[Comparative investigations in juvenile and adult colloid milium (author's transl)].
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Adolescent↗
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Results for “FACIAL DERMATOSES”
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Kerion-like tinea capitis and barbae caused by Microsporum gypseum in Israel.
Four cases of hair invasion by Microsporum gypseum are reported. In three the scalp was involved and in one, the beard. All presented a kerion type of invasion. In 3 cases hair penetration was of the ectothrix type, while in one case the kerion of the scalp resembled the type of invasion seen in T. schonleini infection. None of the invaded hairs showed fluorescence in Wood's light. The soil was the source of infection in 3 patients, the fungus having been isolated from soil samples collected in the vicinity of the houses of these patients through the hair bait method. In one case the source of contamination was the family dog, in which scaly, alopecic, follicularlike lesions caused by the same agent were found.
Adult↗
[Autoradiographic investigations in actinic (senile) comedones (author's transl].
Skin specimens of patients suffering from actinic comedones, young patients with acne vulgaris, and normal controls of the same age groups respectively were subjected to in vitro autoradiography. From the results it can be concluded, that a rise in the proliferational activity in the follicular infundibulum due to actinic stimuli is responsible for the development and growth of actinic comedones.
Acne Keloid↗
Cutaneous pseudolymphoma at the site of prior herpes zoster eruption.
A 55-year old woman with a history of herpes zoster in the dermatome supplied by the mandibular branch of the trigeminal nerve developed cutaneous red papules and umbilicated nodules within the same segment. The clinical and histological diagnosis was pseudolymphoma. The lesions showed a polymorphous infiltrate without germinal center formation. Immunologic phenotyping with monoclonal antibodies revealed the predominance of helper T cells and distinct compartmentalization of B and T cells. The lesions healed up within 7 weeks. The development of pseudolymphomas at the site of previous herpes zoster eruptions seems to be extremely rare.
Adult↗
Skin involvement in Kikuchi's disease: an immunocytochemical and immunofluorescence study.
Kikuchi's disease (KD) is a benign self-limiting febrile illness usually affecting young women, which is manifested clinically by fever and cervical lymphadenopathy. Skin involvement in KD is very rare and is evident clinically in the form of skin rashes and nodules. We describe one such case of KD in a 33-year-old Bulgarian woman who presented with cervical and axillary lymphadenopathy and who developed a transient facial rash. Biopsy of axillary lymph nodes showed the characteristic features of KD with infiltration of the lymph node paracortex by apoptotic plasmacytoid monocytes. Biopsies of the facial skin showed two features: (1) dermal infiltration by apoptotic plasmacytoid monocytes; (2) on immunofluorescence studies of frozen sections prepared from involved and uninvolved facial skin, deposition of immunoglobulins and complement at the dermoepidermal junction and in the walls of dermal blood vessels. Such immunofluorescence findings in the skin of patients with KD have never been described. These findings suggest the presence of an autoimmune reaction as a component of KD.
Adult↗
Cutaneous biopsies for diagnosis of histoplasmosis in an HIV patient.
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AIDS-Related Opportunistic Infections↗
The clinical spectrum of Henoch-Schönlein purpura in infants and young children.
UNLABELLED: Henoch-Schönlein purpura is a common cause of childhood vasculitis. The rarity of the disease under 2 years of age has been the subject of few reports. We present the clinical spectrum of Henoch-Schönlein purpura in 12 children younger than 2 years of age at presentation. The median age at presentation was 11 months. The purpuric skin rash was present in all patients and involved the face in 10 of them. While oedema was a prominent feature in all of our patients only one third had involvement of the kidneys, gastro-intestinal tract or joints. All patients recovered completely after a mean duration of follow up of 10.6 months (range 2-39 months). CONCLUSION: Henoch-Schönlein purpura under the age of 2 years is characterized clinically by oedema and a purpuric skin rash which frequently affects the face. Involvement of the joints, kidneys and gastro-intestinal tract is uncommon and the prognosis is excellent. The clinical spectrum in this age group is a continuation with that of Henoch-Schönlein purpura in older children suggesting a nosological entity.
Age of Onset↗
MR imaging of benign fatty tumors in children: report of four cases and review of the literature.
