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1.
Dermatol Online J ; 30(1)2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38762858

RESUMO

Tumor necrosis factor (TNF) inhibitors may paradoxically induce pustular eruptions, most of which are classified as pustular psoriasis. Amicrobial pustulosis of the folds (APF) is a much rarer entity that was recently recognized to occur in the setting of chronic anti-TNF therapy and inflammatory bowel disease, with 12 existing cases in the literature. Amicrobial pustulosis of the folds is a neutrophilic dermatosis characterized by aseptic pustules involving the major and minor skin folds, genital regions, and scalp. Herein, we report an additional case of paradoxical APF induced by chronic infliximab therapy in a patient with Crohn disease.


Assuntos
Doença de Crohn , Infliximab , Humanos , Infliximab/efeitos adversos , Infliximab/uso terapêutico , Doença de Crohn/tratamento farmacológico , Doença de Crohn/complicações , Adulto , Dermatopatias Vesiculobolhosas/induzido quimicamente , Dermatopatias Vesiculobolhosas/patologia , Masculino , Feminino , Fator de Necrose Tumoral alfa/antagonistas & inibidores
2.
J Cutan Pathol ; 51(6): 441-449, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38415867

RESUMO

BACKGROUND: The histopathologic features of psoriasis are well-documented, but recent studies have highlighted atypical features, such as eosinophils, in clinically confirmed cases. METHODS: A systematic review exploring eosinophils in psoriasis was performed. A novel quality assessment tool (SQAT-Path) we designed for cross-sectional pathology studies was employed. RESULTS: Five studies (N = 218) were identified. The pooled prevalence of dermal eosinophils in psoriasis was 46% (95% confidence interval, 0.27-0.66). The prevalences of 1 to 5 lesional eosinophils (24%) compared to >5 eosinophils (26%) were similar. There was no association between eosinophils and prior treatment. There was also no association between eosinophils and spongiosis. In SQAT-Path, studies scored between 9 and 18 (out of a maximum of 27: "fair" to "good"), consistent with the ratings using other assessment tools. CONCLUSION: Eosinophils were found in approximately half of systematically studied and published cases of psoriasis. When present, their quantity is variable, with the likelihood of having greater than 5 eosinophils in a biopsy section comparable to having between 1 and 5. Greater than 5 eosinophils, as an isolated finding, would not be typical of psoriasis, but should not preclude its diagnosis without considering the overall histologic context.


Assuntos
Eosinófilos , Psoríase , Psoríase/patologia , Psoríase/diagnóstico , Humanos , Eosinófilos/patologia
3.
J Cutan Pathol ; 51(2): 88-91, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37699723

RESUMO

Select Aspergillus species can produce oxalate as a fermentation byproduct, which may react with calcium ions to produce insoluble calcium oxalate crystals in tissues. These crystals are frequently associated with pulmonary Aspergillus infections, yet are rarely described in primary cutaneous aspergillosis. Herein, we report the presence of calcium oxalate crystals detected on cutaneous specimens from primary cutaneous Aspergillus niger and Aspergillus fumigatus infections in an immunocompromised, premature infant. No metabolic sources of oxalosis were found.


Assuntos
Aspergilose , Oxalato de Cálcio , Humanos , Oxalato de Cálcio/metabolismo , Aspergilose/metabolismo , Aspergillus niger/metabolismo , Oxalatos , Pulmão
4.
Hum Pathol ; 140: 101-128, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37003367

RESUMO

Eosinophils are known to be present in inflammatory skin diseases, but their diagnostic utility is not well established. Upon review of the published status of lesional eosinophils, several categories were identified. 1) Lesional eosinophils highly characteristic such that, in their absence, the pathologist may question the diagnosis. These include arthropod bite reactions and scabies, urticarial dermatitis, and other eosinophilic dermatoses. 2) Lesional eosinophils rare or absent, such that, in their presence, the pathologist may question the diagnosis. These include pityriasis lichenoides, graft versus host disease, and connective tissue disorders. 3) Lesional eosinophils variable and, while in some cases expected, are not required for diagnosis. These include drug reactions, atopic dermatitis and allergic contact dermatitis. 4) Lesional eosinophils variable and not expected but may be seen to a limited extent. These include lichen planus and psoriasis.


Assuntos
Dermatite Atópica , Líquen Plano , Psoríase , Dermatopatias , Humanos , Eosinófilos , Diagnóstico Diferencial , Psoríase/diagnóstico , Líquen Plano/diagnóstico , Dermatite Atópica/diagnóstico , Pele , Dermatopatias/diagnóstico
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