Presentation
Source: Aditi Murthy, MD A 3-year-old female presented to urgent care with a 1-week history of a pruritic rash on the legs and torso. On the day of her presentation, she additionally developed two new dark brown marks on her right cheek. [healio.com]
A heavily pregnant woman presents with a risky rash. What is the best management? Dr Jim Newcombe 13th February 2018 0 Comments Jess, a 35-year-old woman, presents to her GP at 39 1 weeks’ gestation in her first pregnancy. [howtotreat.com.au]
We present a case of a female patient with Hodgkin’s lymphoma who presented with classic findings for FE after initiation of chemotherapy. [cureus.com]
Treatment prior to presentation included diphenhydramine, cetirizine, and a 20-mg dose of prednisone without improvement. The patient was otherwise healthy with normal development and growth. [jamanetwork.com]
Dermatology Quiz Case presentation A 10-year-old girl presents with a six-month history of an intensely pruritic rash mainly over the extensor surfaces of her lower legs and arms. She is otherwise well. [medicinetoday.com.au]
Entire Body System
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Cat Scratch
No case of pruritic rash associated with cat scratch disease has been previously reported. In fact, one authority specifically states that the rash of cat scratch disease is nonpruritic. [ncbi.nlm.nih.gov]
Respiratoric
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Malignant Pleural Effusion
Introduction Bleomycin is a sulphur-containing antimicrobial derived from Streptomyces verticillus used in standard chemotherapy for Hodgkin's lymphoma, germ cell tumors, Kaposi sarcoma, and pleurodesis for malignant pleural effusions [1-4]. [cureus.com]
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Pleural Effusion
Introduction Bleomycin is a sulphur-containing antimicrobial derived from Streptomyces verticillus used in standard chemotherapy for Hodgkin's lymphoma, germ cell tumors, Kaposi sarcoma, and pleurodesis for malignant pleural effusions [1-4]. [cureus.com]
Workup
Workup revealed dermatitis herpetiformis (DH) and subclinical celiac disease. [mayoclinic.pure.elsevier.com]
Erythematous, pruritic rash Keywords: Pediatric, Pediatrics, Child, Integumentary, Dermatology, Immune, Infectious, Tinea corporis, Ringworm, Rash, Integumentary/Dermatology Video Features: Vitals & Demographics Differential Diagnosis & Patient Workup [reeldx.com]
The presence of her diffuse rash along with a pulmonary cavitary lesion prompted infectious workup. [cureus.com]
Appropriate laboratory workup should be done to rule out systemic disease, and occasionally a skin biopsy is warranted if the diagnosis is uncertain. [consultant360.com]
Microbiology
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Rickettsia Prowazekii
Serologic studies (IgG and IgM) for dengue virus, Rickettsia rickettsii, Rickettsia typhi, Rickettsia prowazekii, and Leptospira (total antibody), were obtained and returned negative. [academic.oup.com]
Pleura
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Pleural Effusion
Introduction Bleomycin is a sulphur-containing antimicrobial derived from Streptomyces verticillus used in standard chemotherapy for Hodgkin's lymphoma, germ cell tumors, Kaposi sarcoma, and pleurodesis for malignant pleural effusions [1-4]. [cureus.com]
Treatment
Treatment with both topical and systemic steroids was ineffective. Following a living nonrelated renal transplant and removal of the catheter the rash and eosinophilia resolved. [ncbi.nlm.nih.gov]
AB - A 56-year-old man sought treatment after a vacation for an intensely pruritic skin eruption involving the buttocks. On physical examination, annular plaques were noted. [mayoclinic.pure.elsevier.com]
Treatment of diagnoses Treatment varies according to the suspected underlying cause of the rash. [bestessayhelp.com]
Peplomycin, a bleomycin analogue used in the treatment of prostate cancer, breast cancer, and HL, can also cause FE [7, 8]. [cureus.com]
A skin biopsy may be appropriate if the provisional diagnosis is not clear or if the condition is refractory to treatment. Management Treatment of prurigo can be difficult. The first step is focused on preventing ongoing skin picking and scratching. [medicinetoday.com.au]
Prognosis