This study correlates the magnetic resonance imaging characteristics with the pathologic findings in rare benign fatty soft tissue tumors in four children. A review of the literature is presented. Two cases of infiltrating lipoma displayed bright signal on both T1- and T2-weighted images, similar to that observed in subcutaneous fat. Histological study revealed extensive muscle infiltration by mature fat, with some areas of total fatty replacement. The case of facial lipomatosis revealed an extensive process of fatty invasion of adjacent soft tissue and osseous deformity by mass effect of the tumor. This lesion was bright on T1- and T2-weighted images. Histopathologic examination showed widespread invasion of squamous mucosa and skeletal muscle. The single case of lipoblastoma involved the presacral region and right buttock. This lesion, although bright on both T1 and T2 weighting, was relatively hypointense to subcutaneous fat on T1. Microscopic examination revealed a well-encapsulated fatty mass made up of cells ranging from lipoblasts to mature lipocytes. In childhood, when fatty lesions are almost always benign, a morphologic characterization by magnetic resonance may be sufficient basis on which to make critical therapeutic judgements.
Adolescent↗
Nodular amyloidosis: case report and literature review.
BACKGROUND: Amyloidosis refers to a group of depositional diseases that are classified into two main types: systemic and localized. Large nodules of localized cutaneous amyloidosis of the nasal ala and surrounding skin are rare and the treatment is often unsatisfactory. OBJECTIVE: We report a case of rapidly enlarging, localized, nodular cutaneous amyloidosis of the nose and the surrounding skin with a brief review of the current literature regarding treatment of this rare disease. CONCLUSION: Nodular amyloidosis can be treated successfully with cold steel excision in combination with carbon dioxide laser. Close followup of these patients is warranted, as nodular amyloidosis may be the precursor to systemic amyloidosis.
Aged↗
Chediak-Higashi syndrome.
A case of Chediak-Higashi syndrome is reported in a four-year-old boy who presented with recurrent chest infection, partial albinism, hyperpigmentation of the extremities and presence of giant granules in leucocytes and melanocytes in the skin. Parental consanguinity was present. Though uncommon, hyperpigmentation of sun exposed areas may be the initial symptom in Chediak-Higashi syndrome.
Anti-Bacterial Agents↗
Propofol for pulsed dye laser treatments in paediatric outpatients.
Pulsed dye laser is a new treatment for port-wine stains, congenital lesions in the cutaneous vascular plexus. We report our anesthetic experience with paediatric outpatients treated in the dermatology clinic. From April to November 1993, 48 ASA 1 children were anaesthetised for a total of 105 consecutive laser treatments. The youngest was eight months old, the oldest was 12 yrs old and most of the sessions (43%) were done for children aged from two to four years. Each received acetaminophen (10 mg.kg-1 p.o.) before treatment. A propofol infusion was chosen for anaesthesia to achieve early discharge and to reduce the incidence of postoperative emesis. The infusion was adjusted to maintain blood pressure within 20% of baseline and to keep the child immobile. The dose was progressively reduced during the procedure from 400 micrograms.kg-1.min-1 to 100 micrograms.kg-1.min-1. Fentanyl (2 micrograms.kg-1 i.v.) was added for analgesia. Respiration was spontaneous through a nasopharyngeal airway (air in oxygen 40%). Anaesthesia proceeded uneventfully in all cases and lasted for 15-30 min (63% of treatments), 30-45 min (28%) or 45-60 min (9%) according to the size of the lesion. The mean stay in the recovery room was 25.1 min and none of the patients experienced emesis. Our experience shows that general anaesthesia with propofol supplemented with fentanyl offers a rapid onset and awakening, a painless treatment and an immobile child. It is a safe solution to alleviate pain from repeated painful procedures even in small children under two years of age.
Acetaminophen↗
An 8-year experience in airborne contact dermatitis.
OBJECTIVE: A large number of case reports concerning occupational airborne contact dermatitis have been published in the last few years. Our purpose was to establish the prevalence of airborne contact dermatitis in a routinely patch-tested population and to obtain further epidemiologic data. METHODS: In a single-center study, the data of 5,092 routinely patch-tested patients were collected using a standardized questionnaire and a documentation form. The study period extended from October 1994 to March 2002. RESULTS: The clinical diagnosis was airborne contact dermatitis in 15 cases (0.29%). Patch testing revealed positive and relevant results in nine patients (0.18%). Plant or wood extracts were the sensitizers in all cases but two, and perfume and epoxy resin were the sensitizers in one case each. The diagnosis of an irritant airborne contact dermatitis was established in six patients. A relationship with occupation was found in seven cases (0.14%) when 'housewife' was included as an occupational category and in five cases (0.1%) when this was excluded. CONCLUSION: Airborne contact dermatitis is a rare diagnosis in an unselected patch-test population. An occupational relationship was less common than has been implied in case reports in recent years.
