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Basics of onychopathology
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Erythema elevatum diutinum (EED) is clinically characterized by red-to-violaceous, later brown, persistent plaques, and nodules in symmetrical arrangement on the extensor surfaces of the extremities. Periungual lesions exhibit small plaques and nodules.142 Nail involvement with subungual hemorrhage, onycholysis, and paronychia has been described.143 Histopathologically, EED is now regarded as a rare type of chronic fibrosing leucocytoclastic vasculitis.144 It starts with a so-called lymphocytic perivasculitis, which soon develops into a dense diffuse mixed infiltrate, sometimes granulomatous, with abundant neutrophils and often signs of karyorrhexis.145 The capillaries may be thickened with fibrinoid material and there is often a concentric lamellar perivascular fibrosis. The grenz zone may be spared or not. Old lesions become fibrotic with an orderly array of spindle cells and collagen fibers that may run parallel to the skin surface.
Inflammatory dermatoses affecting the nail
Published in Eckart Haneke, Histopathology of the NailOnychopathology, 2017
Erythema elevatum diutinum (EED) is a rare skin disorder clinically characterized by red to violaceous, later brown, persistent plaques and nodules in symmetrical arrangement on the extensor surfaces of the extremities. The lesions are usually asymptomatic, but pruritus, pain, and arthralgia of involved joints have been reported. Whether immunoglobulin A plays a role in the pathomechanism is not yet clear.188–190 Periungual lesions exhibit small plaques and nodules.191 Nail involvement with subungual hemorrhage, onycholysis, and paronychia has been described.192
Is neutrophilic dermatosis a manifestation of familial Mediterranean fever?
Published in Scandinavian Journal of Rheumatology, 2022
M Delplanque, S Ducharme-Bénard, P Moguelet, F Chasset, G Grateau, S Georgin-Lavialle, C Bachmeyer
Although case reports have a high sensitivity for identifying new associations of diseases, they must be interpreted with caution in the era of evidence-based medicine. In accordance with other authors, we considered that well-documented case reports could support the existence of NEND-associated FMF if they met appropriate criteria, which we have previously defined (20–22, 26, 27). A case report supporting a potential association between FMF and NEND required that both diagnoses be confirmed, and that other potential causes for NEND be excluded. We identified eight cases fulfilling the diagnostic criteria for both diseases. Unfortunately, in all these cases, at least one of the most frequent causes of ND had not been excluded based on the information available in the article. We could not find a single case in the literature fulfilling all the prerequisites to support a potential association between FMF and NEND. As a result, this association remains uncertain, such that NEND cannot be considered as a manifestation of FMF (Figure 2). Moreover, even if case reports had fulfilled all of the prerequisites, a dedicated causal study would have been required to confirm a causal relationship between FMF and NEND, given that NEND may also be idiopathic. Of note, apart from Sweet syndrome, neutrophilic panniculitis, and pyoderma gangrenosum, no other well-defined NENDs, such as subcorneal pustular dermatosis, erythema elevatum diutinum, and neutrophilic eccrine hidradenitis, were identified in FMF patients.
Dapsone for the treatment of acne vulgaris: do the risks outweigh the benefits?
Published in Cutaneous and Ocular Toxicology, 2022
Selami Aykut Temiz, Munise Daye
Dapsone is a “4,4′-diamino diphenyl sulfone” compound and an aniline derivative from synthetic sulphones. Sulphonamides were first synthesized as dyes (reproduced from coal) for the cloth industry in 1908. Sulphonamides were first used in humans as antimicrobial agents to treat streptococcal infections. Dapsone derived from sulphonamides was first used in the treatment of leprosy in 19401. Subsequently, it was used in the treatment of bullous dermatoses, especially dermatitis herpetiformis, and in the treatment of non-infectious inflammatory dermatoses, especially neutrophilic dermatoses1,2. Today, Dapsone treatment is among the treatment options for many dermatological diseases2,3. Furthermore, the dapsone treatment is recommended as the first treatment option for the therapy of dermatitis herpetiformis, subcorneal pustular dermatosis, linear IgA bullous dermatosis, and erythema elevatum diutinum3.
Cutaneous small vessel vasculitis
Published in Postgraduate Medicine, 2023
The following represent subclassifications of CSVV: Henoch Schonlein Purpura, Acute hemorrhagic edema of infancy, urticarial vasculitis, erythema elevatum diutinum, and cryoglobulinemic vasculitis. There are also secondary causes of CSVV, such as drugs, infections, vaccinations, connective tissue disease, and malignancies (most commonly hematologic). Approximately half of the patients with systemic vasculitis will develop cutaneous manifestations [5].