RESUMEN
BACKGROUND: Palmoplantar psoriasis is a clinical variant of psoriasis characterized by well-defined erythematous desquamating plaques on palms and soles, which may or may not include pustules. Hyperkeratotic lesions of palm and sole commonly include Psoriasis, Eczema and Tinea. These conditions often present with overlapping clinical and histopathological features requiring clinicohistopathological correlation for a conclusive diagnosis. The presence of munro's microabscess or spongiform pustule of kogoj differentiates psoriasis of palm and sole from other hyperkeratotic lesions of palm and sole. The objective of this study was to study the clinical and histopathological profile of palmoplantar psoriasis and correlate clinical diagnosis with histopathological diagnosis. METHOD: A hospital-based, descriptive study was conducted from January 1, 2020, to December 31, 2020. Fifty-two patients were clinically diagnosed as palmoplantar psoriasis with or without involving other parts of body and routine histopathological evaluation was carried out as per standard protocols. RESULT: Clinically diagnosed 52 cases of palmoplantar psoriasis showed varied histopathology with hyperkeratosis (100%), parakeratosis (100%), regular acanthosis (75%), Supra-papillary thinning (44.2%), spongiosis (65.4%), tortuous vessels in the papillary dermis (78.8%) and mixed inflammatory infiltrates (predominantly lymphocytic-100%), which were observed to be prominent findings in skin biopsies of our patients. Clinicopathological correlation was achieved in 88.5% of cases. CONCLUSION: This study shows clinically diagnosed palmoplantar psoriasis with histopathological features consistent with palmoplantar psoriasis in 88.5% cases. Thus, clinically inconclusive hyperkeratotic lesions with palmoplantar psoriasis can be diagnosed with histopathological correlation improving the therapeutic intervention.
Asunto(s)
Psoriasis , Centros de Atención Terciaria , Humanos , Psoriasis/patología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Adolescente , Anciano , Dermatosis de la Mano/patología , Piel/patologíaAsunto(s)
Dermatosis de la Mano , Humanos , Animales , Masculino , Dermatosis de la Mano/patología , Dermatosis del Pie/patología , Boidae , FemeninoAsunto(s)
Antituberculosos , Mycobacterium tuberculosis , Exposición Profesional , Tuberculosis Cutánea , Veterinarios , Humanos , Masculino , Antituberculosos/uso terapéutico , Mycobacterium tuberculosis/aislamiento & purificación , Piel/patología , Piel/microbiología , Tuberculosis Cutánea/diagnóstico , Tuberculosis Cutánea/tratamiento farmacológico , Tuberculosis Cutánea/microbiología , Tuberculosis Cutánea/patología , Persona de Mediana Edad , Biopsia , Isoniazida/uso terapéutico , Rifampin/uso terapéutico , Etambutol/uso terapéutico , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/tratamiento farmacológico , Dermatosis de la Mano/microbiología , Dermatosis de la Mano/patología , Exposición Profesional/efectos adversosAsunto(s)
Melanocitos , Humanos , Melanocitos/patología , Dermatosis de la Mano/patología , Femenino , Masculino , Biopsia , Mano/patología , Persona de Mediana EdadRESUMEN
ABSTRACT: Circumscribed palmar or plantar hypokeratosis (CPPH) is a new dermatologic disorder that firstly defined Pérez A et al in 2002. Since that time, further cases of CPPH have been reported by different authors in different countries. We report a 69-year-old Turkish woman who presented with asymptomatic, erythematous patches on the thenar region of the left hand and on the second left finger. Skin biopsy showed histological features of CPPH. In this article, it was emphasized that CPPH may be seen more frequently than expected and the clinical and pathological features of this disease with suspected malignant transformation should be known.
