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Subungual pyogenic granuloma (PG) can be caused by numerous medications including chemotherapeutic agents. These lesions grow rapidly, oftentimes causing significant pain and bleeding, prompting patients to seek treatment. The management of subungual PG ranges from topical steroids to surgical excision. However, patients with chemotherapy-induced PGs are prone to developing multiple or recurrent lesions. Therefore, finding a therapeutic option that effectively eliminates the tumor and prevents the need for repeated procedural interventions is important. The use of topical β-adrenergic antagonists has been reported to be effective in regressing cutaneous PG.
In this report, we present a case of chemotherapy-induced subungual PG of the toenail arising in a 62-year-old woman that was successfully treated with topical timolol solution.
This case highlights the promising use of timolol solution for therapeutically challenging PGs, such as those of subungual regions. This option may be particularly useful for individuals who are vulnerable to multiple PGs secondary to chemotherapy who wish to avoid repeated procedural interventions.
This case highlights the promising use of timolol solution for therapeutically challenging PGs, such as those of subungual regions. This option may be particularly useful for individuals who are vulnerable to multiple PGs secondary to chemotherapy who wish to avoid repeated procedural interventions.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of hair follicles which usually affects patients' quality of life negatively. Although there are various therapeutic approaches including topical and systemic antibiotics, retinoids, biological agents, and also surgical modalities, there is no curative treatment option and clinical management of HS is still challenging.
Herein, we present a 43 year-old man with HS who had used different treatments in 15 years. The patient showed improvement initially with adalimumab, then exhibited secondary unresponsiveness after 18 months. While worsening of HS was recorded due to increased discharge under secukinumab, no additional benefit was observed with methotrexate. He was not willing to undergo surgical procedures due to previous surgical experience. selleck chemicals llc Finally, certolizumab pegol has been started to patient with similar dosing to psoriasis patients. Sartorius, 10-point visual analogue scale (VAS), and dermatological life quality index (DLQI) scores regressed from 171 to 105, 9/10 to 3/10, and 27 to 19 after 3 months with certolizumab pegol treatment.
Certolizumab pegol is a humanized antigen-binding fragment of a monoclonal antibody which binds to TNF-alpha. However, certolizumab pegol is only approved for plaque psoriasis in dermatology; it is likely to be a promising effective agent for HS, especially in challenging cases.
Certolizumab pegol is a humanized antigen-binding fragment of a monoclonal antibody which binds to TNF-alpha. However, certolizumab pegol is only approved for plaque psoriasis in dermatology; it is likely to be a promising effective agent for HS, especially in challenging cases.
Lichen planus (LP) can lead to severe scarring of the nail unit leading to anonychia. There are very few reports of squamous cell carcinoma (SCC) occurring in the lesions of ungual LP.
The aim of this study was to revise the previously reported cases of SCC appearing in ungual LP and to present a new case.
A PubMed search was performed with the terms "nail lichen planus" and "squamous cell carcinoma." Reported cases as well as a new case were depicted in a table.
Only 2 indexed articles reporting 3 cases were found. All patients suffered of long-lasting scarring ungual LP.
The occurrence of SCC in nail LP is rare. LP is not "premalignant" per se, but SCC might rarely arise in LP scars.
The occurrence of SCC in nail LP is rare. LP is not "premalignant" per se, but SCC might rarely arise in LP scars.Cutaneous elastofibroma is part of the connective tissue nevus complex. Two subungual cases remotely similar to the one presented here have been described before. This patient presented with an unusual form of subungual elastofibroma of the big toe, which was surgically removed. Histopathology revealed a connective tissue tumor extremely rich in very fine elastic fibers. Their relationship to oxytalan and elaunin fibers is discussed as is the potential association of this nail bed lesion with the onychodermis.Becker's nevus (BN) is an acquired unilateral hyperpigmented hairy macule, whereas morphea is a chronic connective tissue disease of unknown etiology, characterized by skin thickening with increased quantities of collagen in the indurated lesion, usually involving the upper trunk and proximal extremity. The occurrence of both disease in the same anatomical site and individual was not reported previously. We report this rare case in a 17-year-old, Indian girl and was diagnosed after clinical histopathology and dermoscopic correlation. Morphea can be an interesting incidental occurrence within a large plaque of BN.Nail pathology may reflect a wide array of localized and systemic dermatological conditions. Certain nail findings such as melanonychia can create diagnostic challenges even to nail experts. We report a case of a 78-year-old man who presented with melanonychia of the great toe. Nail clipping showed focal melanin deposition, and dermoscopy demonstrated a region of localized erythema in the lunula concerning for possible melanocytic neoplasm. Subsequent nail biopsy showed numerous vertically oriented filamentous bacteria and coccobacilli within the nail plate consistent with a diagnosis of subungual nail erythrasma. Nail erythrasma is a rare entity. Additionally, this case highlights a new clinical presentation of nail erythrasma as melanonychia.
Alopecia areata (AA) is a form of nonscarring alopecia and one of the most common autoimmune disorders. Persistent or severe variants lead to potential disfigurement and are associated with a significant negative impact on the patient's quality of life.
