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Case Reports in Dermatology

Takeshi Namiki, Yumiko Sone, Keiko Miura, Masaru Tanaka, Hiroo Yokozeki
Methotrexate-related lymphoproliferative disorder (MTX-LPD) is a rare disorder caused by long-term MTX therapy for autoimmune diseases. There has been no report of the dermoscopic features of MTX-LPD to date. A 64-year-old female presented with a slightly elevated indurated erythematous plaque with scales on her right thigh. The patient had been treated for rheumatic arthritis with MTX and prednisolone for more than 15 years, and 18 mg/week MTX without prednisolone had been administered in the last year. Dermoscopy revealed dotted vessels and glomerular vessels on pink homogeneous areas and multiple surface scales...
May 2018: Case Reports in Dermatology
Sebastian Hoffmann, Mark Berneburg, Stephan Schreml
Bullous pemphigoid (BP) is a blistering autoimmune disease mainly observed in elderly patients. Several triggers are known for this autoimmune disease and some drugs are known to be a cause of BP. However, there are only few case reports on the induction of BP under adalimumab therapy. Other autoimmune diseases, such as lupus erythematosus, are also known to occur under TNF inhibition. Here, we report on an 81-year-old patient who received adalimumab for ulcerative colitis and subsequently developed BP. Other causes of BP (tumors, other drugs, viral or toxoplasma infections) were excluded...
May 2018: Case Reports in Dermatology
Homaid Alotaibi, Fahad Alsaif, Azhar Alali, Mohammed Almashali, Dana Al-Dabeeb, Abdul-Aziz Altaweel
Background: Nevus lipomatosis cutaneous superficialis (NLCS) is a rare hamartoma of mature adipose tissue characterized by solitary or multiple, soft, skin-colored or yellowish lobules that may coalesce to give rise to plaques with a cerebriform surface. There are two clinical types: (1) multiple lesions that are usually presented in a segmental distribution and (2) a solitary papule or nodule. Aim and Objective: To study the clinical and histopathological features of 5 Saudi patients with NLCS...
May 2018: Case Reports in Dermatology
Michael Kunz, Katrin Kerl, Ralph Peter Braun
Basal cell carcinoma (BCC) is the most common cancer in humans worldwide. Many highly specific dermoscopic criteria for BCC are well established in the literature. On the contrary, other malignant or benign skin tumors may mimic BCC by exhibiting similar or even the same dermoscopic features and therefore obscuring the diagnosis of BCC in certain situations. We herein report a case of BCC with dermoscopic features of both BCC and desmoplastic trichoepithelioma (DT). We would like to remind of the often neglected differential diagnosis of DT in a lesion with arborizing vessels and otherwise unusual dermoscopic presentation...
May 2018: Case Reports in Dermatology
Giancarlo Meloni, Massimo Milani
Plantar warts account for 30% of all cutaneous warts. These lesions could be very painful, especially if the lesion is located over pressure sites such as the metatarsal head. Plantar wart treatment remains a challenging therapeutic problem. A 67-year-old immunocompetent nonsmoking man presented with a large mosaic plantar wart on his right foot. The lesion had been present for 5 years. Several cryotherapy sessions (a total of 6 procedures) had been performed with no success. The lesion was therefore treated with a 5-fluorouracil (5-FU) regimen and then with a topical combination of 5-FU and salicylic acid, but also these approaches failed...
May 2018: Case Reports in Dermatology
Shireen Dumont, Marc Péchère, Laurence Toutous Trellu
Background: Prurigo nodularis is a condition of unknown origin defined by papulonodular eruption and intense pruritus. Hodgkin lymphoma often presents nonspecific initial symptoms. An association between systemic malignancy and cutaneous manifestations has long been documented. We report a case of prurigo nodularis as a first presentation of Hodgkin lymphoma. Case: A 35-year-old woman presented with a 2-year history of pruritus. Previously diagnosed with bedbugs, the pruritus persisted even after insect eradication, with the appearance of papulonodular lesions consistent with chronic prurigo...
