Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash,
usually induced by drugs, which recently has been linked to spider bite. We
report a case of a male patient, 48 years old, with an erythematous rash
accompanied by fever and small non-follicular pustules. He reported previous
pain in the buttock with the onset of a necrotic plaque. The lesion was
compatible with spider bite of the genus Loxosceles. According to the EuroSCAR
group instrument, the patient scored +10 indicating definite diagnosis of AGEP.
As the patient had a compatible lesion and had no other triggers of AGEP, in an
Loxosceles endemic area, the AGEP would be associated with spider bite, as
described in other publications.
A case of exuberant pretibial mucinosis in a patient with normal thyroid function
is reported. A review of literature on possible etiologies other than thyroid
disease for the accumulation of mucin in the pretibial area is presented. In the
patient described, it is possible that vascular insufficiency is involved.
However, this is not the only factor responsible for the accumulation of mucin,
since there are still unidentified causes and many patients with vascular
diseases do not develop similar injuries.
Confined hyperpigmentation over areas of resolving psoriatic plaques have been described as lentiginosis, postinflammatory hyperpigmentation, nevus spillus and spleckled pigmentation. We present a case of a 46 year-old patient who developed acanthosis nigricans (AN) and lentiginosis after resolution of psoriasis when treated with adalimumab. The concomitance of the appearance of AN and the use of adalimumab, may reveal that the drug is involved in the development and persistence of the disorder.
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