Kara Adistri; Windy Keumala Budianti; Rhida Sarly Amalia
Abstract
Pityriasis lichenoides chronica (PLC) is a chronic skin disorder with unknown etiology. This disorder still poses difficulty in diagnosis and treatment. Currently, there is no guideline established for the treatment of PLC. Most of the proposed therapy show transient or limited effects. Combination therapy ...
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Pityriasis lichenoides chronica (PLC) is a chronic skin disorder with unknown etiology. This disorder still poses difficulty in diagnosis and treatment. Currently, there is no guideline established for the treatment of PLC. Most of the proposed therapy show transient or limited effects. Combination therapy is usually the best approach. A 40-year-old man presented with erythematous papules appearing recurrently in crops in the last nine months localized mainly to the trunk and proximal extremities. A complete response was not achieved with topical and systemic corticosteroids. The combination of narrowband UVB phototherapy and cyclosporine showed satisfying results following a short duration of therapy. A complete response was seen after eight sessions of narrowband UVB phototherapy. No side effects were observed. The combination therapy of phototherapy and cyclosporine is a potential choice that needs to be considered in the management of PLC.
Delara Babaie; Shabnam Eskandarzadeh; Rudolf Valenta; Mehrnaz Mesdaghi
Abstract
Atopic dermatitis (AD) is a chronic allergic inflammation of the skin. Precise identification of the causative allergen is an important step in the successful treatment of patients with moderate to severe AD. Common diagnostic methods in allergy assess the presence or absence of allergen-specific sensitization, ...
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Atopic dermatitis (AD) is a chronic allergic inflammation of the skin. Precise identification of the causative allergen is an important step in the successful treatment of patients with moderate to severe AD. Common diagnostic methods in allergy assess the presence or absence of allergen-specific sensitization, but none exhibits a complete clinical correlation. Component-resolved diagnostics (CRD) is a new precise method for identifying the culprit allergen. Here, we report the case of a nine-year-old boy with severe AD. He was polysensitized (based on a skin prick test), with a poor response to routine AD therapeutic measures and food elimination diets. He had experienced recurrent flares while under treatment. Skin biopsy confirmed AD. Systemic therapy with cyclosporine (200 mg per day) was initiated and caused significant symptom relief within eight weeks. However, he had a flare when the dose was decreased to 150 mg daily. The causative allergen was diagnosed based on CRD, and he was successfully treated by allergen immunotherapy. CRD can determine the causative allergen in selected polysensitized patients with AD with poor response to treatment. The application of allergen-specific immunotherapy in AD management is controversial, but highly sensitized patients could benefit from it once the diseasecausing allergen is identified.
Sepaskhah Mozhdeh; Maghami Zohreh
Volume 18, Issue 4 , 2015, , Pages 179-181
Abstract
Pityriasis lichenoides is an uncommon, acquired, papulosquamous disorder that exhibits various clinical presentations, including acute, chronic, and febrile ulceronecrotic Mucha- abermann forms. Pityriasis lichenoides chronica (PLC) is the chronic form of this continuum. Its treatment is challenging ...
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Pityriasis lichenoides is an uncommon, acquired, papulosquamous disorder that exhibits various clinical presentations, including acute, chronic, and febrile ulceronecrotic Mucha- abermann forms. Pityriasis lichenoides chronica (PLC) is the chronic form of this continuum. Its treatment is challenging for patients and clinicians and some cases are multidrug resistant. Today, this disorder has many treatment choices, including topical corticosteroids, topical calcineurin inhibitors, phototherapy (ultraviolet (UV) A and narrow band UVB), methotrexate, dapsone, cyclosporine and recently etanercept. In our experience, mycophenolate mofetil was effective as a new treatment for pityriasis lichenoides.
