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Mark Lebwohl - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Intertriginous psoriasis: from the Medical Board of the National Psoriasis Foundation.
Journal of the American Academy of Dermatology, 2009Co-Authors: Robert E. Kalb, Mark Lebwohl, Jerry Bagel, Neil J. Korman, Melodie Young, Elizabeth J. Horn, Abby S. Van VoorheesAbstract:Background Involvement of areas of the skin fold is common in patients with psoriasis although the exact incidence is unknown. This report summarizes studies regarding the therapy of Intertriginous psoriasis. Objective A task force of the National Psoriasis Foundation Medical Board was convened to evaluate treatment options. Our aim was to arrive at a consensus on therapy for Intertriginous or inverse psoriasis. Methods Reports in the literature were reviewed regarding psoriasis affecting the skin-fold areas and its therapy. Limitations There are few evidence-based studies on the treatment of Intertriginous psoriasis. Results The recommended short-term (2-4 weeks) therapy for inverse psoriasis is low- to mid-potency topical steroids. For long-term therapy, topical calcipotriene (calcipotriol) or one of the immunomodulating agents, pimecrolimus or tacrolimus, is favored. Conclusions Low- to mid-potency topical steroids are recommended as first-line, short-term treatment. It is recommended that their use should either be of limited duration (less than 2-4 weeks) or that the lowest effective strength be used intermittently for long-term care to minimize the potential for risks. Calcipotriene (calcipotriol), pimecrolimus, and tacrolimus, while not as highly efficacious as topical steroids, are associated with fewer long-term risks and are therefore recommended for long-term therapy when feasible.
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Tacrolimus ointment is effective for facial and Intertriginous psoriasis.
Journal of the American Academy of Dermatology, 2004Co-Authors: Mark Lebwohl, Amy Krupnick Freeman, M. Shane Chapman, Steven R. Feldman, Jennifer Hartle, Alice HenningAbstract:Background Intertriginous and facial involvement are manifestations of psoriasis that require a different approach than is used for typical plaque psoriasis on other skin areas. Topical corticosteroids are the primary treatment for psoriasis; however, the side effects of corticosteroids are magnified on Intertriginous and facial skin. Topical tacrolimus offers the potential for anti-inflammatory effect without the atrophy or other local side effects associated with the use of topical corticosteroids. Objective To determine the efficacy and tolerability of 0.1% tacrolimus ointment for the treatment of facial or Intertriginous psoriasis. Methods One hundred sixty-seven patients 16 years or older were evaluated in an 8-week, randomized, double-blind, vehicle-controlled, multi-center study. Upon entry into the study, patients were randomized 2:1 to apply the tacrolimus ointment 0.1% or vehicle twice daily to all psoriatic lesions of the face or Intertriginous areas for 8 weeks. The physician's global assessment was used to assess improvement from baseline. The inverse psoriasis severity for patients was measured using a 6-point scale from clear to very severe. Results As early as day 8, more patients ( P =.004) had cleared or achieved excellent improvement in the 0.1% tacrolimus ointment group compared to the vehicle group (24.8% vs 5.8%). At the end of the 8-week treatment period 65.2% of the tacrolimus ointment group and 31.5% of the vehicle were clear or almost clear ( P Conclusion Tacrolimus ointment is an effective treatment for psoriasis of the face or Intertriginous areas.
