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Open Access Publications from the University of California

Scholarly Works (3 results)

  • Article
  • Peer Reviewed
Dermatology Online Journal, Volume 26, Issue 11 (2020)

A 65-year-old man with acute myeloid leukemia 6 was treated by bone marrow allograft, developed a systemic classic chronic graft versus host disease with hepatic, rheumatologic, ophthalmic, and muco-cutaneous involvement. He received systemic corticosteroid, ruxolitinib and extracorporeal photopheresis which resulted in complete remission. During follow-up the patient presented with viral cutaneous warts on his neck and submandibular area. After various subsequent topical treatments, he developed localized cutaneous GVHD without any general GVHD reactivation symptoms. To the best of our knowledge, there has been no description in the literature of a graft versus host disease developing after local immunomodulatory or cytotoxic treatments. Topical therapies are commonly used by dermatologists for superficial skin cancers and some viral skin lesions, in high risk populations such as organ transplant patients with regular follow-up.Practitioners should be made aware of a possible localized cutaneous GVHD reactivation induced by Koebner phenomenon after local therapy.

    Cover page: Iatrogenic cutaneous graft versus host disease.Creative Commons 'BY-NC-ND' version 4.0 license
    • Article
    Dermatology Online Journal, Volume 21, Issue 9 (2015)
    This paper describes a case of pruritus caused by dysmetabolic hyperferritinemia treated by multiple phlebotomies.A 63-year-old man was followed for generalized pruritus, which was resistant to the usual treatments. He presented with metabolic syndrome. Physical examination showed only excoriations and lichenification on the skin. The serum ferritin was high at 1043 ng/ml, with transferrin saturation at 67%. The other biological investigations and genetic tests for hemochromatosis were negative.In spite of the dietary measures, the ferritin level was still high (853ng/ml). Magnetic resonance imaging confirmed hepatic iron overload.The association of hyperferritinemia, hepatic iron overload, and metabolic syndrome led to the diagnosis of dysmetabolic hyperferritinemia.Phlebotomies are an unusual treatment, but because the pruritus and hyperferritinemia were still present, phlebotomy wasinitiated. After 19 months, the patient reported improvement of his pruritus and normalization of ferritin levels.
      Cover page: Generalized pruritus in dysmetabolic hyperferritinemia treated by phlebotomyCreative Commons 'BY-NC-ND' version 4.0 license
      • Article
      Dermatology Online Journal, Volume 25, Issue 2 (2019)
      Acrodermatitis continua of Hallopeau, first described in 1890, is an uncommon variant of pustular psoriasis. It presents as a sterile pustular eruption of the tips of fingers and toes. The condition has a chronic, relapsing course and is often resistant to many anti-psoriatic therapies. In the following case, we present our experience of etanercept use in a 61-year-old man. Although initial therapy with high-dose etanercept achieved a rapid, sustained response and remission, the lesions relapsed a few months into a lower, maintenance dosage. This result prompted the use a second biotherapeutic agent ustekinumab, which resulted in complete remission, but required a higher dosage than recommended with reduced dosing intervals.
        Cover page: Acrodermatitis continua of Hallopeau response to optimized biological therapyCreative Commons 'BY-NC-ND' version 4.0 license
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