A Case of Linear Exacerbation of Atopic Dermatitis with Secondary Prurigo Nodularis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Inflammatory acquired Blaschko-linear dermatoses (IABLD) are a continuous concept involving diseases such as lichen striatus, blaschkitis, and atopic dermatitis. However, atopic dermatitis that showed increase in severity along Blaschko lines is rarely reported on its own. Herein, we report a rare case of atopic dermatitis with secondary prurigo nodu- laris along Blaschko lines, which may be valuable in broadening the concept of IABLD. A 28-year-old male presented with multiple, pruritic, brownish nodules on the left lower ex- tremity along Blaschko lines for 3 to 4 years. The patient had atopic dermatitis since child- hood. Histopathologic findings revealed compact orthohyperkeratosis, hypergranulosis, spongiosis, and irregular acanthosis in the epidermis. Fibrosis with vertically arranged collagen fibers and perivascular lymphohistiocytic infiltration were shown in the upper dermis. We diagnosed the case as secondary prurigo nodularis along Blaschko lines, accom- panied by the preceding atopic dermatitis. We hypothesized that the patient’s underlying atopic dermatitis increased in severity along Blaschko lines, and prurigo nodularis occurred due to frequent scratching. The lesions improved with topical methylprednisolone cream, oral antihistamines and intralesional triamcinolone injection.
Abstract
Inflammatory acquired Blaschko-linear dermatoses (IABLD) are a continuous concept involving diseases such as lichen striatus, blaschkitis, and atopic dermatitis. However, atopic dermatitis that showed increase in severity along Blaschko lines is rarely reported on its own. Herein, we report a rare case of atopic dermatitis with secondary prurigo nodu- laris along Blaschko lines, which may be valuable in broadening the concept of IABLD. A 28-year-old male presented with multiple, pruritic, brownish nodules on the left lower ex- tremity along Blaschko lines for 3 to 4 years. The patient had atopic dermatitis since child- hood. Histopathologic findings revealed compact orthohyperkeratosis, hypergranulosis, spongiosis, and irregular acanthosis in the epidermis. Fibrosis with vertically arranged collagen fibers and perivascular lymphohistiocytic infiltration were shown in the upper dermis. We diagnosed the case as secondary prurigo nodularis along Blaschko lines, accom- panied by the preceding atopic dermatitis. We hypothesized that the patient’s underlying atopic dermatitis increased in severity along Blaschko lines, and prurigo nodularis occurred due to frequent scratching. The lesions improved with topical methylprednisolone cream, oral antihistamines and intralesional triamcinolone injection.
참고문헌 (7)
- Keegan BR, ""Pediatric blaschkitis" : expanding the spectrum of childhood acquired Blaschko-linear dermatoses", Pediatr Dermatol, 24, pp.621~627 (2007)
- Hladik F, "Atopic dermatitis with increased severity along a line of Blaschko", J Am Acad Dermatol, 53(5), pp.S221~S224 (2005)
- Taieb A, "Lichen striatus : a Blaschko linear acquired inflammatory skin eruption", J Am Acad Dermatol, 25, pp.637~642 (1991)
- López-Cedeño A, "Superimposed linear atopic dermatitis", Pediatr Dermatol, 35, pp.393~395 (2018)
- Van Gysel J, "A linear lesion in a child with atopic dermatitis : not a coincidence", Clin Case Rep, 7, pp.1667~1669 (2019)
- Miyachi Y, "Prurigo nodularis. A possible relationship to atopy", J Dermatol, 7, pp.281~283 (1980)
- Napolitano M, "Effectiveness of dupilumab for the treatment of generalized prurigo nodularis phenotype of adult atopic dermatitis", Dermatitis, 31, pp.81~84 (2020)