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Tacrolimus ointment for the treatment of psoriasis on the face and Intertriginous areas
Journal of the American Academy of Dermatology, 2003Co-Authors: Amy Krupnick Freeman, Giselle Singer, Gregory J. Linowski, Christopher J. Brady, Leah Lind, Paul Vanveldhuisen, Mark LebwohlAbstract:Abstract The safety and efficacy of 0.1% tacrolimus ointment for the treatment of psoriasis on the face, Intertriginous areas, or both were evaluated in an open-label, clinical trial of 21 patients with psoriasis. Patients applied 0.1% tacrolimus ointment twice daily for 8 weeks. Efficacy was assessed through the investigator's evaluation of the individual signs and symptoms of psoriasis, and the physician's global evaluation of change in disease status. Assessments of cutaneous atrophy and other adverse events were made throughout the study to evaluate the safety of tacrolimus ointment. A total of 21 patients were enrolled in the study; 21 patients at least 18 years of age received study medication. Statistically significant improvement in the physician's assessment of the individual signs and symptoms was observed during the study. A total of 81% of patients (17 of 21) experienced complete clearance at day 57 (end of treatment). Only 2 patients reported adverse events, which were limited to itching and the feeling of warmth at the application site. None of the patients had atrophy, telangiectasia, or striae develop during the study. In summary, tacrolimus 0.1% ointment may be a safe and effective treatment option for patients with psoriasis on the face, Intertriginous areas, or both. (J Am Acad Dermatol 2003;48:564-8.)
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An open‐label study of the safety and efficacy of limited application of fluticasone propionate ointment, 0.005%, in patients with atopic dermatitis of the face and Intertriginous areas
International journal of dermatology, 2002Co-Authors: Mei-heng Tan, Stacie L. Meador, Giselle Singer, Mark LebwohlAbstract:Background The treatment options for facial and Intertriginous skin are limited because these sites are more susceptible to corticosteroid-induced atrophy. The long-term management of these corticosteroid-sensitive sites requires the use of dosing regimens that are effective, but also safe. Methods The affected areas in 21 patients with atopic dermatitis were treated twice daily for 2 weeks, and then once daily for two consecutive days each week for eight more weeks. Results After 2 weeks, treatment success occurred in 95% of facial and Intertriginous lesions and also in 95% of nonfacial, nonIntertriginous lesions. During long-term therapy, treatment success was maintained in > 76% of facial and Intertriginous lesions, and > 76% of other lesions. Recurrence rates were low, and skin atrophy and telangiectasia did not occur. Conclusions Patients with atopic dermatitis of facial and Intertriginous areas were successfully treated with a limited application of fluticasone propionate ointment, 0.005%. The treatment resulted in rapid healing and provided efficacy with a low rate of recurrence and no evidence of skin atrophy or telangiectasia over 8 weeks.
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an open label study of the safety and efficacy of limited application of fluticasone propionate ointment 0 005 in patients with atopic dermatitis of the face and Intertriginous areas
International Journal of Dermatology, 2002Co-Authors: Mei-heng Tan, Stacie L. Meador, Giselle Singer, Mark LebwohlAbstract:Background The treatment options for facial and Intertriginous skin are limited because these sites are more susceptible to corticosteroid-induced atrophy. The long-term management of these corticosteroid-sensitive sites requires the use of dosing regimens that are effective, but also safe. Methods The affected areas in 21 patients with atopic dermatitis were treated twice daily for 2 weeks, and then once daily for two consecutive days each week for eight more weeks. Results After 2 weeks, treatment success occurred in 95% of facial and Intertriginous lesions and also in 95% of nonfacial, nonIntertriginous lesions. During long-term therapy, treatment success was maintained in > 76% of facial and Intertriginous lesions, and > 76% of other lesions. Recurrence rates were low, and skin atrophy and telangiectasia did not occur. Conclusions Patients with atopic dermatitis of facial and Intertriginous areas were successfully treated with a limited application of fluticasone propionate ointment, 0.005%. The treatment resulted in rapid healing and provided efficacy with a low rate of recurrence and no evidence of skin atrophy or telangiectasia over 8 weeks.
Giselle Singer - One of the best experts on this subject based on the ideXlab platform.
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Crisaborole 2% ointment for the treatment of Intertriginous, anogenital, and facial psoriasis: A double-blind, randomized, vehicle-controlled trial.
