scholarly journals The Challenge of Skin Lesions in Systemic Diseases

2021 ◽  
Author(s):  
Ana Isabel Lopes ◽  
Isabel O. Cruz ◽  
Rui Môço
Keyword(s):  
Erythema Nodosum ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Low Grade ◽  
Systemic Diseases ◽  
Medical Problems ◽  
Anterior Side ◽  
History Of ◽  
Nodular Lesions ◽  
Inflammatory Drugs

A 47-year-old man, obese, without medical problems, presented with a 15-day history of painful erythematous nodular lesions on the anterior side of lower limbs. He had no improvement with antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs). He developed migratory and symmetric arthralgias (ankles, knees, elbows) and low-grade fever. The skin lesions progressed to the upper limbs. On physical examination, a mild swelling and tenderness in both ankles was noted, and lesions suggestive of erythema nodosum were seen.[...]

P087 Polyarteritis nodosa: a case report

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
A Azirar ◽  
A Ghannam ◽  
A Elaouli ◽  
M Rkain ◽  
N Benaajiba ◽  
...  
Keyword(s):  
Polyarteritis Nodosa ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Periarteritis Nodosa ◽  
Minimal Effective Dose ◽  
First Child ◽  
History Of ◽  
Inflammatory Syndrome ◽  
Made In

Abstract Background Polyarteritis nodosa is a necrotizing vasculitis of small and medium caliber arteries. Rarely described in children, its pathophysiology is complex and remains poorly elucidated. Two main forms were described in the literature: cutaneous and visceral. Material and results We report the cases of two boys, aged of 7 and 11 years old. They had a history of recurrent sore throat with a recurrent aphthosis in the 11-year-old child. Both boys presented with polyarthralgias, myalgias, polymorphous skin lesions made of livedo reticularis with subcutaneous nodosa on the lower limbs in the first child and distal necrosis of the toes with oedema of the lower limbs in the second. Patients suffered also of cough evolving in a context of alteration of the general state made of fever and asthenia. A biological inflammatory syndrome was present in both children and the skin histology confirmed periarteritis nodosa. The evolution was marked by the disappearance of arthralgias and myalgias after a corticosteroid-based treatment with progressive dose reduction until minimal effective dose. Conclusion The diagnosis of Polyarteritis nodosa should be made in any child presenting with the following signs: fever, altered general condition, myalgias, arthralgias and skin manifestations. The prognosis is usually benign but long-term surveillance is necessary.

A bullous rash

2020 ◽  
pp. edpract-2020-319179
Author(s):  
Vanessa Migliarino ◽  
Alberto Di Mascio ◽  
Irene Berti ◽  
Andrea Taddio ◽  
Egidio Barbi
Keyword(s):  
Bacterial Culture ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Antibody Detection ◽  
Topical Steroids ◽  
List Type ◽  
Bullous Dermatosis ◽  
History Of ◽  
Linear Iga Bullous Dermatosis ◽  
Severity Of The Disease

A 3-year-old boy presented with a 5-day history of bullous skin lesions localised mainly in the upper and lower limbs and in the genital region (figure 1). Lesions were not pruritic nor painful and showed a central crust. There was no family history of skin disorders or autoimmune diseases. The child never had fever and his physical examination was otherwise unremarkable.Figure 1Bullous skin lesions forming around a central crust, localised in the upper and lower limbs.QuestionsWhat is the most likely diagnosis based on this clinical presentation?Bullous impetigo.Bullous pemphigoid.Linear IgA bullous dermatosis.Dermatitis herpetiformis.What would be the next step in the investigation to confirm your diagnosis?Skin biopsy.Swab test for bacterial culture with an antibiogram.Anti-transglutaminase antibody detection.What is the mainstay of management?Dapsone.Systemic steroids.Topical steroids.All of the above answers are correct, according to the severity of the disease.Answers can be found on page 02.

Prostate adenocarcinoma and cutaneous metastases

2020 ◽  
pp. 205141582095475
Author(s):  
Jeff John ◽  
Tanya Wantenaar ◽  
John Lazarus ◽  
Ken Kesner
Keyword(s):  
Prostate Cancer ◽  
Skin Lesions ◽  
Prostate Adenocarcinoma ◽  
Cutaneous Lesions ◽  
Cutaneous Metastases ◽  
Primary Malignancy ◽  
Level Of Evidence ◽  
History Of ◽  
Adenocarcinoma Of The Prostate ◽  
Nodular Lesions

