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1.
Dermatol Online J ; 30(3)2024 Jun 15.
Article in English | MEDLINE | ID: mdl-39090038

ABSTRACT

Lichen sclerosus (LS) is a chronic inflammatory dermatosis primarily affecting the genitalia, commonly characterized by pearly-white papules and plaques. Although predominantly affecting females, LS can manifest across all age groups, with a bimodal distribution observed in prepubescent girls and postmenopausal women. This case report presents an unusual instance of exclusive extragenital LS in a 10-year-old girl, showcasing hyperpigmented patches and wrinkled plaques resembling lichen planus on her forearms and lower legs. Histopathological analysis confirmed LS, revealing distinctive epidermal changes and lymphocytic infiltrates. The absence of mucosal involvement and unique clinical presentation differentiated this case from typical LS manifestations. Treatment with topical clobetasol propionate demonstrated significant improvement in pruritus. Extragenital LS is infrequent, particularly among children, and its diagnosis necessitates a comprehensive clinicopathological correlation. The reported case contributes valuable insights into this uncommon variant, emphasizing the importance of accurate diagnosis and tailored treatment strategies. Additionally, it highlights the efficacy of high-potency topical corticosteroids in managing this condition.


Subject(s)
Clobetasol , Lichen Planus , Lichen Sclerosus et Atrophicus , Humans , Female , Child , Lichen Planus/pathology , Lichen Planus/drug therapy , Lichen Sclerosus et Atrophicus/pathology , Lichen Sclerosus et Atrophicus/drug therapy , Clobetasol/therapeutic use , Forearm/pathology , Leg/pathology
2.
Rheumatol Int ; 44(2): 379-396, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38141121

ABSTRACT

Pseudoxanthoma Elasticum (PXE) is a rare genetic disorder caused by an autosomal recessive mutation in the ABCC6 gene. It manifests with distinctive clinical symptoms impacting the skin, eyes, and cardiovascular system, along with an elevated risk of cardiovascular diseases. We present a case of a 34-year-old male patient who was initially referred to the rheumatology clinic for evaluation due to suspected large vessel vasculitis. The patient's primary complaint was severe hemifacial pain radiating to the neck and upper limb. Radiological imaging studies unveiled substantial vascular narrowing and collateral vessel formation, prompting further investigation to exclude systemic vasculitis. Intriguingly, the patient also exhibited cutaneous manifestations, which were later confirmed via skin biopsy as consistent with PXE. An ophthalmological examination further revealed the presence of the classic PXE findings of angioid streaks. Given the rarity of PXE and its multifaceted clinical presentation, it can be particularly challenging to diagnose and manage. As such, cases like the one presented here may necessitate a referral to a rheumatologist for evaluation of potential systemic involvement. To provide a comprehensive perspective on PXE, we conducted a systematic review of case reports published in the past decade in English, collected from PubMed, Scopus, and the Directory of Open Access databases. The analysis of these cases will be discussed to shed light on the diversity of PXE's clinical features and the diagnostic and management dilemmas it poses and to facilitate ongoing exploration and research into this intricate condition, ultimately leading to improved care for individuals affected by PXE.


Subject(s)
Cardiovascular System , Pseudoxanthoma Elasticum , Vasculitis , Male , Humans , Adult , Pseudoxanthoma Elasticum/complications , Pseudoxanthoma Elasticum/diagnosis , Pseudoxanthoma Elasticum/genetics , Skin/pathology , Mutation , Cardiovascular System/pathology , Vasculitis/pathology , Rare Diseases/pathology
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