MyMedR

We describe a 6-year-old boy with an asymptomatic linear eruption on the left index finger with mild erythema of the proximal nail fold, nail dystrophy, and subungual hyperkeratosis of the nail. A diagnosis of nail lichen striatus was made. The child was successfully treated with a topical corticosteroid. Because of its rarity, nail lichen striatus is often under-recognized. Physicians should be familiar with the nail involvement in individuals with lichen striatus so that an accurate diagnosis can be made and unnecessary investigations and treatment avoided.

Matched MeSH terms: Erythema

Fulltext Parvovirus B19 associated haemophagocytic lymphohistiocytisis in hereditary spherocytosis patient: a case report

Cheong, CS, Gan, GG, Chen, TM, Lim, CC, Nadarajan, VS, Bee, PC

JUMMEC, 2016;19(2):12-16.

MyJurnal

Haemophagocytic lymphohistiocytosis (HLH) is a clinico-pathologic entity caused by increased proliferation
and activation of benign macrophages with haemophagocytosis throughout the reticulo-endothelial system.
Virus-associated HLH is a well-recognised entity. Although majority of parvovirus B19 associated HLH does not
require any specific treatment and carries good prognosis, outcome of children is worse than adults. We report
here a case of HLH associated with acute parvovirus B19 infection in a young healthy patient with underlying
hereditary spherocytosis, with bone marrow findings typical of parvovirus infection. Although this patient
had spontaneous recovery of cell counts, he succumbed due to complication from prolonged ventilation.
Unexpectedly, his immunoglobulin levels were inappropriately normal despite on-going ventilator associated
pneumonia, which reflects inadequate humoral immune response towards infection.

Matched MeSH terms: Erythema Infectiosum

Fulltext Extensive lip ulcers: a case report. Erythema multiforme

Chean KY

Aust Fam Physician, 2014 Jul;43(7):443-4.

PMID: 25006604

Matched MeSH terms: Erythema Multiforme/complications; Erythema Multiforme/diagnosis*

Fulltext Eyelid abscess with dacryocystitis due to burkholderia pseudomallei

Chee, Yik Chang

Borneo Journal of Medical Sciences, 2020;14(3):61-62.

MyJurnal

A 24-year-old female complained of a 2-week history of fever and right-eye swelling. There was no ocular pain, blurring of vision, or history of prior trauma to the affected eye. On examination, she was febrile and not in respiratory distress. The right lower eyelid appeared swollen with skin erythema (Figure 1), while the visual acuity was normal. The white cell count was 14.8 × 103/μL (normal range = 4 – 10 × 103/μL). Her liver and renal function tests were within the normal range. The abdominal ultrasonography revealed multiple splenic microabscesses, while chest radiograph was normal. Contrast-enhanced computed tomography of the orbit showed a right lower eyelid abscess with extension into the right nasolacrimal duct (Figure 2). Incision and drainage of the eyelid abscess were performed and the culture of the pus, as well as the blood, yielded Burkholderia pseudomallei. She received intravenous ceftazidime 2 g every 8 hours for 4 weeks, followed by oral trimethoprim-sulfamethoxazole for 20 weeks’ duration. The right eyelid abscess and splenic microabscesses resolved completely post-treatment. Please interpret the figures and suggest the provisional diagnosis.

Matched MeSH terms: Erythema

Development and evaluation of nanostructured lipid carrier-based hydrogel for topical delivery of 5-fluorouracil

Rajinikanth PS, Chellian J

Int J Nanomedicine, 2016 Oct 5;11:5067-5077.

