RESUMO
ABSTRACT: Hydrophilic polymer embolism from vascular medical devices is an underrecognized clinical entity that can cause deleterious end-organ ischemia and culminate in mortality. This is concerning as we are in the era where minimally invasive procedures are commonplace. Diagnosis is often made retrospectively after obtaining histopathological tissue samples showing endoluminal, cerebriform, amorphous, anucleate, basophilic, nonrefractile, nonpolarizable foreign body material. We detail 2 more cases of cutaneous hydrophilic polymer embolism to underscore its salient clinicopathological features and increase awareness of this important iatrogenic entity.
Assuntos
Embolia , Humanos , Embolia/patologia , Embolia/etiologia , Corpos Estranhos/patologia , Corpos Estranhos/complicações , Interações Hidrofóbicas e Hidrofílicas , Polímeros/efeitos adversos , Polímeros/químicaRESUMO
This case series reports on cases of diffuse alopecia with trichomalacia after use of a detangling hairbrush.
Assuntos
Doenças do Cabelo , Humanos , Doenças do Cabelo/induzido quimicamente , Doenças do Cabelo/diagnóstico , Cabelo , Alopecia/diagnóstico , Alopecia/etiologiaRESUMO
BACKGROUND: There is considerable variation in the literature regarding the dermatopathologic diagnostic features of and reporting guidelines for actinic keratosis (AK) and cutaneous squamous cell carcinoma (cSCC). OBJECTIVE: To develop consensus recommendations regarding diagnostic criteria, nomenclature, and reporting of AK and cSCC. METHODS: Literature review and cross-sectional multiround Delphi process including an international group of expert dermatopathologists followed by a consensus meeting. RESULTS: Consensus was achieved regarding the key dermatopathologic features necessary for diagnosing cSCC, AK, and associated variants; grading of degree of cellular differentiation in cSCC; utility of immunohistochemistry for diagnosis of cSCC; and pathologic features that should be reported for cSCC and AK. LIMITATIONS: Consensus was not achieved on all questions considered. CONCLUSION: Despite the lack of clarity in the literature, there is consensus among expert dermatopathologists regarding diagnostic criteria and appropriate reporting of AK and cSCC. Widespread implementation of these consensus recommendations may improve communication between dermatopathologists and clinicians, facilitating appropriate treatment of AK and cSCC.
Assuntos
Carcinoma de Células Escamosas , Ceratose Actínica , Neoplasias Cutâneas , Humanos , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Consenso , Estudos Transversais , Ceratose Actínica/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologiaRESUMO
Iododerma is an uncommon dermatosis caused by excessive iodine exposure and is associated with significant morbidity and mortality. Because of its heterogenous clinical presentation and variable histopathological findings, which depend on the time the skin biopsy is performed, the diagnosis of iododerma is often delayed. We report a rare case of acute iododerma in a woman with end-stage diabetic nephropathy with antecedent radioiodine contrast exposure, presenting histopathologically as cryptococcoid neutrophilic dermatosis (CND). We underscore important clinicopathological pitfalls to avoid misdiagnosis with similar overlapping entities such as Sweet syndrome, review all published cases of CND and draw novel insights into its associated entities.
Assuntos
Dermatite , Toxidermias , Síndrome de Sweet , Feminino , Humanos , Radioisótopos do Iodo , Dermatite/patologia , Pele/patologia , Síndrome de Sweet/induzido quimicamente , Síndrome de Sweet/diagnóstico , Toxidermias/patologiaAssuntos
Doenças Ósseas Metabólicas , Ossificação Heterotópica , Dermatopatias Genéticas , Neoplasias Cutâneas , Humanos , Bochecha , Dermatopatias Genéticas/diagnóstico , Ossificação Heterotópica/complicações , Ossificação Heterotópica/diagnóstico , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnósticoRESUMO
Miliarial gout is a rare clinical variant of chronic tophaceous gout characterised by tiny milia-like papules containing chalky tophaceous material. In this report, we present a case of miliarial gout in a patient with known history of gouty arthritis and review the reported cases of miliarial gout in the literature to discuss its characteristics, diagnosis and treatment.
Assuntos
Gota/patologia , Dermatopatias Papuloescamosas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Dermatopatias Papuloescamosas/etiologiaRESUMO
ABSTRACT: Cryocrystalglobulinemia (CCG) is a rare subset of type 1 cryoglobulinemia that is classically associated with an underlying paraproteinemia. The cryocrystalglobulins are characterized by extracellular crystals, which are eosinophilic, periodic acid-Schiff positive, and exhibit nonbirefringence under polarized light. This archetypal appearance renders CCG readily diagnosable histologically. Unlike in mixed cryoglobulinemias (types II and III cryoglobulinemia) where there is complement-mediated inflammation amounting to vasculitis, the deposition of crystallized paraproteins within vessels in CCG result in an occlusive vasculopathy and culminate in severe systemic involvement. Aside from cutaneous lesions, the resultant ischemic hypoperfusion manifest frequently with fulminant acute kidney failure, polyarthralgia, peripheral neuropathy, or gastrointestinal ulceration, conferring a poor prognosis. We present an unusual case of a patient diagnosed with immunoglobulin G kappa multiple myeloma that first presented with cutaneous necrosis as a result of CCG and did not have any renal impairment or fatal outcome. We highlight this uncommon entity to underscore the clinical importance of early diagnosis to avoid significant morbidity and mortality. In addition, we also discuss a novel feature of transepidermal elimination of crystalline precipitates demonstrated on his skin biopsy.
Assuntos
Crioglobulinemia/etiologia , Mieloma Múltiplo/patologia , Dermatopatias/complicações , Dermatopatias/etiologia , Idoso , Crioglobulinemia/patologia , Humanos , Masculino , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Dermatopatias/patologiaAssuntos
Anemia Macrocítica/diagnóstico , Doenças Hereditárias Autoinflamatórias/diagnóstico , Linfadenite Histiocítica Necrosante/diagnóstico , Policondrite Recidivante/diagnóstico , Tromboembolia Venosa/diagnóstico , Idoso , Anemia Macrocítica/tratamento farmacológico , Diagnóstico Diferencial , Doenças Hereditárias Autoinflamatórias/tratamento farmacológico , Linfadenite Histiocítica Necrosante/tratamento farmacológico , Humanos , Masculino , Policondrite Recidivante/tratamento farmacológico , Tromboembolia Venosa/tratamento farmacológicoRESUMO
BACKGROUND: Alopecia areata (AA) is usually a benign cause of patchy hair loss that often resolves within a few weeks to months. Most treatment modalities are ineffective in the treatment of severe AA. The use of paint psoralen and ultraviolet-A (PUVA) in the treatment of patients with severe forms of AA has been reported in the literature. AIMS AND OBJECTIVE: The aim of this study was to evaluate the effectiveness of paint PUVA therapy in the treatment of AA in Singapore. MATERIALS AND METHODS: We performed a 10-year retrospective analysis of patients who underwent paint PUVA for AA. We evaluated patient demographics and treatment outcomes in the form of percentage change in baseline severity of alopecia tool score and final amount of hair regrowth and relapse rate. RESULTS: Ten patients were included in this study. With paint PUVA therapy, significant hair regrowth was seen in six patients. Paint PUVA therapy in our study showed minimal side effects. CONCLUSION: PUVA gives fair response in AA in a reasonable time as per our center's experience in Singapore.