- Bilateral agminated skin-colored papules and nodules on the dorsum of the hands. [Journal Article]
- IJIndian J Dermatol Venereol Leprol 2018 Aug 14
- Human Cutaneous Protothecosis: A Case Report and Review of Cases from Mainland China, Hong Kong, and Taiwan. [Journal Article]
- MMycopathologia 2018 Aug 16
- We present a case of cutaneous protothecosis caused by Prototheca wickerhamii infection. The patient was a 72-year-old man with hypoalbuminemia. He responded well to fluconazole treatment. We reviewe...
We present a case of cutaneous protothecosis caused by Prototheca wickerhamii infection. The patient was a 72-year-old man with hypoalbuminemia. He responded well to fluconazole treatment. We reviewed this case along with 17 other cases of cutaneous protothecosis reported from mainland China, Hong Kong, and Taiwan. Of the 18 cases, 7 each occurred in mainland China and Taiwan, and 4 occurred in Hong Kong. Thirteen cases were caused by P. wickerhamii (72.2%), and three were caused by P. zopfii (16.7%); in two cases, the species was not identified (11.1%). In all, 9 (50%) patients were immunocompromised, and 10 (55.5%) patients denied having a history of trauma. All patients presented with polymorphic skin lesions, and erythematous papules, plaques, or nodules was the most common presentation (15/18, 83.3%). Genotyping was performed in five cases, mostly by means of small subunit ribosomal DNA amplification (four cases). Susceptibility tests (6 patients) showed that P. wickerhamii was sensitive to amphotericin B and voriconazole but resistant to fluconazole or itraconazole. Treatment succeeded in 15 (83.3%) patients and failed in 3 (16.7%). Our data indicate that the number of cutaneous protothecosis cases is underestimated in China, and the skin lesions have some diagnostic value.
- The utility of FDG-PET/CT imaging in the evaluation of multicentric reticulohistiocytosis: A case report. [Journal Article]
- MMedicine (Baltimore) 2018; 97(33):e11449
- CONCLUSIONS: MRH is a progressive destructive arthritic condition, and early diagnostic and therapeutic strategies are necessary to improve the outcome. FDG-PET/CT and joint ultrasonography might be noninvasive imaging modalities that could help diagnose MRH.
- Lymphedema in patients with hidradenitis suppurativa: a systematic review of published literature. [Journal Article]
- IJInt J Dermatol 2018 Aug 13
- CONCLUSIONS: Lymphedema appears to be a relatively rare complication of chronic HS that most commonly affects the anogenital region. Based on the evidence available, dermatologists should pursue a collaborative approach with surgery in the management of this condition at early stages.
- Unusual presentation of erythema elevatum diutinum with underlying hepatitis B infection. [Journal Article]
- CCutis 2018; 101(6):462-465
- Erythema elevatum diutinum (EED) is a rare, chronic, cutaneous small vessel vasculitis of unclear pathogenesis. Classically, lesions present as symmetric red to purple plaques, papules, and nodules o...
Erythema elevatum diutinum (EED) is a rare, chronic, cutaneous small vessel vasculitis of unclear pathogenesis. Classically, lesions present as symmetric red to purple plaques, papules, and nodules overlying joints. First-line therapy is dapsone. We present a case of EED with widespread lesions involving the hands, extensor arms and legs, and trunk. Multiple biopsies showed concentric intradermal perivascular inflammation with dermal fibrosis and leukocytoclastic vasculitis (LCV) suggesting EED in various stages of evolution. An extensive workup was positive for underlying hepatitis B infection. Our case represents the clinicopathologic spectrum that EED can present and emphasizes the importance of searching for an underlying etiology.
- [Tuberous sclerosis complex: the role of patient's history and clinical examination]. [Journal Article]
- PAPan Afr Med J 2018; 29:147
- Tuberous sclerosis complex (TSC) is a neurocutaneous multisystemic syndrome most commonly affecting the skin, the brain, the kidneys, the lungs and the eyes. The diagnosis is based on clinical charac...
Tuberous sclerosis complex (TSC) is a neurocutaneous multisystemic syndrome most commonly affecting the skin, the brain, the kidneys, the lungs and the eyes. The diagnosis is based on clinical characteristics; 90% of patients have skin lesions and seizures are the initial symptom in 80% of patients. Patients with STB often show a high incidence of neuropsychiatric symptoms, including mental retardation, autism and learning difficulties. Epilepsy and brain and renal tumors are treated with aggressive therapeutic and surgical approaches. We report the case of a 13-year old girl, presenting with a 1-year history of acne resistant to therapy. Clinical examination showed symmetric grouped red papules with smooth surface on the central face and the chin (A). The objective clinical examination also showed frontal fibrous plaques (A), achromic macules on the upper limbs and grayish tumors in the periungual folds of the toes (B). During a new interview, patient's mother reported that these lesions had their onset when the patient was 5 years old, manifesting as seizures at the age of 2 years and disappearing at the age of 6 years, with good psychomotor development. The girl had a history of consanguinity but she had no other family history. Based on these major criteria, the diagnosis of Tuberous sclerosis complex was made. The patient underwent MRI of the brain showing intensely enhanced multiple bilateral subependymal and intraventricular nodules as well as signal abnormalities in the subcortical white matter at the level of the frontal, parietal and temporal area and linear abnormalities in the subcortical white matter. Thoracoabdominopelvic CT scan showed liver and renal lesions suggesting angiomyolipomas. Ophthalmologic examination, electrocardiogram and cardiac ultrasound were normal. Vascular laser treatment of angiofibromas, annual clinical monitoring and paraclinical monitoring every 3 years were proposed to the patient.
