Evaluation of corticophobia in patients with atopic dermatitis and psoriasis using the TOPICOP© score.

INTRODUCTION: Atopic dermatitis (AD) and psoriasis (PS) are skin diseases that have a significant impact on the quality of life. The correct application of corticosteroids in topical treatment is highly effective and safe for patients. Excessive and irrational fear of these drugs based on incorrect information is increasingly observed at dermatological clinics. METHODS: To assess the extent of corticophobia, we conducted a single-center cross-sectional survey using the TOPICOP© questionnaire. RESULTS: The study included 57 patients (56% female) with AD and 58 patients (60% female) with PS. The combined TOPICOP© score averaged around 44, showing no significant difference between the two skin conditions. However, consistently higher scores were observed among female participants compared to males. CONCLUSIONS: The prevalence of corticophobia was comparable to that reported in other similar studies and was higher among female patients, which replicates previous findings. Patients with AD, who were younger on average than patients with PS, often relied on friends, acquaintances, family members, and the internet as their main information sources. Providing correct and reliable information to patients is crucial for ensuring treatment adherence.

Malignant Syphilis in a Female Patient: A Case Report and Mini-Review.

Malignant syphilis (MS) is a rare form of secondary syphilis with grotesque skin lesions, systemic manifestation and life-threatening complications. This article presents a case of MS in an immunocompetent 41-year-old female, who initially manifested with a generalized nonpruritic erythematous rash and systemic symptoms. She was mistreated for generalized impetigo and hepatitis attributed to chronic alcoholism. After partial recovery and a 3-month latent period, she developed infiltrated plaques with crusts on the trunk, head and neck; pharyngitis and laryngeal lesions; generalized lymphadenopathy and nonspecific systemic symptoms. Serologic tests confirmed syphilis, and cerebrospinal fluid analyses indicated the presence of anti-treponemal antibodies. Urine drug screening was positive for cannabinoids. The polymerase chain reaction from skin biopsy samples identified T. pallidum, confirmed with Warthin-Starry staining. Immunohistochemical analysis was uncharacteristic. Tertiary syphilis, neurosyphilis, ocular syphilis and otosyphilis were excluded. However, the patient was treated for neurosyphilis with benzylpenicillin (18 million IU intravenously daily, 14 days) and corticosteroids. No Jarisch-Herxheimer reaction occurred. Ten months after treatment, residual scars were visible, and 1 year later, she attempted suicide. Since MS can resemble other diseases, it should be suspected in a mentally ill patient with chronic drug abuse, systemic nonspecific manifestations and dermatological abnormalities, including the head and neck region.

A patient with urticarial lesions, recurrent fever, and IgM-type monoclonal gammopathy.

Schnitzler syndrome is a rare acquired autoinflammatory syndrome. It presents with an urticarial rash and a monoclonal gammopathy, usually of the IgM kappa type. In addition, patients can present with bone and/or joint pain, recurrent fever, asthenia, weight loss, myalgia, headache, lymphadenopathy, hepatomegaly, or splenomegaly. An elevation of blood inflammation markers is commonly found. Skin biopsy of the urticarial rash reveals neutrophilic infiltrate, known as neutrophilic urticarial dermatosis. To confirm the diagnosis, two sets of diagnostic criteria have been established. The syndrome shares many features with other autoinflammatory disorders, such as adult-onset Still's disease and NLRP3-auto-inflammatory disorders (NLRP3-AID, formerly known as cryopyrin-associated periodic syndromes, or CAPS). The pathogenesis of the disease is not yet fully understood; however, it is believed that interleukin (IL)-1ß plays a crucial role and explains the excellent effectiveness of IL-1 blocking agents. It is a chronic disease, and some patients develop lymphoproliferative disease, and seldom AA amyloidosis.