Concurrent Varicella-Zoster Virus Reactivation and Recurrent Herpes Simplex Virus Infection in the C2 Dermatome With Varicella-Zoster Virus Encephalitis: A Case Report and Review of the Literature.

Herpes simplex virus (HSV) and varicella-zoster virus (VZV) are common viruses that are present in the general population. However, it is uncommon for both viruses to coincide at the same time and location. These viruses infect the nervous system to establish latency and have been associated with neurological disorders. We discuss a case of co-occurring VZV reactivation and recurrent HSV infection with subsequent VZV encephalitis following an insult to the neurologic system.

What's Eating You? Tropical Rat Mite (Ornithonyssus bacoti).

The tropical rat mite (Ornithonyssus bacoti) commonly infests wild and pet rodents, but they are not host specific. Bodily contact with wild or domesticated rodents is the most common source of infestation. Mites can live off many mammal hosts for a long period of time; therefore, living in quarters infested by mice can lead to mite exposure. Human infestation presents as urticarial, pruritic, cutaneous lesions that may be misdiagnosed as an arthropod bite, an infection, or contact dermatitis. Symptomatic relief of pruritus can be provided with a topical corticosteroid or antihistamine. The most effective treatment is an antiparasitic, such as permethrin cream, as well as extermination of rodents, mites, and any other pests in the patient's living space.

Considerations for cutaneous physiologic changes of pregnancy that fail to resolve postpartum.

Pregnancy prompts many adaptive and unique physiologic modifications, with cutaneous changes being possibly the most noticeable. These cutaneous changes are of interest to physicians, since they must be diagnosed as anticipated normal physiologic changes or potentially harmful and managed accordingly. Research has been conducted on physiologically normal and abnormal cutaneous manifestations of pregnancy but is lacking in regard to the persistence of these changes after delivery. This prompts the question as to whether these are normal physiologic changes taking longer to resolve, abnormal changes that may have been previously misdiagnosed, or a separate underlying change that is incorrectly attributed to a common dermatosis caused by pregnancy. Some of the conditions that may persist longer than expected during or after pregnancy, and thus require further workup for an underlying condition, include telogen effluvium, severe hirsutism, palmar erythema, and striae. The objective of this review is to focus on these four common cutaneous physiologic changes of pregnancy, and what to consider when they do not resolve as expected.

Bacteriophages: An Alternative to Combat Antibiotic Resistance?

BACKGROUND: Antibiotic resistance has become one of the largest pitfalls of modern medicine, and this has fueled the search for a safe and effective alternative. Of these alternatives, bacteriophage (phage) therapy has emerged as a potential option since it is capable of destroying pathogenic bacteria, without disrupting commensal bacterial populations. Although numerous studies have shown its efficacy in various conditions such as dysentery, sepsis, and meningitis, very little research has focused on its prospective usage to treat dermatological conditions. This review discusses the emerging phage therapy studies surrounding infections caused by Cutibacterium acnes (C. acnes), Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa), and Klebsiella pneumoniae (K. pneumoniae). Phage therapy shows major potential for future usage in the field of dermatology, yet further research must be performed to assure safety and efficacy in humans. J Drugs Dermatol. 2022;21(12):1311-1315. doi:10.36849/JDD.6638.

DMSO: an aid to combat pain and pruritus.

Dimethyl sulfoxide (DMSO) is a highly reactive by-product of paper production in the form of an odorless, colorless liquid that has been studied since the 1860s. Initially it was utilized as a solvent, but more recently it is being investigated for therapeutic applications. Owing to its versatility, the use of DMSO has been proposed in many different medical fields for a variety of applications, with possibly the widest use being in the field of dermatology. The clinical interest in the use of DMSO for dermatology conditions stems from this solution's efficacy as a vehicle to deliver pharmacological agents across the stratum corneum and its ability to penetrate biological membranes. Currently there is only one FDA approval for the use of DMSO, and it is not in the dermatologic field but rather for interstitial cystitis. Outside of the FDA scope of usage, DMSO is used frequently to treat osteoarthritis in humans and animals, as well as other chronic pain conditions. This suggests the possible utility of DMSO being applicable to other inflammatory conditions such as pruritus. Further research is necessary to explore the promising utilization opportunities of DMSO in dermatology.

Pain and Pruritus: a study of their similarities and differences.

Pruritus is one of the most common dermatologic complaints and, as the most common dermatologic symptom, is a major contributor to frequent dermatology visits. Chronic pruritus mirrors another major medical condition faced by millions of Americans each year - chronic pain. In older literature, pain and pruritus were thought to have been conveyed by the same C fiber, and the proportion contributing to pruritus was just a small subset of this general fiber. Overall, pain and pruritus share many integral similarities. Although these sensations both initiate the body's awareness to injury, pain and itch may have evolved for sensing different damages such as a burrowing parasite or a noxious stimulus, respectively. This seems to have been validated through analyses of their pathophysiology, acute and chronic conditions, and treatment modalities. However, their symptoms and intrinsic mechanisms vary considerably. It is important to view pruritus in more of an overall, whole body experience, rather than just the sensory aspect. Future studies should investigate the psychological treatment of chronic pruritus, considering the immense similarities with its chronic pain counterpart.