Volume 2 Issue 2

Case Report: Newly Diagnosed Sweet's Syndrome in an adult Patient with a Longstanding Common Variable Immunodeficiency

Y Turkowski*, M. Mahalingam, and N Konnikov

Sweet's Syndrome (SS) is an idiopathic disease characterized by various skin lesions including tender erythematous papules, plaques, or nodules on the face, neck, trunk, and upper extremities, and associated with pyrexia and malaise. Common Variable Immunodeficiency (CVID) is a disease of unknown etiology. Intrinsic B-cell defects and abnormalities in helper T cell-mediated activation of B cells lead to IgG, IgA, and occasionally IgM antibody deficiencies cause recurrent bacterial infections.
We present an adult patient with long-lasting history of CVID treated with Intravenous Immunoglobulin (IVIG) who subsequently developed SS. To the best of our knowledge only two cases of co-occurrence of these two clinical entities have been described in the literature.
We have consulted a patient with CVID who was hospitalized with tender, erythematous, well-demarcated papulo-nodular lesions on both hands and tender draining erythematous nodules on the right knee and calf. In addition, he developed a painful deep red nodule on the right buttock area. His blood culture and cutaneous cultures from draining lesions on the leg were negative. A skin biopsy revealed neutrophilic dermatosis consistent with SS. Therapy with minocycline resulted in a rapid and complete resolution of SS.
Although the etiopathogenesis of SS is unknown, investigators believe that interleukin (IL)-2, and interferon-? may play a role in the development of SS.
There are two cases of pediatric-onset SS who subsequently were diagnosed with CVID. In our case an adult patient with long-standing CVID subsequently developed SS.

Cite this Article: Turkowski Y, Mahalingam M, Konnikov N. Newly Diagnosed Sweet's Syndrome in an adult Patient with a Longstanding Common Variable Immunodeficiency. Sci J Clin Res Dermatol. 2017;2(2): 043-045.

Published: 28 December 2017

Review Article: Adipose Tissue: Function, Adipokines, and Alterations Related with Psoriasis

Gloria Bertha Vega-Robledo*, Diego Oliva-Rico and Guadalupe Rico-Rosillo

Adipose tissue considered as an organ with neuro-immuno-endocrine functions, participates in the homeostasis of the organism. It has a great plasticity and functional variability according to the nutrient intake or with the increase or decrease of its tissue volume, which modifies both the function and the number of the cells that integrate it or reach it. The elements released abnormally by these cells, among others cytokines and adipokines, cause inflammation both local and systemic, mainly when they come from the visceral adipose tissue and can affect diverse organs like the liver and the cardio-vascular system. The damage may also be manifested in the skin by elements from both the local and visceral subcutaneous tissue.
Some inflammatory skin diseases have been associated with the physiological state of adipose tissue and have shown reciprocal expression between inflammatory and lipid genes in the injured skin. It has been pointed out that obesity implies an increased risk of inflammatory skin diseases including eczema, atopic dermatitis and psoriasis, the latter being related to the increase of adipokines and the metabolic syndrome.

Cite this Article: Vega-Robledo GB, Oliva-Rico D, Rico-Rosillo G. Published Date:Adipose Tissue: Function, Adipokines, and Alterations Related with Psoriasis. Sci J Clin Res Dermatol. 2017;2(2): 036-042.

Published: 28 October 2017

Case Report: HIV Positive Patients Adalimumab use with Hidradenite Suppurative Recalcitrant: Challenges and Perspectives

Debora Bergami Rosa Soares*, Roberto Souto, Mario Chaves and Priscilla Magalhaes Parreira De Carvalho

Introduction: Suppurative hidradenitis is a debilitating chronic inflammatory disease with a severity variable spectrum. Increased survival of HIV + patients after the institution of antiretroviral therapy increased the chances of this population to develop chronic diseases. Treatment of hidradenitis in HIV is highly challenging, since most available therapies target some degree of immunosuppression.
Case report: We present the case of a HIV + patient with extensive hidradenitis in the gluteal region refractory to several treatments. We chose to use Adalimumab with excellent initial response, especially in pain, pruritus (itching) and anemia, with response oscillations throughout the follow-up. There was no influence of anti-TNF alpha on viral load, CD4 or any whatsoever opportunistic infection risk.
Conclusion: The patient with HIV may have peculiar aspects in the course of hidradenitis, being able to present atypical and more severe clinical pictures. Immunobiologicals are possibly a therapeutic option in this disease, but studies in this population are relatively insufficient. The use of these medications in HIV + patients does not appear to significantly alter any viral load and CD4, as in the case here presented. However, more studies are vitally necessary to establish the safety and the efficacy of biological therapy in HIV and Hidradenitis patients.

Cite this Article: Rosa Soares DB, Souto R, Chaves M, De Carvalho PMP. HIV Positive Patients Adalimumab use with Hidradenite Suppurative Recalcitrant: Challenges and Perspectives. Sci J Clin Res Dermatol. 2017;2(2): 032-035.

Published: 23 September 2017

Case Report: Primary Cutaneous Cryptococcosis: about a Diffuse Case in a Subject not Infected by HIV in West Africa

Andonaba JB*, Konate I, Ouedraogo AS, Sangare I, Bamba S, Diallo B, Barro/Traore F, Niamba P and Traore A

The Primary Cutaneous Cryptococcosis (PCC) is a fungal infection due to the Cryptococcus neoformans (C. neoformans). It occurs after a transcutaneous inoculation most often among the subject immunocompromized. We report a case of profuse PCC at a young subject, not infected by HIV in West Africa. The observation has concerned a young farmer of 21 years who has presented umbilicated and necrotic papules, festers by location and diffuse, associated with nodular and tumoral lesions, painless and scattered whose the puncture brought back of frank pus. India ink staining showed yeasts compatible with Cryptococcus spp. The histopathology showed of yeasts to Gromori Grocott and the absence of tuberculosis. The patient received fluconazole for his treatment. The observance has not been good and the patient had recourse to the traditional treatments; the death occurred because of hepatitis with ascitic fluid. Better observance of antifungal treatment is able to improve the vital prognosis.
Keywords: Cutaneous cryptococcosis; Immunocompetent; Treatment; Burkina Faso

Cite this Article: Andonaba JB, Konate I, Ouedraogo AS, Sangare I, Bamba S, et al. Primary Cutaneous Cryptococcosis: about a Diffuse Case in a Subject not Infected by HIV in West Africa. Sci J Clin Res Dermatol. 2017;2(2): 028-031.

Published: 04 August 2017

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