Prostate cancer is the second most frequently diagnosed cancer in men and the fifth leading cause of mortality worldwide. Men of African descent with prostate adenocarcinoma tend to present late with advanced, aggressive and often metastatic disease. Cutaneous metastases are extremely rare, with the incidence reported to be as low as 0.36%. We report a case of prostate adenocarcinoma with cutaneous metastases. A 69-year-old African male known to the urology unit, with metastatic adenocarcinoma of the prostate, presented with a two-week history of pale-to-purple large nodular lesions on the skin of his left hemiscrotum and smaller nodules on the penile shaft. Punch biopsies of the scrotal nodules revealed metastatic prostate adenocarcinoma. Bilateral orchidectomy and excision of the cutaneous lesions were performed. Although cutaneous metastases are rare, more so in patients with adenocarcinoma of the prostate, any skin lesions in patients with a known primary malignancy should raise a suspicion of metastasis. All physicians should therefore have a low threshold for the biopsy of any unusual skin lesion in patients with known prostate cancer. Level of evidence: 5.

scholarly journals Atypical clinical presentation of distal renal tubular acidosis: a case report registered in Amazonas, Brazil

2020 ◽  
Vol 42 (3) ◽  
pp. 380-383
Author(s):  
Daniel Monteiro Queiroz ◽  
Rolando Guillermo Vermehren Valenzuela ◽  
Ana Wanda Guerra Barreto Marinho ◽  
Samanta Samara Bicharra dos Santos ◽  
Danielle Ochoa da Silva ◽  
...  
Keyword(s):  
Renal Tubular Acidosis ◽  
Skin Lesions ◽  
Clinical Findings ◽  
Distal Renal Tubular Acidosis ◽  
Lower Limbs ◽  
Hypokalemic Paralysis ◽  
Immunological Tests ◽  
History Of ◽  
Similar Report ◽  
Renal Tubular

ABSTRACT We report an unusual case of a 24-year-old girl with a history of recurrent hypokalemic paralysis episodes and skin lesions on the lower limbs and buttocks, both of which had an acute evolution. In subsequent investigations, the patient also had nephrocalcinosis, nephrolithiasis, hyperchloremic metabolic acidosis and persistent alkaline urinary pH. The findings were consistent with distal renal tubular acidosis as the cause of hypokalemic paralysis. Clinical findings, immunological tests and the result of skin biopsy suggested primary Sjögren's syndrome as an underlying cause. The patient developed azotemia due to obstructive nephrolithiasis. All the features presented in this case are an unusual manifestation of distal renal tubular acidosis; so far, we are not aware of a similar report in the literature.

scholarly journals Friction-Induced Biphasic Cutaneous Amyloidosis

Dermato ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 31-34
Author(s):  
Thilo Gambichler ◽  
Laura Susok ◽  
Marc H. Segert
Keyword(s):  
Medical History ◽  
Unusual Case ◽  
Normal Skin ◽  
Skin Lesions ◽  
Systemic Diseases ◽  
Histopathological Findings ◽  
History Of ◽  
Patient’S History

Primary cutaneous amyloidoses (PCA) are a group of conditions characterized by deposition of amyloid in previously normal skin, without association with other skin or systemic diseases. We describe a Kazakhstani female with a 30-year history of increasingly spreading hyperpigmented macular as well papular skin lesions on her upper trunk accompanied by pruritus. Moreover, her medical history included intensely rubbing her skin with a cotton towel following bathing and showering. On the basis of the clinical and histopathological findings, the diagnosis of biphasic cutaneous amyloidosis was made. The present unusual case of biphasic cutaneous amyloidosis can be subsumed under mechanically-induced forms of cutaneous amyloidosis. In conclusion, the present case underscores the necessity to explore carefully the patient’s history in order to discover the cause of PCA.

scholarly journals Lymphomatoid Papulosis in a Case of Atypical Secondary Syphilis

2019 ◽  
Vol 14 (4) ◽  
pp. e32-e33
Author(s):  
Xin (Peter) Mu ◽  
Ian Mazzetti
Keyword(s):  
Clinical History ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Low Grade ◽  
Cutaneous Lesions ◽  
Syphilis Infection ◽  
Lymphomatoid Papulosis ◽  
History Of ◽  
Skin Biopsies ◽  
Syphilis Serology