PMID: 27785014

The aim of this study was to develop a nanostructured lipid carrier (NLC)-based hydrogel and study its potential for the topical delivery of 5-fluorouracil (5-FU). Precirol(®) ATO 5 (glyceryl palmitostearate) and Labrasol(®) were selected as the solid and liquid lipid phases, respectively. Poloxamer 188 and Solutol(®) HS15 (polyoxyl-15-hydroxystearate) were selected as surfactants. The developed lipid formulations were dispersed in 1% Carbopol(®) 934 (poly[acrylic acid]) gel medium in order to maintain the topical application consistency. The average size, zeta potential, and polydispersity index for the 5-FU-NLC were found to be 208.32±8.21 nm, -21.82±0.40 mV, and 0.352±0.060, respectively. Transmission electron microscopy study revealed that 5-FU-NLC was <200 nm in size, with a spherical shape. In vitro drug permeation studies showed a release pattern with initial burst followed by sustained release, and the rate of 5-FU permeation was significantly improved for 5-FU-NLC gel (10.27±1.82 μg/cm(2)/h) as compared with plain 5-FU gel (2.85±1.12 μg/cm(2)/h). Further, skin retention studies showed a significant retention of 5-FU from the NLC gel (91.256±4.56 μg/cm(2)) as compared with that from the 5-FU plain gel (12.23±3.86 μg/cm(2)) in the rat skin. Skin irritation was also significantly reduced with 5-FU-NLC gel as compared with 5-FU plain gel. These results show that the prepared 5-FU-loaded NLC has high potential to improve the penetration of 5-FU through the stratum corneum, with enormous retention and with minimal skin irritation, which is the prerequisite for topically applied formulations.

Matched MeSH terms: Erythema/metabolism; Erythema/prevention & control

Erythema exudativum multiforme following sulphonamide therapy

D'ABRERA VS

Med J Malaya, 1957 Dec;12(2):427-34.

PMID: 13515874

Matched MeSH terms: Erythema Multiforme/etiology*

Fulltext Occupational and Environmental Risk Factors Influencing the Inducement of Erythema among Nigerian Laboratory University Workers with Multiple Chemical Exposures

Reuben U, Ismail AF, Ahmad AL, Maina HM, Daud A

Int J Environ Res Public Health, 2019 04 13;16(8).

PMID: 31013942 DOI: 10.3390/ijerph16081334

: The chemicals from laboratories pose a significant risk forinducing erythema, an abnormal redness of the skin, as a result of poor occupational and environmental factors that promote hypersensitivity to a chemical agent. The aim of this present study was to determine the occupational and environmental risk factors influencing the inducement of erythema in laboratory workers due to exposure to chemicals. This was a cross-sectional study on a population-based sample of Nigerian university laboratory workers. Data were collected using the erythema index meter and an indoor air control meter. The study included 287 laboratory workers. The laboratory workers who properly used personal protective equipment (PPE) were 60% less likely to have induced erythema (adjusted odds ratio (AOR) = 0.40; 95% confidence interval CI: 0.22-0.77; probability value p = 0.011). The chemical mixture exceeding the permissible exposure limit (PEL) was found to have a small effect in inducing the erythema (AOR = 4.22; 95%CI: 2.88-12.11; p = 0.004). Most of the sampled laboratories where the respondents worked had unsuitable temperatures (AOR = 8.21; 95% CI: 4.03-15.01; p = 0.001). Erythema was more frequently found in the respondents who spent 4-5h in the laboratory (AOR = 3.11; 95%CI: 1.77-9.23; p = 0.001). However, high levels of ventilation reduce the likelihood of erythema in a laboratory by 82% (0.18). Multiple logistic regressions revealed that PPE, PEL, exposure time, temperature, and ventilation were the probable predictive factors associated with the inducement of erythema. Providing better educational knowledge and improving the attitude towards hazards and safety in a laboratory would lead to reduced rates of new cases.

Matched MeSH terms: Erythema/chemically induced*

Fulltext Reactive arthritis in tuberculosis: A case of Poncet's disease

Irmi Z, Zaiton A, Faezah H

Malays Fam Physician, 2013;8(1):24-7.

PMID: 25606264 MyJurnal

Reactive arthritis and erythema are uncommon presentations of tuberculosis (TB). Reactive arthritis in tuberculosis (TB) is known as Poncet's disease, a rare aseptic form of arthritis observed in patients with active TB. We report a case of Poncet's disease in a 20-year old man whose reactive arthritis overshadowed other clinical symptoms of TB resulting in delayed diagnosis and treatment. Although a conclusive diagnosis of Poncet's disease is not possible, reactive immunologic reactions such as reactive arthritis and erythema nodosum even without respiratory symptoms should raise suspicion on possible TB. Thus, taking a thorough medical history as well as performing relevant examinations and investigations for possible TB will help expedite the diagnostic process.

