Laboratory Features Elevation of sarcoplasmic enzymes in serum (creatine phosphokinase, aldolase, transaminases and lactic dehydrogenase) is valuable both for diagnosis and for following the clinic...

Polymyositis and dermatomyositis (first of two parts)

Centers for Disease Control and Prevention (CDC) : Advisory Committee on Immunization Practices (ACIP) : Quadrivalent human papillomavirus vaccine : recommendations of the Advisory Committee on Immunization Practices (ACIP)

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Polymyositis and dermatomyositis (second of two parts).

background The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicella– zoster virus (VZV). We tested the hypothesis that vaccination against VZV would decrease the incidence, severity, or both of herpes zoster and postherpetic neuralgia among older adults. methods We enrolled 38,546 adults 60 years of age or older in a randomized, double-blind, placebo-controlled trial of an investigational live attenuated Oka/Merck VZV vaccine (“zoster vaccine”). Herpes zoster was diagnosed according to clinical and laboratory criteria. The pain and discomfort associated with herpes zoster were measured repeatedly for six months. The primary end point was the burden of illness due to herpes zoster, a measure affected by the incidence, severity, and duration of the associated pain and discomfort. The secondary end point was the incidence of postherpetic neuralgia. results More than 95 percent of the subjects continued in the study to its completion, with a median of 3.12 years of surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster (315 among vaccine recipients and 642 among placebo recipients) and 107 cases of postherpetic neuralgia (27 among vaccine recipients and 80 among placebo recipients) were included in the efficacy analysis. The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1 percent (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5 percent (P<0.001), and reduced the incidence of herpes zoster by 51.3 percent (P<0.001). Reactions at the injection site were more frequent among vaccine recipients but were generally mild. conclusions The zoster vaccine markedly reduced morbidity from herpes zoster and postherpetic neuralgia among older adults.

https://www.nejm.org/doi/pdf/10.1056/NEJMoa051016

A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.

https://www.jidonline.org/article/S0022-202X(15)36098-X/pdf

Global Epidemiology of Psoriasis: A Systematic Review of Incidence and Prevalence

Population-based study of herpes zoster and its sequelae.

Pyoderma gangrenosum (PG) has four distinctive clinical and histologic variants. Some have morphologic and histologic overlapping features with other reactive neutrophilic skin conditions. PG often occurs in association with a systemic disease, and the specific clinical features of the skin lesion may provide a clue to the associated disease. Management of PG depends on its type and severity and usually requires aggressive local and systemic treatment.

Pyoderma gangrenosum: Classification and management

Pyoderma gangrenosum is a rare but significant cause of ulcerations. It is a diagnosis of exclusion. Herein, we suggest diagnostic criteria and some historical perspectives on the diagnosis of pyoderma gangrenosum.

Pyoderma gangrenosum: clinicopathologic correlation and proposed diagnostic criteria.

The clinical, histologic, and immunofluorescent findings in 86 cases of pyoderma gangrenosum seen at the Mayo Clinic between 1970 and 1983 were reviewed. Males and females were affected in equal numbers. The most frequent site of lesions was the leg. Sixty-seven patients (78 per cent) had associated systemic disease, with arthritis and inflammatory bowel disease being commonest. Cutaneous histopathologic changes varied with the site of biopsy. Lymphocytic vasculitis was predominant in the zone of erythema peripheral to the area of ulceration, while neutrophilic infiltrate and abscess formation were more prominent centrally. In most cases studied, direct immunofluorescence showed immunoglobulins and complement deposited in and around superficial and deep dermal vessels.

Pyoderma gangrenosum: a review of 86 patients.

Little information is available concerning the clinical course of lichen planus and its variations. Most of the previous statistical studies date back to the American Dermatologic Association symposium on lichen planus in 1919. These reports, 1-4 however, say little about the course of the disease other than noting its great variability. In 1955 Tompkins 5 reported a follow-up study of 41 patients with lichen planus. He classified the disease into localized, disseminate, and generalized types, depending on the extent of involvement. In the generalized and disseminate cases the tendency was for a more acute onset and spread of the lesions, and usually for a short duration, which averaged 8 months. The localized forms tended toward chronicity and minimal dissemination with an average duration of 3 years and 10 months. Recurrence of lichen planus was noted in 12% of patients after complete clearing had occurred. Another 19% of patients had hypertrophic

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=derm&articleId=526872&pdfFileName=archderm_84_2_001.pdf

Harold O. Perry

Papers

Population-based study of herpes zoster and its sequelae.

Pyoderma gangrenosum: Classification and management

Pyoderma gangrenosum: clinicopathologic correlation and proposed diagnostic criteria.

Pyoderma gangrenosum: a review of 86 patients.

The variations and course of lichen planus.