Clinical Drug-Resistant Cutaneous Tuberculosis Presenting as Lupus Vulgaris Ulcerative Type in an Indian Female With Poncet's Disease: A First-of-Its-Type Report.

Tuberculosis of the skin is rare and a difficult diagnosis. Moreover, recurrent episodes of mycobacterial infection in the skin with Poncet's disease are rarely reported in females. Herein, the first of its type case of clinical drug-resistant tuberculosis of the skin in an Indian female is presented. She had a history of cutaneous tuberculosis five times in the past. At the sixth time, she came with complaints of an ulcerative lesion over her right forearm and cubital fossa with left knee swelling. The paucibacillary nature of the infection made the diagnosis exceedingly challenging. However, a detailed clinical examination with a suspicion of drug resistance resulted in management with significant clinical improvement.

Diascopy and histopathological evaluation of nonblanching erythematous dermatoses in dogs.

BACKGROUND: Diascopy is a point-of-care diagnostic test used to differentiate skin erythema due to vascular dilation from haemorrhage. In the veterinary literature, only a handful of diseases have been described to be associated with a negative (nonblanching) diascopy result, and histological investigation of haemorrhage has been inconsistent. OBJECTIVES: Retrospective study to undertake a histopathological investigation of canine, nonblanching erythematous dermatoses for the presence or absence of haemorrhage and vascular changes. MATERIALS AND METHODS: Skin biopsies from dogs presented with moderate-to-severe nonblanching erythema were evaluated histologically. Additionally, clinical data about each patient were analysed. RESULTS: Twenty cases were identified with nonblanching erythema. Diagnoses included vasculopathy (n = 6), canine eosinophilic dermatitis (n = 3), cutaneous epitheliotropic T-cell lymphoma (n = 2), and one case each of sterile granuloma and pyogranuloma syndrome, German shepherd dog pyoderma, multiple mast cell tumours, haemangiosarcoma, exfoliative cutaneous lupus erythematosus, canine leishmaniosis with sebaceous adenitis, sebaceous adenitis with concurrent dermatophytosis, calcinosis cutis and canine atopic dermatitis with insect-bite reaction. One or more vascular changes were present in all 20 cases and included perivascular oedema, endothelial swelling and neutrophilic infiltration of vessel walls. Haemorrhage was identified in 17 of 20 cases (85%). Three cases without dermal haemorrhage were calcinosis cutis, sebaceous adenitis with dermatophytosis and canine atopic dermatitis with insect-bite reaction. CONCLUSIONS AND CLINICAL RELEVANCE: Negative diascopy was associated with haemorrhage and vascular pathological findings in the majority of cases, yet not all. Haemorrhage was identified histologically in all diseases previously reported as nonblanching as well as in a few additional diseases.

Hemangioma of Tongue With Multiple Phleboliths Involving Multiple Spaces of the Right Side of the Head and Neck Region: A Case Report Along With the Importance of Specialized Imaging.

Hemangioma is one of the most common tumors of dilated blood vessels, which is usually present at birth and involutes over time. Although considered the most common tumor in the head and neck region, the oral cavity is less commonly affected. The occurrence of hemangioma in the tongue is very rare (14%). Changes in blood flow are dynamic within the hemangioma resulting in thrombus and phleboliths. Phleboliths are small blood clots that occur in a vein, which usually hardens over time due to calcifications. The phleboliths are also called vein stones, which tend to be oval-shaped and are generally less than 5 millimeters in diameter. This paper reports a case of hemangioma of the tongue. On routine radiographic investigation (orthopantomogram), multiple phleboliths were found extending over the right side of the jaw involving the ramus and body of the mandible, which was an incidental finding. On specialized imaging, the extent of the phleboliths turned out to involve multiple spaces, which was unexpected.

Granuloma faciale: An unusual diascopic finding.

Granuloma faciale (GF) is a benign, chronic inflammatory disorder, characterized by reddish brown plaques with prominent follicular orificesand telangeictasia, usually occurring over the face. The condition often presents a problem in differential diagnosis. Herein we describe a case of GF with an unusual diascopic finding of an apple jelly appearance on diascopy.