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At least 289 records · Page 16Linked to original sources

Skin disorders with prominent eosinophilic infiltration treated successfully with nicotine. Report of two cases.

BACKGROUND: Nicotine was effective in the treatment of skin disorders attributable to neutrophils such as pyoderma gangrenosum and orogenital ulcerations due to Behçet's disease. OBJECTIVE: We assessed the efficacy of nicotine for treating skin disorders with prominent eosinophilic infiltration. PATIENTS AND METHODS: A 67-year-old man with Kimura's disease was treated for 2 weeks with nicotine chewing gum (6 mg/day). A 50-year-old woman with erythema nodosum with eosinophilic infiltration was treated for 4 weeks with transdermal nicotine patches (5 mg/day). RESULTS: Both patients showed a dramatic clinical and histopathological improvement. CONCLUSION: Our results suggest that nicotine may be useful for treating skin disorders with eosinophilic infiltration as well as neutrophilic dermatoses.

Administration, Topical↗

Neutrophilic figurate erythema of infancy.

We describe a transient figurate erythema in an 11-month-old female infant with a 2-month history of arcuate and annular erythematous lesions localized on the face, trunk, and limbs. Constitutional symptoms were absent. Previous medical history was unremarkable. Full blood examination, erythrocyte sedimentation rate, antistreptolysin-O titer, anti-Ro, and anti-La antibodies were within normal limits or negative. Histologic examination revealed a superficial and deep perivascular and interstitial dermatitis constituted mostly of neutrophils and abundant nuclear dust. The lesions resolved spontaneously within a few months without scarring or atrophy. Recurrence has not occurred. This case suggests that figurate erythemas in infants rarely may disclose a neutrophilic histologic pattern, which must be differentiated from that of other neutrophilic dermatoses.

Antibodies, Antinuclear↗

A case of actinic granuloma associated with periumbilical perforating pseudoxanthoma elasticum.

We report an unusual case of actinic granuloma of the face and periumbilical perforating pseudoxanthoma elasticum located superior to the umbilicus in a 57-year-old Korean woman. Histopathologically, these two dermatoses have a similar degeneration of elastic fibers, but they show different host reactions to the altered elastic fibers. In the actinic granuloma, actinically damaged elastic fibers were followed by granulomatous infiltration on the sun-exposed area, while in the perforating pseudoxanthoma elasticum, the altered elastic fibers induced a foreign body reaction, with subsequent transepidermal elimination. This is the first case report showing both actinic granuloma and periumbilical perforating pseudoxanthoma elasticum in the same patient, which suggests that the basic mechanism eliciting these dermatoses is similar.

Biopsy, Needle↗

Pyogenic granuloma.

Pyogenic granuloma (PG) is an acquired vascular lesion of the skin and mucous membranes common to the pediatric age group. PG appears as a solitary red nodule on the head or neck. The nodule is prone to hemorrhage, and bleeding is often refractory to pressure. The etiology of PG is unknown, but proposed agents include trauma, infection, and preceding dermatoses. Several surgical treatments are available with variable cosmetic results and recurrence rates.

Child↗

Regional dermatoses in the African race. Papular lesions on the face.

Many diseases are peculiar to the black race and most practicing physicians in Africa have limited access to histopathologists, therefore, diagnosis is largely clinical. A retrospective study of 10,000 consecutive patients seen at the skin clinic of the Lagos University Teaching Hospital, Nigeria, was conducted with the objective of identifying the notable dermatoses affecting various parts of the body. The face and the shins were observed to have a very broad spectrum of dermatoses. Useful clinical descriptions of these dermatoses are highlighted in a three part paper to help practicing physicians.

Adult↗

Steroid dermatitis resembling rosacea: aetiopathogenesis and treatment.

BACKGROUND: Corticosteroids were first introduced for topical use in dermatology in 1951. Since then uncontrolled use (abuse) has caused many different reactions, often with manifestations resembling those of rosacea. OBJECTIVE: The prolonged use of local corticosteroids (usually 2-6 months) may lead to a clinical picture of severe dermatitis with erythema, papules and pustules that are classified according their localization to three types. The treatment of choice is tetracycline in combination with local application of neutral ointments. CONCLUSIONS: Trivial skin dermatoses, especially on the face, should not be treated with local corticosteroids.