Matched MeSH terms: Erythema; Erythema Nodosum

Fulltext Erythema nodosum leprosum in Malaysians

Jayalakshmi P, Ganesapillai T, Ganesan J

Int. J. Lepr. Other Mycobact. Dis., 1995 Mar;63(1):109-11.

PMID: 7730709

Matched MeSH terms: Erythema Nodosum/pathology*

Fulltext Toe-tourniquet syndrome: A rare potentially devastating entity

Baloch N, Atif M, Rashid RH, Hashmi PM

Malays Orthop J, 2015 Nov;9(3):55-57.

PMID: 28611912 DOI: 10.5704/MOJ.1511.008

Toe-tourniquet syndrome is a rare and commonly misdiagnosed condition caused by a hair or a fiber wrapped around digits (fingers and toes). A four months baby girl who was crying and presented with redness and swelling at her 2nd and 3rd toes of right foot. Child had red and swollen 2nd and 3rd toes of right foot with hair end protruding through wounds. Constricting hairs were cut and removed. Toetourniquet syndrome is a rare entity which is caused by hair wrapped around a toe or a digit. Diagnosis is mostly clinical. In order to prevent this condition to happen, education of parents and clinicians is a cornerstone.

Matched MeSH terms: Erythema

Fulltext Contact dermatitis presenting as non-healing wound: case report

Leelavathi M, Le Y, Tohid H, Hasliza A

Asia Pac Fam Med, 2011 May 15;10(1):6.

PMID: 21575147 DOI: 10.1186/1447-056X-10-6

Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-defined ulcer with surrounding erythema and erosion was noted. There was a yellow crust overlying the center of the ulcer and the periphery was scaly. Further inquiry revealed history of self treatment with a yellow solution to clean his wound for 3 weeks. Patient was provisionally diagnosed to have allergic contact dermatitis secondary to acriflavine. Topical acriflavine was stopped and the ulcer resolved after treatment with non-occlusive saline dressing. Skin patch test which is the gold standard for detection and confirmation of contact dermatitis showed a positive reaction (2+) to acriflavine. Acriflavine is widely used as a topical antiseptic agent in this part of the world. Hence, primary care physicians managing a large variety of poorly healing wounds should consider the possibility of contact allergy in recalcitrant cases, not responding to conventional treatment. Patient education is an important aspect of management as this would help curb the incidence of future contact allergies.

Matched MeSH terms: Erythema

Fulltext Leprotic iritis and blindness

Hobbs HE

Int. J. Lepr. Other Mycobact. Dis., 1972;40(4):366-74.

PMID: 4677492

Matched MeSH terms: Erythema Nodosum/complications; Erythema Nodosum/pathology

Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy: results of a randomized trial

Hindley A, Zain Z, Wood L, Whitehead A, Sanneh A, Barber D, et al.

Int J Radiat Oncol Biol Phys, 2014 Nov 15;90(4):748-55.

PMID: 25585779 DOI: 10.1016/j.ijrobp.2014.06.033

We wanted to confirm the benefit of mometasone furoate (MF) in preventing acute radiation reactions, as shown in a previous study (Boström et al, Radiother Oncol 2001;59:257-265).

Matched MeSH terms: Erythema/pathology; Erythema/prevention & control

Objective assessment of psoriasis erythema for PASI scoring

Ahmad Fadzil MH, Ihtatho D, Mohd Affandi A, Hussein SH

J Med Eng Technol, 2009;33(7):516-24.

