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Ivermectin (IVM) is a broad-spectrum anti-parasitic drug with significant anti-inflammatory properties. The emergence of treatment resistance to lindane, permethrin, and possibly malathion complicates the global strategy for management of common parasitic skin diseases such as scabies and head lice. In this regard. IVM has been safely and effectively used in the treatment of these common human infestations. In addition, IVM may be useful in inflammatory cutaneous disorders such as papulopustular rosacea where demodex may play a role in pathogenesis. Herein, we review the current applications of topical IVM in dermatology.

Background: Papillomatosis is a known histopathologic pattern usually seen in human papillomavirus (HPV) infection and verruca vulgaris is the typical example. This pattern is also detected in some other benign cutaneous lesions such as nevus sebaceous (NS), seborrheic keratosis (SK), trichilemmoma (TL) and inverted follicular keratosis (IFK). The association between papillomatous lesions and HPV infection is questionable. Objective: The objective of this study was to investigate the presence of HPV deoxyribonucleic acid (DNA) in non-genital benign papillomatous skin lesions (NS, SK, TL and IFK) by polymerase chain reaction (PCR). Materials and Methods: A total of 100 specimens of non-genital NS, SK, TL and IFK were retrieved from archives of Dermatopathology Department of Razi Hospital, between 2003 and 2010. The conventional PCR using consensus GP5+/GP6+ primer and hydroxymethylbilane synthase gene as inner control was performed. Results: PCR for HPV DNA revealed no positive results in any of 28 seborrheic keratosis (SK), 28 nevus sebaceous (NS), 28 inverted follicular keratosis (IFK) and 13 trichilemmoma (TL) studied specimens. Conclusion: Papillomatosis is usually a characteristic pattern of HPV infection. However, we found no association between HPV infection and non-genital benign papillomatous lesions.

Genetic testing revealed a somatic I UBA1 i c.118-1G > C loss of splice-site mutation, and bone marrow biopsy showed vacuolization of erythroid and granulocyte precursors, consistent with VEXAS syndrome. Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome - clinical presentation of a newly described somatic, autoinflammatory syndrome. Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome: a presentation of two cases with dermatologic findings. [Extracted from the article]

Byline: Hayedeh. Ghani-Nejad, Zahra. Hallaji, Maede. Damavandi, Vahide. Lajevardi, Nessa. Aghazadeh, Hooman. Moeini, Sara. Beigi Background: Phototherapy may alter the morphologic features of melanocytic nevi. Dermoscopy is a non-invasive method [...]

Background/Objective: Autoimmune progesterone dermatitis (APD) is a rare autoimmune hypersensitivity reaction that occurs cyclically at the peak of endogenous progesterone production during the menstrual cycle in women. No study characterizing APD in the adolescent population is found; it appears likely to be underdiagnosed and undertreated. Methods: A retrospective, single‐center, review of all adolescent and pediatric patients (<20 years old at onset) with documented diagnosis of APD. Results: Seventeen adolescent APD patients were included (mean age at diagnosis: 14.4 ± 2 years, mean interval of 13.6 ± 11.1 months between symptom onset and diagnosis). Twelve patients presented with urticaria, two with fixed drug eruption. Erythema multiforme, eczema, and recurrent aphthous stomatitis were present in one patient each. Exposure to exogenous progestin was present in two patients prior to disease onset. Progesterone skin test was performed in six patients with positive results in two. Fourteen patients received antihistamines and/or a topical corticosteroid. Combined oral contraceptives (COCs) were given to eleven patients, in seven via continuous daily dosing. Gonadotropin‐releasing hormone agonist (GnRHa) was used in five, progesterone desensitization in four, omalizumab in two, and danazol in one patient. Conclusions: Adolescent APD is associated with a significant delay in diagnosis. The most common manifestation is urticaria. Exogenous exposure to progestins is uncommon in adolescent APD. Continuous COC, GnRHa, and progesterone desensitization have been used to control symptoms. Large, multicenter studies are required to better define, diagnose, and treat this under recognized condition among adolescent patients. [ABSTRACT FROM AUTHOR]

