scholarly journals Grover’s disease in a patient with atopic dermatitis - a case report

2021 ◽  
Vol 74 (1-2) ◽  
pp. 33-37
Author(s):  
Sanja Jakovljevic ◽  
Ljuba Vujanovic ◽  
Dejan Ogorelica ◽  
Aleksandra Fejsa-Levakov ◽  
Jasmina Sekulic
Keyword(s):  
Case Report ◽  
Immunoglobulin E ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Elevated Serum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Complete Regression ◽  
Laboratory Findings ◽  
Topical Corticosteroids

Introduction. Grover?s disease is characterized by pruriginous polymorphic rash with a variable course and duration. Although the etiology is still unknown, the disease is often associated with other dermatoses, malignant diseases, use of certain medications, as well as immunosuppression. Case Report. We report a case of a 70-year-old male patient who was referred for examination to the Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, due to a rash that lasted for nine months. The first lesions on the skin appeared around the nipples as exudative eczematous plaques. A few months later, identical lesions appeared on the lower legs. During treatment with systemic antihistamines and topical corticosteroids, there were episodes of transient improvements and re-exacerbations. In the meantime, erythematous brownish, round and oval papules appeared on the abdomen and the back, accompanied by intense itch. Laboratory findings revealed eosinophilia and elevated serum immunoglobulin E levels. A skin biopsy of the back lesion was performed and the histopathological examination confirmed the diagnosis of Grover?s disease. After the systemic treatment using corticosteroids and antihistamines, with gradual dose reduction and application of topical corticosteroids and emollients, complete regression of the skin lesions was achieved. Conclusion. Since the clinical manifestations of the disease may be nonspecific and discrete, dermatopathological analysis is of crucial importance in making the correct diagnosis. In patients with atopy, the treatment with systemic corticosteroids, antihistamines and topical agents may lead to regression of skin lesions with a significant improvement in the quality of life.

scholarly journals Gastric Plexiform Fibromyxoma Arising in the Cardia in an Adolescent Male: A Rare Tumor with an Unusual Location

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Awrad Nasralla ◽  
Mufeed Alwabari ◽  
Osama Alsaif ◽  
Samir S. Amr
Keyword(s):  
Abdominal Pain ◽  
North America ◽  
Gastrointestinal Stromal Tumor ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Adolescent Male ◽  
Rare Tumor ◽  
Review Of The Literature ◽  
Unique Case

Plexiform fibromyxoma of the stomach, also known as plexiform angiomyxoid myofibroblastic tumor, is a rare benign gastric mesenchymal tumor, first described in 2007, which usually arises in the gastric antrum and affects adults. Few cases have been reported in children and adolescents. It can present with different clinical manifestations including abdominal pain, dyspepsia, hematemesis, and vomiting. Preoperatively, this tumor is usually diagnosed as gastrointestinal stromal tumor (GIST), and the correct diagnosis is made only after histopathological examination following surgical resection. Most cases were reported from East Asia (China, Japan, and Korea), North America, and Europe. We report herein a unique case of plexiform fibromyxoma, the first to be reported from the Middle East, arising in the cardia of the stomach in a 16-year-old adolescent male, with a brief review of the literature.

scholarly journals Primary biliary cirrhosis and hepatic sarcoidosis: A case report

2014 ◽  
Vol 71 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Tamara Alempijevic ◽  
Aleksandra Sokic-Milutinovic ◽  
Ljubisa Toncev ◽  
Aleksandra Pavlovic-Markovic ◽  
Srdjan Djuranovic ◽  
...  
Keyword(s):  
Case Report ◽  
Primary Biliary Cirrhosis ◽  
Liver Function ◽  
Elevated Serum ◽  
Liver Function Tests ◽  
Unknown Etiology ◽  
Biliary Cirrhosis ◽  
Laboratory Findings ◽  
Function Tests ◽  
Elevated Liver Function Tests

