ABSTRACT
Background: Early lesions of vitiligo can be confused with various other causes of hypopigmentation and depigmentation. Few workers have utilized dermoscopy for the diagnosis of evolving lesions of vitiligo. Aim: To analyze the dermoscopic findings of evolving lesions in diagnosed cases of vitiligo and to correlate them histopathologically. Methods: Dermoscopy of evolving lesions in 30 diagnosed cases of vitiligo was performed using both polarized light and ultraviolet light. Result: On polarized light examination, the pigmentary network was found to be reduced in 12 (40%) of 30 patients, absent in 9 (30%), and reversed in 6 (20%) patients; 2 patients (6.7%) showed perifollicular hyperpigmentation and 1 (3.3%) had perilesional hyperpigmentation. A diffuse white glow was demonstrable in 27 (90%) of 30 patients on ultraviolet light examination. Melanocytes were either reduced in number or absent in 12 (40%) of 30 patients on histopathology. Conclusion: Pigmentary network changes, and perifollicular and perilesional hyperpigmentation on polarized light examination, and a diffuse white glow on ultraviolet light examination were noted in evolving vitiligo lesions. Histopathological examination was comparatively less reliable. Dermoscopy appears to be better than routine histopathology in the diagnosis of evolving lesions of vitiligo and can obviate the need for a skin biopsy.
Subject(s)
Dermoscopy/methods , Dermoscopy/statistics & numerical data , Humans , Hyperpigmentation/diagnosis , /radiotherapy , Patient Selection , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/radiotherapy , Ultraviolet Therapy/methods , Vitiligo/diagnosis , Vitiligo/radiotherapyABSTRACT
As the skin is the largest and complex organ, a wide variety of tumourlike lesions are encountered in the clinical practice. The ability to properly diagnose & treat these common lesions & to distinguish them from malignant tumours is the vital skills for all clinicians. Objective: To analyse retrospectively tumourlike lesions of skin with respect to age, sex, clinical features and histopathological features in a tertiary referral centre in Maharashtra, India. Methods : The present study consisted of analysis of tumourlike lesions of skin received in the histopathology section of department of pathology over a period of 5 years that is from August 2005 to July 2010 .The material comprised of biopsies and excision specimens. The clinical and histopathological details were noted. The findings were compared with those reported by other authors. Results : One hundred and seventy five (175) cases of tumourlike lesions of skin were seen .These lesions presented as skin swellings or tumours. Maximum cases (34.8%) of tumourlike lesions occurred in fourth & fifth decades with male preponderance (1.35:1). The maximum number of cases was encountered in the head & neck region (63.4%). Their size ranged from 0.4 to 9 cms. Epidermal cyst was the commonest tumourlike lesion (59.4%) followed by dermoid cyst (13.1%).Other lesions were trichilemmal cyst, fibroepithelial polyp, keloid, hypertrophic scar and epidermal nevus. Conclusion : Tumourlike lesions are clinically diagnosed by their presentation. However, the histopathological examination confirms the clinical diagnosis. The pathologic evaluation of all tumourlike lesions is mandatory to avoid patient’s and family’s anxiety.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Dermoid Cyst/diagnosis , Dermoid Cyst/epidemiology , Dermoid Cyst/pathology , Epidermal Cyst/diagnosis , Epidermal Cyst/epidemiology , Epidermal Cyst/pathology , Female , Humans , Male , Middle Aged , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/epidemiology , Skin Diseases, Papulosquamous/pathology , Skin Diseases, Vesiculobullous/diagnosis , Skin Diseases, Vesiculobullous/epidemiology , Skin Diseases, Vesiculobullous/pathology , Young AdultABSTRACT
Dowling Degos disease is a rare, reticulate pigmentary disorder with variable phenotypic expression that manifests as hyperpigmented macules and reticulate pigmentary anomaly of the fl exures. Many variants of this condition and its overlap with other reticulate pigmentary disorders have been reported in the literature. We present here two cases of DDD with follicular localization, both clinically and histologically. It was associated with ichthyosis vulgaris in one case. Follicular DDD is an uncommon variant of this evolving dermatosis. Our report supports the possible role for disordered follicular keratinisation in its pathogenesis.
