Photosensitive lichenoid eruption and inhaled tiotropium bromide.
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Biomedical subjects
Publications and source records attributed to C Peteiro.
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Cutaneous angiosarcoma (AS) of the face and scalp of the elderly is a rare malignant tumour with a very poor prognosis. The variable presentation and the benign appearance of the cutaneous AS may often delay the correct diagnosis. Because it is extremely aggressive, only early detection and treatment can modify the prognosis. We describe a case of an old man who was diagnosed of AS of the face and scalp 1 month after developing the cutaneous lesion. After treatment with placitaxel, the lesion completely diminished. Unfortunately, he developed pulmonary fibrosis and died 6 months after diagnosis. Predisposing factors of this entity are also discussed.
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Neutrophilic eccrine hidradenitis was initially described in acute myelogenous leukaemic patients undergoing chemotherapy, suggesting a drug-induced mechanism. It has been reported in some with various neoplastic and non-neoplastic conditions as well as in healthy individuals. However, most the reported cases have been described in acute myelogenous leukaemic cases receiving chemotherapy. We describe a neutrophilic eccrine hidradenitis case unassociated with chemotherapy in a woman with chronic myelogenous leukaemia.
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A small proportion of patients with alpha1-antitrypsin (alpha1AT) deficiency experience recurrent ulcerating panniculitis. Studies suggest that alpha1AT-deficiency panniculitis reflects an uncontrolled inflammatory process because of the serum's incapacity to neutralize proteolytic enzymes released by leukocytes in the skin. Dapsone is considered the treatment of choice for this entity, but it is limited by its side effects, especially hematologic ones. Tetracyclines have anticollagenase and anti-inflammatory activity and have been used successfully to treat this type of panniculitis. We report the case of a 42-year-old woman with recurrent alpha1AT-deficiency panniculitis who did not tolerate the side effects of dapsone or systemic corticosteroid. Minocycline treatment led to disappearance of lesions, and long-term administration prevented recurrences without evident negative side effects. We consider minocycline a safe treatment that allows control of alpha1AT-deficiency panniculitis.
A 48-year-old man, previously healthy and asymptomatic, showed a unique skin lesion located on the right buttock. The histopathological study of the lesion disclosed an adenocarcinoma metastatic to the skin. The primary tumour was found at the head of the pancreas, and was confirmed by biopsy. Six months after the beginning of treatment with Gemcitabine the patient is still asymptomatic, and the cutaneous lesion has disappeared. Carcinomas of the pancreas represent less than 5% of human malignant neoplasms, skin involvement is rare, and metastasis generally multiple and situated in the periumbilical area. To our knowledge, very few patients have been reported with a solitary cutaneous lesion disclosing a pancreatic adenocarcinoma. The atypical location, the absence of related symptoms or analytical disorders, and the good progress of the patient make this case especially interesting.
We report 3 cases of congenital multiple glomus tumors seen during the last 5 years. One of them showed autosomal dominant inheritance with male-to-male transmission. The remaining patients had no family history of similar lesions. The clinical and histopathological aspects of our patients support the recently described type 2 segmental manifestation of multiple glomus tumors. One of the cases showed associated multiple and giant trichilemmal cysts with a linear distribution in the scalp.
Malignant neoplasms from natural killer (NK) cells are characterized by their positivity for CD56 and absence of monoclonal TCR gene rearrangement. Recently, they have been classified into four main types (nasal and nasal-type NK cell lymphoma, aggressive NK cell leukemia/lymphoma, and blastoid NK cell leukemia/lymphoma), based on clinical features, racial predisposition, presence of azurophilic granules, immunophenotype and association with Epstein-Barr virus (EBV) infection. A 72-year-old Caucasian man presented with a malignant neoplasm comprised of blastoid cells without azurophilic granules in the Giemsa stain, with positivity for CD2, CD4, HLA-DR, CD45 and CD56, and negativity for CD3 (surface and cytoplasmic) and CD5. In situ hybridization for EBV and PCR analysis of rearrangement of the T cell receptor gene were negative. Based on these results, a diagnosis of blastoid NK cell lymphoma was made. In this case the first clinical manifestations were the cutaneous lesions, and, although the disease was already advanced at the diagnosis, the patient responded completely to the treatment and remains asymptomatic 14 months after diagnosis.
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An 87-year-old woman developed erythema, induration and tenderness of the skin overlying each breast. One year before, she had undergone an axillary lymph node dissection because of metastases from melanoma. The primary site was unknown. A skin biopsy showed pigmented tumor nests within the dermal lymphatic vessels, and immunohistochemistry confirmed the melanocytic origin. The diagnosis of inflammatory metastatic melanoma was made.
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A case of amitriptyline-induced superficial erythema annulare centrifugum (EAC) is reported. Its singular characteristics are prominent epidermal manifestations, with clinical and histologic vesiculation, associated with vacuolar degeneration at the dermoepidermal junction; numerous arciform lesions, accompanied by diffuse erythema on rechallenge; quick change, more rapid than that usually described for EAC; and a short course, in contrast with the usual chronic evolution of EAC. To our knowledge, this is the first reported case of EAC associated with amitriptyline intake.
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A 74-year-old man presented with a tumor on his scalp that he had since birth. The authors observed a verrucous pink crusted plaque. The tumor was clinically diagnosed as nevus sebaceus and was removed. Histopathologic study showed, arising from nevus sebaceus, a lobular neoplasm with the classic features of trichilemmoma. Desmoplasia was present in the center of the trichilemmomatous area. This description is typical of a special, uncommon type of trichilemmoma that histologically mimics invasive carcinoma.
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Generalized (diffuse) plane xanthoma (GPX) is a normolipaemic xanthomatosis that is very frequently associated with a haematological disorder, and especially with monoclonal gammapathies, which it may precede by several months or years. Here, we report a case of GPX associated with idiopathic Bence-Jones proteinuria, a very rare type of monoclonal gammopathy of undetermined significance. To our knowledge, this association has not been previously described.
Hair follicle nevus has been variously defined as a specific type of neoplasm with follicular differentiation or as a synonym for trichofolliculoma; the latter view has predominated in recent years. We report a nodular lesion that was identified histopathologically as a hamartoma with follicular differentiation and that systematic serial sectioning showed not to be a trichofolliculoma. After reviewing previous descriptions of lesions diagnosed as hair follicle nevus, and in the light of our own observations, we believe that hair follicle nevus is a distinct type of adnexal hamartoma.