Adolescent↗
Allergies induced by orthodontic alloys: incidence and impact on treatment. Results of a survey in private orthodontic offices in the Federal State of Hesse, Germany.
BACKGROUND: The incidence of allergies in general is on the increase. An allergic reaction can also occur during any dental and orthodontic treatment. However, the allergic potential of orthodontic appliances is frequently overestimated. MATERIAL AND METHOD: The incidence of suspected allergic reactions during fixed appliance therapy in 68 orthodontic offices in the German State of Hesse was determined by questionnaire at approximately 0.3% of the 60,000 patients covered. RESULTS: More extraoral (45%) than intraoral (17%) skin changes were registered, with both intraoral and extraoral changes being observed in 38%. In 53% of the affected cases the therapy was adapted to nickel-free materials, whereas it was continued as planned after a brief recovery period in 33%. The treatment was discontinued in 14% of the affected patients, corresponding to one in every 3150. The individual tolerance can often be tested by inserting one bracket or one band. In addition, early orthodontic treatment seems to promote a certain immune tolerance, especially towards extraoral nickel contacts. However, if a patient is known to have a nickel allergy, materials containing nickel should be renounced on principle in the orthodontic appliances. CONCLUSION: Skin changes occurring in the course of orthodontic treatment should be examined and verified if necessary by a dermatologist. Gold plating and other coatings (titanium nitride) of the metal elements even encourage corrosion after a brief protection period. Soldering should be avoided.
Adolescent↗
[Partsch's chronic granulomatous inflammation, the cutaneous manifestation of a dental cause].
Dentogenous inflammatory diseases can lead to typical dermatological facial symptoms with formation of cutaneous sinuses. Partsch's chronic granulomatous inflammation can result from conducted inflammation of a nonvital tooth via a chronic apical inflammation. In this rare disease, the granulomatous tissue perforates the bone, channels through the overlying skin, and drains via cutaneous or oral sinuses. A frequent localization of the cutaneous sinus is the skin inferior to the body of the mandible, and it is caused by an inflammation of the lower molars. Treatment consists of identifying the responsible teeth and eliminating the focus of infection. Chronically progressive periradicular granuloma and/or radicular cysts can be present with impressive dermatological symptoms. Therefore, X-ray examinations are necessary to exclude possible dentogenic causes in cases of badly healing processes of the face or neck.
Adult↗
[Conservative treatment of facial wrinkles in the hands of the plastic surgeon].
The conservative treatment of facial wrinkles is an integral part of the growing market for aesthetic surgery. Unfortunately, physicians of any specialty and even nonphysicians tried to occupy this lucrative field without providing serious information and knowledge about a holistic plastic surgical concept, which includes second- and third-step aesthetic surgical procedures when conservative treatment does not suffice. The following article outlines and critically evaluates the current state of knowledge.
Acrylic Resins↗
[Initial scleromyxedema. Successful treatment with melphalan].
Scleromyxedema is a rare mucinous disease without thyroid dysfunction, associated with a monoclonal gammopathy. The deposits of mucin in the skin and other organs such as the cardiovasculary system, determine the prognosis of the disease. A 74-year old patient with initial scleromyxedema is described, in whom a pulse therapy with melphalan was initiated already in the early stages of the disease. Four cycles of melphalan in combination with prednisolon led to a complete and sofar stable remission of the disease.
Aged↗
[ANCA-positive vasculitis of the skin and kidneys associated with acne conglobata].
A 19 year old man with severe acne conglobata and ulcerated pyoderma gangraenosum-like skin lesions on the face was first treated with isotretinoin (Roaccutan((R))), then immunosuppressively with prednisolone, diaminodiphenylsulfone (Dapson-Fatol((R))) and mycophenolate mofetil (Cellcept((R))). Under a daily maintenance dose of immunosuppressive treatment with 2.5 mg prednisolone and 1 g mycophenolate mofetil, weakness, muscle and joint aches appeared. Due to proteinuria, haematuria and an elevated antineutrophil cytoplasmic antibody (cANCA) and the histological detection of a leukocytoclastic vasculitis, the diagnosis of cANCA positive vasculitis of the skin and kidneys was established. Therapy with cyclophosphamide (Endoxan((R))) along with prednisolone was effective. An exact classification of this disease process was not possible.
Acne Vulgaris↗