TL;DR: Three weeks after a single treatment with no other therapy, pruritus intensity was dramatically reduced to 9 points and pain intensity reduced to an average of 6 points, as shown in Figure 2.
Abstract: DEAR EDITOR, We would like to report on successful treatment of brachioradial pruritus (BRP) with a single application of a high-dose capsaicin patch. Five patients (four women; 54– 69 years old) had been suffering from BRP, confirmed by magnetic resonance tomography, for 72 months (median). The intraepidermal nerve fibre density (IENF) in itchy skin was reduced (4 4 1 1 fibres mm ) compared with their intraindividual nonlesional IENF (17 4 10 2 fibres mm ) (P < 0 05). Pruritus intensity on the visual analogue scale (VAS, range 0–100) ranged from 50 to 80 (average 64 11 4 points; median 65); pain intensity on the VAS ranged from 5 to 90 (average 58 33 3 points; median 65). Dermatological examinations showed scratch lesions in dermatomes C5/C6 in all patients. As previous therapies with anticonvulsants (n = 3) and nonspecific therapies (antihistamines, n = 2) failed, we stopped the medication and in all patients applied the topical capsaicin 8% patch (Qutenza ), with each patch containing a total of 179 mg capsaicin (640 lg cm ). The patch was applied exactly to the itchy area for 60 min (Fig. 1) after pretreatment with topical lidocaine 2 5% containing emollient for 60 min. All patients reported burning pain during the application which lasted for up to 12 h (average 5 2 4 0 h; median 4 h). Directly after removal of the patch, the skin showed self-limited erythema. As shown in Figure 2, 3 weeks after a single treatment with no other therapy, pruritus intensity was dramatically reduced to 9 points (SD 8 9; median 10; P = 0 002). The mean itch reduction was 85% (SD 13 6%) measured by a dynamic score (100% = complete relief). Pain intensity reduced to an average of 6 points (SD 8 9; median, 0 points; P = 0 03). Patients reported improvement starting the day after treatment with capsaicin. The quality of life as measured by the
TL;DR: Adenopathy and extensive skin patch overlying a plasmacytoma is a very rare syndrome featuring a red-to-brown, violaceous skin patch along with aplastic anaemia and a dermal vascular hyperplasia with increased surrounding dermal mucin.
Abstract: Adenopathy and extensive skin patch overlying a plasmacytoma is a very rare syndrome featuring a red-to-brown, violaceous skin patch along with a plasmacytoma. Only 11 case reports exist in the literature. Skin biopsies from the cutaneous patch overlying the plasmacytoma exhibit a dermal vascular hyperplasia with increased surrounding dermal mucin. Radiation therapy is used to treat and cure the plasmacytoma.
TL;DR: Each of these methods is imperfect and in need of greater study using a critical approach, better techniques, more attention to irritant controls, and better definition of atopic populations to provide diagnostic help in patients with difficult-to-manage AD.
Abstract: We have outlined rationale and problems associated with three types of patch tests that may provide diagnostic help in patients with difficult-to-manage AD. Each of these methods is imperfect and in need of greater study using a critical approach, better techniques, more attention to irritant controls, and better definition of atopic populations. Proof of validity for aeroallergen patch testing will necessarily require large quantities of purified antigens. In spite of all these problems, patch testing can be useful and sometimes essential for the diagnosis and management of difficult AD.
TL;DR: A cutaneous patch study was conducted, with standard battery from the Spanish Contact Dermatitis Research Group, vaseline with carbamazepine at 10% and lectures at 48 and 96 hours, and the result was positive for carbamazenine and negative for all other patches in both cases.
Abstract: We present two cases of cutaneous erythroderma induced by carbamazepine therapy, both cases with just cutaneous affection and only one suspicious drug. A cutaneous patch study, with standard battery from the Spanish Contact Dermatitis Research Group, vaseline with carbamazepine at 10% and lectures at 48 and 96 hours, was conducted. The result was positive for carbamazepine and negative for all other patches in both cases. All controls were negative. This is a very simple test, easy to perform, specific and with low side effects, allowing the diagnosis of this pathology.