- Treatment of Sweet's syndrome in pregnancy. [Journal Article]
- DTDermatol Ther 2018 Jul 25; :e12619
- Pregnancy-associated Sweet's syndrome is a rare occurrence (2%), with good prognosis, spontaneous resolution after delivery, and not increased infant morbidity and mortality. However, differential di...
Pregnancy-associated Sweet's syndrome is a rare occurrence (2%), with good prognosis, spontaneous resolution after delivery, and not increased infant morbidity and mortality. However, differential diagnosis is not easy for physician not familiar with skin lesions. Systemic involvement, even though unusual, might occur in nearly every organ of the body, including pericardium, myocardium, and placenta, as well as one report of early fetal miscarriage, questioning the possibility of risks underestimation. We present two further cases, one occurred in a 31-year-old woman at 26 weeks of gestation and the other on a 26-year-old woman at 24 weeks of gestation, primigravidae. Both presented with tender papules and nodules on their face and upper body parts. Laboratory examinations and skin biopsy histology were pathognomonic. Monitoring of general maternal and fetal conditions showed no signs of sufferance, but the decision to accelerate skin symptoms release, being time to delivery quite distant, challenge the treatment options. There are no recommended treatments for Sweet syndrome and the choice is very limited during pregnancy. A short course of oral steroids was very effective, with lesions healing in few days, no relapses or fetal complications. When pregnant patients exhibit fever, neutrophilia, arthralgia or myalgia, and tender erythematous plaques or nodules, Sweet syndrome should be considered. The trained dermatologist is in the leading position to address the differential diagnosis, reassure the patient, and avoid complications, even if they are rare.
- Peno-Scrotal Elephantiasis Nostras Verrucosa: Rare Disorder in a Young Nigerian. [Journal Article]
- WAWest Afr J Med 2018 May-Aug; 35(2):128-130
- Elephantiasis Nostras Verrucosa (ENV) is a rare cutaneous complication of chronic lymphatic obstruction. It represents the late stage of chronic non-filarial lymphoedema, resulting in the recurrent a...
Elephantiasis Nostras Verrucosa (ENV) is a rare cutaneous complication of chronic lymphatic obstruction. It represents the late stage of chronic non-filarial lymphoedema, resulting in the recurrent and progressive swelling of the affected part, and is marked by both physical and psychological impairment in health-related quality of life. Morphologically it appears as clusters of verrucous (wart-like) papules and nodules arranged in a cobblestone-like pattern, often presenting a mossy appearance. I hereby describe the case of a young man with progressively worsening peno-scrotal ENV; highlighting the delay in diagnosis occasioned by the low level awareness of this harrowing affliction among medical practitioners, and mentioning the negative impact on the patient's health-related quality of life (HRQoL). Filarial lymphoedema is predominantly seen in the tropics; however, despite the dearth of reports, this case confirms the existence of ENV in this region. Following an extensive literature search and to the best of my knowledge, I am yet to come across other reported cases of elephantiasis nostras verrucosa emanating from Africa.
- Flesh-colored papules and nodules on the face. [Journal Article]
- JCJAAD Case Rep 2018; 4(6):512-514
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- Clonal neutrophil infiltrates in concurrent Sweet's syndrome and acute myeloid leukemia: A case report and literature review. [Journal Article]
- CGCancer Genet 2018; 226-227:11-16
- Sweet's syndrome (SS), also known as acute febrile neutrophilic dermatosis is often associated with a hematological malignancy, especially acute myeloid leukemia (AML) and myeloid dysplasia syndrome....
Sweet's syndrome (SS), also known as acute febrile neutrophilic dermatosis is often associated with a hematological malignancy, especially acute myeloid leukemia (AML) and myeloid dysplasia syndrome. Histopathologically, SS is characterized by diffuse infiltrates in the upper dermis, predominantly consisting of mature neutrophils. The origin of neutrophils invading the skin remains unknown. Herein, we report a patient with concurrent acute monoblastic leukemia and SS who initially presented with discrete erythematous papules and nodules on the neck. Single nucleotide polymorphism (SNP) array and next generation sequencing (NGS) revealed a concordant fms-related tyrosine kinase-3 (FLT-3) gene mutation in the bone marrow and skin lesion, indicating that the neutrophilic infiltrates were clonally related to the underlying myeloid neoplasm. This is the first case report of concurrent SS and AML, in which SNP array and NGS analysis were applied to confirm the clonality of the neutrophilic infiltrates.