PMID: 19639508 DOI: 10.1080/07434610902744074

Skin colour is vital information in dermatological diagnosis as it reflects the pathological condition beneath the skin. It is commonly used to indicate the extent of diseases such as psoriasis, which is indicated by the appearance of red plaques. Although there is no cure for psoriasis, there are many treatment modalities to help control the disease. To evaluate treatment efficacy, the current gold standard method, PASI (Psoriasis Area and Severity Index), is used to determine severity of psoriasis lesion. Erythema (redness) is one parameter in PASI and this condition is assessed visually, thus leading to subjective and inconsistent results. Current methods or instruments that assess erythema have limitations, such as being able to measure erythema well for low pigmented skin (fair skin) but not for highly pigmented skin (dark skin) or vice versa. In this work, we proposed an objective assessment of psoriasis erythema for PASI scoring for different (low to highly pigmented) skin types. The colour of psoriasis lesions are initially obtained by using a chromameter giving the values L*, a*, and b* of CIELAB colour space. The L* value is used to classify skin into three categories: low, medium and highly pigmented skin. The lightness difference (DeltaL*), hue difference (Deltah(ab)), chroma (DeltaC*(ab)) between lesions and the surrounding normal skin are calculated and analysed. It is found that the erythema score of a lesion can be distinguished by their Deltah(ab) value within a particular skin type group. References of lesion with different scores are obtained from the selected lesions by two dermatologists. Results based on 38 lesions from 22 patients with various level of skin pigmentation show that PASI erythema score for different skin types i.e. low (fair skin) to highly pigmented (dark skin) skin types can be determined objectively and consistent with dermatology scoring.

Matched MeSH terms: Erythema/pathology*

A Randomized, Single-Blind Trial of Clobetasol Propionate 0.05% Cream Under Silicone Dressing Occlusion Versus Intra-Lesional Triamcinolone for Treatment of Keloid

Nor NM, Ismail R, Jamil A, Shah SA, Imran FH

Clin Drug Investig, 2017 Mar;37(3):295-301.

PMID: 27888448 DOI: 10.1007/s40261-016-0484-x

BACKGROUND AND OBJECTIVE: Keloid is conventionally treated with intra-lesional (IL) triamcinolone, which is highly operator dependent and has its own adverse effects. Topical steroid and silicone dressings are a patient friendly and non-invasive treatment alternative. We therefore sought to determine the efficacy and safety of topical clobetasol propionate (Dermovate(®)) 0.05% cream under occlusion with Mepiform(®) silicone dressing compared to IL triamcinolone in the treatment of keloid.

METHODS: This was a prospective, randomised, observer-blinded study. Two keloids on the same site were randomly assigned to receive either daily topical clobetasol propionate 0.05% cream under occlusion with silicone dressing (Scar 1) or monthly IL triamcinolone injection (Scar 2). Efficacy was assessed using patient and observer scar assessment scale (POSAS) at 4-weekly intervals up to 12 weeks. Dimension of keloid and adverse effects were also assessed.

RESULTS: A total of 34 scars from 17 patients completed the study. There was significant improvement of POSAS at 12 weeks compared to baseline within each treatment group. However, there was no statistically significant difference in POSAS at 12 weeks between the two treatments. Keloid dimensions showed a similar trend of improvement by week 12 with either treatment (p = 0.002 in Scar 1, p = 0.005 for Scar 2). However, there was no significant difference between the treatment. In the IL triamcinolone group, all patients reported pain and 70.6% observed necrotic skin reaction. There was a significantly higher rate of adverse effects such as erythema (41.2 vs. 17.6%), hypopigmentation (35.3 vs. 23.5%), telangiectasia (41.2 vs. 17.6%) and skin atrophy (23.5 vs. 5.9%) documented in the IL triamcinolone group when compared to clobetasol propionate 0.05% cream under occlusion with silicone dressing.

CONCLUSION: Clobetasol propionate 0.05% cream under occlusion with silicone dressing is equally effective and has fewer adverse effects compared to IL triamcinolone. Hence, it may be used as an alternative treatment for keloid particularly in patients with low pain threshold, needle phobia and those who prefers home-based treatment.

Matched MeSH terms: Erythema/epidemiology

Fulltext Histopathology of skin lesions in leprosy

Jayalakshmi

Malays J Pathol, 1980 Aug;3:39-45.

PMID: 7186596

Matched MeSH terms: Erythema Nodosum/pathology

Erythema nodosum-like lesions in a renal transplant recipient

Yap FB, Lee BR

Arch Dermatol, 2011 Jun;147(6):735-40.

PMID: 21690541 DOI: 10.1001/archdermatol.2011.128-a

Matched MeSH terms: Erythema Nodosum/diagnosis*; Erythema Nodosum/drug therapy; Erythema Nodosum/parasitology*

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