Subject(s)
Adult , Female , Humans , Hyperpigmentation/diagnosis , Hyperpigmentation/therapy , Male , Skin Diseases/diagnosis , Skin Diseases/therapy , Skin Diseases, Genetic/diagnosis , Skin Diseases, Genetic/therapy , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/therapy , Young AdultABSTRACT
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Ear Auricle/radiation effects , Radiation Injuries/etiology , Skin Diseases, Papulosquamous/etiology , Sunlight/adverse effects , Age Factors , Asymptomatic Diseases , Brazil/epidemiology , Chi-Square Distribution , Cross-Sectional Studies , Diagnosis, Differential , Prevalence , Radiation Injuries/diagnosis , Radiation Injuries/epidemiology , Skin Pigmentation , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/epidemiologyABSTRACT
El pseudoacné de la línea transversa nasal (PLTN) es un cuadro benigno, no asociado a patología sistémica, que se caracteriza por la presencia de lesiones similares a las del acné en la unión de los tercios medio e inferior del puente nasal, sitio que anatómicamente corresponde a la zona de unión de los cartílagos nasales alares y triangulares. En esta área anatómica han sido descriptas líneas de color piel, hipo o hiperpigmentadas, con o sin atrofia, que en su trayecto pueden desarrollar quistes de milium, comedones, pápulas y/o pústulas. El diagnóstico de PLTN debe ser considerado en todo paciente con una pápula de evolución crónica o quistes de milium en la línea transversa nasal, especialmente si tiene antecedentes de frotamiento de la nariz o rinitis alérgica. Presentamos 10 pacientes, 9 pediátricos y un adulto, con lesiones en la línea transversa nasal. Las diferentes manifestaciones clínicas observadas fueron pápulas, comedones, quistes de milium y/o hipopigmentación. Concluimos que las lesiones en la línea transversa nasal son más frecuentes que lo descripto en la literatura y que existe un espectro clínico muy amplio, que va desde una mínima hipopigmentación lineal hasta la presencia de lesiones quísticas. Algunos autores, al igual que nosotros, se replantean el nombre de esta entidad por la presencia de comedones.
Pseudoacne of the nasal crease is a benign isolated condition, characterized by lesions that resemble acne at the junction of the middle and lower thirds of the nose, known as nasal crease, that anatomically corresponds to the site of union of the alar and triangular nasal cartilages. Different types of lesions have been described in this area: atrophic lines, hypo or hyperpigmented lines with or whithout atrophy that may develop milium cysts, comedones, papules and/or pustules. Pseudoacne of the nasal crease should be suspected in any individual with chronic papular lesions or milia over the nasal crease, especially when having a history of chronic rubbing of the nose or rhinitis. We present 10 patients (9 children and an adult) with lesions over the nasal crease. Different clinical manifestations observed were: papules, comedones, milium cysts and/or hypopigmentation. We conclude that these clinical presentations are likely much more common than reported in the literature and that a wide spectrum of lesions exists, ranging from a minimal hypopigmented crease to cystic lesions. Considering the common finding of comedones, we also suggest -as well as other authors- that the name pseudoacne should be revised.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adult , Acneiform Eruptions , Skin Diseases, Papulosquamous/diagnosis , Nose Diseases , Hypopigmentation/diagnosis , Nasal Cavity , Nasal SeptumABSTRACT
La elastólisis de la dermis papilar similar a pseudoxantoma elástico es un raro trastorno adquirido caracterizado por pápulas y placas amarillentas localizadas principalmente en cuello y región supraclavicular. Los hallazgos histopatológicos y la ausencia de afectación sistémica lo diferencian del pseudoxantoma elástico. Comunicamos seis pacientes de sexo femenino de entre 72 y 79 años con diagnóstico clínico e histopatológico de esta entidad.
