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Methotrexate (MTX), formerly known as amethopterin, is a chemotherapy agent and immune-system suppressant. It is used to treat cancer, autoimmune diseases, and ectopic pregnancy and for medical abortions. Types of cancers it is used for include breast cancer, leukemia, lung cancer, lymphoma, gestational trophoblastic disease, and osteosarcoma. Types of autoimmune diseases it is used for include psoriasis, rheumatoid arthritis, and Crohn's disease. It can be given by mouth or by injection.
Lichen planus (LP) is a chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, and is only named that because it looks like one. It is characterized by polygonal, flat-topped, violaceous papules and plaques with overlying, reticulated, fine white scale, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. Although there is a broad clinical range of LP manifestations, the skin and oral cavity remain as the major sites of involvement. The cause is unknown, but it is thought to be the result of an autoimmune process with an unknown initial trigger. There is no cure, but many different medications and procedures have been used in efforts to control the symptoms.
A papule is a circumscribed, solid elevation of skin with no visible fluid, varying in area from a pinhead to 1 cm. Papules can be brown, purple, pink or red in color, and can cluster into a papular rash. They may open when scratched and become infected and crusty. Larger non-blisterform elevated lesions may be termed nodules.
Polymorphous light eruption (PLE), sometimes also called polymorphic light eruption (PMLE), is a non-life-threatening and potentially distressing skin condition that is triggered by sunlight and artificial UV exposure in a genetically susceptible person, particularly in temperate climates during the spring and early summer. Due to its many clinical appearances, it is named polymorphic or polymorphous and the terms are used interchangeably. The resulting itch can cause significant suffering.
Fox–Fordyce disease is a chronic blockage of the sweat gland ducts with a secondary, non-bacterial inflammatory response to the secretions and cellular debris in the cysts. The inflammation is often accompanied by intense itching. In general, the disease often causes skin to darken near the affected area and raised bumps or papules to appear. In addition, hair follicles can become damaged which cause hair loss. Hidradenitis is very similar, but tends to have a secondary bacterial infection so that pus-draining sinuses are formed. It is a very devastating skin disease that does not have universally curative treatments.
Lymphomatoid granulomatosis is a very rare lymphoproliferative disorder first characterized in 1972. Lymphomatoid means lymphoma-like and granulomatosis denotes the microscopic characteristic of the presence of granulomas with polymorphic lymphoid infiltrates and focal necrosis within it.
Papular mucinosis is a rare skin disease. Localized and disseminated cases are called papular mucinosis or lichen myxedematosus while generalized, confluent papular forms with sclerosis are called scleromyxedema. Frequently, all three forms are regarded as papular mucinosis. However, some authors restrict it to only mild cases. Another form, acral persistent papular mucinosis is regarded as a separate entity.
Gianotti–Crosti syndrome, also known as infantile papular acrodermatitis, papular acrodermatitis of childhood, and papulovesicular acrolocated syndrome, is a reaction of the skin to a viral infection. Hepatitis B virus and Epstein–Barr virus are the most frequently reported pathogens. Other viruses implicated are hepatitis A virus, hepatitis C virus, cytomegalovirus, coxsackievirus, adenovirus, enterovirus, rotavirus, rubella virus, HIV, and parainfluenza virus.
Actinic prurigo is a rare sunlight-induced, pruritic, papular or nodular skin eruption. Some medical experts use the term actinic prurigo to denote a rare photodermatosis that develops in childhood and is chronic and persistent; this rare photodermatosis, associated with the human leukocyte antigen HLA-DR4, is often called "Familial polymorphous light eruption of American Indians" or "Hereditary polymorphous light eruption of American Indians" but some experts consider it to be a variant of the syndrome known as polymorphous light eruption (PMLE). Some experts use the term actinic prurigo for Hutchinson's summer prurigo and several other photodermatoses that might, or might not, be distinct clinical entities.
Prurigo gestationis is an eruption consisting of pruritic, excoriated papules of the proximal limbs and upper trunk, most often occurring between the 20th and 34th week of gestation.
Atrichia with papular lesions is a diffuse hair loss caused by an abnormality of the human homologue of the mouse hairless gene.
Fixed drug reactions, are common and so named because they recur at the same site with each exposure to a particular medication. Medications inducing fixed drug eruptions are usually those taken intermittently.
Lichen myxedematosus is a group of cutaneous disorders considered mucinoses. Conditions included in this group are:
Generalized granuloma annulare is a skin condition of unknown cause, tending to affect women in the fifth and sixth decades, presenting as a diffuse but symmetrical, papular or annular eruption of more than ten skin lesions, and often hundreds.
Cutaneous lymphoid hyperplasia refers to a groups of benign cutaneous disorders characterized by collections of lymphocytes, macrophages, and dendritic cells in the skin. Conditions included in this groups are:
Papular eruption of blacks is a cutaneous condition characterized clinically by small, pruritic papules and histologically by a mononuclear cell-eosinophil perivascular infiltrate.
Pruritic papular eruption (PPE) is characterized chronic pruritus and symmetric papular and pustular on the extensor surfaces of the arms, dorsum of the hands, trunk, and face with sparing of the palms and soles. with the absence of other definable causes of itching in an HIV infected patient. PPE seems to be much more prevalent in less developed regions of the world.
A syphilid is any of the cutaneous and mucous membrane lesions characteristic of secondary and tertiary syphilis.
Sarcoidosis, an inflammatory disease, involves the skin in about 25% of patients. The most common lesions are erythema nodosum, plaques, maculopapular eruptions, subcutaneous nodules, and lupus pernio. Treatment is not required, since the lesions usually resolve spontaneously in two to four weeks. Although it may be disfiguring, cutaneous sarcoidosis rarely causes major problems.
References
- ↑ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 181. ISBN 0-7216-2921-0.
- ↑ Mebazaa A, Kenani N, Denguezli M, et al. (January 2008). "Methotrexate-induced papular eruption following treatment of psoriasis". Ann Pharmacother. 42 (1): 138–41. doi:10.1345/aph.1K271. PMID 18094347.
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