Journal of the American Academy of Dermatology, 2019Co-Authors: Peter W Hashim, Giselle Singer, Margot Chima, Hee J. Kim, Jennifer Bares, Christopher J. Yao, Tinley Chen, Jordan Genece, Danielle Baum, Grace KimmelAbstract:Background Psoriasis of the Intertriginous, anogenital, and facial regions remains a therapeutic challenge, with current algorithms lacking a topical agent that exhibits both high efficacy and minimal side effects. Objective To assess the safety and efficacy of crisaborole 2% ointment—a nonsteroidal phosphodiesterase 4 inhibitor—in the treatment of Intertriginous, anogenital, and facial psoriasis. Methods A double-blind, randomized, vehicle-controlled trial was conducted in 21 participants. Participants were randomized 2:1 to receive 4 weeks of twice-daily treatment with either crisaborole 2% ointment (n = 14) or vehicle ointment (n = 7), followed by 4 weeks of open-label treatment with crisaborole 2% ointment. Disease severity was measured by using the Target Lesion Severity Scale (TLSS). Results After 4 weeks, participants in the crisaborole group demonstrated 66% improvement compared with 9% in the vehicle group (P = .0011). Participants in the crisaborole group continued to experience improvement through the open-label phase, demonstrating 81% lesional improvement by week 8, with 71% of these participants achieving clinical clearance. There were no adverse events. Limitations The study was limited to a single tertiary care center and small sample size. Conclusion Treatment with crisaborole 2% ointment was well-tolerated and led to clinical improvement in participants with Intertriginous, anogenital, or facial psoriasis.
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Tacrolimus ointment for the treatment of psoriasis on the face and Intertriginous areas
Journal of the American Academy of Dermatology, 2003Co-Authors: Amy Krupnick Freeman, Giselle Singer, Gregory J. Linowski, Christopher J. Brady, Leah Lind, Paul Vanveldhuisen, Mark LebwohlAbstract:Abstract The safety and efficacy of 0.1% tacrolimus ointment for the treatment of psoriasis on the face, Intertriginous areas, or both were evaluated in an open-label, clinical trial of 21 patients with psoriasis. Patients applied 0.1% tacrolimus ointment twice daily for 8 weeks. Efficacy was assessed through the investigator's evaluation of the individual signs and symptoms of psoriasis, and the physician's global evaluation of change in disease status. Assessments of cutaneous atrophy and other adverse events were made throughout the study to evaluate the safety of tacrolimus ointment. A total of 21 patients were enrolled in the study; 21 patients at least 18 years of age received study medication. Statistically significant improvement in the physician's assessment of the individual signs and symptoms was observed during the study. A total of 81% of patients (17 of 21) experienced complete clearance at day 57 (end of treatment). Only 2 patients reported adverse events, which were limited to itching and the feeling of warmth at the application site. None of the patients had atrophy, telangiectasia, or striae develop during the study. In summary, tacrolimus 0.1% ointment may be a safe and effective treatment option for patients with psoriasis on the face, Intertriginous areas, or both. (J Am Acad Dermatol 2003;48:564-8.)
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An open‐label study of the safety and efficacy of limited application of fluticasone propionate ointment, 0.005%, in patients with atopic dermatitis of the face and Intertriginous areas
International journal of dermatology, 2002Co-Authors: Mei-heng Tan, Stacie L. Meador, Giselle Singer, Mark LebwohlAbstract:Background The treatment options for facial and Intertriginous skin are limited because these sites are more susceptible to corticosteroid-induced atrophy. The long-term management of these corticosteroid-sensitive sites requires the use of dosing regimens that are effective, but also safe. Methods The affected areas in 21 patients with atopic dermatitis were treated twice daily for 2 weeks, and then once daily for two consecutive days each week for eight more weeks. Results After 2 weeks, treatment success occurred in 95% of facial and Intertriginous lesions and also in 95% of nonfacial, nonIntertriginous lesions. During long-term therapy, treatment success was maintained in > 76% of facial and Intertriginous lesions, and > 76% of other lesions. Recurrence rates were low, and skin atrophy and telangiectasia did not occur. Conclusions Patients with atopic dermatitis of facial and Intertriginous areas were successfully treated with a limited application of fluticasone propionate ointment, 0.005%. The treatment resulted in rapid healing and provided efficacy with a low rate of recurrence and no evidence of skin atrophy or telangiectasia over 8 weeks.
