Tissue swelling, vasodilatation, and the formation of wheals can be prevented by blocking the participating H 1-receptors using antihistamines such as dimetidine and loratadine/desloratadine. Hives, however, involve pruritic, raised skin wheals, which may or may not be edematous. The hallmark of AGEP is an edematous diffuse erythema with the rapid appearance of multiple, sterile non-follicular pustules. Parameters such as pKa and ClogP of the triggering drug, cutaneous fatty acid profile, and ceramide profile enables new concepts in risk assessment and scoring of AGEP as well as prophylaxis outcome. The suggested model of a compartmentalized ceramide metabolism provides a more sophisticated explanation of cutaneous drug adverse effects and the individual sensitivity to UV radiation. This kind of papules are equally present in polymorphous light eruption (PMLE/PLE) and acne aestivalis (Mallorca acne). However, independently from a lysosomomotropic drug, severe depletion of ATP and NAD(P)H, e.g., by UV radiation or a potent photosensitizer can trigger likewise the collapse of the lysosomal transmembrane proton gradient resulting in lysosomal C 16-ceramide synthesis and pruritic papules. Deficiency of NADPH in presence of lysosomotropic drugs promotes the synthesis of C 16-ceramide in lysosomes and may contribute to emerging pruritic papules of AGEP. ELOVL6 and ELOVL7 are sensitive to ROS induced depletion of cellular NADPH and insufficient regeneration via the pentose phosphate pathway and mitochondrial fatty acid oxidation. There is evidence that the individual ability to respond to external oxidative stress is crosslinked with the elongation of long-chain fatty acids to very long-chain fatty acids by ELOVLs. Lysosomotropism is a common charcteristic of various drugs, but independent of individuals. Amiodarone, chlorpromazine, amitriptyline, and trimipramine are classified lysosomotropic as well as photosensitizing, however, they fail to trigger rash and pruritic papules in all individuals. To date, the etiology is not well understood and individual susceptibility still remains unknown. 2020 doi:10.1016/j.jaad.Rash, photosensitivity, erythema multiforme, and the acute generalized exanthematous pustulosis (AGEP) are relatively uncommon adverse reactions of drugs. Journal of the American Academy of Dermatology. Dermatomyositis: Diagnosis and treatment. Genetics and Rare Diseases Information Center. Dermatomyositis: Clinical features and pathogenesis. Clinical manifestations of dermatomyositis and polymyositis in adults. National Institute of Neurological Disorders and Stroke. Risk of cancer appears to level off three years or so after a diagnosis of dermatomyositis. Dermatomyositis in adults has been linked to an increased likelihood of developing cancer, particularly ovarian cancer in women. Signs include a dry cough and shortness of breath. Interstitial lung disease refers to a group of disorders that cause scarring of lung tissue, making the lungs stiff and inelastic. Interstitial lung disease can occur with dermatomyositis. In a small number of people who have dermatomyositis, congestive heart failure and heart rhythm problems develop. Dermatomyositis can cause heart muscle inflammation. Other conditions - such as lupus, rheumatoid arthritis, scleroderma and Sjogren's syndrome - can occur with dermatomyositis. This condition causes your fingers, toes, cheeks, nose and ears to turn pale when exposed to cold temperatures. Dermatomyositis might cause other conditions or put you at higher risk of developing them, including:
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