Subject(s)
Dermatitis, Atopic/diagnosis , Pruritus/pathology , Severity of Illness Index , Sleep/physiology , Adult , Aged , Female , Humans , Male , Middle Aged , Pilot Projects , Surveys and Questionnaires , Young AdultABSTRACT
A switch from cell-mediated to humoral immunity (helper T 1 [Th1] to helper T 2 [Th2] shift) during gestation plays a key role in placental immune tolerance. As a result, skin diseases that are Th2 mediated often worsen, whereas skin diseases that are Th1 mediated often improve during gestation. Also, due to fluctuations in glandular activity, skin diseases involving sebaceous and eccrine glands may flare, whereas those involving apocrine glands may improve during pregnancy. Despite these trends, inflammatory and glandular skin diseases do not always follow the predicted pattern, and courses are often diverse. We review the gestational course of inflammatory skin diseases, such as atopic dermatitis (atopic eruption of pregnancy), psoriasis, impetigo herpetiformis, urticaria, erythema annulare centrifugum, pityriasis rosea, sarcoidosis, Sweet syndrome, and erythema nodosum, as well as glandular skin diseases, including acne vulgaris, acne rosacea, perioral dermatitis, hidradenitis suppurativa, Fox-Fordyce disease, hyperhidrosis, and miliaria. For each of these diseases, we discuss the pathogenesis, clinical presentation, and management with special consideration for maternal and fetal safety.
Subject(s)
Pregnancy Complications/diagnosis , Pregnancy Complications/therapy , Skin Diseases/diagnosis , Skin Diseases/therapy , Acne Vulgaris/drug therapy , Acne Vulgaris/etiology , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/drug therapy , Dermatitis, Perioral/etiology , Erythema Nodosum/diagnosis , Female , Fox-Fordyce Disease/therapy , Hidradenitis Suppurativa/therapy , Humans , Pityriasis Rosea/diagnosis , Pityriasis Rosea/etiology , Pregnancy , Pregnancy Complications/etiology , Psoriasis/complications , Psoriasis/therapy , Remission, Spontaneous , Rosacea/therapy , Sarcoidosis/complications , Sarcoidosis/drug therapy , Skin Diseases/etiology , Sweet Syndrome/diagnosis , Symptom Flare Up , Urticaria/drug therapyABSTRACT
Acrodynia, also known as pink disease, erythredema polyneuropathy, Feer syndrome, and raw-beef hands and feet, is thought to be a toxic reaction to elemental mercury and less commonly to organic and inorganic forms. Occurring commonly in the early 20th century, acrodynia is now a seemingly extinct disease in the modern world because of regulations to eliminate mercury from personal care products, household items, medications, and vaccinations. We present a case of a 3-year-old girl with acrodynia secondary to toxic exposure to elemental mercury in the home environment.
Subject(s)
Acrodynia/etiology , Hypertension/chemically induced , Mercury Poisoning/diagnosis , Mercury/toxicity , Acrodynia/diagnosis , Acrodynia/drug therapy , Antihypertensive Agents/therapeutic use , Chelating Agents/therapeutic use , Chelation Therapy , Child, Preschool , Female , Floors and Floorcoverings , Humans , Hypertension/diagnosis , Hypertension/drug therapy , Mercury/urine , Mercury Poisoning/drug therapy , Succimer/therapeutic use , Treatment OutcomeABSTRACT
Sweet's syndrome-like (Sweet's-like) neutrophilic panniculitis is usually idiopathic, but is frequently associated with hematologic, inflammatory, and immunologic disease. Drug-related cases of Sweet's syndrome have been reported. Of relevance, chemotherapy with the retinoid all-trans-retinoic acid (ATRA) infrequently induces Sweet's-like neutrophilic panniculitis that occurs concomitantly with neutrophilic differentiation. The pathologic features are limited to the adipose tissue or include both the dermis and the subcutaneous fat; the neutrophilic infiltrate can be observed in the lobules, the septae, or both. We present this case because of the unusual subcutaneous neutrophilic infiltrate consistent with Sweet's-like neutrophilic lobular panniculitis in a patient with acute promyelocytic leukemia receiving ATRA chemotherapy. This case highlights the important connection between ATRA and Sweet's syndrome.
