Pigmented purpuric dermatosis-like sarcoidosis.

Sarcoidosis is a chronic multisystem granulomatous disease of unknown origin. Recently, a purpuric variant of cutaneous sarcoidosis resembling pigmented purpuric dermatosis (PPD) has been documented. Herein, we describe another unusual case with clinical features mimicking PPD, characterized by brownish macules and flat-topped papules with a slightly purpuric component on the legs and dorsum of the feet and histopathological features consistent with sarcoidosis. We designated this unusual clinical presentation as "PPD-like sarcoidosis".

Circumscribed acral hypokeratosis: a report of 2 cases and a brief review of the literature.

Circumscribed acral hypokeratosis (CAH) is characterized by solitary or multiple circular, depressed, slightly erythematous patches on the palms or soles. Keratinization defects on acral sites or prior trauma to the affected area have been considered as potential triggers of CAH. Although affected patients typically present with a long-term history of the disease and characteristic cutaneous lesions, CAH is not well known by dermatologists. In this article, we describe 2 patients with CAH. From a clinical point of view, we emphasize its unique cutaneous expression, and from a histologic perspective, we speculate on protracted or repetitive blunt trauma in the elicitation of this dermatosis, perhaps only in patients with a genetic predisposition.

Dermatoscopy as an adjunctive diagnostic tool in aquagenic syringeal acrokeratoderma.

Aquagenic syringeal acrokeratoderma (ASA) is a rare skin disorder of the palms and/or soles, characterized by whitish papules with occasional pruritus or pain sensation. Herein we report a 27-year-old man with a diagnosis of ASA based on clinical and histopathological features, and describe the dermatoscopic features consistent with threefold enlarged sweat duct pores compared with a normal-looking palmar skin area. As far as we are aware, dermatoscopic features of ASA have not been reported so far.

Terra firma-forme dermatosis.

Terra firma-forme dermatosis is characterized by 'dirty' brown-grey cutaneous patches and plaques that can simply be eradicated by forceful swabbing with alcohol pads. The pathogenesis has been attributed to abnormal and delayed keratinization. Although affected patients present with typical lesions, the disorder is not well-known by dermatologists. In this report, we describe two patients with terra firma-forme dermatosis in the setting of xerosis cutis and atopic dermatitis. From a clinical point of view, we lay emphasis on its unique expression and diagnosis/treatment. From a histological perspective, we highlight its resemblance to dermatosis neglecta and speculate on the role of 'neglect' in a patient with seemingly adequate hygiene. The role of urea containing emollients in the development of this disorder remains to be determined.

Acquired perforating dermatosis successfully treated with photodynamic therapy.

Acquired perforating dermatosis is a rare perforating skin disorder characterized by intensely pruritic papules or nodules with central adherent plugs mainly observed on the lower extremities and transepidermal elimination of collagen bundles. Treatment of acquired perforating dermatosis is a matter of debate and conventional treatment options including topical and systemic retinoids, topical corticosteroids and keratolytics, ultraviolet B phototherapy, psoralen plus ultraviolet A (PUVA), allopurinol and cryosurgery show mixed results. Herein, we describe a 60-year-old woman with a diagnosis of acquired perforating dermatosis secondary to diabetes mellitus in whom we achieved excellent results with photodynamic treatment. As far as we are aware, this is the first case report of photodynamic treatment for acquired perforating dermatosis.

Intraventricular hemorrhage as an unusual presenting form of Sneddon syndrome.

BACKGROUND: Intraventricular hemorrhage, which has a poor prognosis, is an extremely rare presenting symptom of central nervous system vasculitis. Sneddon syndrome, which is a systemic vasculitic disease, generally presents with ischemic stroke and livedo reticularis. Intraventricular hemorrhage is extremely rare in Sneddon syndrome and has not been reported as the presenting complaint. METHODS: We report a 37-year-old woman who presented with acute intraventricular hemorrhage, and on further evaluation her condition was diagnosed as Sneddon syndrome. RESULTS: Patient underwent ventriculoperitoneal shunting operation for hydrocephalus and her condition markedly improved 6 months later; she was independent in her activities of daily living. CONCLUSIONS: In this report, we emphasize the importance of multisystemic evaluation of patients, especially those with obscure angiography findings.

Eruptive vellus hair cysts: report of a pediatric case with partial response to calcipotriene therapy.

Eruptive vellus hair cysts (EVHCs) are characterized by asymptomatic, follicular, comedonelike papules usually located on the anterior chest and abdomen. We present a pediatric case of EVHC associated with attention deficit hyperactivity disorder that partially responded to calcipotriene cream within 2 months. Our aim is to refamiliarize clinicians with a common albeit frequently unrecognized disorder of vellus hair follicles.

Dermal vacuoles in two biopsies of psoriasis.

Two patients presented with cutaneous lesions clinically typical of psoriasis. The first case was a 38-year-old man and the second was a 51-year-old woman. To confirm the diagnosis, 4-mm punch biopsy samples were obtained from both patients from the lesions on the knees. Histology in both cases was in favour of psoriasis and also revealed empty vacuoles in the papillary dermis, concentrated at sites of intense lymphocyte infiltration. The empty vacuoles resembled true fat cells or fat globules. They did not reveal positive immunostaining with CD34 antigen, suggesting that they were not lined by endothelial cells. Final histological diagnosis was psoriasis associated with dermal vacuolization.

Acute actinic cheilitis-like chemical irritant reaction following accidental contact with ethylene glycol-favorable response to topical 1% pimecrolimus cream: a case report.

Ethylene glycol is a colorless, odorless, nonvolatile, water-soluble fluid, mainly used as automobile antifreeze and coolant. This substance is a frequent culprit in accidental and intentional poisonings. Although potentially fatal systemic consequences of ethylene glycol ingestion are well known, local adverse effects through brief skin and mucosa contact with ethylene glycol have been rarely reported. Herein we report a patient with accidental ethylene glycol contact to the lower lip, who presented with acute, manifest, actinic cheilitis-like chemical irritant reaction and favorably responded to topical pimecrolimus 1% cream.

Unilateral transient reactive papulotranslucent acrokeratoderma in a child.

Transient reactive papulotranslucent acrokeratoderma is a rare, acquired, reactive, and episodic disorder of the palmar skin. Herein I report on a 6-year-old child with unilateral involvement and associated with ipsilateral hyperhidrosis and pruritus. Further observations are required for unraveling the etiopathogenesis of this disorder and its accurate classification.

Absence of estrogen and progesterone receptors around the affected vessels of angioma serpiginosum: case report.

Angioma serpiginosum is a disorder of dilated superficial dermal capillaries. The disease is considered by some authors to be a consequence of increasing levels of estrogens. We present a case of angioma serpiginosum in a 46-year-old White woman. The lesions consisting of red-purple puncta were grouped as vaguely annular and angular patches with serpiginous borders, located on the right side of the neck, the right side of the abdomen, and on the left arm. Histopathologic examination revealed clusters of dilated capillaries in the dermal papillae, without endothelial proliferation. Periodic acid-Schiff (PAS) stain-positive deposits were noted around the affected blood vessels. However, immunohistochemical analysis revealed the absence of estrogen and progesterone receptors within the involved blood vessels. Hormonal assays were also normal. Our observations suggest that a hormonal stimulus probably plays no role in the pathogenesis of angioma serpiginosum. The significance of PAS-positive deposits as a diagnostic marker for angioma serpiginosum needs further confirmation.