Cutaneous findings in HIV-1-positive patients in Thailand.
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Biomedical subjects
Publications and source records attributed to P Palungwachira.
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Nodular cutaneous amyloidosis is a rare disease that predominantly affects women in their sixth and seventh decades. The genital organ is the rarest cutaneous location with only four reported cases of vulvar involvement. We report the first known case of this entity involving the glan penis. The clinical feature of nodular cutaneous amylodosis, the histopathology, the pathogenesis and the therapy are discussed.
The fine structure of five cases of glomus tumor was described. All of the cases showed a solid type, and the glomus cells were shown to be typical or modified smooth muscle cells. The authors' conclusion is that the glomus cells were not derived from pericytes, but from smooth muscle cells of vascular part of the glomus, and are thought to be a specialized smooth muscle cell tumor.
We report a case of (generalized) fixed drug eruption induced by atenolol, a beta adrenoreceptor blocking agent. Atenolol has been shown to be effective treatment for hypertension, angina pectoris and cardiac arrhythmia. However, adverse skin reactions are very rare. We present a case of (generalized) fixed drug eruption due to atenolol and review the cutaneous reaction to the drug.
We describe a 62-year-old woman with Psoriasis who presented as Methotrexate-induced pericarditis and pericardial effusion. Aspiration of the pericardium was required and the patient made a satisfactory recovery. At six-months follow-up, she remained well, psoriasis plaques was controlled by topical crude coal tar and topical corticosteroid. These complications are extremely rare, but have been described as isolated phenomena associated with methotrexate therapy.
Clinical, histopathologic and electronmicroscopic findings in a case of congenital localized multiple fibromatosis of interscapular region are presented. This 10 year-old Japanese girl developed this lesion since she was 3 weeks old, metastases have never been observed. The histological and electron-microscopic features point to the hamartomous origin of this tumor with partial differentiation of its cells towards myofibroblasts and atypical fibroblasts. The differential diagnosis from other soft tissue tumors in infancy and early childhood is discussed.
A case of junctional epidermolysis bullosa was reported. A four-month-old boy was presented with generalised blisters after minor trauma since birth. There was no family history of blistering diseases or consanguinity. Skin examination revealed blisters primarily on the upper and lower extremities. Erosions were also noted on the face, abdomen and buttocks. The lesions healed without milia or scarring formation. Anonychia of all fingers and toe nails were noted. Skin biopsy from the blisters showed subepidermal bulla with a few inflammatory cells. Electron microscopic examination revealed cleavage plane at the lamina lucida and the absence of hemidesmosomes. These findings supported a diagnosis of junctional epidermolysis bullosa. The patient was treated with topical and systemic antibiotics. However, the blisters gradually increased. He died of uncontrolled sepsis and diarrhea.
Electron microscopy is now widely used in the evaluation of disease tissue. Indeed, these relatively new diagnostic methods have become essential to the fields of dermatology. Their value in the pathology of skin is no less great: Definitive diagnosis of most connective tissue disorders (amyloidosis, hyalinosis, etc.) is not possible without ultrastructural and histochemical analysis. Cellular inclusions are helpful in the diagnosis of a number of skin disorders: filamentous and granular inclusions in recurrent digital fibroma of childhood and tubuloreticular inclusions in collagen vascular diseases. Hair abnormalities are best analyzed by scanning electron microscopy.
Keratoderma hereditaria mutilans is a rare inherited cornification disorder characterized by hyperkeratosis of palms and soles with a characteristic "honey-comb" appearance, keratotic constriction furrows of one or more digits (pseudo-ainhum) and threatening spontaneous amputation. Approximately 30 cases have been reported, but the ultrastructural features have not been well characterized. In this article, we describe the clinical, histologic, and ultrastructural findings in our patient. A biopsy specimen taken before treatment with etretinate showed hyperkeratosis with a well-preserved granular layer and acanthosis. Ultrastructural examination disclosed that the spinous cells and granular cells contained marked swollen mitochondria, many desmosomes, and that corneocytes contained many membrane coating granules (MCG) and lipid like vacuoles. After initiation of treatment, considerable clinical improvement was observed, but without significant histologic modification. The principal post-treatment ultrastructural changes were the reduction of mitochondrial swelling in spinous and granular cells and the reduction in the number of MCG in corneocytes. The intercellular spaces showed increased amounts of fine and coarse granular substances. Stimulation of Langerhans cells was observed. Marginal band formation occurred normally after treatment.
A 39-year-old Thai man had eczema on the left groin accompanied by asymptomatic white nodules on the public hair for two weeks. Examination with the Wood's lamp, microscopic examination, culture and biochemical testing showed organisms compatible with Trichosporon beigelii. The diagnosis of "White Piedra" was made, and this is the first case of White Piedra to be reported in Thailand.
Topical application of a clioquinol and Bacitracin powder resulted in contact urticaria and an anaphylactoid reaction. Prick tests with clioquinol and bacitracin solution produced a wheal and flare response. This problem is unusual, but has been reported and previous reports are summarized.
Infantile acropustulosis (IA) is a well-recognised syndrome described primarily among black male infants, which may also occur among white and East Asian children. The eruption occurs mainly on the distal areas of the extremities and is characterised by recurrent crops of 1 to 2 mm pruritic papules and pustules in infants from 2 to 10 months of age. We report one patient with infantile acropustulosis and a history of atopic dermatitis and abnormally high IgE serum value. Immunofluorescent studies of involved skin gave negative results. Infantile acropustulosis has been reported by several authors within recent years. The clinical and histological features and differential diagnosis of infantile acropustulosis are discussed. This disease is uncommon but not rare, and persists for about two years.
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