Asunto(s)
Dermatosis de la Mano , Femenino , Humanos , Anciano , Dermatosis de la Mano/patología , Piel/patología , Biopsia , Transformación Celular Neoplásica/patología , Dedos/patologíaRESUMEN
Neutrophilic dermatosis of the dorsal hands (NDDH) is a variant of Sweet syndrome that presents with erythematous bullae, papules/plaques, or pustules on the dorsal hands. It is most commonly associated with hematologic and solid organ malignancies, though cases of NDDH associated with inflammatory bowel disease, rheumatologic disorders, and medication exposure have also been described in the literature. Felty syndrome is a rare complication of long-standing rheumatoid arthritis characterized by neuropathy, splenomegaly, and neutropenia. Granulocyte colony stimulating factors (e.g., filgrastim) can be utilized to rescue the neutropenia observed in Felty syndrome, but this treatment may subsequently cause Sweet syndrome. Herein, we present a 64-year-old man with Felty syndrome and a complex medical history who presented with sudden onset, painful blisters located on the dorsal and palmar aspects of his bilateral hands. Given the patient's past medical history, a broad differential diagnosis, including disseminated fungal and viral infection was initially considered. A punch biopsy of the skin lesion disclosed neutrophilic dermatosis, which together with laboratory data satisfied the von den Driesch criteria for Sweet syndrome. As the lesions were localized exclusively on the patient's hands, the qualification of NDDH was also endorsed.
Asunto(s)
Dermatitis , Síndrome de Felty , Dermatosis de la Mano , Neutropenia , Enfermedades de la Piel , Síndrome de Sweet , Masculino , Humanos , Persona de Mediana Edad , Síndrome de Sweet/inducido químicamente , Síndrome de Sweet/diagnóstico , Filgrastim/efectos adversos , Síndrome de Felty/complicaciones , Dermatosis de la Mano/patología , Enfermedades de la Piel/complicaciones , Dermatitis/complicaciones , Vesícula/complicaciones , Neutropenia/inducido químicamente , Neutropenia/complicacionesRESUMEN
ABSTRACT: Circumscribed palmar or plantar hypokeratosis is a focal disorder of keratinization that consists of a reduction in the thickness of the corneal layer of the epidermis of palms or soles. Although it is considered a benign entity, the thinning of the stratum corneum facilitates ultraviolet damage in the affected skin, which may result in an increased risk of developing focal epidermal dysplasia. Other factors, such as immunosuppression in transplanted patients, may play a role as well. We present a case of circumscribed palmar or plantar hypokeratosis with features of Bowen disease limited to the hypokeratotic epidermis.
Asunto(s)
Neoplasias del Ano , Enfermedad de Bowen , Dermatosis de la Mano , Queratosis , Neoplasias Cutáneas , Humanos , Enfermedad de Bowen/patología , Queratosis/patología , Dermatosis de la Mano/patología , Epidermis/patología , Neoplasias del Ano/patología , Hiperplasia/patología , Neoplasias Cutáneas/patologíaRESUMEN
Aquagenic wrinkling of the palms (AWP) is a rare dermatological disease characterized by development of rapid and excessive wrinkling and oedema of the palms and transient whitish or yellowish papules without erythema on the palmar surfaces after immersion in water. This phenomenon can be accompanied by pain and/or pruritus. The most common treatment of AWP involves aluminium-based topicals. This article discusses the associations, pathological mechanisms and treatment options of AWP.
Asunto(s)
Dermatosis de la Mano , Envejecimiento de la Piel , Humanos , Aluminio , Dermatosis de la Mano/etiología , Dermatosis de la Mano/patología , Mano/patología , Agua/efectos adversosRESUMEN
Circumscribed palmar or plantar hypokeratosis (CPH) is a depressed, well-delimited, erythematous lesion usually found in the thenar and hypothenar regions of the palms or the soles, predominately in women. It was first described by Pérez et al. in 2002 as a benign entity of unknown origin. Histologically, the depressed area corresponds to a thinning of the stratum corneum. It is a well-demarcated lesion with a sharp stair in the stratum corneum between normal and involved skin and the affected corneocytes are more eosinophilic than normal. We present two new cases of CPH, both occurring in females and in the hand, one of which was located in the thenar region and the other in the finger. We discuss the histopathological and dermatoscopical findings.
Asunto(s)
Dermatosis de la Mano , Femenino , Dermatosis de la Mano/patología , HumanosAsunto(s)
Antibacterianos/efectos adversos , Erupciones por Medicamentos/etiología , Dermatosis de la Mano/inducido químicamente , Úlcera Cutánea/patología , Combinación Trimetoprim y Sulfametoxazol/efectos adversos , Anciano , Erupciones por Medicamentos/patología , Dermatosis de la Mano/patología , Humanos , Masculino , Recurrencia , Úlcera Cutánea/inducido químicamenteRESUMEN
A 65-year-old man presented to our hospital with a 1-year history of multiple nodules on his arms and hands without itching or pain.
