China
Africa
Explore chapters and articles related to this topic
Hands & Feet
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Acute eczema resulting in blistering on the palms and soles is termed pompholyx (or dyshidrotic eczemaUSA). Because of the thickened stratum corneum, the epidermal blisters persist and appear as tiny grey-white ‘grains’ within the skin. Eventually they burst and erosions occur. Sometimes, pompholyx can occur as an isolated episode which then resolves spontaneously.
Test of time and test of treatment
Published in Caroline J Rodgers, Richard Harrington, Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Caroline J Rodgers, Richard Harrington
At this stage, the differential diagnosis is broad for rashes that affect the hands and includes: Atopic dermatitis.Irritant contact dermatitis.Allergic contact dermatitis (a type IV delayed hypersensitivity reaction).Pompholyx (vesicular hand dermatitis) – although in pompholyx the vesicles tend to occur on the palmar surface and sides of the fingers, which is not the case here.Discoid eczema, which also forms part of the differential diagnosis for a rash on the hands, but the rash here is of different morphology.Psoriasis: it is sometimes very difficult to distinguish between eczema and psoriasis on the hands.Scabies.Infection with gram-positive bacteria.Fungal infection (particularly if there is asymmetrical/unilateral involvement).
Aspects of Nickel Allergy: Epidemiology, Etiology, Immune Reactions, Prevention, and Therapy
Published in Jurij J. Hostýnek, Howard I. Maibach, Nickel and the Skin, 2019
In cases of extremely hypersensitive patients, an alternative therapeutic approach to using antiinflammatory topical corticoids is the systemic administration of chelating agents such as tetraethylthiuramdisulfide (TETD, Antabuse, disulfiram), DDC, or triethylenetetramine. It only yields limited success, however; the dermatitis is not completely suppressed or resumes after cessation of treatment. Eleven patients whose NAH status was confirmed by oral nickel dosing were given 100 mg TETD tablets orally over 2 months. In some of the patients dermatitis cleared, but skin flares reappeared when treatment was discontinued (Kaaber et al., 1979). A similar course and outcome of chelation therapy with a daily oral dose of 200 mg disulfiram over 8 weeks was reported by Christensen. Although in 11 patients with pompholyx the condition resolved and 8 showed partial improvement, relapse occurred in all patients within weeks after treatment was discontinued (Christensen and Kristensen, 1982). TETD and DDC given orally brought relief in nickel dermatitis only as long as dosing continued (Menné and Kaaber, 1978). TETD given orally caused a measurable rise in serum and urinary nickel levels, suggesting that preexisting nickel deposits are mobilized and excreted by chelation (Christensen, 1982b; Christensen and Kristensen, 1982; Kaaber et al., 1979; Menné et al., 1980). Chelating drugs given systemically were reported to produce toxic side effects, however (Spruit et al., 1978). TETD caused lassitude in patients (Kaaber et al., 1979) and hepatotoxicity (Kaaber et al., 1987).
A brief guide to pustular psoriasis for primary care providers
Published in Postgraduate Medicine, 2021
Jeffrey J. Crowley, David M. Pariser, Paul S. Yamauchi
For localized sub-types of pustular psoriasis, the main differential diagnoses include PPP and ACH, pompholyx (also called dyshidrotic eczema, or acute and recurrent vesicular hand dermatitis), and nail infection (for ACH). Pompholyx is a chronic dermatitis characterized by the appearance of clusters of vesicles (clear blisters) on the palms and soles, accompanied by erythema and intense pruritus, and pustules may be present [39]. It is rarely difficult to distinguish between PPP and pompholyx, although discriminatory histopathologic features have been described [40]. Nail infection may be investigated by testing the pustule material (e.g. gram stain for possible bacterial infection; potassium hydroxide test for possible fungal infection; polymerase chain reaction testing for possible herpetic whitlow [41]).
Expression of aquaporins mRNAs in patients with otitis media
Published in Acta Oto-Laryngologica, 2018
Su Young Jung, Sung Su Kim, Young Il Kim, Hyung-Sik Kim, Sang Hoon Kim, Seung Geun Yeo
To our knowledge, this is the first study showing the expression of AQPs in patients with choleOM. CholeOM is diagnosed by the histologic identification of keratinizing squamous epithelium (skin) in ME lined with modified respiratory epithelium [20]. This study showed that the levels of AQP1, 3, and 5 mRNAs were higher in patients with choleOM than in patients with other OM types and that the levels of AQP4 and 10 mRNAs were higher in patients with choleOM than in COM. AQP3 and 10 have been shown to be important in the formation of blisters, in inflammation, and in drying observed in the pathogenesis of pompholyx [8]. AQP3 is highly expressed in tissue, such as skin, that consists of squamous epithelium. The physiological functions of AQP3 include barrier maintenance, hydration, and elasticity, cell proliferation, and migration (such as in tumorigenesis and wound healing) [17]. The higher level of AQP3 expression in choleOM may be due to cholesteatoma samples consisting of squamous epithelial cells. In addition, AQP3 knockout mice showed abnormalities in the stratum corneum of the skin, and the growth rates of various types of cells in AQP1 and AQP4 knockout mice were decreased [16,19]. These findings indicated that the elevated expression of AQP1, 3, and 4 in choleOM, unlike in other types of OM, is associated with abnormal hyperproliferation of keratinizing squamous epithelium of the skin, a pathophysiological characteristic of choleOM. Furthermore, AQP1, 3, and 4 likely play specific roles in choleOM.