Morphea as an isotopic response to pigmented purpuric dermatosis and lichen striatus.

Morphea is an uncommon inflammatory and fibrosing disorder that has a polymorphous clinical presentation. We report two cases of morphea developing as an isotopic response after a preceding benign skin disease, accompanied by a review of the literature. This case series highlights the importance of return to care recommendations for benign skin conditions such lichen striatus and pigmented purpuric dermatoses due to the rare possibility of subsequent morphea development.

Clinical and epidemiological profile of lichen striatus in children-Experience from a tertiary care hospital.

We analyzed records of 30 patients with lichen striatus (age < 18 years) in this retrospective study. Seventy percent were females and 30% were males with a mean age of diagnosis of 5.38 ± 4.22 years. The most common age group affected was 0-4 years. The mean duration of lichen striatus was 6.66 ± 4.22 months. Atopy was present in 9 (30%) patients. Although LS is a benign self-limited dermatosis, long-term prospective studies with a greater number of patients will help in better understanding of the disease including its etiopathogenesis and association with atopy.

Rapid and successful effects of combining dupilumab with ultraviolet B radiation therapy in the treatment of Papuloerythroderma of Ofuji.

Papuloerythroderma of Ofuji (PEO) is an uncommon disease characterised by widespread erythroderma composed of intensely pruritic solid papules coalescing into plaques sparing the skin folds (deck-chair sign). The pathogenesis of PEO remains unclear, although T helper (Th) 2 and Th22 cells may play an important role. Dupilumab is an interleukin (IL)-4 receptor α-antagonist that effectively reduces Th2 responses, which has drawn increasing attention in the treatment of PEO patients. Here, we reported a successful case of dupilumab treatment in combination with ultraviolet B (UVB) radiation therapy, which is well known and effective for chronic itch. The patient had a significant decrease in visual analogue scale (VAS) score and eosinophil after only 1 week of treatment, which may be due to the combination effect.

Disseminated papular variant of Dowling-Degos disease: Histopathological features in POGLUT1 mutation.

Dowling-Degos disease is a rare benign genodermatosis. It is characterized by lentiginous hyperpigmentation and reddish-brown papules and plaques. The flexor sides and intertrigines are often affected, but the clinical appearance may vary. Mutations in different genes are responsible for the clinical manifestation. While mutations in the keratin 5 (KRT5) gene favor a reticular distribution pattern, mutations in the POGLUT1 gene lead to a disseminated, papular clinical picture. Acantholytic variants of Dowling-Degos disease have historically been referred to as Galli-Galli disease, but our case study shows that the histopathological changes can vary even within a single patient. To date, no standardized therapy concept exists. The main focus is on keratolytic measures, with varying response. New therapeutic approaches using laser technology appear to be a promising treatment option.

Pityriasis rubra pilaris with erythema gyratum repens-like eruption and resolution with ustekinumab.

Erythema gyratum repens (EGR) is a rare paraneoplastic disorder often preceding the diagnosis of underlying malignancy by 9 months on average, while pityriasis rubra pilaris (PRP) is an uncommon papulosquamous inflammatory disease. We present the case of a 58-year-old woman with an EGR-like eruption transforming from resolving PRP, without associated malignancy. Her rash dramatically resolved within a month of ustekinumab initiation, which supports this presentation as a unique entity.

Familial Dyskeratosis Comedones without Dyskeratosis-A Rare Entity.

A 42-year-old woman presented with multiple, discrete, symmetric hyperkeratotic papules and comedo-like lesions over the cheek and upper part of the back. These lesions first began to appear at the age of 20 years. Since then, new lesions have periodically appeared with spontaneous regression. Keratinous material could be extruded, leaving behind pock-like scars. The scalp, palms, soles, and mucous membranes were spared. Because the lesions were asymptomatic, the patient did not seek any treatment (Figure 1 and 2). (SKINmed. 2022;20:152-153).