Journal of cutaneous medicine and surgery
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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.
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Diagnosis of pyoderma gangrenosum can be difficult, leading to overdiagnosis or underdiagnosis. ⋯ Diagnosis of pyoderma gangrenosum should be considered in patients with purulent ulcers affecting the legs or peristomal sites. To confirm the diagnosis, specific features should be sought, including pathergy, crater-like holes or cribriform scarring, and association with inflammatory bowel disease. Other causes of ulceration should be excluded.
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To better understand cutaneous photosensitivity reactions, a review of its etiologic factors, clinical characteristics, pathogenesis, and treatment modalities was undertaken. ⋯ Photoinduced reactions produced by exogenous chemicals are common skin disorders. Definitive therapy requires identifying and removing the offending agent, either the photosensitizing chemical or light. The use of fully protective clothing and a sunscreen of high SPF are important measures when light exposure is inevitable.
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Epidermodysplasia verruciformis (EV) is a rare disorder characterized by widespread flat and common verrucae. From 25% to 50% of EV cases are inherited, usually with an autosomal recessive pattern. An X-linked inheritance has also been reported. Many EV patients have a cellular immunity defect. HIV-associated lesions have been found to contain HPV-5, HPV-8, and HPV-20. ⋯ To our knowledge, this is the first reported case of epidermodysplasia verruciformis in HIV-positive pediatric patients.
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Cutaneous calciphylaxis is a rare disorder that occurs most frequently in patients with end-stage renal disease (ESRD), those on hemodialysis, and renal transplant recipients. It is frequently associated with hyperparathyroidism and a markedly elevated calcium-phosphate product, and it carries a high mortality rate. The usual clinical presentation is of painful, stellate necrosis of the thighs or buttocks, often in the setting of livedo reticularis. Death usually results from septicemia. ⋯ This case demonstrates an unusual clinical variant of calciphylaxis that presented without the characteristic stellate necrosis or livedo reticularis that normally marks this condition and spontaneous resolution without incurring septicemia. Regardless of morphology, calciphylaxis should be considered in the differential diagnosis of painful, necrotic lesions occurring in the setting of ESRD.