performed in all cases, were collected. The patients completed a questionnaire on disease course and outcome. Results: Sixty-five patients were included. Sixteen patients showed morphological changes over time and were excluded. Investigations in the remaining 49 patients with a consistent papular morphology yielded a well-defined diagnosis in 23 (46%). Twenty-six patients (54%; 14 male) were diagnosed with idiopathic papular dermatitis. Their mean age at onset was 61.6 ± 14.4 years and the mean duration of disease 3.11 ± 2.726 years. In 60%, the rash resolved with conservative treatment during follow-up (mean 4.35 ± 2.53 years). Conclusions: Chronic papular eruptions encompass a wide range of skin diseases. In more than half of the cases, the etiopathogenesis remains unclear. On the basis of our results, we propose a diagnostic algorithm for idiopathic papular dermatitis.

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The vasculopathic reaction pattern

Weedon¹

2010

Weedon's Skin Pathology

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Long-term Control of Papular Dermatitis (“Dermal Hypersensitivity Reaction”) With Mycophenolate Mofetil

Cited by 11 publications

References 5 publications

Protective Role of STAT6 in Basophil-Dependent Prurigo-like Allergic Skin Inflammation

Protective Role of STAT6 in Basophil-Dependent Prurigo-like Allergic Skin Inflammation

Idiopathic Papular Dermatitis in the Spectrum of Chronic Papular Eruptions (Subacute Prurigo): Reappraisal and Diagnostic Algorithm

The vasculopathic reaction pattern

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