Introduction. Primary biliary cirrhosis (PBC) is an immunemediated chronic progressive inflammatory liver disease leading to destruction of small interlobular bile ducts. Sarcoidosis is a chronic disorder of unknown etiology characterized by non-caseous granulomas. Case report. We reported a 69-year-old female patient with abdominal pain, malaise, vertigo, headaches, hands tremor and partial loss of hearing. Initial laboratory findings revealed elevated liver function tests and cholesterol with positive antimytochondrial and antinuclear antibodies. Liver biopsy revealed granuloma typical for PBC and granulomatous lesions typical for sarcoidosis. Elevated serum angiotensin-converting enzyme and granulomatous lesion on the brain magnetic resonance imaging (MRI) were detected and the patient was diagnosed with overlap of PBC and liver sarcoidosis and neurosarcoidosis. The patient was treated with ursodeoxicholic acid (UDCA) and prednisolone. Six months later the patient was symptom-free with laboratory findings within normal range. Conclusion. In PBC patients it is important to consider coexisting granulomatous liver diseases if elevated liver function tests persist despite UDCA therapy.

scholarly journals Topical Application of Herbal Mixture Extract Inhibits Ovalbumin- or 2,4-Dinitrochlorobenzene-Induced Atopic Dermatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Soon Re Kim ◽  
Han-Seok Choi ◽  
Hye Sook Seo ◽  
Youn Kyung Choi ◽  
Yong Cheol Shin ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Topical Application ◽  
Immunoglobulin E ◽  
Elevated Serum ◽  
Ethanol Extract ◽  
Inflammatory Cells ◽  
Skin Lesions ◽  
Serum Ige ◽  
Beneficial Effects ◽  
Blood Eosinophils

KM110329 is four traditional herbal medicine mixtures with anti-inflammatory properties. Atopic dermatitis (AD) is an inflammatory skin disease associated with enhanced T-helper2 (Th2) lymphocyte response to allergens that results in elevated serum eosinophil and Immunoglobulin E (IgE) levels and leukocyte infiltration in atopic skin sites. In this study, we investigated the effect of topical application of KM110329 ethanol extract on the ovalbumin (OVA) or 2,4-dinitrochlorobenzene- (DNCB-) induced AD mouse models. For that purpose, we observed the effects of KM110329 on blood eosinophils, skin mast cells, production of serum IgE, and expression of cytokine mRNA in the atopic dermatitis skin lesions of OVA allergen- or DNCB-treated BALB/c mice. KM110329 significantly reduced blood eosinophils cell numbers in OVA or DNCB-treated BALB/c mice. Histological analyses demonstrated decreased mast cell count as well as dermal infiltration by inflammatory cells. In the skin lesions, mRNA expression of interleukine (IL)-4, IL-13, and IL-17 was inhibited by KM110329. KM110329 also suppressed the production of serum IgE level in both the OVA- and DNCB-induced atopic dermatitis model. Taken together, our results showed that topical application of KM110329 extracts exerts beneficial effects in AD symptoms, suggesting that KM110329 might be a useful candidate for the treatment of AD.

scholarly journals Kimura's Disease: A Case Report

2000 ◽  
Vol 79 (3) ◽  
pp. 195-199 ◽  
Author(s):  
Sebastian J. Karavattathayyil ◽  
John R. Krause
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Salivary Glands ◽  
Immunoglobulin E ◽  
Elevated Serum ◽  
Neck Region ◽  
Kimura’S Disease ◽  
Head And Neck Region

Kimura's disease is a rare, idiopathic condition that usually affects young men of Asian descent. The disease is characterized by swelling and lesions in the head and neck region, with involvement of the subcutaneous soft tissue, major salivary glands, and lymph nodes. Patients almost always have eosinophilia and elevated serum immunoglobulin E levels. The diagnosis is established by biopsy. Kimura's disease is usually self-limiting. Its etiology is unknown but is thought to be a manifestation of an aberrant allergic response. In this paper, we describe the case of a 30-year-old patient who was diagnosed with Kimura's disease at our institution.

scholarly journals New-onset cutaneous sarcoidosis under tocilizumab treatment for giant cell arteritis: a quasi-paradoxical adverse drug reaction. Case report and literature review

2019 ◽  
Vol 11 ◽  
pp. 1759720X1984179 ◽  
Author(s):  
Rosaria Del Giorno ◽  
Alfonso Iodice ◽  
Cristina Mangas ◽  
Luca Gabutti
Keyword(s):  
Case Report ◽  
Clinical Response ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Case Reports ◽  
Skin Lesions ◽  
Cutaneous Sarcoidosis ◽  
Cutaneous Lesions ◽  
Topical Corticosteroids ◽  
New Onset

