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Acute erythematous rash on the trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Acute urticaria is defined as urticaria which has been present for less than 6 weeks. Individual lesions last for less than 24 hours (‘here today and gone tomorrow’). A central itchy white papule or plaque due to dermal oedema (weal) is surrounded by an erythematous flare. The lesions are variable in size and shape, and may be associated with swelling of the soft tissues of the eyelids, lips and tongue (angioedema, see p. 70). To identify how long the weals last, draw around one, and ask to see the patient the following day. Lesions which last for longer than 24 hours should be classified as urticarial dermatoses and require a biopsy for diagnosis. The weal is the result of degranulation of mast cells releasing histamine and other mediators of inflammation. Degranulation can be caused by allergic (IgE) and non-allergic stimuli.
Cutaneous adverse events of immune checkpoint inhibitor therapy: incidence and types of reactive dermatoses
Published in Journal of Dermatological Treatment, 2022
Thomas K. Le, Subuhi Kaul, Laura C. Cappelli, Jarushka Naidoo, Yevgeniy R. Semenov, Shawn G. Kwatra
Because of the nonspecific diagnosis of ‘rash’ that has been frequently reported in many anti-PD-1 clinical trials, the incidence of clinical phenotypes of rash, for example, eczema, lichenoid dermatitis, oral mucositis, or urticaria, remains poorly understood (7). This documentation may be limited by the awareness and skill of the person documenting in the electronic medical record. Disaggregation and more precise terms, as performed in this study, could thus provide valuable insight into the incidence of specific dermatoses. One example of the usefulness of disaggregation is with urticaria. Although urticaria has been seen with a pooled incidence rate of 1.4% (6/427) with the administration of nivolumab (14), in our analysis we did not observe a significant association between urticarial dermatoses and anti-PD-1 therapy. Discrepancies like this could be explained by providers not having the dermatologic knowledge to code these events in detail, further highlighting the necessity for dermatology input within multi-disciplinary teams caring for these complex patients. In contrast, lichen planus or lichenoid dermatitis is 10.7-fold more likely to develop in those treated with nivolumab or pembrolizumab than the general population (95% CI 5.6–20.7), which is consistent with prior findings (34).
Cutaneous manifestations related to the COVID-19 pandemic: a review article
Published in Cutaneous and Ocular Toxicology, 2021
Hamideh Molaee, Fakhri Allahyari, Seyed Naser Emadi, Shokofeh Radfar, Zahra Razavi
The most common drug reactions following Hydroxychloroquine application were maculopapular, erythematous, and urticarial dermatosis. Also, cutaneous severe skin reaction could appear as generalized red or purple skin rashes, angioedema, blisters, skin peeling, burning sensation in eyes, or painful skin after using Azithromycin. Furthermore, maculopapular drug eruptions, exfoliative erythroderma, SJS/TEN, severe cutaneous drug reactions, injection site reactions might develop after using antiretrovirals such as Lopinavir and Ritanavir22.
Schnitzler syndrome refractory to anakinra: successful treatment with canakinumab
Published in Journal of Dermatological Treatment, 2023
Angel Luis Salcedo-Mingoarranz, María Dorado-Fernández, Sofía García-Martínez, Paz Collado-Ramos, Nicolás Silvestre-Torner
Regarding SchS pathophysiology, IL-1β, a proinflammatory cytokine mainly produced by monocytes and macrophages, plays an essential role in the development of SchS (8). Increased levels of IL-1β and interleukin-18, neutrophilia in blood and tissues, recurrent fever, neutrophilic urticarial dermatosis and a genetic predisposition caused by a mutation of NLRP3 gene have been described (7, 9).