What's new in skin diseases?

September 1, 2005

Hepatitis C patients receiving treatment with interferon have a tendency to develop lesions consistent with sarcoidosis, both on the skin and internally.

Chicago - In dermatology it has become almost run-of-the-mill to talk about new treatments, new therapies, new devices and techniques for improving the skin - but what about new diseases? New skin conditions?

J. Mark Jackson, M.D., of Louisville, Ky., says a number of skin conditions may create some diagnostic difficulties for dermatologists simply because they are not commonly seen, but they are appearing more frequently. He updated dermatologists at the American Academy of Dermatology's Academy '05, here, on what to look for.

MRSA

Community-acquired MRSA is similar to the condition that develops and is readily recognizable in a hospital setting because of the frequency of occurrence.

Recently, however, there have been recognized outbreaks of MRSA in community settings. Dr. Jackson says although it appears to respond to oral antibiotics, versus the IV antibiotics required for hospital MRSA, community-acquired MRSA is problematic because it occurs in group-setting environments and has a rapid spread from person to person.

Dr. Jackson says the biggest problem with community-acquired MRSA is the speed with which it spreads.

"Twelve people on a football team get it, then they go home and all of their families get it. It doesn't take long to spread that way," Dr. Jackson says.

He says there really isn't any way to stop the colonization of MRSA.

"It usually colonizes the inner part of the nasal and genital mucosa," he explains. "It doesn't usually cause problems there, so there has been some thought that carriers should treat the nose with topical mupirocin to prevent active infection and spread."

Community-acquired MRSA can be treated with antibiotics such as trimethoprim sulfa, the tetracylines and clindamycin, but it may require prolonged or repeated dosage because of the resiliency of the disease.

NFD

Nephrogenic fibrosing dermopathy is a newly recognized progressive fibrotic skin disorder found in patients with chronic renal failure.

The cause is unknown, but Dr. Jackson says it is found almost exclusively in patients on hemodialysis. Why it affects those people has not been determined.

"Patients get a progressive hardening of the skin of the extremities and restriction of motion because the skin starts to contract because of the tightness of the skin," he explains.

Treatment options are limited. Dr. Jackson recommends physical therapy to maintain range of motion, and notes that improvement in renal function often results in the improvement of the fibrosis. Few studies exist on the condition, but he expects more information to be collected and collated in the next couple of years.

"The patients need fairly potent immunosuppressives, but their underlying health conditions often preclude their use," he says.

Interferon-induced sarcoidosis

Hepatitis C sufferers can develop interferon-induced sarcoidosis.

Hepatitis C patients receiving treatment with interferon have a tendency to develop lesions consistent with sarcoidosis, both on the skin and internally.

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