scholarly journals Blaschkoian Lichen Planus in an Amazghi; A Rare Case Report

2014 ◽  
Vol 8 (1) ◽  
pp. 45-50
Author(s):  
Ebtisam Elghblawi

Lichen planus (LP) is a common acquired inflammatory dermatosis of unknown origin with several morphological forms. Linear lichen planus is frequently seen but cases of zonal/ zosteriform/ dermatomal/ blaschkoid LP are rare. Typically LP is merely acknowledged as an old companion to a dermatologist in the clinic. Nonetheless sometimes it comes in masquerades. Many reports have documented LP to occur in scars of previous herpes zoster (HZ) lesions. Zosteriform LP without evidence of HZ is an extremely rare occurrence in the head and neck area. To the best of my knowledge such a condition has not been reported in the literature previously. I report a healthy 53-year old Amazaghi woman with grouped lichenoid, unilateral linear plaque skin lesion on the right side of the face that followed the lines of Blaschko with no previous history of HZ on the involved area. The punch biopsy specimen confirmed the typical histology of lichen planus. A clinical diagnosis was made based on the clinical picture and biopsy reading. Usually Blaschko linear skin lesions develop later in life with distinctive features, and thus it should be differentiated from other acquired skin dermatoses. I report this case of LP type for its scarcity and to add one more case to the list of existing literature, with the idiosyncrasy of late presentation onset.

Author(s):  
Zulqarnain Masoodi ◽  
Johannes Steinbacher ◽  
Peter Wimberger ◽  
Peter Tadeusz Panhofer ◽  
Chieh-Han John Tzou

Chronic skin lesions of the thigh (wounds, fistulas etc) are relatively uncommon, vis-à-vis, their notorious cousins over the distal limb. Even when present, the cause is usually obvious, mostly as trauma or a systemic affliction. We present an unusual case of chronic fistulas over the right thigh in a patient of carcinoma rectum for which anterior resection and an end colostomy was done 4 years earlier. Postsurgical pelvic abscesses finding their way into the thigh are a known entity, but they are usually accompanied by systemic/local features and their presentation is within a shorter time span. The novelty of our case lies in its manifestation (as a cluster of chronic fistulas and not a frank abscess), its late presentation as well as in the absence of any systemic/local inflammatory signs. Our primary objective is to educate wound physicians about the origin of such fistulas whenever they deal with patients who have had a preceding surgical intervention of the abdomen. In our humble opinion, this will ease out many diagnostic and management dilemmas, that such patients can potentially pose.


2017 ◽  
Vol 2 (1) ◽  
pp. 145-147
Author(s):  
Sairil Pokharel ◽  
S Karki ◽  
A Pradhan ◽  
S Agrawal

Melanotrichoblastoma is a variant of pigmented trichoblastoma. It shows heavily pigmented epithelial lobules and differentiaion toward the hair bulb. Abundant dendritic melanocytes are found within the tumor masses. These melanocytes show positivity for S100 protein, HMG45/gp 100 and tyrosinase. The case is being reported because of its rarity.A twenty eight year lady presented to Dermatology OPD with a single nodular lesion on the right temporal region since last five years. Punch biopsy was done. Haematoxylin and eosin stained slides were studied and immunohistochemistry analysis was also done.Variably sized epithelial lobules of basaloid cells spanning the entire dermis was noted on H and E stained slides. Some lobules showed pale looking cells- a reminiscent of follicular germinative cells. Intralesional melanocytes with pigmentation were observed. Immunohistochemistry results showed the melanocytes positive for HMB-45 and S100 and the stroma positive for CD 34. Hence, a definitive diagnosis of Melanotrichoblastoma was made.This case is being presented to emphasize the difficulty posed by adnexal tumors in clinical diagnosis due to their clinical similarity with malignant lesion and rarity.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017


2005 ◽  
Vol 42 (3) ◽  
pp. 378-381 ◽  
Author(s):  
Y. Kim ◽  
S. Reinecke ◽  
D. E. Malarkey