May 2018: Case Reports in Dermatology
Megan E MacGillivray, Thomas G Salopek
Porphyria cutanea tarda (PCT) is a cutaneous porphyria that presents later in life with cutaneous findings in sun-exposed sites. We report a complex case of PCT in a 67-year-old woman with an unusual constellation of cutaneous findings: scleroderma, acquired ichthyosis, and nonscarring alopecia. Possible triggers for her PCT include tamoxifen treatment for breast cancer and carrier status of the hemochromatosis gene. High-dose chloroquine was used to successfully achieve clinical remission and normalize her uroporphyrins...
May 2018: Case Reports in Dermatology
Yuki Hattori, Kanako Matsuyama, Tomoko Takahashi, En Shu, Hiroyuki Kanoh, Mariko Seishima
Panniculitis is an uncommon skin eruption observed in patients with dermatomyositis (DM)/clinically amyopathic dermatomyositis (CADM), especially in anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive DM. We present here a 51-year-old Japanese woman with an anti-MDA5 antibody-positive DM who initially had cellulitis-like erythema on her right mandible. Histopathological findings showed a subcutaneous lobular infiltration of lymphocytes. The patient developed typical skin eruptions of DM/CADM, rapidly progressive interstitial lung disease, and severe muscle weakness 2 weeks after the first visit...
May 2018: Case Reports in Dermatology
Sahar Alsharif, Sohad Hindi, Fay Khoja
Focal dermal hypoplasia (FDH) or Goltz syndrome is a rare X-linked dominant multisystemic disease involving the ectoderm, mesoderm, and endoderm. About 95% of the cases appear de novo, and 90% of them are females. Recently, the studies revealed that FDH is caused by a mutation in the PORCN gene. We report a case of unilateral FDH or Goltz syndrome in a 16-year-old girl presenting with hypopigmented-reticulated atrophic macules and patches in a linear pattern distributed along the lines of Blaschko over the right side of the face and the right arm...
May 2018: Case Reports in Dermatology
Kathrin Hanfstingl, Agnes Pekar-Lukacs, Reinhard Motz, Emmanuella Guenova, Wolfram Hoetzenecker
Pityriasis rubra pilaris is an inflammatory dermatologic disorder of unknown cause and often confounded with psoriasis. It is characterised by hyperkeratotic follicular papules, scaly erythematous plaques, palmoplantar keratoderma, and a progression to generalised erythroderma. Here, we report the case of a 68-year-old man with pityriasis rubra pilaris, who was successfully treated with ixekizumab, an interleukin-17A inhibitor.
May 2018: Case Reports in Dermatology
Nobuko Tabata, Chiyoko Nagano Inoue
We report a 10-year-old boy with localized scleroderma of the linear and plaque type, who showed proteinuria and hematuria. In this patient, skin, articular, and renal manifestations appeared successively and then began to resolve in the same order. A renal biopsy specimen demonstrated mild mesangial cell proliferation, exudate of immunoglobulin in the glomerular capillary, and large electron-dense deposits in the afferent arteriole. We consider that there were some transient factors that had caused the skin and articular manifestations, which also induced renal vascular inflammatory responses...
January 2018: Case Reports in Dermatology
Kallapan Pakornphadungsit, Poonkiat Suchonwanit, Tueboon Sriphojanart, Pamela Chayavichitsilp
Leukonychia is defined as white discoloration of the nails caused by an abnormal keratinization of the nail matrix. Congenital leukonychia totalis is a rare nail disorder, which is typically inherited in an autosomal dominant pattern. This condition can be presented as an isolated condition or in association with systemic diseases. We report a case of a 7-year-old Thai boy who developed asymptomatic white discoloration of all the nails since birth, with an absence of any predisposing factors or associated conditions...
January 2018: Case Reports in Dermatology
Rawan Amir, Salwa Sheikh
Introduction: Adenolipoma is a relatively recently described lesion representing a rare variant of lipoma in which eccrine glands and ducts are found interspersed amongst mature adipose tissue. This benign lesion was first described by Hitchcock et al. in 1993 [J Am Acad Dermatol 1993; 29: 82-85]. The next case series was written by Ait-Ourhrouil and Grosshans [Ann Dermatol Venerol 1997; 124: 845-848] in which they deemed adenolipoma a misnomer based on the pathophysiology of the lesion and suggested the name peri-sudoral lipoma instead...