AbstractLymphomatoid papulosis is an indolent cutaneous lymphoproliferative disorder that presents as recurrent self-resolving papulonodular skin lesions. Currently, there are no known causes for lymphomatoid papulosis and definitive diagnosis is only made histologically. A 64-year-old man presented with a 6-week history of bilateral leg pains, low-grade fevers, and a widespread eruption of painless erythematic papules. Despite testing positive for syphilis serology, he lacked the typical clinical history for classic syphilis and therefore, skin biopsies were performed to confirm the diagnosis. Unexpectedly, the skin biopsies revealed lymphomatoid papulosis which resolved with antibiotic treatments for syphilis. Considering the synchronous resolution of the patient’s syphilis infection and his cutaneous lesions, this is the first report of findings to suggest syphilis as a possible cause for lymphomatoid papulosis. Clinicians should appreciate the possibility of alternative diagnosis for cutaneous presentations in settings of confirmed syphilis infections. RESUMELa papulose lympho-matoïde est un trouble lymphoprolifératif cutané indolent qui se présente sous la forme de lésions cutanées papulonodulaires auto-résolutives récurrentes. Actuellement, il n’y a pas de causes connues de la papulose lymphomatoïde et le diagnostic définitif n’est posé que sur le plan histologique. Un homme de 64 ans a présenté une histoire de 6 semaines de douleurs bilatérales aux jambes, de fièvres de bas grade et d’éruptions généralisées de papules érythémateuses indolores. Malgré un test sérologique positif pour la syphilis, il n’avait pas les antécédents cliniques typiques de la syphilis classique et des biopsies cutanées ont donc été effectuées pour confirmer le diagnostic. De façon inattendue, les biopsies cutanées ont révélé une papulose lymphomatoïde qui s’est résorbée grâce à des traitements antibiotiques contre la syphilis. Compte tenu de la résolution synchrone de l’infection syphilitique du patient et de ses lésions cutanées, il s’agit du premier rapport de résultats suggérant que la syphilis est une cause possible de papulose lymphomatoïde. Les cliniciens devraient apprécier la possibilité d’un diagnostic alternatif pour les présentations cutanées dans les contextes d’infections syphilitiques confirmées.

scholarly journals Infantile Hemangioma: A Retrospective Study

2020 ◽  
Vol 32 (1) ◽  
pp. 21
Author(s):  
Eva Lydiawati ◽  
Iskandar Zulkarnain
Keyword(s):  
Clinical Features ◽  
Early Recognition ◽  
Clinical Manifestations ◽  
Infantile Hemangioma ◽  
Skin Lesions ◽  
Pediatric Dermatology ◽  
Facial Region ◽  
History Of ◽  
Nodular Lesions ◽  
One Year

Background: Infantile Hemangioma (IH) is a benign vascular neoplasm and most commonly found in newborns. IH appears in the first few weeks of life and mostly resolve immediately. Early recognition of symptoms, diagnosis, and therapy has an important role in determining the prognosis of this condition. Purpose: The purpose of this study is to evaluate the clinical features of new IH patients in the Pediatric Dermatology Division of the Dermatology & Venereology Department outpatient clinic of Dr. Soetomo General Hospital Surabaya in 2008-2017. Methods: This is a retrospective descriptive study from the medical records of new IH patients over a period of 10 years (2008-2017). Results: A total of 84 new IH patients were observed in this study. The data showed that: the most age group was 0-1 year old (71.43%), female (63.1%), and no family history of a similar condition (94.05%). The most common complaint reported was the presence of bumps (59.52%). Most complaints occurred before the patients turned one year old (89.29%) and involved the facial region (58.33%). From the clinical features, the most frequent skin lesions were macules (35.36%). In addition, there was a combination of macular and nodular lesions in 28.13% of patients. The most widely used therapy is laser modality found in 55.45% of patients. Conclusion: Clinical features of IH patients, in accordance with the theory and treatment choices, dependent on the patients’ conditions and clinical manifestations of the disease. 

scholarly journals Multiple cavitary pulmonary nodules in association with pyoderma gangrenosum: case report

2012 ◽  
Vol 87 (2) ◽  
pp. 301-304 ◽  
Author(s):  
Maraya de Jesus Semblano Bittencourt ◽  
Luciana Fontenele Brito Soares ◽  
Lilia Sampaio Lobato ◽  
Alexandre Dias Mançano ◽  
Helandro Stuart Castro Leandro ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Pulmonary Nodules ◽  
Unknown Origin ◽  
Pulmonary Involvement ◽  
Lower Limbs ◽  
Lung Nodules ◽  
Systemic Diseases ◽  
Wegener Granulomatosis ◽  
Nodular Lesions ◽  
High Doses

Pyoderma gangrenosum is a rare neutrophilic disease of unknown origin that is associated with systemic diseases in 50% of cases. It is characterized by erythematous-violaceous nodular lesions that quickly progress to painful ulcers, with undermined edges, necrotic-hemorrhagic, varying in size and depth, located mainly in the lower limbs. Extracutaneous locations of pyoderma gangrenosum are rare, usually involving the lungs; the main differential diagnosis in these cases is Wegener granulomatosis. We report a case of pyoderma gangrenosum, which showed multiple cavitary lung nodules, with good response to high doses of steroids. Once excluded the possibility of Wegener granulomatosis, the authors concluded that it was the manifestation of systemic pyoderma gangrenosum with pulmonary involvement.