Background: New-onset sarcoidosis has been previously described in three case reports in patients affected by rheumatoid arthritis treated with tocilizumab (TCZ). The existence of a cause–effect mechanism between the biological treatment and the onset of the illness is still being debated. Patient concerns: A 74-year-old woman was diagnosed with giant cell arteritis (GCA). The first-line treatment with glucocorticoids; and the second-line with methotrexate and low-dose glucocorticoids were stopped due to multiple pathological vertebral fractures and insufficient biological and clinical response. The cytotoxic agent, cyclophosphamide, was then introduced and in turn stopped, because of gastrointestinal side effects. Thereafter a treatment with TCZ was begun. The patient experienced good clinical response; however, 8 months later she developed painful hyper-pigmented reddish cutaneous micronodular lesions localized to the abdomen and thorax. A cutaneous biopsy was performed, and histological analysis showed noncaseating epithelioid granulomas in the hypodermis. The diagnosis of cutaneous sarcoidosis was made. Interventions: Topical corticosteroids were administered and, as requested by the patient, TCZ was discontinued with slow but complete resolution of the skin lesions. After TCZ discontinuation however, the GCA flared and the patient’s symptoms and biological abnormalities reappeared. Thus, after a 6-month suspension, TCZ was re-administered. At 2 months later the skin lesions compatible with cutaneous sarcoidosis reappeared. Topical corticosteroids were once again prescribed and as suggested by the patient the TCZ posology was reduced. The patient’s symptoms disappeared, and the cutaneous lesions resolved. Lessons: The time elapsed from TCZ treatment start and the onset of cutaneous sarcoidosis, as well as its recurrence after TCZ suspension and rechallenge supported the diagnosis of a drug-induced reaction. To the best of our knowledge, this case report represents the first instance of cutaneous sarcoidosis most likely induced by TCZ in patients affected by GCA. In addition, our case emphasizes that although TCZ in monotherapy confirms to be an effective treatment for GCA, further immunological disorders could be unmasked, and the discussed side effect of the drug could be dose-dependent.

Bullous Systemic Lupus Erythematosus Mimicking Bullous Pemphigoid: A Case Report

2021 ◽  
Vol 3 (2) ◽  
pp. 51-58
Author(s):  
Vesri Yossy ◽  
Gardenia Akhyar ◽  
Alimuddin Tofrizal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Skin Eruption ◽  
Bullous Pemphigoid ◽  
Lupus Erythematosus ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Direct Immunofluorescence ◽  
Systemic Lupus ◽  
Autoimmune Blistering Diseases

Introduction: Bullous systemic lupus erythematosus (BSLE) is an infrequent but distinct presentation of systemic lupus erythematosus (SLE) in less than 5% of lupus cases. It is characterized by vesicobullous skin eruption in SLE that can develop either before or after SLE diagnosis has been established. Distinguish between BSLE with other autoimmune blistering diseases such as bullous pemphigoid (BP), dermatitis herpetiformis, linear IgA, etc., is very important to prevent misdiagnosis. The physician must be able to combine clinical, histological and immunofluorescence finding for the diagnosis approach. We report a case of blistering skin eruption in SLE patient. Case Report: A 19-year-old female patient complained of tense blistering on her lip, face and wrists since one month ago. She was diagnosed with SLE two weeks ago. The dermatological state showed bullae and vesicle on erythematous/ normal base, erosions, excoriation and blackish red crust on the lip, face, armpit, neck, abdomen and wrists. Histopathological examination of the lesion showed sub-epidermal bullae containing PMN leukocytes consist of abundant neutrophils, only occasional eosinophils and the presence of keratotic plugs. Direct immunofluorescence (DIF) of the skin showed linear deposition of IgG, IgA, IgM and C1q at the dermo-epidermal junction. This patient exhibited similar features to both BSLE and BP with tensed clear blisters and subepidermal cleft. BSLE differ from BP by abundant neutrophils found on histopathological examination, whereas BP has abundant eosinophils. Conclusion: Immunofluorescence examination shows linear IgG in BP, whereas linear or granular IgG in BSLE. Establishing the correct diagnosis is important to prevent misdiagnosis and mistreatment.

scholarly journals Lepromatous leprosy mimicking systemic lupus erithematosus: a case report

