Idiopathic Papular Dermatitis in the Spectrum of Chronic Papular Eruptions (Subacute Prurigo): Reappraisal and Diagnostic Algorithm.


Journal

Dermatology (Basel, Switzerland)
ISSN: 1421-9832
Titre abrégé: Dermatology
Pays: Switzerland
ID NLM: 9203244

Informations de publication

Date de publication:
2019
Historique:
received: 02 11 2018
accepted: 31 12 2018
pubmed: 6 3 2019
medline: 18 12 2019
entrez: 6 3 2019
Statut: ppublish

Résumé

The clinical diagnosis of papular eruptions is common but poorly characterized in the literature and the etiology is often unknown. To characterize the entity of idiopathic papular dermatitis in the spectrum of chronic papular eruptions. The cohort consisted of patients who presented at a tertiary medical center in 2005-2014 with a papular eruption of at least 4 months' duration. Findings on histological analysis and thorough clinical investigation, performed in all cases, were collected. The patients completed a questionnaire on disease course and outcome. Sixty-five patients were included. Sixteen patients showed morphological changes over time and were excluded. Investigations in the remaining 49 patients with a consistent papular morphology yielded a well-defined diagnosis in 23 (46%). Twenty-six patients (54%; 14 male) were diagnosed with idiopathic papular dermatitis. Their mean age at onset was 61.6 ± 14.4 years and the mean duration of disease 3.11 ± 2.726 years. In 60%, the rash resolved with conservative treatment during follow-up (mean 4.35 ± 2.53 years). Chronic papular eruptions encompass a wide range of skin diseases. In more than half of the cases, the etiopathogenesis remains unclear. On the basis of our results, we propose a diagnostic algorithm for idiopathic papular dermatitis.

Sections du résumé

BACKGROUND BACKGROUND
The clinical diagnosis of papular eruptions is common but poorly characterized in the literature and the etiology is often unknown.
OBJECTIVE OBJECTIVE
To characterize the entity of idiopathic papular dermatitis in the spectrum of chronic papular eruptions.
METHODS METHODS
The cohort consisted of patients who presented at a tertiary medical center in 2005-2014 with a papular eruption of at least 4 months' duration. Findings on histological analysis and thorough clinical investigation, performed in all cases, were collected. The patients completed a questionnaire on disease course and outcome.
RESULTS RESULTS
Sixty-five patients were included. Sixteen patients showed morphological changes over time and were excluded. Investigations in the remaining 49 patients with a consistent papular morphology yielded a well-defined diagnosis in 23 (46%). Twenty-six patients (54%; 14 male) were diagnosed with idiopathic papular dermatitis. Their mean age at onset was 61.6 ± 14.4 years and the mean duration of disease 3.11 ± 2.726 years. In 60%, the rash resolved with conservative treatment during follow-up (mean 4.35 ± 2.53 years).
CONCLUSIONS CONCLUSIONS
Chronic papular eruptions encompass a wide range of skin diseases. In more than half of the cases, the etiopathogenesis remains unclear. On the basis of our results, we propose a diagnostic algorithm for idiopathic papular dermatitis.

Identifiants

pubmed: 30836368
pii: 000496540
doi: 10.1159/000496540
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

205-212

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Ayelet Ollech (A)

Department of Dermatology, Northwestern University, Chicago, Illinois, USA, ayeollech@yahoo.com.
Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel, ayeollech@yahoo.com.

Emmilia Hodak (E)

Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Michael David (M)

Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Akiva Trattner (A)

Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Elena Didkovsky (E)

Institute of Pathology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Lev Pavlovsky (L)

Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.

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