Asunto(s)
Agaricales/aislamiento & purificación , Dermatomicosis/microbiología , Dermatomicosis/patología , Granuloma/microbiología , Granuloma/patología , Dermatosis de la Mano/microbiología , Dermatosis de la Mano/patología , Anciano , Brazo/patología , Diagnóstico Diferencial , Glucocorticoides/efectos adversos , Glucocorticoides/uso terapéutico , Gota/patología , Humanos , Huésped Inmunocomprometido , Masculino , Púrpura Trombocitopénica Idiopática/tratamiento farmacológico , Púrpura Trombocitopénica Idiopática/inmunologíaRESUMEN
We report an 11-year-old girl who presented with white papules on the dorsal and palmar region of the hands bilaterally. The parents reported that the lesions had appeared four months before and some had resolved spontaneously. The girl was suffering from celiac disease, Down syndrome, and alopecia areata treated with topical corticosteroids. At the first visit, the girl presented with alopecia areata, corticosteroid acne, and a dozen white papules located on the hands. On dermoscopy, a whitish structureless area was seen. Histological examination showed the presence of calcium deposits without tissue damage, thus confirming the diagnosis of milia-like idiopathic calcinosis cutis. At 6-month follow up, the lesions had completely disappeared. Milia-like idiopathic calcinosis cutis is a benign cutaneous disorder consisting of calcium deposits in an apparently undamaged dermis and is typically associated with Down syndrome. Up to a quarter of patients have coexisting syringomas. The milia-like papules tend to self-resolve as patients reach adulthood, so a wait-and-see approach is recommended.
Asunto(s)
Calcinosis/complicaciones , Síndrome de Down/complicaciones , Dermatosis de la Mano/complicaciones , Piel/patología , Alopecia Areata/complicaciones , Calcinosis/patología , Niño , Preescolar , Femenino , Dermatosis de la Mano/patología , Humanos , Lactante , Masculino , Enfermedades de la Piel/complicacionesRESUMEN
Knuckle pads are benign painless papules and nodules that most commonly appear on the extensor surfaces of the proximal interphalangeal joints. Knuckle pads are frequently misdiagnosed due to their location overlying joints, which can lead to costly interventions and patient discomfort for a relatively harmless condition. We describe a 44-year-old woman who presented with mildly painful nodules on multiple bilateral proximal interphalangeal joints. The patient did not have a family history of fibromatosis and the rheumatoid factor was negative. Histology showed mild epidermal hyperkeratosis, papillomatosis, and acanthosis with a deep dermal, poorly circumscribed, proliferative nodule made of spindled myofibroblasts without cytological atypia. The diagnosis of knuckle pads was established based on the clinical and morphological presentation of the nodules. Treatment with intralesional triamcinolone acetonide injection produced significant clinical improvement. Our findings highlight the challenging diagnosis of knuckle pads and the importance of increasing the familiarity of knuckle pads in modern medical practice.
Asunto(s)
Fibroma/diagnóstico , Articulaciones de los Dedos/patología , Dermatosis de la Mano/diagnóstico , Queratosis/diagnóstico , Adulto , Diagnóstico Diferencial , Errores Diagnósticos , Femenino , Fibroma/patología , Dermatosis de la Mano/patología , Humanos , Queratosis/patología , Papiloma/diagnósticoAsunto(s)
Infecciones por Erysipelothrix/diagnóstico , Erysipelothrix/aislamiento & purificación , Dedos/patología , Dermatosis de la Mano/microbiología , Diagnóstico Diferencial , Infecciones por Erysipelothrix/complicaciones , Eritema/etiología , Fiebre/etiología , Dedos/diagnóstico por imagen , Dedos/microbiología , Dermatosis de la Mano/patología , Humanos , Imagenología Tridimensional , Masculino , Dolor/etiología , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
Colloid milium, also known as colloid degeneration of the skin or dermal hyalinosis, is a cutaneous deposition disease that presents as three subtypes: juvenile, nodular, and adult. Adult colloid milium is characterized by amyloid-like depositions in the dermis, mimicking cutaneous amyloidosis histologically. A 70-year-old man presented with lesions on the sun-exposed skin of the face, dorsal hands, and dorsal forearms resembling adult colloid milium. A punch biopsy was performed on the left zygoma and histopathological features were consistent with this diagnosis, though cutaneous amyloidosis was considered. A case of adult colloid milium is presented to emphasize the clinical and histopathologic differentiation from cutaneous amyloidosis.