Perforating folliculitis associated with tumour necrosis factor-alpha inhibitors administered for rheumatoid arthritis.

Perforating dermatoses are characterized by transepithelial elimination of dermal structures. We report a 61-year-old man with rheumatoid arthritis who developed a perforating folliculitis following the administration of two tumour necrosis factor (TNF)-alpha inhibitors, infliximab and etanercept. To our knowledge, no perforating disorders have been reported associated with these drugs.

Pyoderma caused by Pseudomonas aeruginosa infection in dogs: 20 cases.

In this report we describe the historical, clinical, histopathological and microbiological features, as well as treatments and clinical outcome, of pyoderma where Pseudomonas aeruginosa alone was isolated on bacterial culture from lesional skin. Twenty dogs were included in this retrospective study. Seven dogs without prior history of systemic or skin disease presented with acute deep pseudomonal pyoderma characterized by a sudden onset of dorsal truncal pain.

Acquired perforating dermatosis: clinicopathological features in twenty-two cases.

Background: The term of acquired perforating dermatosis (APD) comprises the perforating dermatoses occurring in adult patients. Clinical and histological features of the disease are not uniform, and may resemble any of the four classic perforating disorders: elastosis perforans serpiginosa, reactive perforating collagenosis, perforating folliculitis or Kyrle's disease. Chronic renal failure and/or diabetes mellitus usually accompany this skin disease.

[Diabetic skin changes from the dermatological point of view].

Even a half of diabetic patients are suffering from skin troubles. Hyperglykemia causes skin changes leading to higher incidence of bacterial and mycotic infections, provokes skin degenerative processes, macro- and microangiopathy and neuropathy. Diabetic dermopathy, rubeosis, bullousis and scleredema are based on these changes.

[Cutaneous manifestations of chronic hemodialysis. Prospective study of 363 cases].

Objective: Chronic hemodialysis patients experience frequent and varied cutaneous manifestations, of often hypothetical pathogenesis. The aim of this work is to assess the prevalence and nature of these cutaneous lesions and discuss some pathogenic mechanisms.

Methods: This prospective study was conducted from 1 February through 30 April 1996.

Ultraviolet phototherapy for pruritus.

Ultraviolet-based therapy has been used to treat various pruritic conditions including pruritus in chronic renal failure, atopic dermatitis, HIV, aquagenic pruritus and urticaria, solar, chronic, and idiopathic urticaria, urticaria pigmentosa, polycythemia vera, pruritic folliculitis of pregnancy, breast carcinoma skin infiltration, Hodgkin's lymphoma, chronic liver disease, and acquired perforating dermatosis, among others. Various mechanisms of action for phototherapy have been posited. Treatment limitations, side effects, and common dosing protocols are reviewed.

Perforating disorder caused by salt-water application and its experimental induction.

Background: Perforating disorders are uncommon diseases characterized by transepidermal elimination histopathologically and include reactive perforating collagenosis, elastosis perforans serpiginosa, Kyrle's disease and perforating folliculitis. In addition, perforating disorders can develop in patients with diabetes mellitus, renal failure and even by accidental exposure of calcium salts.

Methods: We report two cases of perforating disorder caused by chemical burn with commercially available salt-water application for self-treatment of chronic dermatitis or pruritus.

ESRD-associated cutaneous manifestations in a hemodialysis population.

Cutaneous manifestations occurring in patients with end stage renal disease (ESRD) can indicate systemic problems that have significant morbidity and mortality risks. Skin changes are sometimes a consequence of the disease that caused the renal failure or may be an ESRD manifestation. Pruritus is the most prevalent ESRD cutaneous complaint, but its pathogenesis is not understood.

Behçet's disease in southern Chinese patients.

Objective: To describe the clinical characteristics of Behçet's disease (BD) in a southern Chinese population and compare them with those reported in other ethnic groups.

Methods: Patients with BD from 4 large regional hospitals in Hong Kong were identified from the hospital information retrieval system. Their records were retrospectively reviewed and the diagnosis was verified by at least 2 rheumatologists using the International Study Group (ISG) criteria.

[Kyrle's disease].

Introduction: Hyperkeratosis follicularis et parafollicularis in cuten penetrans known as Kyrle's disease is a recessive hereditary genodermatosis. Generally, Kyrle's disease appears between 30 to 50 years of age and women are affected more than men.

Case Report: We report a case of a 40-year-old man, a worker in a cement factory, who noticed the first skin lesions six years ago.

Expression of the 67-kDa elastin receptor in perforating skin disorders.

Background: Perforating skin dermatoses include elastosis perforans serpiginosa (EPS), reactive perforating collagenosis, Kyrle's disease and perforating folliculitis. In addition to these four diseases, an acquired form of perforating dermatosis associated with diabetes mellitus and/or chronic renal failure has been reported for which the term acquired perforating dermatosis (APD) was proposed. The molecular mechanism of transepidermal elimination of dermal components in perforating skin dermatoses remains unclear.

