Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Jan 2010
ReviewCaterpillars and moths: Part I. Dermatologic manifestations of encounters with Lepidoptera.
Caterpillars are the larval forms of moths and butterflies and belong to the order Lepidoptera. Caterpillars, and occasionally moths, have evolved defense mechanisms, including irritating hairs, spines, venoms, and toxins that may cause human disease. The pathologic mechanisms underlying reactions to Lepidoptera are poorly understood. ⋯ It also reviews the known pathomechanisms of disease caused by Lepidopteran exposures and how they relate to diagnosis and management. Part II discusses the specific clinical patterns caused by Lepidopteran exposures, with particular emphasis on groups of caterpillars and moths that cause a similar pattern of disease. It also discusses current therapeutic options regarding each pattern of disease.
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J. Am. Acad. Dermatol. · Jan 2010
ReviewCaterpillars and moths: Part II. Dermatologic manifestations of encounters with Lepidoptera.
Caterpillars and moths (order Lepidoptera) are uncommonly recognized causes of adverse cutaneous reactions, such as localized stings, papular dermatitis, and urticarial wheals. These reactions are typically mild and self-limited; however, in South America, the sting of Lonomia caterpillars can cause a potentially fatal hemorrhagic diathesis related to massive fibrinolysis. ⋯ Therapies for mucocutaneous reactions to Lepidoptera are largely empiric, with the exception of antivenin against Lonomia obliqua envenomation. Part II of this two-part series on caterpillars and moths reviews the varied symptoms caused by Lepidopteran exposures, reviews the differential diagnosis, and discusses appropriate treatment algorithms.
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J. Am. Acad. Dermatol. · Jan 2010
Stevens-Johnson syndrome and toxic epidermal necrolysis in Asian children.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe drug reactions. There have been few reviews of SJS and TEN in children. ⋯ The use of intravenous immunoglobulins or systemic corticosteroids did not improve the outcome of SJS and TEN.
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J. Am. Acad. Dermatol. · Nov 2009
Review Case ReportsAggressive subcutaneous panniculitis-like T-cell lymphoma with hemophagocytosis in two children (subcutaneous panniculitis-like T-cell lymphoma).
Subcutaneous panniculitis-like T-cell lymphoma is an uncommon form of cutaneous lymphoma in the pediatric population. It is characterized histologically by subcutaneous infiltration of pleomorphic cytotoxic T cells, mimicking a lobular panniculitis. Although usually described as having an indolent clinical course, the condition may be complicated by systemic involvement and hemophagocytic syndrome, resulting in a poorer prognosis. We present two pediatric patients with aggressive forms of subcutaneous panniculitis-like T-cell lymphoma complicated by hemophagocytic syndrome, and discuss the current literature.
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J. Am. Acad. Dermatol. · Nov 2009
Comparative Study Clinical TrialAccuracy of teledermatology for pigmented neoplasms.
Accurate diagnosis and management of pigmented lesions is critical because of the morbidity and mortality associated with melanoma. ⋯ In general, the diagnostic accuracy of teledermatology was inferior whereas management was equivalent to clinic dermatology. However, for the important subgroup of malignant pigmented lesions, both diagnostic and management accuracy of teledermatology was generally inferior to clinic dermatology and up to 7 of 36 index melanomas would have been mismanaged via teledermatology. Teledermatology and teledermatoscopy should be used with caution for patients with suspected malignant pigmented lesions.