Juvenile xanthogranuloma with inconspicuous foam cells and giant cells.
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Biomedical subjects
Publications and source records attributed to C K Janniger.
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Seborrheic dermatitis is a common condition that usually appears as simple dandruff. It may affect the scalp, the central part of the face and the anterior portion of the chest, as well as flexural creases of the arms, legs and groin. It occurs most often in infants and in adults between 30 and 60 years of age. Patients with acquired immunodeficiency syndrome may have particularly resistant cases of seborrheic dermatitis. Diagnosis of this condition is generally straightforward, but the differential diagnosis includes a variety of conditions, such as psoriasis vulgaris (sebopsoriasis), atopic dermatitis, tinea capitis and candidiasis, as well as other, more rare conditions. Seborrheic dermatitis may be associated with or caused by a variety of underlying disorders. Treatment is generally topical. Steroid creams, selenium, salicylic acid and coal tar preparations, and pyrithione zinc are frequently used to treat this condition.
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We report two patients with ecchymotic patches that did not suggest the diagnosis of Kaposi's sarcoma. The principal complaint of one patient was facial and periorbital edema with bilateral periorbital ecchymosis. On his trunk were patches resembling pityriasis rosea-like Kaposi's sarcoma. Both types of lesions proved to be Kaposi's sarcoma on histologic examination. The second patient had scattered ecchymotic lesions, with typical lesions of Kaposi's sarcoma elsewhere on his body. The ecchymotic lesions showed a large amount of extravasated red blood cells and no evidence of amyloid. This variant has not been described previously to our knowledge.
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Kaposi's sarcoma is a unique neoplasm which has emerged as an important element of AIDS in homosexuals but not in others at high risk for AIDS. The biology of this important tumor may be related to cytokines secreted by HIV-infected cells and/or by Kaposi's sarcoma cells themselves. We report 3 patients with multiple keloid-like tumors. These lesions proved to be Kaposi's sarcoma histologically, yet with a unique keloidal component. This variant has not been described previously. It is possible that cytokines that stimulate Kaposi's sarcoma cell growth may also stimulate proliferation of local fibroblasts to produce this variant.
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There are two types of sclerosing basal cell carcinoma (BCC), one entirely with this histology and a second with a prominent sclerosing component. Sclerosing BCC and nodular BCC with a sclerosing component often represent a difficult diagnostic and therapeutic challenge.
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