Abdullah Alfadley

Treatment of prurigo nodularis with thalidomide: a case report and review of the literature.

A 37‐year‐old man was first seen on 20 March 1997 for a 5‐year history of widespread, persistent, and intensely pruritic skin lesions on all the extremities. Two years following the appearance of prurigo nodularis (PN), the patient developed a major depressive disorder for which he was given antidepressant agents (amitriptyline and clonazepam) by the psychiatrist. His past history also revealed hepatitis B virus infection. Examination revealed numerous, excoriated, erythematous papules and nodules on all extremities of variable size (ranging from 1 to 3 cm), accompanied by secondary pigmentary changes and scars ( Fig. 1 ). Investigations revealed normal complete blood count (CBC), urea, creatinine, and liver enzymes. Hepatitis B surface antigen was positive.

Becker's melanosis: a report of 12 cases with atypical presentation.

Beckers melanosis is a distinct clinical entity. It usually presents in adolescence as a unilateral, hyperpigmented, hairy cutaneous hamartoma. We report herein 12 cases of Beckers melanosis that differ in their presentation from classical Beckers melanosis, and we believe that such presentations are not uncommon.

Extensive Darier's disease with esophageal Involvement

Although the involvement of mucous membranes in Dariers disease is relatively uncommon, Dariers disease has been associated with mucosal lesions, especially in the oral mucosa. In the English literature there is only one report describing the involvement of esophageal mucous membranes in a patient with Dariers disease. Herein, we report the second case of Dariers disease with esophageal involvement.

Anonychia congenita totalis: a case report and review of the literature

A 27‐year‐old man presented with a history of the absence of the nails of all the fingers and toes since birth. His parents were first‐degree cousins and there was no other case in the family. The past medical history was unremarkable. Examination revealed the absence of all the nails of all the toes and fingers ( Fig. 1 ). The teeth and hair were normal and there were no significant skin lesions. Other systemic examinations were normal. X‐Ray of the hands and feet showed the presence of terminal phalangeal bones. The patient was diagnosed with anonychia congenita totalis simplex.

Scleromyxedema: Possible association with seminoma

Although scleromyxedema has been associated with neoplasm in rare instances, the literature showed no evidence of association with seminoma. We report a 43-year-old man who presented with a scleromyxedema and relapsed seminoma. The skin lesions of scleromyxedema cleared completely on treatment of seminoma with chemotherapy.

Lupus erythematosus-associated primary and secondary anetoderma.

Background: Anetoderma (focal loss of dermal elastic tissue) can either be primary, which is an idiopathic occurrence of anetoderma in normal areas of the skin, or secondary, which is preceded by an inflammatory dermatosis in the same location. Objective: Sporadic reports of lupus erythematosus-associated anetoderma have been described in the literature. All reported cases were positive for antiphospholipid antibodies. We present a patient with primary and secondary anetoderma with chronic lupus dermatitis and negative antiphospholipid antibodies. Method and Results: A middle-aged woman presented with a soft nodule with a wrinkled surface on her left arm and an erythematous atrophic plaque with a nodular surface on the chest. Skin biopsy from the left arm showed epidermal atrophy without inflammatory changes. Histologic findings of the lesion on the chest were consistent with chronic lupus dermatitis and secondary anetoderma. Laboratory investigations showed positive antinuclear antibody anti-double-stranded deoxyribonucleic acid (DNA) antibody but negative antiphospholipid antibodies. Conclusion: Primary and secondary anetodermas may occur in patients of lupus dermatitis without positive antiphospholipid antibodies.

Rituximab/IVIG in pemphigus – a 10 year study with a long follow-up

Abstract Background: Pemphigus is a chronic potentially life-threatening autoimmune blistering disease affecting the skin and/or mucous membranes. Rituximab is being increasingly used and found efficacious in the treatment of pemphigus. Objective: To present the Middle-Eastern experience with the use of rituximab in pemphigus. Methods: A retrospective analysis of patient files was conducted which revealed 23 patients of pemphigus who were treated with rituximab (either alone or with IVIG) in the dermatology department of a tertiary care hospital from July 2004 to December 2014. Results: The mean time to disease control was 8 weeks (median 5 weeks and range 2–30 weeks). 90.9% attained early study end point with the first cycle of rituximab. The remaining 9.1% needed an additional course of rituximab + IVIG to attain disease control. 90.5% of our patients attained complete remission during the study period. The average time to attain complete remission on minimal treatment was 25.4 weeks and partial remission on minimal treatment was attained after a mean period of 18.3 weeks. Rituximab was well tolerated by our patients and the rate of adverse-effects in our cohort was comparable to the previous reports. Conclusions: Rituximab is an effective and safe treatment for pemphigus and should be considered earlier in the algorithm of pemphigus treatment.