Crusted papule: insect bite or something else?
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INTRODUCTION: Cutaneous elastosis with cysts and comedones (Favre-Racouchot) is one of the oldest known manifestations of helioderma. Both sides of the face are usually involved symmetrically. CASE REPORT: We observed a 65-year-old woman with extremely severe Favre-Racouchot disease localized exclusively on the left side of the face. The diagnosis of elastosis with cysts and comedones was confirmed histologically. This elastosis with cysts and comedones was associated with spasms of the hemiface treated with injections of botulinic toxin. This association was fortuitous and we retained actinic irradiation as the causal agent in this woman who had worked for 15 years in the same room. The elastosis occurred on the side of the face which had been continuously exposed at the same orientation to the window. COMMENTS: This original observation is similar to cases where facial exposure to artificial light or sunlight is asymmetrical, leading to a higher incidence of lesions on one side of the face: colloid milium, actinic keratosis, Dubreuilh melanoma (malignant lentigo) or simple helioderma. The asymmetrical nature of the actinic lesions is often related to automobile driving. This case was particular since it demonstrated that Favre-Racouchot elastosis with cysts and comedones is due to actinic irradiation and not to skin aging.
We report a case of solid persistent facial oedema in a 18-year-old woman. A biopsy specimen from the nose demonstrating lympho-epithelioid granulomas and an electro-neuro-myographic examination revealing sub-clinical sequellae from an old right facial palsy, led to the definite diagnosis of Melkersson-Rosenthal syndrome (MRS). We focus on the differential diagnosis of persistent facial oedema and outline the difficulties to establish the diagnosis of MRS when all features of the classic triad "recurrent labial edema-facial nerve palsy-lingua plicata" are not present.
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A fourteen-year-old male with solitary neurilemmoma over his left cheek is described. Clinically, it was mistaken for molluscum contagiosum. The case is reported for its rarity and unique features.
Based on their experience of facial tissue expansion, the authors present a model of an external filling valve and illustrate its advantages in 9 cases in which 13 external valve were used: painful injection, absence of leakage, fast and confortable filling. The indications are sequelae of facial burns, face scars, treatment of orbito-temporal neurofibromatosis. The major advantage is rapid tissue expansion which reduces the problems of infection and skin loss.
This article describes a rare case of granuloma of the lacrimal sac, which was treated with dacryocistorhinostomy and glabellar flap. In addition, the possible etiologic factors, the differential diagnosis and reconstructive techniques indicated in such cases are described.
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This study demonstrates a strong association between the occurrence of oro-facial lesions and HIV-1 seropositivity in a group of patients in Dar es Salaam. Among the different oro-facial lesions Kaposi's sarcoma seems to be the most frequent and the most important pathognomonic feature. Since some of the lesions occur fairly early in HIV infection, a through and systematic examination of the oro-facial region may provide an early clue for HIV infection.
OBJECTIVES: To evaluate patients with multiple endocrine neoplasia type 1 (MEN 1) for cutaneous manifestations. DESIGN: Survey during a 3-year period. SETTING: The National Institutes of Health, a tertiary referral research hospital in Bethesda Md. PATIENTS: A consecutive sample of 32 individuals with previously diagnosed MEN1 who were not preselected for the presence of skin lesions were examined for cutaneous abnormalities. None of the patients or family members were diagnosed as having tuberous sclerosis. INTERVENTIONS: Lesions were identified by clinical appearance, photographed, and confirmed histologically. MAIN OUTCOME MEASURE: To determine the frequency of skin lesions in patients with MEN1. RESULTS: Multiple facial angiofibromas were observed in 28 (88%) of the patients with MEN1, with 16 patients (50%) having 5 or more. Angiofibromas were clinically and histologically identical to those in individuals with tuberous sclerosis. Collagenomas were observed in 23 patients (72%). Also observed were cafe au lait macules in 12 patients (38%), lipomas in 11 patients (34%), confetti-like hypopigmented macules in 2 patients (6%), and multiple gingival papules in 2 patients (6%). CONCLUSIONS: Multiple angiofibromas, collagenomas, lipomas, confetti-like hypopigmented macules and multiple gingival papules are cutaneous manifestations of MEN1 and should be looked for in both family members of patients with MEN1 and individuals with hyperparathyroidism of other MEN1-associated tumors. Multiple angiofibromas can no longer be considered pathognomonic for tuberous sclerosis. The observation of angiofibromas in individuals without tuberous sclerosis necessitates further biochemical testing for MEN1.
BACKGROUND: The treatment of complex and diffuse actinic keratoses involving the face presents a problem in that they frequently recur despite traditional treatment modalities. The carbon dioxide (CO2) laser is an effective method for resurfacing actinically damaged facial skin. OBJECTIVE: The purpose of this study is to show the usefulness of the CO2 laser for the treatment of actinically damaged skin in patients with proven actinic keratoses and squamous cell carcinoma in situ of the face. METHODS: In an office surgery setting, the Sharplan 1030 or 40C CO2 laser with the SilkTouch flashscanner attachment was utilized to treat various regions of the face in 14 patients. RESULTS: All patients were satisfied with the aesthetic outcome of their laser procedures and no clinical evidence of residual or recurrent lesions have been noted. There were no long-term complications reported. CONCLUSIONS: Based on this preliminary report, the CO2 laser appears to be an excellent alternative for the surgical treatment of premalignant lesions of the face and can be used effectively without significant complications.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.