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an open label study of the safety and efficacy of limited application of fluticasone propionate ointment 0 005 in patients with atopic dermatitis of the face and Intertriginous areas
International Journal of Dermatology, 2002Co-Authors: Mei-heng Tan, Stacie L. Meador, Giselle Singer, Mark LebwohlAbstract:Background The treatment options for facial and Intertriginous skin are limited because these sites are more susceptible to corticosteroid-induced atrophy. The long-term management of these corticosteroid-sensitive sites requires the use of dosing regimens that are effective, but also safe. Methods The affected areas in 21 patients with atopic dermatitis were treated twice daily for 2 weeks, and then once daily for two consecutive days each week for eight more weeks. Results After 2 weeks, treatment success occurred in 95% of facial and Intertriginous lesions and also in 95% of nonfacial, nonIntertriginous lesions. During long-term therapy, treatment success was maintained in > 76% of facial and Intertriginous lesions, and > 76% of other lesions. Recurrence rates were low, and skin atrophy and telangiectasia did not occur. Conclusions Patients with atopic dermatitis of facial and Intertriginous areas were successfully treated with a limited application of fluticasone propionate ointment, 0.005%. The treatment resulted in rapid healing and provided efficacy with a low rate of recurrence and no evidence of skin atrophy or telangiectasia over 8 weeks.
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Limited application of fluticasone propionate ointment, 0.005% in patients with psoriasis of the face and Intertriginous areas
Journal of the American Academy of Dermatology, 2001Co-Authors: Mark Lebwohl, Mei-heng Tan, Stacie L. Meador, Giselle SingerAbstract:Abstract Background: Facial and Intertriginous skin is more susceptible to corticosteroid-induced atrophy. Dosing regimens are needed for long-term management of corticosteroid-sensitive sites. Objective: The safety and efficacy of 0.005% fluticasone propionate ointment were assessed in the short-and long-term management of moderate to severe psoriasis of facial and Intertriginous areas compared with nonfacial, nonIntertriginous areas. Methods: Affected areas in 20 patients with psoriasis were treated twice daily for 2 weeks, then once daily for 2 consecutive days every week for 8 more weeks. Results: More than 50% improvement occurred after 2 weeks (day 15) in 100% of facial and Intertriginous lesions and was maintained during long-term therapy in more than 85% of facial and Intertriginous lesions. More than 50% improvement for nonfacial, nonIntertriginous areas reached only 80% by day 15. Recurrence rates for facial and Intertriginous areas were lower than in the nonfacial, nonIntertriginous areas. Skin atrophy and telangiectasia did not occur. Facial and Intertriginous sites responded more quickly to topical fluticasone propionate ointment than nonfacial, nonIntertriginous skin. Conclusion: Limited application of fluticasone propionate ointment over a period of 10 weeks is effective and delays lesion recurrence without causing skin atrophy in patients with moderate to severe psoriasis in areas at risk for corticosteroid application, such as facial and Intertriginous areas. (J Am Acad Dermatol 2001;44:77-82.)
Neil H. Shear - One of the best experts on this subject based on the ideXlab platform.