A 1-year-old, spayed, female, mixed-breed dog had two reddish-purple cutaneous lesions, one on the right dorsal antebrachium and the other on the right shoulder. The lesions consisted of approximately 13 x 3 cm and 15 x 10 cm, irregular, patchy regions of 0.5-3.0 cm, circular, sometimes raised, reddish-purple swellings resembling ecchymoses. The lesion on the antebrachium had been noticed since the dog was adopted at 6 months of age and appeared to have increased in size over an 11-week period, at which time skin punch biopsy revealed an infiltrative pattern of well-differentiated blood vessels leading to an interpretation that the lesion was a well-differentiated hemangiosarcoma. The second lesion was revealed when the dog had its fur shaved in that area during surgical preparation to excise the antebrachial lesion. No other skin lesions were found on the dog. Microscopically, there was a widely disseminated and infiltrative-like pattern of benign-appearing small blood vessels, which were throughout the superficial and deep dermis and subcutis. Although the disseminated nature suggested malignancy, the histologic appearance of well-differentiated small blood vessels and nonprogressive clinical features indicate that the lesions were benign. The dog has been followed for 6 years and to date has no evidence of progression of the antebrachial lesion or shoulder lesion. To the authors' knowledge, this is the first report of a congenital angiomatosis-like lesion in a young dog, with extensive involvement of the forelimb.


2018 ◽  
Vol 16 (1) ◽  
pp. 70-71
Author(s):  
Niharika Jha ◽  
Bimal Kanish ◽  
Anuradha Bhatia

Lichen planus (LP) is a papulosquamous disorder characterized by violaceous, flat topped papules and plaques seen on the volar aspect of the wrists, lumbar region and around the ankles. It can have a varied presentation. Here we describe a rare variant of LP in a female who presented with unilateral eruptions of violaceous papules over the right side of the body.


2011 ◽  
Vol 3 (4) ◽  
pp. 153-158
Author(s):  
Zorica Perić-Hajzler ◽  
Lidija Zolotarevski ◽  
Dušan Šofranac ◽  
Lidija Kandolf Sekulović

Abstract Lichen planus is an acquired inflammatory disease of the skin, mucous membranes and nails. It is characterized by pruritic polygonal livid papules. The disease was first described by Erasmus Wilson in 1869. It is primarily a disease of adults, and it usually occurs between the ages of 30 and 60, without gender predominance. The exact incidence and prevalence of this disease are unknown, but it is thought to affect less than 1% of the general population (0.14 to 0.80%) (1). A 63-year old male patient was admitted to our Department with itchy erythematous papules and plaques which appeared a month before admission. On admission, numerous erythematous and livid papules and plaques of polygonal shape up to 5 mm in diameter were present in the lines of Blaschko, along the left lower extremity, left side of the trunk and the left upper arm (Figures 1-3), while mucous membranes, nails and scalp were spared. Blaschko-linear distribution of skin lesions was first described by a German dermatologist Alfred Blaschko in 1901 in his work ”The distribution of nerves in the skin and their relationship to diseases of the skin”. In 1978, Happle first published that genetic mosaicism was the cause of these peculiar skin changes (1,4,6). Although knowledge of mosaicism in the skin was further elucidated in articles of several authors (Taieb in 1994, Bolognia in 1994, Heide 1996), the exact mechanism and molecular basis for the development of Blashcko linear distribution has not been fully clarified yet (5). Blaschko lines may be related to X-linked, congenital and inflammatory dermatoses, and they may be found in several skin conditions like segmental forms of atopic dermatitis, erythema multiforme, pemphigus vulgaris, vitiligo, and granuloma annulare. This is a case report of a patient with a rare form of lichen planus, with typical clinical manifestations and with Blaschko-linear distribution. Lichen planus in the lines of Blaschko was also described in several other dermatoses: lichen striatus, lichen sclerosus, morphea, porokeratosis of Mibelli, mucinosis follicularis and psoriasis vulgaris. The treatment included topical corticosteroids under occlusion, due to comorbidities, with satisfactory response. Other options include, topical calcineurin inhibitors, intralesional and systemic corticosteroids, retinoids, phototherapy and in resistant cases that severely affect the quality of life methotrexate, cyclosporine and thalidomide.


2015 ◽  
Vol 7 (1) ◽  
pp. 15-22
Author(s):  
Dragana Ljubisavljević ◽  
Zorana Zlatanović ◽  
Radmila Milenković ◽  
Danijela Popović ◽  
Mirjana Paravina