The four clinical variants of adult T-cell leukemia–lymphoma — acute, lymphomatous, chronic, and smoldering — affect the clinical presentation and prognosis. [blogs.nejm.org]
[…] and anakinra. [5], [6] Acute pulmonary embolism manifested by our patient is a rare, life-threatening complication of adult-onset Still's disease. [7] Lee et al. have noted that adult-onset Still's disease associated with persistent rash has a poor prognosis [ijdvl.com]
intrahepatic cholestasis of pregnancy, pemphigoid gestationis). 29 – 37 Early recognition, precise diagnosis, and prompt treatment are essential for improving maternal and fetal prognosis. Enlarge Print Table 4. [aafp.org]
In severe cases clonal T-cell populations can be detected in the blood or bone marrow and the prognosis is worse.3 Drug rash Drug hypersensitivity induced rashes are the commonest cause of new onset rashes in inpatients. [gmjournal.co.uk]
Etiology
The exact etiology of pruritic folliculitis is unknown. [aafp.org]
This report describes the investigation in Crawford County, Kansas, by public health agencies and entomologists to identify the etiology of the pruritic rash and to assess the extent of the outbreak. [cdc.gov]
The exact pathophysiology and etiology of VZV reactivation is unknown, but an age-related decline in VZV-specific cell mediated immune responses appears to be important. ( JAMA 2009;302[1]:108.) [journals.lww.com]
If blisters are present, one should have a higher degree of suspicion for a different etiology such as pemphigoid gestationis. [aocd.org]
Epidemiology
Chikungunya fever: an epidemiological review of a re-emerging infectious disease. Clin Infect Dis 2009 ; 49 : 942 – 8. 4 Centers for Disease Control and Prevention. Chikungunya virus. . 5 Pan American Health Organization. [academic.oup.com]
Epidemiological and clinical study of grain itch. JAMA 1952;150:575--9. Peter M. Beware of oak leaf gall mites; they may be coming back. K-State Research and Extension News; May 6, 2005. Available at . [cdc.gov]
The epidemiology of pruritus depends on its underlying cause or causes. However, in general, the incidence of chronic pruritus increases with age, it is more common in women, and in those of Asian background. [dermnetnz.org]
In this article the epidemiology, risk factors, clinical presentation, radiographic findings and management is discussed. The majority of patients with small joint osteoarthritis respond well to non surgical treatments. [edoc.co.za]
Histopathological and epidemiological characteristics of patients with erythema exudativum multiforme major, Stevens-Johnson syndrome and toxic epidermal necrolysis. Br J Dermatol. 1996;135(1):6–11. 39. Kemmett D, Hunter JA. [aafp.org]
Pathophysiology
Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment. An Bras Dermatol 2014;89(6):865–77. [racgp.org.au]
The exact pathophysiology and etiology of VZV reactivation is unknown, but an age-related decline in VZV-specific cell mediated immune responses appears to be important. ( JAMA 2009;302[1]:108.) [journals.lww.com]
Back to Top Pathophysiology Peripheral Mechanisms Physical Stimuli and Neural Pathways Itch can be produced by mechanical (gentle touch, pressure, vibration, and wool), thermal and electrical stimuli such as transcutaneous or direct nerve stimulation. [clevelandclinicmeded.com]
Pathophysiology Itch can be prompted by diverse stimuli, including light touch, vibration, and wool fibers. There are a number of chemical mediators as well as different mechanisms by which the sensation of itch occurs. [merckmanuals.com]
Prevention
This vaccine does not prevent infection but prevents reactivation of the latent virus by suppression because only those who have previously been infected with VZV can get shingles. [journals.lww.com]
Clin Infect Dis 2009 ; 49 : 942 – 8. 4 Centers for Disease Control and Prevention. Chikungunya virus. . 5 Pan American Health Organization. Chikungunya Fever in the Americas. . 6. [academic.oup.com]
The first step is focused on preventing ongoing skin picking and scratching. [medicinetoday.com.au]
The best way to prevent pruritus is to take care of your skin. To protect skin: Use skin creams and lotions that moisturize your skin and prevent dryness. Use sunscreens regularly to prevent sunburns and skin damage. [webmd.com]
Suggested prevention measures included using a DEET-containing product before going outdoors, because DEET is known to repel some mite species ( 5 ). [cdc.gov]