Isolated Erythematous Plaque on Lower Lid in a 12-Year-Old

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. Enhanced computed tomography showed multiple nodules and lymphadenopathies at the mediastinum and axillae. Histopathological examination revealed telangiectasia in the superficial dermis. Atypical lymphoid cells were scattered in the whole dermis and subcutaneous tissue. A perivascular infiltrate of atypical lymphocytes and histiocytoid cells partially destroyed the vessel walls. Epstein-Barr virus in situ hybridization showed a positive result. The cessation of MTX reduced the erythematous plaque, and lymphadenopathies at the neck, mediastinum, and axillae were not palpable. We discuss the relevance of these dermoscopic and histopathological features. The accumulation of such cases will reveal the dermoscopic features of MTX-LPD and the utility of dermoscopy for the diagnosis of MTX-LPD.

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Larva migrans in the oral mucosa: report of two cases

Brazilian Dental Journal ◽

10.1590/s0103-64402011000200014 ◽

2011 ◽

Vol 22 (2) ◽

pp. 166-170 ◽

Cited By ~ 7

Author(s):

José Humberto Damante ◽

Luiz Eduardo Montenegro Chinellato ◽

Fernando Toledo de Oliveira ◽

Cleverson Teixeira Soares ◽

Raul Negrão Fleury

Keyword(s):

Oral Mucosa ◽

Larva Migrans ◽

Common Disease ◽

Erythematous Plaque ◽

Presumptive Diagnosis ◽

Tropical Regions ◽

Linear Pattern ◽

First Case ◽

Histological Characteristics ◽

Posterior Direction

Cutaneous Larva migrans is a very common disease in tropical regions. In the oral mucosa, the infection occurs in the same way as in the skin, but it is rarer. This report describes two cases of Larva migrans in the oral mucosa. The first case was in a 27-year-old woman who presented an erythematous plaque located on the buccal mucosa, extending to a posterior direction, following a linear pattern, to other areas of the mouth. After incisional biopsy of the anterior-most portion of the lesion, morphological details obtained in multiple examined sections suggested Necator or Ancylostoma braziliense larvae as the cause of infection. The second case was in a 35-year-old male who presented a fusiform erythematous plaque in the palatal mucosa. This area was removed and submitted to microscopic examination under a presumptive diagnosis of "parasite migratory stomatitis". The histological characteristics were suggestive of a larva pathway. In both cases the lesion disappeared after biopsy and the patients were symptom-free.

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Alternative Leprosy Treatment Using Rifampicin Ofloxacin Minocycline (ROM) Regimen – Two Case Reports

Serbian Journal of Dermatology and Venerology ◽

10.2478/sjdv-2019-0013 ◽

2019 ◽

Vol 11 (3) ◽

pp. 89-93

Author(s):

Yohanes Widjaja ◽

Khairuddin Djawad ◽

Saffruddin Amin ◽

Widyawati Djamaluddin ◽

Dirmawati Kadir ◽

...

Keyword(s):

Clinical Improvement ◽

Alternative Treatment ◽

Histopathological Examination ◽

Case Reports ◽

Erythematous Plaque ◽

First Case ◽

Satisfactory Outcome ◽

Significant Clinical Improvement ◽

The Right

Abstract Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.

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Lesions of Cutaneous Leishmaniasis Elicited after Local Trauma: A Case Report

Dermatology and Dermatitis ◽

10.31579/2578-8949/008 ◽

2017 ◽

Vol 1 (2) ◽

pp. 01-02

Author(s):

Benjamin Dylan ◽

Hayden Wyatt ◽

Cesar Ricardo ◽

Mitchell Troy

Keyword(s):

Case Report ◽

Cutaneous Leishmaniasis ◽

Simple Procedure ◽

Positive Culture ◽

Medical Community ◽

Erythematous Plaque ◽

Knowing That ◽

Unsuccessful Treatment ◽

The World ◽

Local Trauma

In Brazil there is an average of 30,000 cases of Cutaneous Leishmaniasis reported annually, and around the world it happens for about each 20 seconds. Although there are still opportunities to contribute with studies about this disease; supporting the medical community, especially dermatologists, mainly because of the necessity of knowing that a relatively simple procedure can result such a relevant trauma. Female patients presented erythematous plaque in the limb. Lesion appeared days after laser sessions for hair removal. Biopsy showed amastigotes forms and positive culture. After unsuccessful treatment it was managed with N-methyl glucamine 20 mgSbV/kg/day, during 20 days, there was significant improvement of the clinical picture. This study aims to present a case report of Cutaneous Leishmaniasis initiated after local trauma. Literature reports describe primary or secondary lesions of Cutaneous Leishmaniasis elicited after a local trauma. The mechanism used in order to explain these events was the migration of infected macrophages induced by cytokines. Similar events have also been reported as part of the locus minoris resistentiae concept that comprises situations in which microorganisms have a tendency to settle at places of weakened resistance. Considering that Leishmaniasis lesions are usually developed in promastigote forms are inoculated by the Phlebotominae, in this case it was noted that the infection has been favored by the local trauma.

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Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque

Journal of Cutaneous Pathology ◽

10.1111/cup.13872 ◽

2020 ◽

Vol 48 (1) ◽

pp. 128-132

Author(s):

Ingrid Ferreira ◽

Olivier De Lathouwer ◽

Hugues Fierens ◽

Anne Theunis ◽

Josette André ◽

...

Keyword(s):

Differential Diagnosis ◽

Adenomatoid Tumor ◽

Erythematous Plaque

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Extramammary Paget's Disease: A Case Report

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v8i1.29847 ◽

2020 ◽

Vol 8 (1) ◽

pp. 83-85

Author(s):

Anita Shah ◽

Yogesh Poudel ◽

Anuj Poudel

Keyword(s):

Paget’S Disease ◽

Paget's Disease ◽

Extramammary Paget’S Disease ◽

Erythematous Plaque ◽

Eosinophilic Cytoplasm ◽

Topical Glucocorticoids ◽

Atypical Cells ◽

History Of ◽

White Scale ◽

Extramammary Paget's Disease

A 60- year-old man presented with four year history of a non- healing rash. The rash was pruritic and painless. He had previously been treated empirically with oral and topical antibiotics, topical antifungal agents, and topical glucocorticoids without improvement. The physical examination revealed an erythematous plaque with superficial white scale affecting the skin of the groin and scrotum. Skin biopsy and histopathology revealed epidermal infiltration by large atypical cells that had eosinophilic cytoplasm and prominent nucleoli, findings were consistent with Pagets disease. Extramammary Paget's disease (EMPD) is an intraepithelial adenocarcinoma that is sometimes misdiagnosed as dermatitis clinically. It most commonly involves the vulva and in perianal skin, scrotum, penis and axilla. The patient was kept on regular surveillance. The patient has increased intensity of itching and increase in size of lesion after six months of diagnosis.

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