A 51-year-old female patient presenting with refractory alopecia universalis was successfully treated with oral tofacitinib. Recurrence was not observed following 17 months of therapy.
None of the currently employed therapies for AA are reliably effective nor are they approved for the disease. In this setting, Janus kinase inhibitors emerge as a promising novel treatment, as increasing evidence supports their effectiveness in AA.
None of the currently employed therapies for AA are reliably effective nor are they approved for the disease. In this setting, Janus kinase inhibitors emerge as a promising novel treatment, as increasing evidence supports their effectiveness in AA.
Keratosis follicularis spinulosa decalvans (KFSD) is a rare, X-linked, hereditary disorder of keratinization, characterized by skin involvement and progressive scarring alopecia of scalp, eyebrows, and eyelashes. The diagnosis is helped by the particular clinical features, but pathology is mandatory.
We described a case of a female patient referred to the outpatient's hair consultation of our department, in which we performed trichoscopy as a very useful tool for the diagnosis, followed by pathology that confirmed KFSD.
In our article, we underlined the importance of trichoscopy for the diagnosis of this hair disease, with also a review of the literature on diagnosis and treatment.
In our article, we underlined the importance of trichoscopy for the diagnosis of this hair disease, with also a review of the literature on diagnosis and treatment.Excess hair is a problem for both men and women who want to conform to today's cosmetic social norms. Chemical depilatories are a safe, fast, and inexpensive method of hair removal. The most commonly used depilatory agents are thioglycolates and to a lesser extent, sulphides. The most common side effect of chemical depilatories is irritant contact dermatitis. However, allergic contact dermatitis is rare and may be related to lanolin, fragrance, or thioglycolate itself. Unilateral koilonychia as a side effect of chemical depilatories has not been described previously in the literature. We report this case due to its rarity and highlight the significance of nail protection while using chemical depilatory products.
Keratitis-ichthyosis-deafness (KID) syndrome is a rare genodermatosis characterized by keratitis, neurosensorial auditory impairment and ichthyosiform skin involvement. Frequent complications of the syndrome are chronic, opportunistic cutaneous infections, and the development of skin cancers. Several cases of association between KID syndrome and other conditions, including hidradenitis suppurativa (HS), are described in the literature. This correlation could be explained by the hyperproliferative state of the epidermis, which occurs in KID syndrome and may favor follicular plugging.
The aim of this study was to describe a very rare case of association between KID syndrome and HS and its complex therapeutic management.
The failure of the drugs commonly used in HS and the excellent results of surgery, although difficult to achieve, were experienced.
Despite the technical difficulties related to surgery, namely, cutaneous superinfections, frequent dehisce of the suture, and closure by secondary intention, the authors strongly recommend the surgical approach in these patients.
Despite the technical difficulties related to surgery, namely, cutaneous superinfections, frequent dehisce of the suture, and closure by secondary intention, the authors strongly recommend the surgical approach in these patients.
Trichodynia can be described as a feeling of discomfort in the scalp. Studies on trichodynia also have different data.
The aim of this study was to investigate the frequency and associated factors of trichodynia.
A questionnaire was applied to 249 patients who were admitted to the Hair Diseases Unit of Istanbul University, Cerrahpaşa Hospital. We recorded the age, sex, hair loss duration, diagnosis, and whether or not patients had trichodynia symptoms.
Out of a total of 249 patients, 89 patients (35.7%) had trichodynia. We found that the mean age of patients with trichodynia was higher than the mean age of those without trichodynia. Trichodynia was more common in women than in men. In addition, it was more common in the cicatricial alopecia group than the other disease groups.
The frequency of trichodynia was significantly higher in women in comparison to that in men. Symptoms of trichodynia were significantly more common in patients with cicatricial alopecia in comparison to that in the other 4 diagnostic categories. There was no significant difference between the 4 diagnostic categories in terms of trichodynia severity.
The frequency of trichodynia was significantly higher in women in comparison to that in men. Symptoms of trichodynia were significantly more common in patients with cicatricial alopecia in comparison to that in the other 4 diagnostic categories. There was no significant difference between the 4 diagnostic categories in terms of trichodynia severity.Onychomycosis is one of the most common nail disorders and may be difficult to distinguish from other causes of nail dystrophy, based on clinical grounds alone. With this study, we aimed to describe the use of fungal testing by dermatologists and family physicians in their daily current practice, analyze their respective familiarity with nail disease diagnosis, and ultimately treatment decision-making by both groups. An online survey was distributed among Portuguese dermatologists, trainees, and family physicians by email. The survey focused on the diagnostic impression, use of diagnostic methods to confirm a fungal infection, and the subsequent assessment of treatment. One hundred fifty-one responses were obtained, 60 (39.7%) from dermatologists and 91 (60.3%) from family physicians; 98.3% of dermatologists mentioned usually requesting a fungal testing at their local institution or outside, while this percentage was 50.5% among family physicians (p less then 0.001). Regarding the diagnosis, the median of correct diagnosis by the dermatologist group was higher (10/15) than the family physicians (6/15).