scholarly journals Psoriatic onycho-pachydermo-periostitis / Psoriatični onihopahidermoperiostitis

2010 ◽  
Vol 2 (2) ◽  
pp. 54-58
Author(s):  
Zorica Perić-Hajzler ◽  
Lidija Kandolf-Sekulović ◽  
Lidija Zolotarevski
Keyword(s):  
Psoriatic Arthritis ◽  
Antibody Therapy ◽  
Skin Lesions ◽  
Treatment Modalities ◽  
Psoriatic Skin ◽  
Symptom Improvement ◽  
Nail Changes ◽  
The Family ◽  
History Of ◽  
Inflammatory Drugs

Abstract Psoriatic onycho-pachydermo-periostitis has been recognized as an uncommon subset of psoriatic arthritis, and to date, only a few cases have been reported. In general, psoriatic onycho-pachydermo-periostitis is regarded as a unique variant of psoriatic arthritis, but its pathology and pathophysiology are not well understood. Although psoriatic onychopachydermo- periostitis is usually found in patients with psoriasis, it can also be found in patients without psoriatic skin lesions. It is characterized by psoriatic nail changes (usually onycholysis), painful swelling of the soft tissue close to the distal phalanges, and radiographic changes of the distal phalanges with periosteal reaction and bone erosions. We present a 58-year-old man with a 3-year history of deformation, thickened nails and pustules on the skin of his fingers and toes, and painful redness of the nail bed accompanied with pain in small joints. The family history was negative. After confirmation of the diagnosis, methotrexate: 15 mg weekly, was initiated which led to symptoms improvement. Treatment of psoriatic onycho-pachydermo-periostitis is difficult. It is based on treatment modalities used for other forms of psoriatic arthritis, such as sulphasalazine, methotrexate, and anti-tumor necrosis factor antibody therapy with adalimumab and etanercept. Nonsteroidal anti-inflammatory drugs are usually ineffective. Retinoids, subungual cyclosporine and corticosteroid therapy also showed inefficient. In our patient, methotrexate has shown efficacy in symptom improvement.

scholarly journals Study on safety and efficacy of low dose oral cyclosporine for the treatment of prurigo nodularis in Bangladeshi population

2018 ◽  
Vol 7 (1) ◽  
pp. 16-23
Author(s):  
Atia Sharmeen ◽  
Muhammad Hasibur Rahman ◽  
Mahmud Javed Hasan
Keyword(s):  
Family History ◽  
Side Effects ◽  
Low Dose ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Prurigo Nodularis ◽  
College Hospital ◽  
Modest Improvement ◽  
Dose Oral ◽  
History Of

Prurigo nodularis (PN) is a disease with multiple itching nodules situated chiefly on the extremities. The disease is often persistent and the therapy is refractory. Oral cyclosporine used in moderate to severe psoriasis has shown modest improvement in the skin lesions with significant side effects. The drug is recently used in the treatment of PN with variable efficacy. The present study was therefore intended to investigate whether low dose oral cyclosporine can be preferred as an effective and safe therapy for Prurigo nodularis. This quasi-experimental study was conducted in the Department of Dermatology and Venereology of Community Based Medical College Hospital, Mymensingh, Bangladesh, over a period of 6 months between July 2016 to December 2016. A total of 96 clinically diagnosed cases of prurigo nodularis attending at the above mentioned places were consecutively included in the study. After evaluation of the baseline clinical and laboratory features of the patients, oral cyclosporine was given as 2 mg/kg/day for consecutive 12 weeks. A female preponderance was observed in the study with female to male ratio being 7:3. The putative etiological factors present among the patients were a history of frequent mosquito bite (43.8%), anaemia (28%), hypertension (27.1%) bronchial asthma (22.9%), family history of PN (29.2%) and family history of atopy (24%). The nodules were mainly distributed in front of the lower limbs followed by upper limbs and trunk. In terms of nodule characteristics, 33.3% were excoriated, 38.5% were palpable, 26% flattened, 28.1% infected and 35.4% pruritic nodules In the present study, majority (87.5%) of the patients became free from visible lesions after 12 weeks of treatment with cyclosporine. Serum IgE and total eosinophil count reduced significantly after treatment than those before treatment (177.5 vs. 91.6 U/mL, p < 0.001 and 0.5 vs. 0.3 k/μL, p < 0.001 respectively. However, 8.2% of the patients exhibited albuminuria during the course of treatment. Most of the patients of Prurigo Nodularis after 12 weeks of treatment with low-dose oral cyclosporine became free from the lesions without any significant side-effects. CBMJ 2018 January: Vol. 07 No. 01 P: 16-23

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