Sujet(s)
Antituberculeux , Mycobacterium tuberculosis , Exposition professionnelle , Tuberculose cutanée , Vétérinaires , Humains , Mâle , Antituberculeux/usage thérapeutique , Mycobacterium tuberculosis/isolement et purification , Peau/anatomopathologie , Peau/microbiologie , Tuberculose cutanée/diagnostic , Tuberculose cutanée/traitement médicamenteux , Tuberculose cutanée/microbiologie , Tuberculose cutanée/anatomopathologie , Adulte d'âge moyen , Biopsie , Isoniazide/usage thérapeutique , Rifampicine/usage thérapeutique , Éthambutol/usage thérapeutique , Dermatoses de la main/diagnostic , Dermatoses de la main/traitement médicamenteux , Dermatoses de la main/microbiologie , Dermatoses de la main/anatomopathologie , Exposition professionnelle/effets indésirablesSujet(s)
Eczéma , Dermatoses de la main , Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Chine , Produits dermatologiques/usage thérapeutique , Produits dermatologiques/effets indésirables , Peuples d'Asie de l'Est , Eczéma/traitement médicamenteux , Dermatoses de la main/traitement médicamenteux , Pyrimidines/usage thérapeutique , Pyrimidines/effets indésirables , Études rétrospectives , Sulfonamides/usage thérapeutique , Sulfonamides/effets indésirables , Résultat thérapeutiqueSujet(s)
Marqueurs biologiques , Eczéma atopique , Dermatoses de la main , Psoriasis , Humains , Eczéma atopique/diagnostic , Eczéma atopique/thérapie , Eczéma atopique/immunologie , Eczéma atopique/traitement médicamenteux , Psoriasis/immunologie , Psoriasis/diagnostic , Psoriasis/traitement médicamenteux , Psoriasis/thérapie , Marqueurs biologiques/sang , Dermatoses de la main/traitement médicamenteux , Dermatoses de la main/diagnostic , Dermatoses de la main/thérapie , Maladie chroniqueRÉSUMÉ
BACKGROUND: Hand eczema (HE) is a common and heterogeneous condition. It has a wide range of etiologies and clinical manifestations. In this study the efficacy of triamcinolone 0.1% cream and sulfur 2% creams was compared in treating patients with HE. METHODS: This randomized, triple-blind clinical trial was performed on 70 patients with HE (including 70 right and 70 left hands). In this study, two creams were used including triamcinolone 0.1% and sulfur 2.0%. Patients were treated with these creams twice a day (once in every 12 h) for 4 weeks. Follow-up was 4 weeks after treatment. Hand Eczema Severity Index (HECSI), itching, dryness, burning sensation, and erythema scores were collected three times during the study and compared between treatment regimens. RESULTS: Findings showed that both triamcinolone (0.1%) and sulfur (2.0%) creams could significantly reduce the scores of HECSI, itching, dryness, burning sensation, and erythema, and the therapeutic effects lasted for at least 4 weeks after cessation of topical treatment. CONCLUSION: Topical sulfur cream (2.0%) is as effective as triamcinolone (0.1%) cream in treatment of HE without any prominent adverse reactions.
Sujet(s)
Eczéma , Dermatoses de la main , Indice de gravité de la maladie , Crème pour la peau , Soufre , Triamcinolone , Humains , Mâle , Femelle , Eczéma/traitement médicamenteux , Adulte , Dermatoses de la main/traitement médicamenteux , Adulte d'âge moyen , Crème pour la peau/administration et posologie , Crème pour la peau/effets indésirables , Résultat thérapeutique , Triamcinolone/administration et posologie , Triamcinolone/effets indésirables , Soufre/administration et posologie , Soufre/effets indésirables , Jeune adulte , Prurit/traitement médicamenteux , Prurit/étiologie , Administration par voie cutanée , Glucocorticoïdes/administration et posologie , Glucocorticoïdes/effets indésirablesSujet(s)
Anticorps monoclonaux humanisés , Eczéma , Humains , Anticorps monoclonaux humanisés/usage thérapeutique , Études rétrospectives , Femelle , Mâle , Maladie chronique , Adulte d'âge moyen , Eczéma/traitement médicamenteux , Adulte , Dermatoses de la main/traitement médicamenteux , Études de cohortes , Sujet âgé , Dermatoses du pied/traitement médicamenteuxRÉSUMÉ
BACKGROUND: Chronic Hand Eczema (CHE) is a heterogeneous fluctuating inflammatory disease that represents a significant burden. Effective treatment options for moderate to severe CHE are limited. OBJECTIVES: To assess how patients with moderate to severe CHE are treated in clinical practice. METHODS: A retrospective, physician-led patient record review assessed the demographic, clinical and treatment characteristics of patients aged ≥18 years with CHE across seven countries. Each participating physician was requested to review records for their three most recent patients with moderate to severe CHE treated with a topical or systemic therapy. RESULTS: A total of 264 physicians, of whom 88.6% were dermatologists and 70.1% were predominantly or partly hospital-based, reviewed the records of 792 patients. Signs were present on hands only in 56.4% of patients and the mean time on current treatment was 16.7 months. Overall, 62.9% of patients received systemic therapy and almost one-quarter (23.4%) were treated with a biologic; 28.6% of patients were only treated with topical corticosteroids and/or topical calcineurin inhibitors. CONCLUSION: In patients with moderate to severe CHE, most received systemic therapy with one-quarter on biologic therapy. However, given that many of these treatments have limited evidence of efficacy in CHE, there is a need for studies specifically in patients with CHE as well as new therapeutic options.
