Ann Dermatol Vener
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Congenital adipose plantar warts, a recently individualized entity, have an unknown long term evolution. Our patient, seen again aged 28 years represents the longest follow-up of the affection in the literature. ⋯ Congenital adipose plantar warts are characterized by a bilateral, asymptomatic, plantar nodule of the heel, present at birth, corresponding histologically to a normal hypodermis, occasionally with interlobular fibrosis. The follow-up of published cases has only covered childhood. Our observation suggests the persistence of the affection into adulthood. It also emphasizes the possible functional problem created when walking.
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Urticaria is a classic cutaneous manifestation of drug allergy considered like the second most frequent drug eruption after maculopapular exanthemas. Most of the time drugs are responsible of acute urticaria lasting less than 24 hours. The mechanisms of these acute urticarial reactions are multiple, mostly related to an IgE-induced reaction. ⋯ However drugs like nonsteroidal anti-inflammatory drugs and acetysalicylic acid can, by a pharmacologic mechanism, exacerbate or trigger chronic urticaria. Angiotensin-converting enzyme inhibitors, by a defect of degradation of bradykinin, may also induced angioedemas. In this context, if an allergologic investigation is useful in the exploration of acute urticaria, it seems useless for chronic urticaria.
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The official policy of the French National Health Insurance system is to deny reimbursement for drugs prescribed for off-label indications. The objectives of this study were 1) to quantify the use of off-label prescriptions by physicians from a hospital department of dermatology in France; 2) to characterize these off-label prescriptions; 3) to assess data from the literature on the appropriateness of these off-label prescriptions. ⋯ This study showed a great number of off-label prescriptions in dermatology. These prescriptions were often related to rare diseases that were managed by senior dermatologists. These off-label prescriptions were rarely in accordance with data from evidence-based-medicine.