Typical and atypical clinical appearance of atopic dermatitis.

Atopic dermatitis is a complex, systemic inflammatory disorder associated with a variety of clinical features. The original criteria of Hanifin and Rajka include major criteria and a list of about two dozen minor criteria however, even the minor criteria do not include some features of atopic dermatitis noted less commonly but still seen with some frequency. This contribution first reviews the common clinical appearance of atopic dermatitis in infancy, childhood, and adulthood, as well as the less typical appearances, including lichenoid atopic dermatitis; juvenile plantar dermatosis; nummular-type atopic dermatitis; follicular atopic dermatitis; alopecia of atopic dermatitis; eczema coxsackium; and psoriasiform, perineal, and lip licker's dermatitis.

Chemical Tattoo Treatment Leading to Systemic Cobalt Hypersensitivity.

An otherwise healthy 36-year-old Caucasian woman, without prior history of atopic dermatitis or eczema, presented to an outside dermatologist with a generalized, severely pruritic eruption involving the entire body except the face. One month previously, she had used a 50% trichloroacetic acid tattoo removal solution on a blue-colored tattoo on the medial aspect of the left ankle. The patient's eruption persisted for 7 months, and after several attempts to slowly taper her prednisone dose, she presented to our institution.

Adult-Onset Atopic Dermatitis: Fact or Fancy?

Atopic dermatitis therapy can be a challenge in many cases. Persistence into adulthood often reflects the more severe cases and such patients have the added problems of hand eczema and thick nummular lesions that resist topical medications. Within this group are patients labeled as having adult-onset atopic dermatitis, a designation that is hard to define and probably represents those whose childhood eczema was simply forgotten.

The histopathological differentiation between palmar psoriasis and hand eczema: A retrospective review of 96 cases.

Background: The histopathologic differences among palmar psoriasis (PP), hand eczema (HE), and hyperkeratotic hand dermatitis (HHD) have been poorly described.

Objectives: We sought to distinguish among PP, HE, and HHD on a histopathologic basis.

Methods: We retrospectively analyzed the histology of hematoxylin-eosin-stained sections obtained from 96 patients diagnosed with PP, HE, or HHD.

[Nummular dermatitis: report of two cases in children].

Nummular eczema or dermatitis is an uncommon paediatric pathology. It is presented as red-purplish small papules and vesicles that join to form exudative circular patches and then to eczematous or lichenified patches with discoid shape. The lesions appear predominantly on the extensor surface of extremities, although they can appear in trunk, hands or feet.

Leprosy in the Bible.

For many years, the biblical term tzaraat has referred to leprosy. In fact, the disease or diseases described under this name have no relationship to leprosy, as it was known in the Middle Ages or today; moreover, the term referred not only to skin disease, but also to the state of the ritual impurity and punishment for the sins. Although the real nature of tzaraat remains unknown, the differential diagnosis might include the following: Psoriasis, seborrheic dermatitis, favus, dermatophyte infections, nummular dermatitis, atopic dermatitis, pityriasis rosea, crusted scabies, syphilis, impetigo, sycosis barbae, alopecia areata, furuncles, scabies, neurodermatitis, scarlet fever, lupus erythematosus, lichen sclerosus et atrophicus, folliculitis decalvans, morphea, sarcoidosis, and lichen planopilaris.

[The Dutch College of General Practitioners practice guideline 'Eczema'].

The Dutch College of General Practitioners practice guideline 'Eczema' provides recommendations for the diagnosis and treatment of common types of eczema: atopic dermatitis, contact dermatitis, acro-vesicular eczema, nummular eczema, hypostatic eczema, and asteatotic eczema. Age is an important factor when determining the type of eczema. According to the guideline, patient history and physical examination are sufficient in the diagnosis of eczema; additional investigations are rarely indicated.

Patch test results of hand eczema patients: relation to clinical types.

Background: Allergic contact dermatitis is a well-known cause of hand eczema, although the influence of contact allergens on different clinical types of hand eczema remains still unclear.

Objective: To identify most common positive tested allergens among hand eczema patients and to define the relation between specific contact allergies and clinical types of hand eczema according to the guidelines of the Danish Contact Dermatitis Group (DCDG).

Methods: We included 1571 hand eczema subjects who were patch tested from 1 January 2002 to 31 December 2013.

Clinical features and aggravating factors in nummular eczema in Thais.

Background: Nummular eczema is an idiopathic inflammatory skin disease that mostly has a chronic and relapsing course. Many factors are thought to be responsible for this condition, such as atopic dermatitis, dry skin, emotional stress or seasonal variation.

Objective: The purpose of the study was to assess clinical findings and aggravating factors of nummular eczema and to evaluate characteristics, severity of disease and quality of life of patients.

Nummular eczema and contact allergy: a retrospective study.

Background: Etiopathogenesis of nummular eczema is obscure; many causative factors have been proposed. Only a few studies investigated the relevance of contact allergy.

Objective: This retrospective study aimed to investigate the role of contact allergy in the underlying mechanism of nummular eczema.

Skin diseases in rural Yucatan, Mexico.