The microscopic features of patch stage Kaposi sarcoma (KS) and interstitial granuloma annulare (GA) may be difficult to differentiate, because both may exhibit a subtle "busy" dermis due to infiltration of spindled cells between collagen bundles. The clinical distinction is particularly challenging in human immunodeficiency virus (HIV)‐affected individuals, as the incidence of GA appears to be greater in the HIV‐infected population. KS is the most common neoplasm in this population. Despite the significant decrease in the incidence of KS since the advent of highly active antiretroviral therapy (HAART), KS tends to occur with late onset and indolent progression in patients with preserved immune function and minimal viral load. We present a 47‐year‐old homosexual HIV‐positive man, under virologic and immunologic control on long‐term HAART therapy, with a 5‐year history of progressive red‐brown patches and plaques on the legs, feet, hands, and trunk. Prior skin biopsy specimens were interpreted as interstitial GA. Histopathology on new skin biopsy specimens along with review specimens supported the diagnosis of plaque and patch stages of KS, respectively, supported by immunohistochemical expression of human herpes virus‐8 (HHV‐8). This case underscores the importance of maintaining a high suspicion for KS in progressive, treatment‐recalcitrant skin lesions, particularly in HIV‐infected individuals. [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this study was to describe a previously unreported association of oral pemphigus vulgaris with short‐lived blood‐filled painless blisters resembling angina bullosa haemorrhagica (ABH). Methods: A cross‐sectional study of consecutive patients with Pemphigus vulgaris. All patients were examined for the presence of ABH‐like lesions, and demographic, clinical and histopathological data were collected. Histopathological examination was performed when feasible. Results: A total of 318 with pemphigus vulgaris were included (63.5% female, mean age: 46 years). ABH‐like lesions were present in 82 (25.8%) patients, commonly observed in the buccal mucosa (47, 57.3%) followed by the palate (15, 18.3%). All patients had normal platelet counts with no evidence of bleeding diathesis. Biopsies of the ABH‐like lesions showed suprabasal clefts in four of six samples. ABH‐like lesions were significantly associated with partial remission of pemphigus vulgaris (47.5%, P = 0.002) and the use of intraoral steroids (P = 0.001, odds ratio: 5.9 [95% confidence interval: 2.5–13.6]). Conclusion: ABH‐like lesions may represent a transient or abortive form of oral pemphigus vulgaris and tend to have a benign and self‐limiting nature. [ABSTRACT FROM AUTHOR]

The article describes the case of a 12-year-old boy with a history of diabetes insipidus since age 10 and diagnosed with Langerhans cell histiocytosis (LCH) with nail involvement. Multiple finger- and toenails showed varying degrees of onycholysis. Magnetic resonance imaging of the patient's head showed thickening of the pituitary stalk without mass lesions. Recognizing the clinical signs of nail LCH can lead to early and definitive diagnosis of LCH.

Background: Papillomatosis is a known histopathologic pattern usually seen in human papillomavirus (HPV) infection and verruca vulgaris is the typical example. This pattern is also detected in some other benign cutaneous lesions such as nevus sebaceous (NS), seborrheic keratosis (SK), trichilemmoma (TL) and inverted follicular keratosis (IFK). The association between papillomatous lesions and HPV infection is questionable. Objective: The objective of this study was to investigate the presence of HPV deoxyribonucleic acid (DNA) in non-genital benign papillomatous skin lesions (NS, SK, TL and IFK) by polymerase chain reaction (PCR). Materials and Methods: A total of 100 specimens of non-genital NS, SK, TL and IFK were retrieved from archives of Dermatopathology Department of Razi Hospital, between 2003 and 2010. The conventional PCR using consensus GP5+/GP6+ primer and hydroxymethylbilane synthase gene as inner control was performed. Results: PCR for HPV DNA revealed no positive results in any of 28 seborrheic keratosis (SK), 28 nevus sebaceous (NS), 28 inverted follicular keratosis (IFK) and 13 trichilemmoma (TL) studied specimens. Conclusion: Papillomatosis is usually a characteristic pattern of HPV infection. However, we found no association between HPV infection and non-genital benign papillomatous lesions. [ABSTRACT FROM AUTHOR]

Kaposi's sarcoma is a low-grade vascular tumor that its prevalence is increasing all around the world due to the increasing prevalence of HIV and organ transplantations. In this study, we assessed risk factors of Kaposi's sarcoma among Iranian patients were referred to Dermatopathology Department of Razi Hospital of Tehran University of Medical Sciences between the years of 2006 to 2011. Also, disease stages have been assessed on pathologic specimens. Thirty four patients diagnosed with Kaposi's sarcoma entered the study. Of the 34 patients, 29% were female, and 71% were male, mean age was 66 years and average disease duration was 6 months. The most common patient's pathologic stages were reported: patch 32%, patch to plaque 24%, plaque 12%. The most prevalent location of involvement was lower extremity (88%), and upper extremity was involved in 24%. At presentation time, the mean number of lesions was 3 to 4. 15% of patients had a history of smoking and 15% had a history of immunosuppressive drugs. HIV infection did not observe in the patients. Based on the present study, Kaposi's sarcoma is a disease of elderly and is higher in older men. The most common site of Kaposi's sarcoma involvement is lower extremity, and the most common pathologic stage was the patch to plaque. [ABSTRACT FROM AUTHOR]