1,720,975 research outputs found
Juvenile xanthogranuloma: dermoscopic pattern
No full textOur case report is important for a complete definition of the dermoscopic picture of JXG and to avoid that such methodological errors prejudice the correct dermoscopic analysis of lesions, such as amelanotic melanoma, a correct diagnosis of which depends on evaluation/detection of the dermoscopic vascular pattern
False Leser-Trélat sign
No full textCutaneous melanoma metastases (CMMs) have no specific clinical and dermoscopic features, and may be difficult to differentiate from benign lesions. Recently, we observed a case of CMM clinically and dermoscopically resembling eruptive, grouped, seborrheic keratoses (SKs)
Non-invasive diagnosis of nodular scabies: the string of pearls sign
No full textIn nodular scabies the mites often disappear particularly after topical treatment that disintegrates them, thus not allowing the detection of the jetliner sign. As mite’s eggs are more resistant to treatment, is possible to identify the burrows filled with eggs, morphologically and ultrastructurally resembling
a ‘string of pearls’, also in nodular lesions
Malignant nodular hidradenoma of the skin: report of seven cases
No full textBackground: Malignant nodular hidradenoma (MNH) is an infrequent, highly malignant, primary skin tumour derived from eccrine sweat glands. Most tumours occur in elderly individuals. MNH has very poor prognosis, high recurrence and a high rate of metastases. The best method of treatment is still unclear: radical surgical excision is widely used, and selective lymph node dissection is also suggested. The value of the adjuvant radiotherapy and chemotherapy has not been confirmed. Patients and treatment: Seven MNH patients (4 men, 3 women, age 60-87.years) were treated between 1991 and 2007 in the Dermatology Unit of San Donato Hospital of Arezzo and in the Section of Dermatology of University of Siena, Italy. Tumours varied from 0.8 to 4.4.cm in size. All patients underwent local excision; five also had lymph node dissection. One patient underwent adjuvant radiotherapy, and three received chemotherapy. Results: Six of seven patients died, with survival varying from 15 to 45.months. Distant metastases occurred in two patients. Survival time was inversely proportional to the size of the tumour. Conclusions: MNH is an aggressive tumour and should be diagnosed and excised as early as possible. Histological parameters are paramount, but correct diagnosis also calls for attention to clinical presentation and any history of recurrence or recent enlargement of long-standing lesions. In our experience, radiotherapy and chemotherapy do not seem to prolong survival. © 2007 The Authors Journal compilation © 2007 European Academy of Dermatology and Venereology
Terbinafine-induced acute generalized exanthematous pustulosis
No full textTerbinafine is an allylamine antifungal agent, effective in the treatment of dermatomycoses. Many cutaneous adverse reactions have been reported (in about 3% of treated patients). Furthermore terbinafine has been associated with pustular eruptions, as well as the induction and exacerbation of pre-existing psoriasis and acute generalized exanthematous pustulosis (AGEP). AGEP is an uncommon aseptic pustular eruption, classified for many years as a pustular psoriasis, that usually follows recent administration of oral or parenteral drugs. The disease is most frequently triggered by antibiotics, most of all aminopenicillins and macrolides. Characteristic AGEP features include the sudden onset of fever above 38 C with widespread erythematous eruption, rapidly progressing to a fine, non-follicular, micropustular rash. Leucocytosis is generally present, sometimes associated with eosinophilia. The illness usually resolves spontaneously with the fever and the pustulation clearing within 15 days, sometimes followed by desquamation. Hystopathology shows non-follicular spongiotic pustules in the epidermis filled with neutrophils, a mixed perivascular infiltrate of neutrophils and occasional eosinophils with papillary dermal oedema. On this subject, Sideroff et al. recently elaborated a validation score based on morphology, histological criteria, and disease course. The pathogenetic mechanism which leads to the induction of AGEP by some medicines has still not been clarified, but T cells seem to play a crucial role. The authors report a case of a patient with terbinafine-induced AGEP and a review of the literature about this topic. The case illustrates once again the role of terbinafine in AGEP and reminds us that early diagnosis of AGEP is important to avoid unnecessary investigations and/or the administration of antibiotics
About vascular patterns
No full textIn this article we wish to stress the importance in melanoma diagnosis of overall assessment of patients, from medical history to accurate evaluation of dermoscopic pattern
UN CASO DI MACROCHEILIA
No full textUna giovane donna di 40 anni giungeva alla nostra osservazione per la rapida comparsa di una macrocheilia, maggiormente evidente al labbro inferiore. Un trattamento con steroidi per via orale, intrapreso dalla paziente su suggerimento del medico curante, non aveva condotto ad un miglioramento clinico evidente. L’anamnesi era negativa per patologie cutanee e sistemiche. Il decorso della patologia è stato caratterizzato da riacutizzazioni episodiche e remissioni parziali.
La diagnosi clinicamente più probabile, in attesa di conferma istologica, era di cheilite granulomatosa. Questa rara malattia infiammatoria fu descritta per la prima volta da Miescher nel 1945 ed è caratterizzata dal rigonfiamento, generalmente asintomatico, di una o entrambe le labbra. Colpisce prevalentemente i giovani e sebbene inizialmente l’edema possa essere passeggero, in seguito tende generalmente a persistere. Istologicamente si possono rinvenire granulomi non necrotizzanti, edema, linfangectasie e infiltrato linfocitario perivascolare. La cheilite granulomatosa di Miescher può far parte della sindrome di Melkersson-Rosenthal, che si manifesta con altri segni quali paralisi del nervo faciale e lingua fissurata.
Sebbene il riscontro istologico di granulomi non necrotizzanti possa essere utile per confermare l’ipotesi diagnostica, non è un requisito essenziale e la diagnosi viene più spesso formulata sulla base della correlazione tra i dati clinici e anamnestici del paziente. La diagnosi differenziale di fronte ad un edema acquisito del labbro deve essere posta con l’angioedema,le reazioni allergiche, i traumi, l’eritema polimorfo e alcune infezioni (specialmente da H.simplex e da cocchi). Quando l’edema diventa cronico, oltre alle ipotesi post-traumatiche e post-infettive, bisogna inoltre escludere quella paraneoplastica e soprattutto il gruppo delle “granulomatosi orofaciali” di cui fanno parte, oltre alla cheilite granulomatosa e alla sindrome di Melkersson-Rosenthal, anche la sarcoidosi, la malattia di Crohn e alcuni disordini infettivi quali la TBC. Presentiamo questo caso per sottolineare quanto sia fondamentale un’ accurata anamnesi e un attento follow-up volto anche a ricercare l’eventuale comparsa di sintomi che possano far pensare a malattie sistemiche associate alla dermatosi
Xanthomatous papule in a child. Solitary reticulohistiocytoma (SRH)
No full textSolitary reticulohistiocytoma, also known as reticulohistiocytic granuloma1 is a rare neoformation that may develop anywhere on the body, although it does not tend to involve the digits and is uncommon on the face.1 Histologically identical lesions in the oral cavity have been reported. The disease has a male predominance. Most patients are young adults and < 20% of cases have multiple tumours
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