Abstract Verrucous epidermal nevi are noninflammatory, congenital, cutaneous hamartomas composed of keratinocytes, abnormal clone(s) of cells that reflect genetic mosaicism arising from different somatic mutations. Some of these mutations are well recognized, but some are still unidentified. Molecular techniques are used for identification and classification of molecular causes of certain epidermal nevi, whereas all verrucous epidermal nevi are divided into epidermolytic and non-epidermolytic types. They are typically present at birth, but may appear during childhood, even later. Their prevalence in adults ranges from 0.1 to 0.5%, equally affecting both sexes, and about 1 in 1000 newborns. Warty, brown papules without inflammation distinguish verrucous nevi from other epidermal nevi, while presence at birth and persistance distinguish verrucous epidermal nevi from linear viral warts. Epidermolytic and non-epidermolytic verrucous epidermal nevi are almost always hard to distinguish, except by histology. As a rule, verrucous epidermal nevi are asymptomatic, they have a benign course, except occasionally, and therapy is mostly used for cosmetic reasons. Simple excision is usually the treatment of choice. Topical agents are rarely curative, as well as surgery which is associated with relapses, unless both epidermis and the underlying dermis are removed or destroyed at the same time. We present a case of an otherwise healthy 21-year-old female patient, who presented with a solitary congenital verrucous cauliflower-like lesion in the right zygomatic region of the face. The lesion was present from birth. Due to its gradual growth during years, the lesion became a great esthetic and functional problem for this young patient. There was no family history of similar or any other tumorous skin lesions in the family. On examination, the patient had a solitar unilateral, well defined yellowish cauliflower-like verrucous lesion confined to the right malar side of the face. The lesion was distributed along the lines of Blaschko extending horizontally, from its wider 1.5 cm cauliflower-like part on the right zygomatic region, towards its tail-like 0.5 cm thick end on the preauricular region, in approximately 3 cm long tail-like manner without crossing the midline. Since the patient refused biopsy, no exact differentiation between epidermolytic and non-epidermolytic nevi was possible. The diagnosis of verrucous epidermal nevus was based on history and clinical presentation, as a diagnosis of exclusion. Due to the fact that patients with epidermolytic verrucous epidermal nevi are at risk of parenting a child with bullous ichthyosiform erythroderma, the patient was counseled on this risk, and on the possibility of first-trimester antenatal diagnosis. The lesion was successfully treated by radio-wave surgery.


Author(s):  
Sujit S. Prabhu ◽  
Kenneth D. Aldape ◽  
Janet M. Bruner ◽  
Jeffrey S. Weinberg ◽  
Jeffrey S. Weinberg

Background:We report a case and review the recent literature describing 36 patients with both Lhermitte-Duclos disease (LDD) and Cowden disease (CD). Lhermitte-Duclos disease, or dysplastic gangliocytoma, is a benign hamartomatous condition involving the cerebellum. The presenting symptoms are usually headaches, gait ataxia, and symptoms of lower cranial nerve involvement. Cowden disease is a rare autosomal dominant disease that usually presents with multiple mucocutaneous lesions. Patients with CD are prone to multiple systemic malignancies, the most common of which is breast cancer. Recent studies have demonstrated an association between LDD and CD.Methods:A 44-year-old woman with a previous history of breast cancer, multiple benign skin lesions, Hashimoto's thyroiditis, and chronic headaches presented with exacerbation of her headaches during the previous year. Magnetic resonance imaging of the brain revealed a right cerebellar nonenhancing mass and an acquired tonsillar herniation.Results:The patient underwent resection of the right cerebellar mass, posterior fossa decompression, C1 and C2 laminectomies, and a duraplasty. Pathologic examination confirmed LDD. The patient recovered well after surgery, with immediate improvement of her headaches.Conclusion:The association between LDD and CD has been under-recognized and under-reported. Recognition of this association has direct clinical relevance, because diligent monitoring of individuals with LDD and CD may lead to the early detection of systemic malignancies.


2021 ◽  
Vol 5 (5) ◽  
pp. 549-553
Author(s):  
George Glinos ◽  
Madeline Hooper ◽  
G. Eli Morey ◽  
Lucai Seminario-Vidal

Background Wolf’s isotopic response has been described in association with malignancy, infections, and inflammatory disorders. Lichenoid tissue reactions are a rare but recognized example of this phenomenon; only 41 cases of zosteriform lichen planus exist in publication. This case adds to the minimal literature describing lichenoid inflammatory dermatosis compatible with Wolf’s isotopic response.   Methods Literature review and case description.   Results A man in his 30s with a history of herpes zoster presented with a pruritic rash on his left arm. Clinical and histopathological evaluation were consistent with lichen planus in the distribution of a healed herpes zoster rash. The skin lesions improved after six weeks of treatment with clobetasol 0.05% ointment twice daily.   Conclusions The presentation of lichen planus as Wolf’s isotopic response is uncommon, but responsive to standard topical therapy.


VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.


Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33


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