Biomedical subjects
Publications and source records attributed to J Toribio.
A case of multicentric reticulohistiocytosis associated with bilateral Dupuytren's disease and xanthelasmas of the eyelids is described. Ultrastructural examination showed electron-dense intracytoplasmic granules, collagen entrapment and interdigitation of adjacent cytoplasmic membranes.
Five members of two generations of one family were affected with lamellar ichthyosis, suggesting autosomal dominant transmission. The clinical and histopathological characteristics of the cases described here are similar to those reported by Traupe et al. (1984) as autosomal dominant lamellar ichthyosis and thus confirm the existence of this new form of ichthyosis.
This is the case history of a woman with a 6 year history of insulin-dependent diabetes mellitus and a 5 year history of tuberous lesions on the dorsal aspect of the metacarpophalangeal joints. Histological examination revealed multiple necrobiotic foci throughout the dermis and subcutaneous tissue, with varying degrees of degeneration, alternating with fibrotic areas. This picture is compatible with lipoid necrobiosis. The existence of various foci of epithelial perforation, manifested clinically by a point hyperkeratosis similar in appearance to blackheads, suggests transfollicular elimination. This would explain the total absence of a pilosebaceous follicles in the lesion.
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A female patient presented with a tumoral lesion of the areola of the left breast; the lesion surrounded the nipple. Histopathologically there was proliferation of smooth muscle fibers of the middle and deep layers of the dermis; the papillary dermis was not affected. Myomas in this site do not present the typical characteristics of other kinds of leiomyomas, including those of the scrotum. Therefore, mamillary muscle myomas should not be considered authentic tumors, but rather smooth muscle hyperplasias.
A case of solitary subungual glomus tumor, is reported. The histopathologic findings are characteristic and the clinical examination showed an dystrophy of the nail.
A typical clinical and histologic case of so-called 'pagetoid reticulosis' or Woringer-Kolopp disease is reported. This is a chronic cutaneous condition usually with a single focus or at most with a few patches confined to a circumscribed region. A disseminated form has been described as Dupont-Vandaele type, but its relationship to the classic Woringer-Kolopp disease is uncertain. The nosological location of pagetoid reticulosis has not been established, but there are reasons to regard it as a particular and well-defined entity. In relation to the nature of this condition and to the origin of the 'pagetoid cells', it is tempting to consider the possibility that Woringer-Kolopp disease might be a lymphoproliferative epidermotropic disorder, classifiable as a benign form of 'cutaneous T-cell lymphoma', but the early histologic changes are rather indicative of an epidermal origin.
Fifty-five patients with presumptive macular amyloidosis were investigated for the presence of amyloid in dermal tissue. In twenty-six of these patients the diagnosis could be confirmed by the demonstration of amyloid deposits by optical and/or electron microscopy. In this paper attention is called to the frequency of oligosymptomatic forms of macular amyloidosis, which are often overlooked in spite of the usual existence of itching. These inconspicuous forms are termed "minor macular amyloidosis", and they consist of tenuous brown macules on the upper back, irregularly interspersed with the normal skin and with speckles of whitish discoloration. The diagnosis must be verified by the finding of dermal deposits of amyloid. For that purpose the electron microscopy is a much more reliable procedure than conventional methods or thioflavine T.
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Between October 1972 and Paril 1974 a total of four patients suffering from lichen amyloidosus were admitted to the wards of the Department of Dermatology, University Hospital, Valladolid. All these patients also showed a macular amyloidosis associated with the lichenoid eruption. The authors emphasize that macular amyloidosis is quite commonly found as an associated and closely related condition in lichen amyloidosus.
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Cutaneous polyarteritis nodosa (CPAN) is a benign form of vasculitis of small and medium-size arteries with a recurrent but benign course without systemic involvement. This entity is very rare in children, with about 45 cases described in the literature we reviewed. Herein we report a 10-year-old girl with typical CPAN. Trigger factors such as streptococcal infection were not detected. Of four episodes over the last 2 years, only one required treatment with a moderate-sized oral dose of prednisone. In diagnosing CPAN, it is necessary to rule out systemic polyarteritis nodosa, which is also rare in children, as well as other panniculitides and vasculitides.
Rubinstein-Taybi syndrome is characterized by the presence of a peculiar facies, mental retardation, and broad thumbs and great toes. Several associated cutaneous abnormalities have been reported with this syndrome. Ulerythema ophryogenes is a form of follicular keratosis associated occasionally with other ectodermal defects and congenital anomalies. We describe a 9-year-old child with Rubinstein-Taybi syndrome and ulerythema ophryogenes. This association has not been described previously to our knowledge.
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A 67-year-old female presented with a 20-year-old lesion involving the right ear and preauricular area mimicking tuberculous lupus. Fusarium oxysporum infection was confirmed by biopsy studies and cultures. The biopsy specimen showed an unusually extensive dermal invasion with fungal hyphae. This is an uncommon clinical presentation for Fusarium infection in a healthy patient. When referred to us, the patient had received antifungal therapy with itraconazole without any benefit. Improvement was obtained with fluconazole therapy. The spectrum of cutaneous involvement related to Fusarium spp. includes toxic reactions, colonization, superficial indolent infection, deep cutaneous or subcutaneous infections and disseminated infection.
The acute onset and/or rapid increase in size and number of multiple seborrheic keratoses associated with internal malignancy is called sign of Leser-Trélat. Although some authors reject its existence, there are more than 80 well-documented case reports in the literature. Here, we report a 75-year-old man who presented with abrupt appearance of multiple seborrheic keratoses without any suspicious symptom of cancer. The screening for malignant neoplasms let us detect a rectal adenocarcinoma that was in a curative stage. This case-report illustrates a true sign of Leser-Trélat, and proves that these patients must be appropriately investigated for underlying malignancy.