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A Systematic Approach to Systemic Contact Dermatitis and Symmetric Drug-Related Intertriginous and Flexural Exanthema (SDRIFE)
American Journal of Clinical Dermatology, 2011Co-Authors: Monika Winnicki, Neil H. ShearAbstract:Systemic contact dermatitis is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes. Baboon syndrome is perhaps the most recognizable form of systemic contact dermatitis, presenting with diffuse, well demarcated erythema of the buttocks, upper inner thighs, and axillae. Other forms of systemic contact dermatitis include dermatitis at sites of previous exposure to the allergen such as at a previous site of dermatitis or at sites of previous positive patch tests, dyshidrotic hand eczema, flexural dermatitis, exanthematous rash, erythroderma, and vasculitis-like lesions. The most common causes of systemic contact dermatitis consist of three groups of allergens: (i) metals including mercury, nickel, and gold; (ii) medications including aminoglycoside antibacterials, corticosteroids, and aminophylline; and (iii) plants and herbal products including the Compositae and Anacardiaceae plant families and Balsam of Peru. Baboon syndrome caused by systemic medications without a known history of previous cutaneous sensitization in the patient has been termed drug-related baboon syndrome (DRBS) or symmetric drug-related Intertriginous and flexural exanthema (SDRIFE). Criteria for SDRIFE include exposure to systemic drug at first or repeated dose, erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal area, involvement of at least one other Intertriginous localization, symmetry of affected areas, and absence of systemic toxicity. The most common causes are aminopenicillins, β-lactam antibacterials, and certain chemotherapeutic agents, though the list of etiologic agents continues to grow. Baboon syndrome and SDRIFE should be strongly considered in a patient presenting with a symmetric Intertriginous eruption involving multiple body folds. With the knowledge of the most frequent causes of these conditions, a detailed history and review of exposures will guide the clinician in the search for the most likely etiologic agent.
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A systematic approach to systemic contact dermatitis and symmetric drug-related Intertriginous and flexural exanthema (SDRIFE): a closer look at these conditions and an approach to Intertriginous eruptions.
American journal of clinical dermatology, 2011Co-Authors: Monika Winnicki, Neil H. ShearAbstract:Systemic contact dermatitis is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes. Baboon syndrome is perhaps the most recognizable form of systemic contact dermatitis, presenting with diffuse, well demarcated erythema of the buttocks, upper inner thighs, and axillae. Other forms of systemic contact dermatitis include dermatitis at sites of previous exposure to the allergen such as at a previous site of dermatitis or at sites of previous positive patch tests, dyshidrotic hand eczema, flexural dermatitis, exanthematous rash, erythroderma, and vasculitis-like lesions. The most common causes of systemic contact dermatitis consist of three groups of allergens: (i) metals including mercury, nickel, and gold; (ii) medications including aminoglycoside antibacterials, corticosteroids, and aminophylline; and (iii) plants and herbal products including the Compositae and Anacardiaceae plant families and Balsam of Peru. Baboon syndrome caused by systemic medications without a known history of previous cutaneous sensitization in the patient has been termed drug-related baboon syndrome (DRBS) or symmetric drug-related Intertriginous and flexural exanthema (SDRIFE). Criteria for SDRIFE include exposure to systemic drug at first or repeated dose, erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal area, involvement of at least one other Intertriginous localization, symmetry of affected areas, and absence of systemic toxicity. The most common causes are aminopenicillins, β-lactam antibacterials, and certain chemotherapeutic agents, though the list of etiologic agents continues to grow. Baboon syndrome and SDRIFE should be strongly considered in a patient presenting with a symmetric Intertriginous eruption involving multiple body folds. With the knowledge of the most frequent causes of these conditions, a detailed history and review of exposures will guide the clinician in the search for the most likely etiologic agent.
Monika Winnicki - One of the best experts on this subject based on the ideXlab platform.
