Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
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J Dtsch Dermatol Ges · Jun 2007
Case ReportsSuccessful etanercept therapy in therapy refractory acrodermatitis continua suppurativa Hallopeau.
A 50-year-old patient presented with erythema, vesicles and pustules as well as interphalangeal joint pain. Acrodermatitis continua suppurativa Hallopeau was diagnosed. She was treated topically with glucocorticosteroids, calcitriol, calcipotriol, tacrolimus and bath-PUVA therapy without any clear benefit. ⋯ Two weeks later the first rebound of pustules occurred. Etanercept was restarted and the patient cleared rapidly. Etanercept therapy can be a useful therapeutic approach in refractory acrodermatitis continua suppurativa Hallopeau.
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The induction of a granulomatous inflammation by jellyfish toxins is rare. More typically, acute toxic and urticarial reactions are seen. An 11-year-old boy developed a striated urticarial erythema on the left cheek after contact with a gelatinous mass while swimming in the sea in Croatia. ⋯ Histological examination revealed a granulomatous inflammation with some eosinophils. While topical steroid-based antiinflammatory and antibacterial therapy over several weeks was not effective, topical therapy with tacrolimus 0.1% for two two-week treatment periods led to healing of the skin changes with a slight scar. There was no clinical recurrence after 5 month of follow-up.