Subject(s)
Humans , Female , Aged , Dermis/pathology , Elastic Tissue/pathology , Diagnosis, Differential , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/pathology , Pseudoxanthoma ElasticumABSTRACT
Inverse [flexural] psoriasis is characterized by shiny, pink to red, sharply-demarcated thin plaques. Frequency of isolated involvement of these areas is very rare and the morphology is frequently altered by maceration and friction. All this leads to diagnostic confusion. We describe two cases of inverse psoriasis with isolated involvement of axillae. One patient presented with dry mildly scaly plaque, while the other presented with macerated plaque. Histopathology was consistent with the diagnosis of inverse psoriasis. Although there are previous reports, but localization of lesions only to axillae in a case of inverse psoriasis is unique
Subject(s)
Humans , Male , Female , Skin Diseases, Papulosquamous/diagnosis , Axilla/pathology , ParakeratosisABSTRACT
Las blaschkitis pueden definirse como procesos adquiridos inflamatorios cutáneos que asientan en las líneas de Blaschko y pueden tener diversas características clínicas e histopatológicas. Cuando éstas se localizan en la cara se mencionan el liquen estriado, el liquen plano lineal y el lupus eritematoso lineal. Se presenta el caso de una mujer de 42 años de edad con una blaschkitis de 4 meses de evolución localizada en frente cuya histopatología evidenció un ataque centrofolicular inflamatorio y destructivo. Se plantean diagnósticos diferenciales y se comunica la exitosa respuesta terapéutica al tacrolimus tópico.
Subject(s)
Humans , Adult , Female , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/pathology , Diagnosis, Differential , Erythema/pathology , Skin/pathology , Tacrolimus/administration & dosage , Tacrolimus/toxicityABSTRACT
Se presentan 2 casos clínicos de agentes de micosis cutáneas no descritos en el país. El primer caso corresponde a un paciente femenino de 18 años de edad, sin antecedentes mórbidos de importancia, ni viajes al exterior, que presenta una lesión pruriginosa en cara externa del brazo izquierdo de apariencia erito pápulodescamativa de 2 semanas de evolución. Al examen directo, presentó micelios hialinos y en los cultivos micológicos un abundante desarrollo de Microsporum praecox. La lesión remitió completamente al tratamiento con Terbinafina tópica 2 veces al día por 21 días. Se comenta la rara presencia en Chile de M.praecox, especie presente en equinos y su hábitat, pero de dispersión restringida a Francia y Bélgica principalmente. Se discute el posible origen de este agente y las interrogantes en cuanto a su presencia en el país. El segundo caso corresponde a un paciente femenino de 24 años de edad, sin antecedentes mórbidos de importancia, que presenta alteraciones de la uña del primer ortejo derecho durante 2 años, caracterizadas por: engrosamiento subungueal, destrucción distal y cambios de coloración. Consulta con un dermatólogo, quien por su aspecto clínico típico, diagnostica onicomicosis e indica Terbinafina 250 mg diarios por 2 meses, sin embargo, el cuadro clínico se hace refractario en el tiempo frente a diversos antimicóticos usados.
Two clinical cases of agents of cutaneous mycoses not described in the country are reported in this paper. The first case deals with an 18-aged female patient, free from any significant morbid history, who has never traveled abroad, which bears a erytho-papule-descamative pruriginous lesion on the outside of her left arm and 2-week evolution. A direct exam revealed the presence of hyaline mycelia while an abundant development of Microsporum praecox was detected in the mycological cultures. The lesion had a favorable reaction to the treatment with topic Terbinafine twice a day for 21 days. The rare occurrence of M.praecox in Chile, a species commonly found in horses and their habitat yet with a restricted distribution mainly in France and Belgium and the possible origin of this agent in the country is commented. The second case is focused on a 24-age female patient, free from any significant morbid history, who exhibits variations in her first right toe since two years and which are characterized by the following: subungueal thickening, distal destruction and change in colour. She consults a dermatologist, who after considering a typical clinical aspect, determined an onimycosis and recommends 250mg Terbinafine for two months; however the clinical pattern becomes refractory in time due to the use of several antimycotic.