Objectives: There are no known reports of the frequency of skin diseases endemic to rural Yucatan, Mexico. The aim of this study was to report the prevalence of dermatologic conditions in rural villages in that region.

Methods: We conducted a retrospective descriptive study of all cases of skin disease diagnosed by a team of American board-certified dermatologists during consultations in January 2009, August 2009, and June 2010, in the state of Yucatan, Mexico.

Less common clinical manifestations of atopic dermatitis: prevalence by age.

The common manifestations of atopic dermatitis (AD) appear sequentially with involvement of the cheeks in infancy, flexural extremities in childhood, and hands in adulthood. Although less common clinical manifestations are well described, they have not been the subject of epidemiologic studies to describe their prevalence in specific age groups. This observational, cross-sectional, comparative study included 131 children younger than 18 of both sexes with AD who attended the clinics of the Dermatology Department of the National Institute of Pediatrics in Mexico City.

A comparative analysis of mast cell quantification in five common dermatoses: lichen simplex chronicus, psoriasis, lichen planus, lupus, and insect bite/allergic contact dermatitis/nummular dermatitis.

There is a large body of literature demonstrating an important role of mast cells in adaptive and innate immunity. The distribution of mast cells in the skin varies in different parts of the body. It is well known that mast cells are important for effector functions of classic IgE-associated allergic disorders as well as in host defense against infective agents and influence the manifestation of autoimmune diseases.

Clinical features of the extrinsic and intrinsic types of adult-onset atopic dermatitis.

Background: Most study concerning the prevalence and dermatological manifestations of the extrinsic and the intrinsic form of atopic dermatitis (AD) were performed in children and adult AD related to the early-onset AD extending to adult life. Adult-onset AD is a subgroup of AD. Apart from the typical eczematous flexural distribution pattern of AD, this group may also have nontypical morphology and localization.

Shape and configuration of skin lesions: grouped herpetiform.

Lesions that may present in a grouped way include diseases with grouped vesicles such as dyshidrosis, nummular dermatitis, herpes simplex, and herpes zoster; diseases with grouped vesicobullae such as dermatitis herpetiformis, herpes gestationis, subacute lupus erythematosus in the bullous variant, and pemphigus herpetiformis; and diseases with grouped pustules such as pustular psoriasis, dermatitis continua of Hallopeau, and impetigo herpetiformis.

Retrospective study of intraepidermal nerve fiber distribution in biopsies of patients with nummular eczema.

Background: Nummular eczema is a chronic inflammatory condition characterized by pruritus and histologically characterized by spongiosis. The etiology is unknown, and the lesions frequently arise spontaneously. Neuropeptides contribute to mediating and maintaining eczematous conditions.

Dermal dendritic cells in psoriasis, nummular dermatitis, and normal-appearing skin.

Background: The reason psoriasis (PSO) favors extensor skin is unknown. We hypothesized that PSO may involve extensor skin preferentially because of differences in the number or type of dermal dendritic cells (dDCs) between flexural and extensor skin.

Objective: We sought to compare dDC type and distribution in normal-appearing flexural and extensor skin, PSO, and nummular dermatitis (ND).

Classification of hand eczema: clinical and aetiological types. Based on the guideline of the Danish Contact Dermatitis Group.

Background: No generally accepted classification scheme for hand eczema exists. The Danish Contact Dermatitis Group recently developed a guideline defining common clinical types and providing criteria for aetiological types.

Objectives: To test the concepts of this guideline in a group of hand eczema patients.

Arcuate, annular, and polycyclic inflammatory and infectious lesions.

Common shapes encountered in dermatologic diseases include linear, nummular, annular, polycyclic, and arciform. The last three have a relatively restricted differential, which must be entirely explored. It is not uncommon for a single disease to present in annular, arciform or polycyclic configurations; moreover, the lesions may evolve from being arciform to annular and then become polycyclic.

Non-typical morphology and localization in Turkish atopic dermatitis patients with onset before the age of 18 years.

Background: Hanifin and Rajka's criteria (HRC) are the gold standard for the diagnosis of atopic dermatitis (AD). Apart from the age-related distribution and typical morphology of the lesions as defined in one of the major criteria of HRC, patients may also show nontypical morphology and localization.

Aim: The aim of this study was to find the frequency of nontypical morphology and localization in Turkish AD patients with onset before the age of 18 years, who were diagnosed according to HRC.

Phenotypes of atopic dermatitis.

Atopic dermatitis (AD) is a common disease affecting both children and adults. AD develops from a complex interplay between environmental, genetic, immunologic and biochemical factors. Genetic factors predispose atopic subjects to mount exaggerated Th2 responses and to a poorly efficient epidermal barrier, which may be sufficient to initiate inflammation in the skin and may favor allergic sensitization.

Methotrexate is a safe and effective treatment for paediatric discoid (nummular) eczema: a case series of 25 children.

We present a case series of 25 paediatric patients with refractory discoid eczema treated with methotrexate. Patients were commenced on either 5 mg or 10 mg of methotrexate per week. Sixteen patients (64%) completely cleared their eczema after an average of 10.