Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · May 2010
Case ReportsErythema multiforme during anti-tumor necrosis factor treatment for plaque psoriasis.
Tumor necrosis factor alpha (TNF-alpha) inhibitors constitute a class of biologic treatments utilized in the management of psoriasis. We report a case of a patient treated for chronic plaque psoriasis with the anti-TNF-alpha monoclonal antibody adalimumab, who developed erythema multiforme (EM). ⋯ To our knowledge, this is the first case reported in the literature documenting EM occurring subsequent to adalimumab treatment for psoriasis. The recurrent development of EM in our patient while being treated with distinct TNF-alpha inhibitors may suggest that EM is the consequence of a class effect with TNF-alpha inhibitors.
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J. Am. Acad. Dermatol. · Apr 2010
ReviewSystematic review of the safety of topical corticosteroids in pregnancy.
Pregnant women may have skin conditions that require topical corticosteroids. However, little is known about their safety in pregnancy. ⋯ Currently limited and inconclusive data are unable to detect an association between topical corticosteroids and congenital abnormality, preterm delivery, or stillbirth. The current evidence shows no statistically significant difference between pregnant women who use and those who do not use topical corticosteroids. However, there does appear to be an association of very potent topical corticosteroids with low birthweight. Further cohort studies with comprehensive outcome measures, consideration of corticosteroid potency, dosage and indications, and a large sample size are needed.
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J. Am. Acad. Dermatol. · Mar 2010
Case ReportsAn outbreak of Mycobacterium chelonae infections in tattoos.
Nontuberculous mycobacteria infections may occur after cutaneous procedures. Review of the medical records of patients who developed a rash within a tattoo revealed 6 patients with skin infections caused by Mycobacterium chelonae after receiving tattoos by one artist at a single tattoo establishment. The interval between tattoo placement and the skin findings was 1 to 2 weeks. ⋯ Diagnosis was made by culture in 3 patients, histopathology in two patients, and clinical/epidemiologic association in one patient. The M chelonae isolates were clarithromycin susceptible, and the infections responded to macrolide antibiotics. Physicians should consider mycobacterial infections in patients with skin findings within a new tattoo.
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J. Am. Acad. Dermatol. · Feb 2010
Case ReportsTissue gadolinium deposition and fibrosis mimicking nephrogenic systemic fibrosis (NSF)-subclinical nephrogenic systemic fibrosis?
Nephrogenic systemic fibrosis is a condition with significant and often debilitating cutaneous manifestations. Recent research on this disease has delineated an association between nephrogenic systemic fibrosis and exposure to magnetic resonance imaging studies using gadolinium-based contrast agents in patients with ongoing renal failure. ⋯ We describe a hemodialysis-dependent liver transplant recipient who received a gadolinium-based contrast agent and demonstrated insoluble gadolinium deposition in a fibrotic dermis and subcutaneous septum using scanning electron microscopy/energy dispersive x-ray spectroscopy. He has yet to manifest symptoms and signs of nephrogenic systemic fibrosis 3 years after his magnetic resonance imaging study.