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A Systematic Approach to Systemic Contact Dermatitis and Symmetric Drug-Related Intertriginous and Flexural Exanthema (SDRIFE)
American Journal of Clinical Dermatology, 2011Co-Authors: Monika Winnicki, Neil H. ShearAbstract:Systemic contact dermatitis is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes. Baboon syndrome is perhaps the most recognizable form of systemic contact dermatitis, presenting with diffuse, well demarcated erythema of the buttocks, upper inner thighs, and axillae. Other forms of systemic contact dermatitis include dermatitis at sites of previous exposure to the allergen such as at a previous site of dermatitis or at sites of previous positive patch tests, dyshidrotic hand eczema, flexural dermatitis, exanthematous rash, erythroderma, and vasculitis-like lesions. The most common causes of systemic contact dermatitis consist of three groups of allergens: (i) metals including mercury, nickel, and gold; (ii) medications including aminoglycoside antibacterials, corticosteroids, and aminophylline; and (iii) plants and herbal products including the Compositae and Anacardiaceae plant families and Balsam of Peru. Baboon syndrome caused by systemic medications without a known history of previous cutaneous sensitization in the patient has been termed drug-related baboon syndrome (DRBS) or symmetric drug-related Intertriginous and flexural exanthema (SDRIFE). Criteria for SDRIFE include exposure to systemic drug at first or repeated dose, erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal area, involvement of at least one other Intertriginous localization, symmetry of affected areas, and absence of systemic toxicity. The most common causes are aminopenicillins, β-lactam antibacterials, and certain chemotherapeutic agents, though the list of etiologic agents continues to grow. Baboon syndrome and SDRIFE should be strongly considered in a patient presenting with a symmetric Intertriginous eruption involving multiple body folds. With the knowledge of the most frequent causes of these conditions, a detailed history and review of exposures will guide the clinician in the search for the most likely etiologic agent.
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A systematic approach to systemic contact dermatitis and symmetric drug-related Intertriginous and flexural exanthema (SDRIFE): a closer look at these conditions and an approach to Intertriginous eruptions.
American journal of clinical dermatology, 2011Co-Authors: Monika Winnicki, Neil H. ShearAbstract:Systemic contact dermatitis is a condition that occurs when an individual sensitized to a contact allergen is exposed to that same allergen or a cross-reacting molecule through a systemic route. Systemic exposure to allergens can include transcutaneous, transmucosal, oral, intravenous, intramuscular, and inhalational routes. Baboon syndrome is perhaps the most recognizable form of systemic contact dermatitis, presenting with diffuse, well demarcated erythema of the buttocks, upper inner thighs, and axillae. Other forms of systemic contact dermatitis include dermatitis at sites of previous exposure to the allergen such as at a previous site of dermatitis or at sites of previous positive patch tests, dyshidrotic hand eczema, flexural dermatitis, exanthematous rash, erythroderma, and vasculitis-like lesions. The most common causes of systemic contact dermatitis consist of three groups of allergens: (i) metals including mercury, nickel, and gold; (ii) medications including aminoglycoside antibacterials, corticosteroids, and aminophylline; and (iii) plants and herbal products including the Compositae and Anacardiaceae plant families and Balsam of Peru. Baboon syndrome caused by systemic medications without a known history of previous cutaneous sensitization in the patient has been termed drug-related baboon syndrome (DRBS) or symmetric drug-related Intertriginous and flexural exanthema (SDRIFE). Criteria for SDRIFE include exposure to systemic drug at first or repeated dose, erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal area, involvement of at least one other Intertriginous localization, symmetry of affected areas, and absence of systemic toxicity. The most common causes are aminopenicillins, β-lactam antibacterials, and certain chemotherapeutic agents, though the list of etiologic agents continues to grow. Baboon syndrome and SDRIFE should be strongly considered in a patient presenting with a symmetric Intertriginous eruption involving multiple body folds. With the knowledge of the most frequent causes of these conditions, a detailed history and review of exposures will guide the clinician in the search for the most likely etiologic agent.
Yalçın Tüzün - One of the best experts on this subject based on the ideXlab platform.
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acanthosis nigricans a fold Intertriginous dermatosis
Clinics in Dermatology, 2015Co-Authors: Zekayi Kutlubay, Orkhan Bairamov, Burhan Engin, Yalçın TüzünAbstract:Acanthosis nigricans (AN) is a mucocutaneous disorder that is characterized by focal or diffuse hyperkeratotic, surfaces, which are symmetrically distributed hyperpigmented lesions of the skin. It rarely affects mucosal surfaces like oral cavities. Although it is commonly seen in adolescents, AN is also increasingly seen in children who are obese. Recent studies have found that AN can be a cutaneous indicator of insulin resistance and malignancy. Acanthosis nigricans has been associated with type 2 diabetes mellitus, obesity, endocrinopathies, drugs, and malignancies.