Subject(s)
Humans , Adolescent , Adult , Female , Acremonium , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/etiology , Skin Diseases, Papulosquamous/microbiology , Skin Diseases, Papulosquamous/therapy , Microsporum , Mycoses/diagnosis , Mycoses/etiology , Mycoses/therapy , Onychomycosis , ChileSubject(s)
Biopsy, Needle , Child, Preschool , Dermatologic Agents/therapeutic use , Diagnosis, Differential , Facial Dermatoses/diagnosis , Follow-Up Studies , Hand Dermatoses/diagnosis , Humans , Immunohistochemistry , Male , Mastocytosis, Cutaneous/diagnosis , Risk Assessment , Skin Diseases, Papulosquamous/diagnosisSubject(s)
Female , Adult , Humans , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/therapy , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/therapy , Sunscreening Agents/therapeutic use , Hydroxychloroquine/therapeutic use , Prednisone/therapeutic use , Treatment OutcomeABSTRACT
Malignant atrophic papulosis is a rare and fatal condition with multiple organ involvement. We describe a patient with progressive ocular and dermatological findings.
Subject(s)
Adult , Atrophy , Eye Diseases/diagnosis , Fatal Outcome , Humans , Immunosuppressive Agents/therapeutic use , Male , Skin Diseases, Papulosquamous/diagnosis , Vision, Low/diagnosis , Visual FieldsABSTRACT
Grover (1970) describió una dermatosis transitoria, generalmente pruriginosa, papulosa, a veces hiperqueratósica o costrosa, distribuida principalmente en el tronco, que remitía espontáneamente en semanas o meses. La presencia de acantolisis focal, con cuatro patentes histológicas asociadas y formas más crónicas o persistente, fueron descritas un tiempo después. Presentamos seis nuevos casos y efectuamos una revisión de las dermatosis acantolítica transitoria (DAT) a la luz de los conocimientos actuales. Enfatizamos la experiencia y publicaciones de autores iberolatinoamericanos
Subject(s)
Humans , Male , Female , Middle Aged , Acantholysis/etiology , Acantholysis/diagnosis , Acantholysis/pathology , Darier Disease/diagnosis , Diagnosis, Differential , Pruritus/etiology , Self-Evaluation Programs , Skin Diseases, Papulosquamous/diagnosisABSTRACT
Se presenta un caso de fibropapulosis blanca del cuello en una mujer de 63 años con numerosas lesiones papulosas no confluentes en el cuello y zonas del mentón. Debido a que la fibropapulosis blanca del cuello es de reciente reconocimiento, se discuten asimismo los diagnósticos diferenciales que esta afección plantea, tales como el pseudoxantoma elástico clásico y su variedad "pseudoxantoma elástico-simil con elastólisis dérmica papilar", así como el tricodiscoma, el acrocordón, las anetodermias, la dermatofibrosis lenticular diseminada, el nevo conectivo eruptivo y la "piel cetrina" de Milian
Subject(s)
Humans , Female , Middle Aged , Skin Aging/pathology , Skin Diseases, Papulosquamous/diagnosis , Diagnosis, DifferentialABSTRACT
We present in this article a 48 years old female who suffered from papulonecrotic tuberculid for 4 years. The diagnosis is based on the clinical picture, the highly positive tuberculin test, the histopathologic findings and the history of contact with an open pulmonary tuberculosis
Subject(s)
Humans , Female , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Gastrointestinal , Skin Diseases, Papulosquamous/diagnosis , NecrosisABSTRACT
La milia en placa es una lesión inusual de etiología poco clara, que se localiza con preferencia en la zona retroauricular. Presentamos un caso de esta afección en un paciente de sexo femenino de 59 años de edad cuya única sintomatología era un ligero prurito. La histología demostró la presencia de quistes infundibulares pequeños con contenido queratínicos y escasa reacción inflamatoria crónica intersticial. Como otros autores, consideramos a esta lesión como una entidad autónoma, tal vez de origen nevoide