Eosinophilic fasciitis is an uncommon connective tissue disorder that affects patients of all ages, resulting in significant morbidity. Systemic corticosteroids can induce remission of disease. However, there is no universally accepted treatment ladder for eosinophilic fasciitis. This case series evaluates treatment efficacy in patients with eosinophilic fasciitis seen at Wake Forest University Department of Dermatology outpatient clinics. Patient charts were screened using ICD-9 diagnosis code 710.9 (unspecified diffuse connective tissue disease) to identify patients with eosinophilic fasciitis (n=10) seen at our institution. Patients were treated for an average 24 months with a combination of methotrexate and prednisone therapy, unless one or both were contraindicated, with each medication tapered conservatively to prevent disease flares. Alternate treatments included mycophenolate mofetil with prednisone, azathioprine with prednisone, prednisone monotherapy, and methotrexate monotherapy. Disease remission off therapy and on low-dose therapy was 66 and 70%, respectively. Our first-line therapy of concomitant methotrexate and prednisone is well-tolerated and effective for managing patients with eosinophilic fasciitis. Our study was limited to cases seen at a single academic institution.
Olympic athletes are vulnerable to traumatic, environmental and infectious skin manifestations. Although dermatological complaints are frequent among Olympians, there is a scarcity of literature that reviews sports-related dermatoses among Olympic athletes. A comprehensive review of PREMEDLINE and MEDLINE searches of all available literature through to January 2011 was conducted, focusing on sports-related dermatological presentations as well as the key words 'Olympic athletes' and 'skin diseases'. Common skin conditions can be harmful and even prohibitive for competition. Common aetiologies of dermatological conditions related to sports include: skin infections with dermatophytes such as tinea pedis and tinea corporis, bacteria such as pitted keratolysis, and folliculitis and viruses such as herpes gladiatorum. Frictional dermatoses occur commonly and include athlete's nodules, jogger's itch, frictional blisters, callosities and talon noir. Trauma can cause haematomas such as auricular haematomas. Due to long training hours in the sun, many endurance athletes experience high levels of UV radiation and a higher risk for both melanoma and non-melanoma skin cancer. Pre-existing dermatoses can also be aggravated with practice and competition; in particular, atopic eczema and physical urticarias. Infrequent dermatoses are susceptible to misdiagnosis, delay in treatment and needless biopsies. This review highlights the diagnosis and management of sports-related dermatoses by the following general categories of Olympic sport: endurance, resistance, team sport, and performing arts.
Immunosuppressants are helpful in controlling IBD symptoms and progression but should only be used after a thorough assessment of their risks and benefits in each patient. After the initiation of immunosuppressants, patients should have access to appropriate preventative and treatment modalities for NMSC.
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