Support for a Microbial Basis for Hyperkeratotic Flexural Erythema

Abstract

summer. Increased outdoor activity during warmer weather and subsequent direct exposure to soil (e.g. through gardening) and/or insect vectors (when less clothing is worn) are possible sources of transmission in these cases. Furthermore, a potential zoonotic cycle with possums has been postulated to be involved in the expansion of M. ulcerans infections. 2,6 These mammals are commonly seen in urban Melbourne parks and suburbs thus could act as a reservoir for the infection which can be transmitted to humans, most likely indirectly through faeces. 6 The infection is a public health issue and interventions are necessary to prevent transmission; however, this is challenging as the environmental reservoir and mode of transmission remains unknown.

Clinical features, histology, and treatment outcomes of granular parakeratosis: a systematic review

“…The next most commonly implicated precipitant was benzalkonium chloride, a quaternary ammonium cationic detergent found in household laundry detergents. This, combined with reported resolution observed following treatment with systemic antibiotics, has lent support to the role of an altered microbiome in the development of granular parakeratosis 3,14–16 . However, rare reports of congenital onset, and development of granular parakeratosis following administration of systemic medications, highlight that the exact pathogenesis remains elusive and is a subject that warrants further investigation 17–19 …”

“…This, combined with reported resolution observed following treatment with systemic antibiotics, has lent support to the role of an altered microbiome in the development of granular parakeratosis. 3,[14][15][16] However, rare reports of congenital onset, and development of granular parakeratosis following administration of systemic medications, highlight that the exact pathogenesis remains elusive and is a subject that warrants further investigation. [17][18][19] Notably, our review highlights that findings of parakeratosis and retention of keratohyalin granules within the stratum corneum, despite its name, is not always present on histologic examination of granular parakeratosis.…”

Proceeding report of the third symposium on Hidradenitis Suppurativa advances (SHSA) 2018

“…As evidence, HS generally starts during puberty and often abates following menopause in women, with some women experiencing changes in disease activity in association with the menstrual cycle. Several studies of hormone‐targeting therapies have demonstrated improvement in HS in female patients . Based on these findings, spironolactone may be a potential therapy in females.…”