Xerosis, Itching, and Fissures
Gabriella Fabbrocini, Mario E. Lacouture, Antonella Tosti in Dermatologic Reactions to Cancer Therapies, 2019
Skin toxicity plays a key role in the patient's quality of life, affecting the physical, psychological, and social well-being of the individual, and may be so impactful as to lead to discontinuation or dose reduction of the drug. Therefore, an appropriate therapeutic approach to this toxicity appears to be absolutely necessary in order to achieve a balance between administering the drug, improving the patient's quality of life, and patient outcomes (3). In particular, skin xerosis affects more than 80% of patients who are using EGFR inhibitors (4). Advanced age, atopy, and previous cytotoxic agents are the most commonly promoted factors. Dry skin, or xerosis, usually begins between the first and second months of therapy. By 3 months, 50% of patients are affected, and by 6 months 100% of those who receive EGFR-targeted therapy will experience a degree of xerosis (5). This may manifest as dry skin, asteatotic dermatitis, or, in severe cases, skin splitting or fissuring (5). It is typically presented with dry, desquamated, pruriginous skin, and generally involves the same areas previously affected by acneiform eruption (face, trunk, ends) (Figure 12.1).
Basic dermatology in children and adolescents
Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo in Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Stress and mechanical occlusion can exacerbate acne. The role of diet in acne pathogenesis remains controversial, but current research suggests diets with high glycemic index are positively associated with the development of acne.52 Certain medications including systemic steroids, anabolic steroids, lithium, phenytoin, isoniazid, and iodides, among others, can cause the sudden appearance of an acneiform eruption. Endocrinologic abnormalities are well-established causes of acne. A history of hirsutism, irregular menstrual periods, insulin resistance, or deepening of the voice should prompt a further investigation into possible endocrine disturbances that include polycystic ovary syndrome (PCOS). These patients should be screened with lab tests, including serum free and total testosterone, DHEA-S, and 17-hydroxyprogesterone. Glucose intolerance and diabetes screening should also be considered.
Epidemiology of fungal infections: What, where, and when
Mahmoud A. Ghannoum, John R. Perfect in Antifungal Therapy, 2019
Tinea versicolor (pityriasis versicolor) is caused by Malassezia, but as taxonomy has evolved, new species have been implicated as the etiologic agent [465]. M. furfur was originally claimed to be the etiologic agent, but now M. globosa and M. sympodialis are also involved, with M. globosa occurring in temperate climates [462,466–468]. A distinct presentation was reported in 12 patients with atrophic dermatitis found to have tinea versicolor [460]. The lesions, atrophic plaques and papules, resembled other dermatologic conditions such as mycosis fungoides, SLE, and steroid atrophy. Histology revealed hyphae and spores in an atrophied epidermis and dermis, along with other characteristics that prompted the authors to propose the name atrophying tinea versicolor. Malassezia folliculitis, due to M. furfur or M. pachydermatis, has been reported in heart transplant, kidney transplant, and BMT recipients [469–472]. The rash can present as an acneiform eruption or as folliculitis with a papular or papular-pustular appearance. Fever may precede the rash in BMT recipients [313,471,472].
Acneiform eruption associated with the use of vortioxetine
Published in Psychiatry and Clinical Psychopharmacology, 2019
Acneiform is used to describe eruptions that resemble acne vulgaris, but are not aetiologically similar. Acneiform eruption, which is diagnosed based on medical history and clinical features, usually begins within the first 1–3 weeks of drug use [7]. Acneiform eruptions are usually observed in adults, begins as an acute disease, and characterized by pustules on the face, neck, shoulders, chest, and back. Usually, comedones and cysts do not accompany. The lesions can sometimes be itchy. After drug withdrawal, they heal spontaneously depending on the half-life of the drug [8].
Evaluation of autologous platelet-rich plasma plus ablative carbon dioxide fractional laser in the treatment of acne scars
Published in Journal of Cosmetic and Laser Therapy, 2018
Ahmed Mohammed Abdel Aal, Ibrahim Maeraj Ibrahim, Nevein Ahmed Sami, Ibrahim Mohammed Abdel Kareem
Acneiform eruption was observed after treatment in four patients out of 30 (13.3%) on their left sides, while it occurred only in two patients (6.67%) on their right sides of the face with a statistically significant reduction in the occurrence of acneiform eruption on the right side of the face. Other side effects such as petechiae, infections, milia, scaring, and post-inflammatory hypopigmentation did not occur on both sides.
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