tag:blogger.com,1999:blog-9870114.post886636519592681043..comments2024-03-10T08:41:32.400+00:00Comments on VIRTUAL GRAND ROUNDS IN DERMATOLOGY 2.0: Cheilitis OscuraHumane Medicine Huihttp://www.blogger.com/profile/07113291188306363130noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-9870114.post-12226406919863035812018-01-28T13:58:21.193+00:002018-01-28T13:58:21.193+00:00I agree that there may be a photo allergic compone...I agree that there may be a photo allergic component although she has some fissures in the nares that may indicate staph. Would she benefit from oral antibiotics to treat a perioral Derm picture and Topical tacrolimus .1%. Then she says I need a biopsy at some point if she’s had such extensive patch testing and has eruptions in other parts of the bodyBrendahttps://www.blogger.com/profile/08506887593851634737noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-51546674501149860812012-04-29T15:42:44.192+00:002012-04-29T15:42:44.192+00:00A small biopsy would confirm a spongiotic process,...A small biopsy would confirm a spongiotic process, and further patch testing would then be indicated. Remote psoriasiform diagnoses are also in the differential, including paraneoplastic Bazex syndrome.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9870114.post-43259419740813375762012-04-29T06:12:25.258+00:002012-04-29T06:12:25.258+00:00I agree we need to exclude allergic contact dermat...I agree we need to exclude allergic contact dermatitis by doing a patch test to standard series. If the patch test is negative to standard series, I am not sure if dental tray would be useful. How would one explain the lesions on the fingers and ears? Could this be due to secondary spread?<br /><br />I think a more likely aetiology is this could be a endogenous process esp endogenous eczema triggered by some form of irritation from tooth paste. The lesion is too well demarcated but that does not exclude a irritant dermatitis. I would think psoriasis is a high possibility. Could this be lupus? Was it photosensitive? any serology for ANA done? <br /><br />A more appropriate strength for topical tacrolimus should be 0.1% instead of 0.03%. Advise the patient to avoid local irritation from "strong" dental toothpaste. Use oral-B toothpaste which is much milder.Henry Foonghttps://www.blogger.com/profile/02804592640968503188noreply@blogger.com