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Reticular hyperpigmentation
Published in Dimitris Rigopoulos, Alexander C. Katoulis, Hyperpigmentation, 2017
Alexander C. Katoulis, Efthymia Soura
Prurigo pigmentosa is a recurrent dermatosis that is characterized by severe pruritus and a reticulate hyperpigmentation that occurs after the appearance of urticarial-like plagues. The exact etiology and pathogenesis of the condition remain unclear. In general, the disorder most commonly affects individuals of Asian descent and can present at different ages, ranging from 15 to 60 years (average 25–27 years), showing a marked predilection for females.115–117
The HLA-B*13:01 and the dapsone hypersensitivity syndrome in Korean and Asian populations: genotype- and meta-analyses
Published in Expert Opinion on Drug Safety, 2020
Hye Jung Park, Jung-Won Park, Sae Hoon Kim, So-Yun Choi, Hee-Kyoo Kim, Chang-Gyu Jung, Min-Suk Yang, Dong Yoon Kang, Min-Kyoung Cho, Hyouk-Soo Kwon, Hye-Ryun Kang, Yong Won Lee
We retrospectively reviewed electronic medical records of the recruited seven DHS participants and eight dapsone-tolerant participants. Among seven DHS participants, six participants were female, and the age range was from 11 to 59 years old. Dapsone was prescribed at a usual dose (50–100 mg/day), and was prescribed to treat the underlying disease of each patient, including contact dermatitis (case no. 1), folliculitis (case no. 2), parapsoriasis (case no. 3), allergic cutaneous vasculitis (case no. 4), IgA bullous dermatosis (case no. 5), acne vulgaris (case no. 6), and prurigo pigmentosa (case no. 7). The latent period ranged from 14 to 42 days. Among the eight dapsone-tolerant participants, six were male, and the age range was from 33 to 69 years old. The duration from medication start to stop varied from 87 to 362 days. Participant no. 14, a dapsone-tolerant subject who took dapsone for 253 days, presented with HLA-B*13 (Table 1).
Adult-onset Still’s disease accompanied by erythema multiforme presenting as an atypical rash: comments on the article by Shimizu and Nishioka
Published in Scandinavian Journal of Rheumatology, 2020
The diagnosis of AOSD is challenging and sometimes is delayed, as there are no specific biomarkers available in the clinic and laboratory. As the authors summarized, AOSD can present with atypical cutaneous lesions including persistent pruritic papules and/or plaques, lichenoid papules, pigmented plaques, and prurigo pigmentosa-like, dermatomyositis-like, and lichen amyloidosis-like rashes. Dyskeratotic keratinocytes in the upper third of the epidermal layer and neutrophils in the dermis are distinct histological features of these atypical rashes in AOSD (6–10). Histopathological figures of the atypical lesions are useful for discriminating other diseases presenting with dyskeratosis and interface dermatitis, including EM. It is regretful that the patient refused to undergo a skin biopsy.
Adult-onset Still’s disease accompanied by erythema multiforme presenting as an atypical rash
Published in Scandinavian Journal of Rheumatology, 2020
The clinical course of this patient suggests that EM can develop in AOSD patients. Evanescent rash is a well-known typical symptom in AOSD patients. In addition, atypical AOSD cases have been reported to show persistent papules and/or plaques, lichenoid papules, pigmented plaques, and prurigo pigmentosa-like, dermatomyositis-like, and lichen amyloidosis-like rashes (6). However, EM in AOSD patients has been rarely reported. Two cases of EM accompanied by AOSD-like manifestations have been reported, but these patients were finally diagnosed with breast cancer and not AOSD, and EM was considered a symptom of paraneoplastic syndrome (7, 8). In our case, EM was thought to be associated with true AOSD, and not a part of paraneoplastic syndrome, as repeated comprehensive investigations did not reveal a malignancy. We consider our patient to be a rare case of AOSD accompanying EM presenting as an atypical rash. It is important to compile data on rare atypical rashes to diagnose AOSD accurately and to investigate the clinical differences between cases with typical and atypical rash. There is no gold standard for diagnosing AOSD, and this variable phenotype may reflect subgroups with partly different disease mechanisms.