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darier disease a fold Intertriginous dermatosis
Clinics in Dermatology, 2015Co-Authors: Burhan Engin, Zekayi Kutlubay, Emine Erkan, Yalçın TüzünAbstract:Darier disease, also known as Darier-White disease, is characterized by yellow to brown, oily keratotic papules and plaques in the seborrheic areas of the face and chest. This disorder may show different clinical manifestations, such as palmoplantar pits and nail abnormalities. The trigger factors are mechanical trauma, heat, humidity, ultraviolet B, and pyogenic infections. The disease usually becomes apparent in the second decade of life. The ATP2 A2 (SERCA2) gene mutation was detected in all patients. Histopathologic changes include epidermal adhesion loss, acantholysis, abnormal keratinization, eosinophilic dyskeratotic cells in the spinous layer known as corps ronds, and the presence of grains in the stratum corneum. Although the treatment for Darier disease is unsatisfactory, some relief has been achieved with the use of corticosteroids and retinoids.
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hailey hailey disease a fold Intertriginous dermatosis
Clinics in Dermatology, 2015Co-Authors: Burhan Engin, Zekayi Kutlubay, Ugur Celik, Server Serdaroglu, Yalçın TüzünAbstract:Hailey-Hailey disease, also called benign familial pemphigus, is a late-onset blistering disorder that affects the flexures. There are typically painful erosions and cracks in affected areas. Lesions generally begin between 20 and 40 years of age. In two third of all cases, positive family history is detected. In pathogenesis, there is a defect in keratinocyte adhesion due to ATP2 C1 gene mutation. The result of the desmosomal decomposition is acantholysis. Menstruation, pregnancy, skin infections, physical trauma, excessive sweating and exposure to ultraviolet radiation are important triggering factors. Histopathologic changes are suprabasal acantholysis and formation of intraepidermal bullae. In the epidermis, a partial acantholysis that looks like broken bricks is observed.
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Baboon syndrome and toxic erythema of chemotherapy: Fold (Intertriginous) dermatoses.
Clinics in dermatology, 2015Co-Authors: Ronni Wolf, Yalçın TüzünAbstract:Abstract Three decades ago, researchers described an eruption with a very characteristic distribution pattern that was confined to the buttocks and the Intertriginous and flexor areas. They gave this reaction pattern one of the most unforgettable names in dermatology, baboon syndrome (BS), due to the characteristic, bright-red, well-demarcated eruption predominantly on the buttocks and genital area, reminiscent of the red bottom of a baboon. The authors described three cases provoked by ampicillin, nickel, and mercury. They were convinced that BS represented a special form of hematogenous or systemic contact-type dermatitis, but several important papers that appeared during the past decade disagreed and suggested that BS should be distinguished from hematogenous or systemic contact-type dermatitis. A new acronym, SDRIFE (symmetrical drug-related Intertriginous and flexoral exanthema), was proposed along with five diagnostic criteria: (1) exposure to a systemically administered drug at the time of first or repeated doses (contact allergens excluded), (2) sharply demarcated erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area, (3) involvement of at least one other Intertriginous/flexural fold, (4) symmetry of affected areas, and (5) absence of systemic symptoms and signs. Although there are merits to the arguments in favor of SDRIFE, many of us still prefer to use the wittier name baboon syndrome , and even more authors use both terms. We confess that we find it difficult to relinquish the term BS, which has served us so well for years; however, recognition, familiarity, and knowledge of the characteristics of this form of drug eruption must supersede sentimental attachment to a certain nomenclature and so, however reluctantly, we must embrace change. Another Intertriginous drug eruption is the one induced by chemotherapy. Toxic erythema of chemotherapy (TEC) is a useful clinical term that recently has been introduced to describe this group of chemotherapy-induced eruptions. This group of overlapping toxic reactions is characterized by areas of painful erythema often accompanied by edema usually involving the hands and feet, Intertriginous zones (eg, axilla, groin), and, less often, the elbows, knees, and ears. Toxic erythema of chemotherapy is briefly discussed.