Journal of cutaneous medicine and surgery
-
Review
A refresher on herpes zoster, current status on vaccination, and the role of the dermatologist.
Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a significant impact on quality of life. PHN is often chronic and difficult to treat. Dermatologists have always been involved in making the diagnosis of these conditions and, most recently, teaching the need for early antiviral therapy. ⋯ Dermatologists should embrace zoster vaccination and recommend routine vaccination of immunocompetent individuals > age 60 years, as well as patients of any age who are starting immunosuppressants, including biologics. Given that individuals over age 50 years are at risk for PHN and studies have shown that the vaccine's immunogenicity and safety are maintained in individuals age 50 to 59 years, vaccination in this age group may be considered. Some dermatologists may consider vaccinating their own patients, but most will likely recommend that vaccination be performed by their patients' primary care physicians.
-
Postinflammatory hyperpigmentation (PIH) commonly occurs in Fitzpatrick skin types III to VI and can have a considerable impact on quality of life. The majority of cases will improve spontaneously, but this can take months or even years to resolve and in some cases can be permanent. Treatment may be prolonged, lasting 6 to 12 months or longer for adequate restoration of normal pigmentation. ⋯ More randomized controlled clinical studies in large numbers of PIH patients are needed to provide standardized measurable outcomes in this indication.
-
Sarcoidosis is a systemic disease that may present as tattoo granulomas. ⋯ Sarcoid granulomas may develop in tattoos as an isolated local reaction or as the presenting sign of systemic sarcoidosis. The reaction itself may provide insight into further understanding the pathogenesis of sarcoidosis.
-
Review Case Reports
Cutaneous Rosai-Dorfman disease: comprehensive review of cases reported in the medical literature since 1990 and presentation of an illustrative case.
The latest comprehensive review of primary cutaneous Rosai-Dorfman disease was published as part of an exhaustive survey of sinus histiocytosis with massive lymphadenopathy in 1990. Since then, much progress has been made in the understanding of malignant lymphoma and benign disorders of lymphoid and histiocytic origin. ⋯ Purely cutaneous disease without the characteristic lymphadenopathy is rare but has been increasingly reported in the literature. Compared with patients with systemic Rosai-Dorfman disease, patients with primary cutaneous Rosai-Dorfman disease are older, women are more commonly affected, and whites are more likely than blacks to be afflicted.
-
This article provides a practical overview of dermatologic medication use in pregnancy. ⋯ At the end, the reader is challenged with a series of applied clinical scenarios that highlight the presented material and provide information on additional important medications.