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This article in the International Journal of Dermatology examines the management of hospitalized patients with bullous pemphigoid (BP), a skin condition. The study focuses on the use of systemic corticosteroids in severe cases of BP and the challenges in determining appropriate dosages. The researchers conducted a retrospective cohort study of patients admitted to the Italian Hospital of Buenos Aires and found that severe BP patients required higher doses of corticosteroids to achieve disease control compared to moderate cases. The study also highlights the high mortality and re-hospitalization rates among BP patients, with infection being the primary cause. The study suggests the need for specific dosage guidelines for hospitalized severe BP patients and acknowledges the limitations of the study. [Extracted from the article]

Objective The aim of this study was to describe the clinical characteristics of patients with pyoderma gangrenosum ( PG) and to evaluate the association between these characteristics, the treatment followed, and the patient responses, relapses, and mortality rates. Material and methods This retrospective cohort study identified adults diagnosed with pyoderma gangrenosum over the duration of 10 years. Results Thirty-one patients were evaluated; 58% were women and 55% were older than 65 years, 87% presented with the ulcerative type, and 77% showed lower limb compromise. Approximately 74% of the cases were associated with systemic disease. The most frequent were inflammatory bowel disease (32%) and hematologic malignancies (22%). Pyoderma gangrenosum preceded the associated disease in 26% of the patients, all of them were younger than 50 years old ( P = 0.059). In 83% of the latter, the diagnosis of associated disease followed the cutaneous lesions within 24 months. Among the 10 patients with inflammatory bowel disease, six required biologic agents to control the pyoderma gangrenosum ( P = 0.002). Conclusion Despite the advances that have been made in the treatment of patients with pyoderma gangrenosum, we are still unclear as to the optimal way in which patients should be followed up once the diagnosis is made. The results of our study underline the importance of doing screening tests to detect potential disease, emphasizing patients younger than 50 years old, for a minimum time lapse of 24 months. It is essential to design randomized-controlled trials to understand the most appropriate and effective ways of following up patients with pyoderma gangrenosum. [ABSTRACT FROM AUTHOR]

Background Phaeohyphomycosis is an infrequent infection in human beings. However, in recent years, its prevalence has augmented in immunosuppressed patients (mostly in solid organ transplanted patients). Infection can be mucocutaneous or disseminated. In the former, the fungus inoculation occurs mainly through traumatism. Lesions may be polymorphic and asymptomatic, isolated or multiple, and are usually localized in exposed areas of the limbs and head. Treatment is not standardized. When possible, surgical resection of the lesion is combined with systemic antifungals. Methods We communicate three phaeohyphomycosis cases with cutaneous compromise. Results The cases we present show diverse clinical characteristics and varied severity and evolution. Conclusion It is important for dermatologists to recognize this cutaneous fungus infection because the diagnosis using microscopic examination and mycological culture depends on the clinical suspicion. [ABSTRACT FROM AUTHOR]

Background All-trans retinoic acid ( ATRA) is routinely associated with chemotherapy for the treatment of acute promyelocytic leukemia ( APL). Several reports of scrotal ulceration induced by this agent have been made in the recent years. Aims The aim of this article was to report the first case of a lingual ulceration associated with retinoic acid syndrome ( RAS). Matherials and Methods We presented a 32-year-old man with a diagnosis of acute promyelocytic leukemia who received treatment with ATRA. He presented with febrile neutropenia and a lingual ulcer that did not respond to antibiotic and antifungal regimens. He developed weight gain, lower limb edema, polyserositis, and acute renal failure. Retinoic acid syndrome syndrome was diagnosed. Results An exhaustive attempt to exclude infectious causes was made performing repeated cultures, histologic examinations, and direct immunofluorescence for HSV. No causative agent was identified. Re-epithelialization of the ulcer was achieved with ATRA cessation and treatment with systemic steroids. Discussion As far as we are concerned, we report the first case of a lingual ulceration associated with RAS. Conclusion It is important for dermatologists to recognize this cutaneous complication of ATRA as it poses many differential diagnoses in neutropenic patients. [ABSTRACT FROM AUTHOR]

The management of chronic urticaria (CU) has been controversial. Recently updated international guidelines propose evidence-based diagnosis and treatment. Nevertheless, dermatologists have heterogeneous approaches to managing CU. To estimate the percentage of dermatologists who have an optimal approach to CU according to the international guidelines, and to explore the variables associated with optimal management a cross-sectional study using a 17-question survey was delivered by email to dermatologists from Argentina. Optimal first, second, and third line treatment were considered when dermatologists chose a nonsedative antihistamine; increased the dosage of nonsedative antihistamines, and added omalizumab, respectively. Logistic regression was used to identify variables associated with optimal management. A total of 165 questionnaires were available for analysis. An optimal first, second, and third-line treatment approach was identified in 50%, 35%, and 15% of the dermatologists, respectively. The dermatologists' age being above 55 years old (OR: 0.12, 95% CI: 0.01-0.99, p .005) and having more than 5 years of expertise (OR: 0.4, 95% CI: 0.19-0.81, p .001) were significantly associated with a suboptimal approach in second-line treatment. We could not find variables associated with an optimal first or third-line treatment. The real-life management of CU in Argentina is partly suboptimal according to the international guidelines., (© 2019 Wiley Periodicals, Inc.)