Sujet(s)
Eczéma de contact allergique , Produits dermatologiques , Eczéma , Dermatoses de la main , Humains , Adolescent , Adulte , Études rétrospectives , Maladie chronique , Eczéma de contact allergique/traitement médicamenteux , Eczéma de contact allergique/étiologie , Eczéma/traitement médicamenteux , Produits dermatologiques/usage thérapeutique , Dermatoses de la main/traitement médicamenteuxRÉSUMÉ
BACKGROUND: Despite high disease burden, systemic treatment options for patients with atopic hand and/or foot dermatitis (H/F AD) are limited. OBJECTIVES: To evaluate efficacy and safety of dupilumab in H/F AD using specific instruments for assessing disease severity on hands and feet. METHODS: In this multicenter phase 3 trial, adults and adolescents with moderate-to-severe H/F AD were randomized to dupilumab monotherapy (regimen approved for generalized AD), or matched placebo. The primary endpoint was proportion of patients achieving Hand and Foot Investigator's Global Assessment score 0 or 1 at week 16. Secondary prespecified endpoints assessed the severity and extent of signs, symptom intensity (itch, pain), quality of life, and sleep. RESULTS: A total of 133 patients (adults = 106, adolescents = 27) were randomized to dupilumab (n = 67) or placebo (n = 66). At week 16, significantly more patients receiving dupilumab (n = 27) than placebo (n = 11) achieved Hand and Foot Investigator's Global Assessment score 0 or 1 (40.3% vs 16.7%; P = .003). All other prespecified endpoints were met. Safety was consistent with the known AD dupilumab profile. LIMITATIONS: Short-term, 16-week treatment period. CONCLUSION: Dupilumab monotherapy resulted in significant improvements across different domains of H/F AD with acceptable safety, supporting dupilumab as a systemic treatment approach for this often difficult to treat condition.
Sujet(s)
Anticorps monoclonaux humanisés , Eczéma atopique , Dermatoses du pied , Dermatoses de la main , Qualité de vie , Indice de gravité de la maladie , Humains , Anticorps monoclonaux humanisés/usage thérapeutique , Mâle , Femelle , Méthode en double aveugle , Eczéma atopique/traitement médicamenteux , Adulte , Adolescent , Adulte d'âge moyen , Dermatoses de la main/traitement médicamenteux , Dermatoses du pied/traitement médicamenteux , Jeune adulte , Résultat thérapeutique , RendementRÉSUMÉ
Neutrophilic dermatosis of the dorsal hands (NDDH) is an uncommon localized variant of Sweet syndrome first described in 1995. It is characterized by tender erythematous plaques, pustules, and bullae on the dorsa of the hands. A total of 123 cases of NDDH are included in this review. The mean patient age was 62.1 years, and there was a slight female preponderance. Overall, 78.0% of cases had bilateral involvement, and other sites were affected in almost a third of cases. Underlying disease was found in â¼40% of patients, with the most common associations being hematologic disorders (gammopathies, myelodysplasias, or malignancies), recent infection, solid organ tumors, and inflammatory bowel disease. Systemic or topical corticosteroids or both were employed in the treatment of 88.1% of cases, while dapsone, colchicine, and tetracyclines were the most common steroid-sparing agents used. Improvement was often rapid and complete resolution the norm. Although uncommon, NDDH is frequently misdiagnosed, and thus, its exact prevalence is probably underestimated. Misdiagnosis might have significant implications, including treatment delays or incorrect management. Moreover, recognition of NDDH is important, since a correct diagnosis should trigger a search for underlying diseases and proper treatment with corticosteroids, steroid-sparing agents, or both, which is almost invariably curative.