January 2018: Case Reports in Dermatology
Jianfeng Zheng, Yunlu Gao, Xuemei Yi, Yangfeng Ding
Acute generalized exanthematous pustulosis, characterized by subcorneal or superficial intraepidermal pustules, is induced by drugs in more than 90% of cases. Psoriasis is an autoimmune disease triggered by different conditions in genetically susceptible people. Generalized pustular psoriasis is an acute and severe clinical form of psoriasis, which usually occurs in patients with psoriasis undergoing aggravating factors. In this report the authors have reported a 40-year-old male patient with primary syphilis who developed generalized pustular dermatosis after the use of ceftriaxone...
January 2018: Case Reports in Dermatology
Ethan Frank, David Macias, Brian Hondorp, Justin Kerstetter, Jared C Inman
Epidermal inclusion cysts are common lesions that rarely develop into squamous cell carcinoma (SCC). Neoplastic change in these cysts can be associated with prominent symptoms such as pain, rapid growth, or ulceration. This study describes the case of a 64-year-old woman with a 4-year history of a largely asymptomatic neck mass, which after routine excision was found to be an epidermal inclusion cyst harboring well-differentiated SCC. The diagnosis was made incidentally after routine cyst bisection and hematoxylin and eosin staining...
January 2018: Case Reports in Dermatology
Anthony M Maher, Chloé E Ward, Steven Glassman, Ivan V Litvinov
Papuloerythroderma of Ofuji (PEO) is an erythroderma-like eruption with flat-topped papules that spare the skin folds (a "deck-chair sign" finding). Many infections, medications, and systemic diseases have been associated with PEO, including cutaneous T-cell lymphomas (CTCL). The relationship between the clinical presentation of PEO and CTCL remains poorly elucidated. Clinical, laboratory, and histopathological data were obtained from the Lymphoma Clinic at the Ottawa Hospital, Canada. We report 5 patients with deck-chair-sign-positive CTCL, mycosis fungoides, and Sézary syndrome variants...
January 2018: Case Reports in Dermatology
Jingwen Tan, Jia Chen, Lianjuan Yang
Schwannoma is a generally benign tumor of the peripheral nerve sheath arising from Schwann cells. Most schwannomas are found on the head and neck. Here, we describe a rare case of benign vulvar schwannoma located at the labium majus which was similar to an epidermoid cyst in clinical appearance.
January 2018: Case Reports in Dermatology
Shi Yao Sam Yang, Wai Mun Sean Leong, Cruz Maria Teresa Kasunuran, Jing Xiang Huang, Sue-Ann Ju Ee Ho, Chen Wee Derrick Aw, Reshma A Merchant
Leprosy is also known as Hansen disease, as in some countries the diagnosis of leprosy carries a negative stigma and patients fear being shunned as outcasts. Presently, leprosy is primarily limited to specific geographical regions in resource-poor countries. As a result, there is increased difficulty for the younger generation of physicians today to correctly identify leprosy due to a lack of exposure and a low-index of suspicion, particularly in developed countries. In this case, the indurated lesions over the face demonstrated a preference for the outer lateral aspects over the maxillary areas, the nose bridge, and the pinna of the ears consistent with the organism's preference for cooler regions of the body...
January 2018: Case Reports in Dermatology
Reda Hesham Saifaldeen, Mohammad I Fatani, Badee Baltow, Abdulmajeed S Khan
Linear psoriasis is a rare form of the disease characterized by the linear distribution of lesions involving dermatome or along Blaschko's lines. Clinically, it may resemble inflammatory linear verrucous epidermal nevus; a combination of history, skin examination, and histopathology are required to ensure correct diagnosis and appropriate therapy. This paper describes a case of a 23-year-old male presenting with unilateral erythematous scaly plaques arranged in a linear path on the left leg. Etanercept was initiated after poor response to adalimumab...
January 2018: Case Reports in Dermatology
Girish Gulab Meshram, Neeraj Kaur, Kanwaljeet Singh Hura
Giant congenital melanocytic nevi (GCMN) are a rare occurrence. Gain-of-function mutation in the NRAS gene is found to be associated with GCMN, causing abnormal proliferation of embryonic melanoblasts. The two major complications associated with GCMN are malignant melanoma and neurocutaneous melanosis. Treatment of GCMN has conventionally been surgical. However, the role of NRAS inhibitors and inactivation of nevus tissue by high hydrostatic pressure are being explored. We present a case of a 1-day-old neonate born with GCMN, along with a review of the literature...
January 2018: Case Reports in Dermatology
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