RESUMO
The original article was published on February 15, 2020 and corrected on March 15, 2020.The revised version of the article corrects the contact information of the Corresponding Author. The changes appear in the revised online PDF copy of this article.
RESUMO
Thiotepa is a common alkylating agent known to precipitate cutaneous reactions consistent with toxic erythema of chemotherapy, including erythema and hyperpigmentation. Herein, we describe an atypical case of malignant intertrigo involving preferential erythema and desquamation not only of skin folds but also of occluded areas after thiotepa-based conditioning. The diagnosis was complicated by concurrent stomatitis and oral petechiae in the setting of autologous stem cell transplant 11 days prior for diffuse large B-cell lymphoma. Histopathological examination from two cutaneous sites demonstrated epidermal dysmaturation and eccrine gland necrosis consistent with thiotepa-induced desquamation and not Stevens-Johnson syndrome or graft-versus-host-disease. Malignant intertrigo can present with extensive cutaneous involvement, as evidenced by our patient who had 25% body surface area affected. Mucosal involvement is common with most chemotherapeutic regimens and its presence should not deter the astute clinician from consideration of a diagnosis of toxic erythema of chemotherapy. No further interventions were needed and the patient healed spontaneously.
Assuntos
Antineoplásicos Alquilantes/efeitos adversos , Erros de Diagnóstico , Hiperpigmentação/induzido quimicamente , Intertrigo/diagnóstico , Síndrome de Stevens-Johnson/diagnóstico , Tiotepa/efeitos adversos , Idoso , Humanos , Hiperpigmentação/diagnóstico , Hiperpigmentação/patologia , Intertrigo/induzido quimicamente , Intertrigo/patologia , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Estomatite/induzido quimicamenteRESUMO
Many cases of superinfected hidradenitis suppurativa (HS) involve multiple species of bacteria, but gas-producing infections are rare and can complicate the clinical picture. Additionally, recognizing squamous cell carcinoma (SCC) as a complication of longstanding HS is imperative. Herein, we present a unique case of a severe emphysematous HS that was initially mistaken for Fournier gangrene and eventually diagnosed as superinfected SCC.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Gangrena de Fournier/diagnóstico , Hidradenite Supurativa/diagnóstico , Recidiva Local de Neoplasia/tratamento farmacológico , Períneo/patologia , Neoplasias Cutâneas/diagnóstico , Enfisema Subcutâneo/diagnóstico , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/cirurgia , Diagnóstico Diferencial , Hidradenite Supurativa/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Necrose/complicações , Necrose/diagnóstico , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Enfisema Subcutâneo/complicaçõesRESUMO
The Society for Hematopathology and European Association for Haematopathology workshop, from October 27 to 29, 2011, in Los Angeles, CA, exhibited many exemplary skin biopsy specimens with interesting inflammatory changes mimicking features of cutaneous lymphoma. This article reviews features observed in cutaneous lymphoid hyperplasia, cutaneous drug reactions, lupus-associated panniculitis, pityriasis lichenoides, hypereosinophilic syndrome, histiocytic necrotizing lymphadenitis, traumatic ulcerative granuloma with stromal eosinophils, and pigmented purpuric dermatosis, as well as a brief review of the pertinent literature and discussion of submitted conference cases. For the pathologist, it is important to be aware of diagnostic pitfalls as well as the limitations of ancillary testing (eg, clonality studies). Finally, correlation with total clinical information, good communication with clinical colleagues, close clinical follow-up with rebiopsy, and prudent use of laboratory studies are vital and will likely offer the best path toward a correct diagnosis.