Sujet(s)
Dermatite , Dermatoses de la main , Syndrome de Sweet , Humains , Femelle , Adulte d'âge moyen , Dermatoses de la main/diagnostic , Dermatoses de la main/traitement médicamenteux , Dermatoses de la main/complications , Glucocorticoïdes , Syndrome de Sweet/diagnostic , Syndrome de Sweet/traitement médicamenteux , Syndrome de Sweet/complications , Antibactériens , Dermatite/complications , CloqueRÉSUMÉ
Herpetic whitlow is a viral infection of the fingers or toes caused by the herpes simplex virus. Herpes simplex virus is a common pathogen that causes infections in any cutaneous or mucocutaneous surface, most commonly gingivostomatitis or genital herpes. However, infection of the digits is also infrequently reported. Herpetic whitlow occurs when the virus infects the distal phalanx of the fingers or toes by means of direct inoculation, causing pain, swelling, erythema, and vesicle formation. The proper diagnosis is important because the condition can mimic various other podiatric abnormalities such as paronychia, bacterial cellulitis, or even embolic disease. Improper diagnosis often leads to unnecessary work-up, antibiotic therapy, or even surgical intervention. This case will help illuminate the clinical presentation of herpetic whitlow in an atypical location, and the patient's subsequent treatment. We present an atypical case of right hallux herpetic whitlow with delayed diagnosis and associated cellulitis. The patient was admitted after seeing multiple providers for a progressive right hallux infection that presented as a mixture of vesicular lesions and apparent cellulitis. His history was positive for biting his fingernails and toenails, and the lesions were noted to be honeycomb-like, with minimal drainage. The lesions were then deroofed and viral cultures were obtained, which were positive for herpes simplex virus type 1, thus confirming a diagnosis of herpetic whitlow. Although he remained afebrile with negative wound cultures during admission, a secondary bacterial infection could not be excluded because of his nail avulsion and surrounding cellulitis. He was discharged on oral antibiotics, antivirals, and wound care recommendations. Herpetic whitlow should be included in the differential diagnosis of pedal digital lesions that appear as vesicular or cellulitic in the pediatric population.
Sujet(s)
Dermatoses de la main , Herpès , Paronychie , Cellulite sous-cutanée , Enfant , Doigts , Dermatoses de la main/diagnostic , Dermatoses de la main/traitement médicamenteux , Herpès/diagnostic , Herpès/traitement médicamenteux , Herpès/étiologie , Humains , Mâle , Paronychie/complications , SimplexvirusRÉSUMÉ
INTRODUCTION: Chronic hand eczema (CHE) is a highly prevalent, burdensome condition associated with functional impairment. Currently, topical therapeutics are the mainstay of CHE management. However, many cases are refractory to existing topical therapeutics, and the few existing systemic options are often limited in efficacy and by their side effect profiles. AREAS COVERED: Following a brief overview of CHE pathogenesis and existing treatments, this review will outline the mechanisms and available data on emerging and investigational drugs currently being studied in clinical trials for the treatment of CHE. EXPERT OPINION: Immunomodulatory drugs such as topical and systemic JAK inhibitors and Th2-targeting antibodies such as dupilumab are currently under investigation for CHE treatment, with early promise. Management of CHE will likely move toward more targeted treatments through clinical trials and away from broad immunosuppressants such as cyclosporine and methotrexate, which have previously been investigated for CHE and have more side effects. In coming years, CHE patients may benefit from a wider range of both topical and systemic therapeutics that target immune pathways relevant to the various CHE subtypes.
Sujet(s)
Produits dermatologiques , Eczéma , Dermatoses de la main , Maladie chronique , Produits dermatologiques/effets indésirables , Médicaments en essais cliniques/effets indésirables , Eczéma/traitement médicamenteux , Dermatoses de la main/induit chimiquement , Dermatoses de la main/traitement médicamenteux , Humains , Immunosuppresseurs/effets indésirablesSujet(s)
Eczéma de contact allergique , Produits dermatologiques , Eczéma , Dermatoses de la main , Administration par voie orale , Alitrétinoïne/effets indésirables , Azathioprine/effets indésirables , Maladie chronique , Eczéma de contact allergique/traitement médicamenteux , Produits dermatologiques/effets indésirables , Eczéma/traitement médicamenteux , Dermatoses de la main/traitement médicamenteux , Humains , Résultat thérapeutiqueSujet(s)
Azétidines , Eczéma de contact allergique , Eczéma , Dermatoses de la main , Azétidines/usage thérapeutique , Eczéma de contact allergique/traitement médicamenteux , Eczéma de contact allergique/étiologie , Eczéma/traitement médicamenteux , Dermatoses de la main/traitement médicamenteux , Humains , Purines , Pyrazoles/usage thérapeutique , SulfonamidesSujet(s)
Produits dermatologiques , Eczéma , Dermatoses de la main , Infections à staphylocoques , Administration par voie topique , Hormones corticosurrénaliennes/usage thérapeutique , Produits dermatologiques/usage thérapeutique , Eczéma/traitement médicamenteux , Dermatoses de la main/traitement médicamenteux , Humains , Infections à staphylocoques/traitement médicamenteux , Staphylococcus aureusSujet(s)
Mycoses cutanées/complications , Dermatoses du pied/microbiologie , Dermatoses de la main/microbiologie , Microsporum , Teigne tondante/microbiologie , Antifongiques/usage thérapeutique , Enfant d'âge préscolaire , Mycoses cutanées/traitement médicamenteux , Mycoses cutanées/microbiologie , Femelle , Dermatoses du pied/traitement médicamenteux , Griséofulvine/usage thérapeutique , Dermatoses de la main/traitement médicamenteux , Humains , Teigne tondante/traitement médicamenteuxRÉSUMÉ
We report the clinical case of an atopic patient with important manifestations impacting the quality of life at the cutaneous and ocular site. The condition resisted conventional treatments, and omalizumab had to be used to treat the disease successfully.