Paradoxical reactions in patients treated with tumor necrosis factor-alpha inhibitors (TNFis) have an estimated prevalence of 1.5% to 5%. Such reactions usually present as psoriasiform eruptions on the trunk and extremities along with palmar and flexural involvement. When affecting the scalp, new-onset psoriasis induced by TNFi can result in non-scarring or scarring alopecia. Although the paradoxical reaction was first reported in 2003, this TNFi-associated psoriatic alopecia (TiAPA) has been recently reported with increasing frequency. This condition is characteristically reversible and requires clinical and histopathological identification from other diseases for proper treatment. The cessation of TNFi therapy may not be mandatory, and decision to continue TNFi therapy depends on the severity of TiAPA and the risk-benefit ratio of treatment modification on the underlying disease. Herein, we report a case of TiAPA in a patient with inflammatory bowel disease whose alopecia improved following suspension of TNFi. We also describe the clinical and histopathological diagnostic criteria based on review of the literature.
The nasal MRSA carriage rate among DHCPs is 2.9%, which is higher than that in the general population but lower than that in other health-care professionals. Further education of DHCPs on MRSA, especially regarding its seriousness, is needed to improve MRSA infection control in a dental hospital setting.
Sarcoidosis is a multisystem inflammatory disease of unknown aetiology. Skin involvement has been reported in 12%–27% of patients with systemic disease, and scar sarcoidosis is a form of sarcoidosis developing in previous cutaneous scar areas. Scars due to all kinds of trauma, including surgery, vaccines, cosmetic tattoos, and herpes zoster infection, have been reported to be associated with sarcoidosis. Upper eyelid blepharoplasty is a mainstay of aesthetic procedure and of surgical rejuvenation of the orbital region. There have been relatively few reported scar sarcoidosis on blepharoplasty scar, considering many blepharoplasty procedures done for the last century. We report a case of 47-year-old woman presented with abruptly forming bilateral scar sarcoidosis on upper eyelid linear scars of 20 years of duration.
Cellulitis is a microbial infection of the deep dermis and the subcutaneous tissue. Several non‐infectious disorders, such as contact dermatitis, insect bites, stasis dermatitis, and lipodermatosclerosis, masquerade as infectious cellulitis. There are no specific criteria for the diagnosis of cellulitis; thus, it is challenging to correctly diagnose true cellulitis. For previously assumed cellulitis cases that were refractory to conventional antimicrobial treatment, thoroughly investigating the circumstances of symptom initiation, recording the medical history, and performing an attentive physical examination of the patient is critical for distinguishing true cellulitis from conditions that mimic cellulitis. The inquiry should be personalised according to the patient's age and the prescribed medication. Furthermore, imaging studies, including ultrasonography and magnetic resonance imaging, should be considered on certain occasions to non‐invasively aid the differential diagnosis.
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