Administration, Topical↗

Patterns of chronic dermatoses in an Ethiopian central teaching hospital: a histopathologic approach.

BACKGROUND: This study was designed to describe the causes and distributional patterns of chronic infective-parasitic dermatoses. METHODS: A histology-based cross-sectional study was conducted for the years between January 1985 and December 1998 within the Tikur Anbessa Hospital, Department of Pathology, Addis Ababa University. The data were retrieved from the department's archives and all dermatologic cases fulfilling bacterial, viral, fungal, and parasitic etiologies were included in the study. Formalin fixed, and paraffin embedded tissues were stained with the routine hematoxylin and eosin staining procedure and visualized under light microscopy. RESULTS: Out of 162 cases of chronic specific infective-parasitic dermatoses diagnosed, the mean ages for men and women were 31.5 (SD, 16.6) and 25.1 (SD, 14.3) years respectively and the peak age group was 20-29 years (30.2%). Moreover, the ratio of men to women was 1.1:1. The most commonly diagnosed dermatosis was wart (38.9%), followed by cutaneous tuberculosis (17.9%), and cutaneous leishmaniasis (14.2%). The most frequently involved region was the lower limb (46.3%), followed by the face (23.5%). CONCLUSION: This study tried to surface the frequency distribution of the histopathologically-proven dermatoses that are prevalent in our part of the world. The lower limbs being the most frequent sites of dermatoses, their predisposing factors need to be addressed in our communities in order to lessen the effects of these dermatoses. This study may act as a baseline for similar investigations that may be undertaken in the future.

Adolescent↗

Viral folliculitis on the face.

The common clinical presentations of herpes simplex virus (HSV) and molluscum contagiosum (MC) are well known to dermatologists. However, folliculitis due to these viruses is an infrequently reported entity and might be considered a sign of immunosuppression [such as infection with human immunodeficiency virus, (HIV)], especially in cases of folliculitis due to MC. The purpose of this study was to describe the clinical and histopathological characteristics of viral folliculitis due to HSV and MC. We retrospectively collected all our cases with histologically proven folliculitis due to HSV and MC between 1994 and 1999. A total of seven patients aged 7-54 years was identified. Prior to establishment of the diagnosis of folliculitis due to HSV and MC, they were treated with topical antibiotics or topical steroids, without improvement. Tentative diagnoses were bacterial folliculitis, syringoma, perifollicular fibrosis, contact dermatitis or pseudolymphoma. Biopsy of the lesions revealed multiple molluscum bodies in the follicular epithelium with sparing of the epidermis in four patients, and ballooning degeneration and intranuclear viral inclusions in the follicular epithelium in the other three. Three patients had evidence of underlying immune suppression, such as pregnancy, chronic viral hepatitis B and nasopharyngeal carcinoma. One patient had suffered from epilepsy for 4 years. Testing for HIV by enzyme-linked immunosorbent assay was negative in the four patients in whom this was performed, and T-cell subsets were normal in the three patients in whom these were quantified. In cases of molluscum folliculitis treated with simple curettage, the lesions cleared without scarring or recurrence. In cases of herpetic folliculitis, the lesions improved with antihistamines or acyclovir. MC or HSV should be considered in cases that present with folliculitis-like dermatoses but which are refractory to anti-infective and anti-inflammatory treatment.

Adolescent↗

Tinea incognito and "over-the-counter" potent topical steroids.

The term tinea incognito has been used to describe a dermatophyte infection modified by corticosteroid treatment. Lesions are often atypical appearing and the diagnosis is frequently delayed or missed. This difficulty is often exacerbated by the random misuse of potent dermatologic preparations that can alter the initial presentation to the dermatologist. Recently, we have encountered an increasing number of patients who have obtained potent superpotent topical steroids "over the counter" to self-treat various dermatoses. We report two such cases of tinea incognito that were exacerbated and altered clinically by the use of such preparations.

Administration, Topical↗

A unique case of cutaneous calcinosis with transepidermal elimination.

A case of cutaneous calcinosis with unique clinical and histological features which occurred on the cheek of a 14-year-old girl, is reported. Our case had no abnormal findings in laboratory data. Serum calcium and phosphate were normal, there was no underlying disease, and the possibility of self-inflicted dermatoses was denied. Transmission electron microscopy and X-ray microanalysis showed calcium and phosphate deposited around collagen fibers, which were eliminated from the epidermis.