2019 ◽  
Vol 28 (1) ◽  
pp. 77-81
Author(s):  
Niken Kusumaningrum ◽  
Schandra Purnamawati ◽  
Dwi Retno Adi Winarni ◽  
Hardyanto Soebono
Keyword(s):  
Lupus Erythematosus ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Lepromatous Leprosy ◽  
Test Results ◽  
Systemic Lupus ◽  
Double Stranded Dna ◽  
Morphological Index ◽  
Dna Antibodies

The clinical manifestations of leprosy are highly variable, and the disease is notorious for being “a great imitator” of several other conditions. Leprosy may manifest with a variety of phenomena resembling those of autoimmune diseases. Herein, we report a 33-year-old male presenting with wounds on his left leg and hyperpigmented skin lesions all over his body. Six years earlier, the patient was diagnosed with systemic lupus erythematosus (SLE). However, therapy for SLE did not control his symptoms; instead, the patient developed features of leprosy, such as anesthetic skin lesions, nerve enlargement, and tenderness. Tests for antinuclear antibodies and anti-double stranded DNA antibodies were negative. Slit-skin smear showed a bacterial index of 6+ and morphological index of 10 %. Lupus band test results were negative. Histological findings were compatible with lepromatous leprosy. The clinical and serological similarities between leprosy and SLE may lead to erroneous diagnosis. Thus, clinicians should be aware of this characteristic for correct diagnosis.

TRICHILEMMAL CYST OF THE THIRD FINGERTIP: A CASE REPORT

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 131-133 ◽  
Author(s):  
Cenk Melikoglu ◽  
Fikret Eren ◽  
Barış Keklik ◽  
Cem Aslan ◽  
Mustafa Sutcu ◽  
...  
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Hair Follicles ◽  
Nodular Lesion ◽  
Case Presentation ◽  
The Third ◽  
Trichilemmal Cyst ◽  
Common Skin

Introduction: Trichilemmal cysts (TCs) are common skin lesions that occur in hairy areas. A TC involving a fingertip has not been previously described in the literature. We herein report a case of a TC occupying a fingertip region. Case presentation: A 43-year-old woman presented with a 1.5 × 1.5 cm nodular lesion on the third fingertip. The lesion was completely excised, and histopathological examination revealed a TC. Conclusion: TCs may involve atypical locations, such as fingertips, where there are no hair follicles. After surgical excision, a careful histopathological examination should be performed to differentiate TCs from proliferating pilar tumors.

scholarly journals p-ANCA-Associated Vasculitis Caused by Levamisole-Adulterated Cocaine: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Michelle R. Carter ◽  
Sorour Amirhaeri
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Delayed Diagnosis ◽  
Complete Recovery ◽  
Skin Lesions ◽  
Laboratory Findings ◽  
Anca Associated Vasculitis ◽  
Urine Toxicology ◽  
Positive Serum ◽  
Toxicology Screening

A rare case of a patient with an unusual skin rash after using cocaine is presented. A clinical diagnosis of levamisole-induced vasculitis was made based on initial presentation of purpuric skin lesions involving the ears and positive cocaine on urine toxicology screening. The diagnosis was confirmed after laboratory findings of neutropenia, positive serum levamisole, and a histopathologic test of the skin lesions. The pathophysiology of this condition is discussed. Treatment with methylprednisolone and prednisone led to the resolution of the neutropenia and complete recovery of the skin lesions. With the growing use of levamisole-tainted cocaine, clinicians should be aware of the symptoms of vasculitis and neutropenia induced by this combination of drugs to avoid unnecessary tests and delayed diagnosis.

scholarly journals Lichen Planus in the Lines of Blaschko – A Case Report / Blaschko linearni lichen planus – prikaz slučaja

2011 ◽  
Vol 3 (4) ◽  
pp. 153-158
Author(s):  
Zorica Perić-Hajzler ◽  
Lidija Zolotarevski ◽  
Dušan Šofranac ◽  
Lidija Kandolf Sekulović
Keyword(s):  
Case Report ◽  
Lichen Planus ◽  
Clinical Manifestations ◽  
Lichen Sclerosus ◽  
Skin Lesions ◽  
Linear Distribution ◽  
Blaschko Lines ◽  
Genetic Mosaicism ◽  
Mucous Membranes ◽  
Lines Of Blaschko

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.

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