ABSTRACT
Pityriasis rubra pilaris (PRP) is a rare inflammatory dermatosis characterized by hyperkeratotic follicular papules and erythematous-desquamative plaques that tend to progressively evolve into erythroderma. Treatment is challenging given that international guidelines are not available and large-scale trials do not exist. Traditionally, many topical and systemic drugs had been used as consolidated agents; recently, biologicals are gaining increasing importance, promisingly dominating the therapeutic scenario ahead. Herein, we present a case series showing the "past" and the "future" therapeutic approaches to erythrodermic PRP, one case treated with acitretin and nb-UVB phototherapy combination, while the other with ustekinumab, performing also a throughout literature review.
Subject(s)
Dermatologic Agents , Pityriasis Rubra Pilaris , Ultraviolet Therapy , Acitretin/therapeutic use , Dermatologic Agents/therapeutic use , Humans , Pityriasis Rubra Pilaris/diagnosis , Pityriasis Rubra Pilaris/drug therapy , Ustekinumab/therapeutic useSubject(s)
Anticonvulsants/adverse effects , Brain Neoplasms/radiotherapy , Cranial Irradiation/adverse effects , Erythema Multiforme/etiology , Lung Neoplasms/pathology , Phenobarbital/adverse effects , Adult , Brain Neoplasms/secondary , Erythema Multiforme/diagnosis , Erythema Multiforme/drug therapy , Female , Glucocorticoids/therapeutic use , Humans , SyndromeABSTRACT
IMPORTANCE: To date, no dermoscopic features have been described for the diagnosis of primary cutaneous B-cell lymphoma (PCBCL). This tool might be helpful for the clinical differential diagnosis in the context of single erythematous nodules of the skin. OBSERVATIONS: Ten cases of PCBCL, presenting clinically as solitary red/pinkish nodules, were retrospectively retrieved. Patient data were collected along with dermoscopic and histopathological features of each lesion. Most lesions (9/10) showed white circles with a salmon-colored background/area (6 lesions), scales (7 lesions), arborizing vessels (5 lesions) or a polymorphous vascular pattern (2 lesions). Histology revealed a cutaneous marginal zone lymphoma in 6 lesions, a follicle center lymphoma in 2 lesions and a diffuse large B-cell lymphoma in 2 lesions. CONCLUSIONS AND RELEVANCE: Dermoscopic examination may be helpful for improving the clinical recognition of PCBCL although skin biopsy remains mandatory.
Subject(s)
Dermoscopy , Lymphoma, B-Cell, Marginal Zone/diagnostic imaging , Lymphoma, Follicular/diagnostic imaging , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Adult , Aged , Female , Humans , Immunophenotyping , Lymphoma, B-Cell, Marginal Zone/pathology , Lymphoma, Follicular/pathology , Lymphoma, Large B-Cell, Diffuse/pathology , Male , Middle Aged , Skin Neoplasms/pathology , Young AdultABSTRACT
We report the case of a 61-year-old man showing persistent erythematous macules, plaques, and partially confluent nodules with irregular borders, developed on his nose for one year. During that time the patient underwent several dermatological consultations, and all produced the same diagnosis: rhinophyma. So antibiotic and steroid treatment was carried out without any improvement while the lesions kept growing. When the patient came to our observation, physical examination revealed large, infiltrative, oedematous, erythematous plaques and rare nodules, with superficial telangiectatic vessels. Cervical lymphadenopathy was not detectable. Routine laboratory analysis was normal. Punch biopsy was performed, and histopathology and immunohistochemical studies were consistent with cutaneous angiosarcoma. This is the report of a face angiosarcoma with an unusual and very deceptive clinical presentation.