Adolescent↗

Milia en plaque associated with pseudoxanthoma elasticum.

We report a woman with numerous milia occurring in a plaque-type distribution in the postauricular area, who has suffered from cutaneous pseudoxanthoma elasticum on both sides of the neck. Milia may arise primarily or may follow a number of dermatoses. We believe this is a unique case because milia en plaque coexisting with pseudoxanthoma elasticum does not appear to have been reported previously.

Adult↗

[Tinea faciei in a newborn].

Dermatophytosis in newborns and infants has been regarded as very unusual; a case recently observed of a 2-month-old child affected by tinea faciei is described. Twenty days before, localized erythematous infiltrated patches at the upper left eyelid and eyebrows with papules and pustules, were observed. Rarefaction of the eyebrows and partially loss of the eyelashes associated with scattered areas of erythematopapulous lesions on the face, were seen. Mycological examination was positive and trichophyton rubrum colonies grew. Tinea capitis is more common than tinea faciei in newborn and infants. Differential diagnosis includes: seborrheic dermatitis, atopic dermatitis with associated impetigo, candidiasis, bacterial folliculitis. The interhuman transmission by relatives is the most probable modality of trans-mission, as previously reported in the literature. A widespread of the dermatoses was due to previous application of topical corticosteroids. The lesions resolved completely after treatment with miconazole cream, applied twice daily for three weeks.

Age Factors↗

Noduloulcerative or "malignant" syphilis occurring in an otherwise healthy woman: report and review of a dramatic dermatosis.

We present the case of an otherwise healthy woman with noduloulcerative ("malignant") syphilis, the first female patient reported with this dermatosis in fifty years. This rare form of secondary syphilis is characterized by noduloulcerative lesions with rupioid crusts that dramatically involve the face while usually sparing the palms and soles. The aggression and destruction of the skin lesions may mimic that of other granulomatous and infiltrative dermatoses. Since the incidence of syphilis is increasing, physicians should be aware of this variant that is so disfiguring it has historically been referred to as lues maligna.

Facial Dermatoses↗

Milia en plaque.

A 59-year-old woman presented with milia grouped in plaques, in the preauricular areas, bilaterally. Follicle-damaging dermatoses, tumours and external agents, can lead to this peculiar clinical pattern. We outline the clinical and histological features which allow accurate diagnosis of this condition.

Cysts↗

Kaposi's varicelliform eruption. Absence of ocular involvement.

The eponym Kaposi's varicelliform eruption (KVE) describes a characteristic syndrome of disseminated vesicopustules that occasionally complicates a number of dermatoses. Among these, the most common is atopic dermatitis, and the inciting agent is most often herpes simplex virus (HSV). Very few reports of ocular herpetic disease exist among the many cases of KVE reported in the literature, despite extensive cutaneous involvement with herpetic lesions. We describe 10 patients with KVE, none of whom have developed evidence of herpetic ocular disease despite widespread facial involvement in all patients. All random conjunctival swab cultures performed in 3 patients were positive for growth of viable HSV. Although ocular exposure to HSV may commonly occur in KVE, ocular pathology due to this virus does not appear to be a common sequela.

Acyclovir↗

Occupational dermatoses among office personnel.

As offices have become more complex environments, the number of skin problems among office workers has increased. Among the agents implicated are carbonless copy paper, duplicating machines, formaldehyde, video display terminals, and rubber bands. Accurate diagnosis can be difficult but usually results in complete cure.

Dermatitis, Contact↗

Acute hemorrhagic edema in a four-year-old Japanese boy.

A case of acute hemorrhagic edema (AHE), a unique form of leukocytoclastic vasculitis limited only to the skin, was seen in a four-year-old boy. It was characterized by an abrupt onset of fever, peripheral edema, and rosette-shaped purpuric plaques. Although the skin lesion might be confused clinically with other dermatoses such as Henoch-Schönlein purpura, Sweet's disease and erythema multiforme, his laboratory data were normal, and the disorder follows a benign course with spontaneous resolution within one week.

Acute Disease↗