Lichenoid Reactions in Association with Tumor Necrosis Factor Alpha Inhibitors: A Review of the Literature and Addition of a Fourth Lichenoid Reaction.

In this manuscript, a clinical case of a patient treated with adalimumab for Behcet's disease develops lichen planopilaris. A variety of mucocutaneous lichenoid eruptions have recently been described in association with tumor necrosis factor alpha inhibitors. The authors briefly discuss the clinical and pathological presentation of lichen planopilaris as well as a potential pathogenesis of cutaneous adverse effects seen as the result of tumor necrosis factor alpha inhibitor therapy. They review all case reports of lichen planopilaris occurring on tumor necrosis factor alpha inhibitors and suggest its classification as a fourth recognized pattern on this therapy.

A novel treatment for ulcerative calcinosis cutis.

BACKGROUND: Calcinosis cutis is a term used to describe a group of disorders which result in calcium deposits in the skin. These disorders can be separated based on etiology. OBJECTIVE AND METHODS: Sodium thiosulfate has been used to systemically treat calciphylaxis with little to no adverse effects. We report two cases of ulcerative calcinosis cutis which were refractory to multiple topical treatments and did not improve with correction of underlying electrolyte abnormalities. RESULTS: Both cases showed an excellent response to topical 25% sodium thiosulfate compounded in zinc oxide. LIMITATIONS: We are limited by a small sample size (n=2) in this case series. CONCLUSIONS: We recommend topical sodium thiosulfate 25% as an alternative treatment for dystrophic calcinosis cutis.

Cataracts in atopic dermatitis: a case presentation and review of the literature.

BACKGROUND: Atopic dermatitis (AD) is a common skin disorder of increasing prevalence. Many ophthalmologic conditions are associated with AD, including cataract formation. Posterior and anterior subcapsular cataracts have been described in AD. Topical and systemic corticosteroids have been implicated in the development of cataracts. The precise pathogenic mechanisms and risk factors for development of atopic cataract are not clear. OBSERVATION: We report a case of cataract development in a child with severe AD and performed an extensive review of the dermatologic and ophthalmologic literature pertaining to AD and cataract formation. The incidence, demographics, pathogenesis, and characteristics of atopic cataracts are evaluated. CONCLUSIONS: Atopic dermatitis alone is a risk factor to develop both posterior and anterior subcapsular cataracts. There is a slightly increased probability of posterior subcapsular cataracts. However, anterior subcapsular cataracts are more specific to AD. A positive correlation was found between atopic cataract development and a decreased inducibility of superoxide dismutase. This suggests that atopic cataract development is correlated with oxidative damage of the lens and related to chronic inflammation.