Necrotizing infundibular crystalline folliculitis.

We describe a 22-year-old woman with a background of acne who developed multiple folliculocentric facial papules associated with sharply demarcated waxy, keratotic plugs. Multiple skin biopsies showed umbilicated craters that were filled with dispersed bundles of eosinophilic filaments embedded in a pale amorphous matrix forming a plug. The plugs bulged into the upper dermis.

[Significance of postoperative face-down positioning after surgery for idiopathic macular holes: consecutive case-control study].

Background: Postoperative face-down positioning is considered to be a critical part in macular hole surgery with short-acting gas. However, the significance of this posturing remains uncertain using long-acting gas tamponade.

Patients And Methods: Fifty consecutive eyes with idiopathic full-thickness macular holes underwent macular hole surgery with a follow up time of 6-12 months.

A case of diet-related lymphocytic mural folliculitis in a cat.

A 5-year-old cat developed a raised hair coat and adherent crusting lesions involving the skin of the head, dorsal neck and abdomen. Erosions were present on the lips and eyelids. The footpads were dry and scaly.

[Acquired reactive perforating collagenosis in diabetes mellitus].

History And Admission Findings: A 70-year-old woman with type 2B diabetes mellitus was referred to the dermatology department because of inflammatory skin changes of unknown origin over the trunk and limbs. On admission follicular and parafollicular livid-red papulae with central crusts and reddened margins were noted over the lower legs and the lumbosacral region.

Investigations: Further physical examination revealed no additional abnormalities.

[Acquired reactive perforating dermatosis. Successful treatment with allopurinol in 2 cases].

Perforating disorders represent a heterogenous group of dermatoses characterized by transepithelial elimination of dermal structures. Primary perforating disorders should be distinguished from secondary perforating disorders in which perforation with transepithelial elimination is a rare component of a variety of dermatoses. The primary perforating disorders are hyperkeratosis follicularis et parafollicularis in cutem penetrans (Kyrle's disease), elastosis perforans serpiginosa and perforating folliculitis.

Fibronectin and the extracellular matrix in the perforating disorders of the skin.

Despite detailed microscopic descriptions and clinical observation, little is known regarding the pathogenesis of the perforating disorders of skin, which have traditionally been subdivided into numerous microscopic entities associated with various clinical settings. An increasing body of evidence now suggests that the perforating disorders of skin are akin, and may constitute an expanded single pathologic entity. Each of the classic perforating disorders of skin, including elastosis perforans serpiginosa, perforating folliculitis, reactive perforating collagenosis, Kyrle's disease, and perforating disorder of uremia, have been shown to extrude collagen, elastin, and related extracellular matrix components through the epidermis.

Silicon-related syndrome in dialysis patients.

Two dialysis patients with markedly elevated plasma silicon (Si) levels (3,849 and 2,350 micrograms/l, respectively) and a presumed Si-related syndrome are described in this report. One patient presented with transient hypercalcemia in the face of low PTH, vitamin D and plasma A1 levels. Both patients had painful, nodular skin eruptions and aberrant hair growth, characterized as perforating folliculitis on skin biopsy, compatible with known effects of organosilicon compounds in man and animals.

[Skin changes in kidney diseases and in chronic kidney insufficiency].

Skin symptoms in renal disease occur in a series of rare inherited or acquired diseases affecting the kidneys as well as the skin (amyloidosis, vasculitis, angiokeratoma diffusum corporis Fabry) (table 1). Chronic renal failure, regardless of its origin, often causes important skin symptoms, such as pruritus, the typical complexion with elastosis seen in uremic patients, porphyria cutanea uremica, metastatic calcifications, skin necrosis due to uremic small arteries disease with medial calcification and intimal hyperplasia, perforating dermatoses, nail lesions and symptoms of the oral mucosa (table 2). The following article reviews the pathogenesis and the limited possibilities of treatment for skin symptoms in chronic renal failure.

Papulonecrotic tuberculid. A clinical, histopathological, and immunohistochemical study of 15 patients.

We report 10 women and five men with papulonecrotic tuberculid, an uncommon form of cutaneous tuberculosis (TB). The mean age was 22.6 years (range, 2 1/2-35 years) at presentation.

Acquired perforating disease: report of nine cases.

Background: A study of nine Guatemalan patients with acquired perforating disease associated with chronic renal failure, diagnosed at the Guatemalan Social Security Institute, General Hospital, during the period of January 1990 to March 1993, is presented (Table 1).

Methods: A dermatological examination and skin biopsy were done on all patients.

Results: Six of the patients were men and three were women; one case was associated with diabetes mellitus.