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Pathergy

Pathergy refers to an abnormal reaction of the skin that occurs in response to minimal trauma. In Pathergy, integrity of tissue is severely disrupted at the site of injury, resulting in exaggerated inflammatory condition. The response to the trauma in Pathergy phenomena is very severe and prominent compared to the normal skin.


Pathergy can also occur at the site of surgical incisions and cause ulcerations. Pathergy condition is more prevalent along the Silk Route, which spans from Japan and China in the Far East to the Mediterranean Sea, including countries such as Turkey and Iran.


Pathergy is often associated with Behcet Disease and also to an extent with Pyoderma Gangrenosum and Sweet Syndrome. The presence of Pathergy reaction is usually diagnosed with the help of Pathergy test (PT). In a Pathergy test, a sterile needle is inserted into the skin and the site is left for observation for one or two days. Skin of the forearm is normally chosen to perform the test. If the pathergy test is positive, a small red bump or pustule forms under the skin where the needle was inserted. This indicates dysfunction of the immune system and its overreaction to a minor injury. A blunt needle is recommended over a sharp one for better diagnosis of Pathergy.


Positive Pathergy is an important criteria for diagnosis of Behcet Disease. However, the test by itself does not confirm Behcet Disease. It is only indicative and has to be supported by other diagnostic procedures.


Dermatoses

Dermatoses are conditions affecting the skin, nails, hair or glands. Dermatoses may be acute or chronic; acute conditions last from days to weeks and chronic conditions last from months to years. Treatment for dermatoses depends on whether the condition is acute or chronic. Most dermatoses respond to treatment with topical corticosteroids.


Dermatosis types and symptoms

Acute dermatoses: Occur suddenly and symptoms include redness, itching and swelling which may further progress to blisters, oozing, scratch marks etc. But usually the symptoms subside in a few days.

Chronic dermatoses: There are small oozing blisters and crusts that may appear thickened discolored and scaly. The skin is cracked and painful.

Subacute dermatoses: Symptoms include scaliness, scratch marks, redness and may peel off. The affected areas do not ooze and do not have blisters.


Dermatosis classification

Dermatosis may be described through the following terms

Lichenification: Thickening and discoloration of skin like the lichen on a tree.

Lesion: Abnormal area of the skin.

Macule: Change in color or consistency of the skin.

Nodule: a bump in the skin that may measure larger than a centimeter in diameter.

Papule: a bump in the skin that may measure smaller than a centimeter in diameter.

Plaque: A large area of affected skin that may flake or peel, it generally has defined edges.

Pustules: A bump that is filled with pus and may have resulted due to an infection.

Rash: A variety of conditions that may show up as red raised up area from the skin and involves inflammation.

Vesicles and bullae: Raised bumps that are filled with fluid.


Various Dermatosis conditions

Acute febrile neutrophilic dermatosis (Sweet's syndrome): Sweet's syndrome is characterized by skin lesions, sore eyes, ache in joints and fever. Red, swollen rashes and papules that are tender. Neutrophilic dermatosis can be caused due to many infections such as IBD, rheumatoid arthritis or upper respiratory tract infections. Rarely it can be a sign of an underlying blood disorder or cancer.

Contagious pustular dermatosis: Also called Contagious pustular dermatitis, it can be contracted from sheep affected with sheep pox, it shows up as papules.

Digitate dermatosis: Finger shaped psoriatic rash at the side of waist.

Dermatosis cinecienta: Symmetrical patches of thickened skin that are ash colored and is generally common in individuals under 40 years.

Dermatosis neglecta: Appears like warts, is a type of plaque caused due to inadequate washing of skin in a particular area. Dermatosis neglecta surfaces in the form of localized scaling and hyperpigmentation.

Dermatosis papulosa nigra: Often seen in dark skin toned people, many small, benign, dark skin lesions are seen on the face.

Linear lichenoid dermatosis: Small and scaly papule, often seen in children.

Transient acantholytic dermatosis or Grover's disease: Chronic, itchy blistering that is usually triggered by heat or sweating. It appears suddenly as itchy red spots on the trunk. It lasts for weeks to months, but resolves spontaneously.

Juvenile plantar dermatosis: Cracking and peeling of the weight-bearing soles of the juvenile plantar dermatosis: cracking and peeling of the weight-bearing soles of the feet in children.

Rheumatoid neutrophilic dermatosis: Skin manifestation of . It manifests as reddish palms and brittle split nails. The skin on the hands might become translucent and wrinkled.



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Bibliography / Reference

Collection of Pages - Last revised Date: June 24, 2019