Photodermatoses: Kids are not just little people.

Photodermatoses are a group of skin disorders caused by abnormal reaction to ultraviolet radiation. Photodermatoses are divided into four groups: (1) immunologically mediated photodermatoses; (2) chemical- and drug-induced photodermatoses; (3) photoaggravated dermatoses; and (4) hereditary photodermatoses. This contribution discusses differences in the approach and diagnosis of pediatric and adult patients with suspected photodermatoses, focusing on immunologically mediated photodermatoses and chemical- and drug-induced photodermatoses.

Ocular involvement in cutaneous connective tissue disease.

Connective tissue disorders commonly involve multiple organ systems including the skin and eye. The pathogenesis of many of these disorders affects the microvasculature in these organs. Redness, dryness, pain, and vision loss might be signs of ocular disease in a patient with connective tissue disease. Ocular involvement can potentially lead to blindness and indicate systemic involvement. Dermatologists should be aware of potential ocular involvement in cutaneous connective tissue disorders, and their recognition should prompt ophthalmologic evaluation.

Pemphigus.

Pemphigus vulgaris and paraneoplastic pemphigus are 2 subtypes of pemphigus that involve the oral mucosa. These autoimmune blistering disorders have antibodies targeted against proteins of keratinocyte adhesion, thereby causing acantholysis. Clinical findings include oral erosions and flaccid cutaneous bullae and erosions. Further malignancy workup in patients with suspected paraneoplastic pemphigus is warranted. Retrospective uncontrolled studies suggest that immunosuppressive agents reduce mortality in pemphigus vulgaris and cohort uncontrolled studies of rituximab, a monoclonal antibody against CD20, suggest it is an effective treatment for refractory patients. Ongoing studies will define its role in early disease.

Ethical considerations when prescribing biologics in dermatology.

There are no formal publications describing and discussing the various ethical dilemmas encountered when treating dermatologic disease with biologic therapy. Multiple issues such as safety, efficacy, drug accessibility, and cost need to be considered when prescribing biologics. This contribution uses a case-based approach to evaluate the ethical principles involved with biologic therapy.

Update on photodermatoses.

Interactions with ultraviolet radiation (UVR) and chromophores in the skin happen on a daily basis. Photodermatoses, which are abnormal responses to UV exposure, can be classified into subgroups based on pathogenesis. This review will discuss the clinical features, pathogenesis, photobiologic evaluation, prognosis and therapies of the most common photodermatoses.