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At least 667 records · Page 37Linked to original sources
PubMed1995

Furuncular myiasis from Dermatobia hominis infestation. Diagnosis by light microscopy.

Myiasis, the infestation of humans or other vertebrates with fly larvae, may appear as furuncular nodules. Furuncular myiasis occurring in the Western hemisphere, especially in Central and South America, is usually caused by Dermatobia hominis infestation. Travel history, gross examination, and histologic evaluation of the submitted fly larvae will allow the clinician and dermatopathologist to identify the causative organism. We report two cases of furuncular myiasis due to Dermatobia hominis and review the clinical and histopathologic findings pertinent to its diagnosis. In addition, we attempted to identify some of the cardinal internal structures of this organism by extrapolating known information about insect internal anatomy and physiology to the structures visualized during serial transverse sectioning of the larvae.

Adult↗
PubMed1997

The histopathologic spectrum of erythema induratum of Bazin.

Erythema induratum of Bazin is a tuberculid that is strongly associated with tuberculosis. Clinically, erythema induratum of Bazin show recurrent tender subcutaneous nodules that occur mainly on the calves of women with tuberculin hypersensitivity. Previous studies have not documented the histopathologic spectrum of erythema induratum of Bazin in detail. We identified two major histopathologic groups in 19 of 20 skin biopsies obtained from 20 patients with well-documented erythema induratum of Bazin. Six cases (group I) showed focal septolobular panniculitis in close association with a single muscular artery or small vessel with primary neutrophilic vasculitis. Thirteen cases (group II) revealed diffuse septolobular panniculitis with primary neutrophilic vasculitis of either large or smaller vessels. Both groups showed varying combinations and degrees of acute and chronic inflammation, coagulative and caseation-like necrosis, and granulomatous inflammation. Poorly developed granulomas predominated, but mixed, palisading, and lipophagic granulomas also occurred. Inflammation and necrosis were more extensive in group II. Erythema induratum of Bazin may show predominantly acute suppurative or granulomatous panniculitis. Immunostaining showed S100+ antigen-presenting cells, macrophages, and T-lymphocytes. B-lymphocytes were rare. The presence of primary vasculitis and granulomas suggests that types III and IV hypersensitivity reactions play a role in the pathogenesis or erythema induratum of Bazin. The latter remains a clinicopathologic diagnosis, but awareness of the heterogeneous histopathologic spectrum of EIB will ensure a timely diagnosis and institution of antituberculous treatment.

Adolescent↗
PubMed1997

Proliferative fasciitis. Report of a case with histopathologic and immunohistochemical studies.

We present a case of proliferative fasciitis arising adjacent to an operative scar of the right lower leg of a patient with chronic lymphatic leukemia, diabetes mellitus, and multiple subcutaneous angiolipomas. A 61-year old man had a hard mass in his right lower leg that had rapidly increased in size in the past 10 days. The mass was microscopically composed of a dense proliferation of spindle cells forming interlacing fascicles admixed with an inflammatory infiltrate of lymphocytes and eosionphils, focal hemorrhage, and myxomatous change as typically seen in nodular fasciitis as well as many characteristic ganglion cell-like giant cells. Immunohistochemically, most of the spindle-shaped cells were positive for vimentin and alpha-actin, whereas the ganglion cell-like giant cells were positive for vimentin and negative for alpha-actin and lysozyme. We suggest that the main component cells of proliferative fasciitis are fibroblastic in nature, many of which are myofibroblasts in large part, whereas the ganglion cell-like giant cells are related more closely to fibroblasts rather than histiocytes or pericytes. Additionally, proliferating cell nuclear antigen (PCNA) stain revealed that many of the fibroblastic cells showed high proliferative activity, especially in the hypercellular areas, although there was no significant difference in PCNA staining between the focus traumatized by the needle biopsy and the nontraumatized areas.

Actins↗
PubMed1998

Membranocystic lesions in a patient with cytophagic histiocytic panniculitis associated with subcutaneous T-cell lymphoma.

A 51-year-old Japanese woman had erythematous, tender subcutaneous nodules on her lower legs and buttocks, as well as fever, pancytopenia, and liver dysfunction. Histopathologic examination of the nodules showed subcutaneous T-cell lymphoma with cytophagocytosis and membranocystic lesions. Our patient was unique in having the combination of cytophagic histiocytic panniculitis due to subcutaneous T-cell lymphoma and membranocystic lesions.

Cell Membrane↗
PubMed1999

A clinical and histologic study of 37 cases of immunoglobulin A-associated vasculitis.

Immunoglobulin (Ig) A-associated vasculitis is commonly equated with the multiorgan systemic vasculitic syndrome Henoch-Schonlein purpura (HSP), which occurs predominantly in the pediatric age group. By natural language search of the databases of two outpatient dermatopathology practices, the authors selected for review 37 cases of IgA-associated vasculitis, 23 of which were associated with antecedent infection, most commonly of the upper respiratory tract. Criteria for a diagnosis of HSP were met in 15 cases, 13 of which were in the setting of prior infection. Lower extremity skin involvement was ubiquitous. A more widespread form of vasculitis was also seen, particularly in the setting of previous infection. Several of the patients with previous infection had underlying medical illnesses including rheumatoid arthritis, atopy, renal failure, lupus erythematosus, insulin dependent diabetes mellitus, autoimmune thyroid disease, and Wegener's granulomatosis. In those patients lacking an apparent microbial trigger, Sjogren's disease with anti-Ro antibodies and hypergammaglobulinemia, lupus erythematosus, inflammatory bowel disease, IgA paraproteinemia, bronchogenic and prostatic carcinoma, cryoglobulinemia, and lymphoma were uncovered. Regardless of whether an infectious stimulus was implicated, certain cofactors with the potential to enhance vascular injury were uncovered; these included anti-Ro antibodies, antineutrophil cytoplasmic antibody, diabetic microangiopathy, and a hyperviscosity state. In the infective group, a pustular vasculitis, defined as a neutrophilic vascular reaction in concert with epithelial pustulation, was seen in 81% of cases versus 33% in the noninfectious group (p = 0.02). The prototypic histomorphology in the noninfective group was one of a mild cell poor leukocytoclastic vasculitis; Vasculitis was of greater severity in patients with antecedent infection (p = 0.026). An infectious trigger, typically of mucosal origin, can frequently be identified in patients with cutaneous IgA-associated vasculitis, especially those with the symptom complex of HSP. The light microscopy appears to distinguish patients who have an infectious trigger from those who do not. IgA-associated vasculitis may be a clue to the presence of certain underlying disorders where there is immune dysregulation or enhanced susceptibility to immune complex entrapment.

Adolescent↗
PubMed1994

Dermopathy of Graves disease (pretibial myxedema). Review of 150 cases.

Pretibial myxedema is an uncommon manifestation of Graves disease, and little information is available regarding its natural course and its relation to other manifestations of Graves disease. We reviewed 150 consecutive cases with the diagnosis of pretibial myxedema over a 20-year period in a referral center. Only 1 patient in this group did not have ophthalmopathy, whereas 88% had significant proptosis and 30% required orbital decompression surgery. Dermopathy was a late manifestation of Graves disease, and its onset usually followed the diagnosis of hyperthyroidism and ophthalmopathy. In a few patients, dermopathy preceded diagnosis of hyperthyroidism or onset of ophthalmopathy. Fourteen patients were never clinically hyperthyroid; spontaneous hypothyroidism had developed in 11 in this group. All cases involved the lower extremities, with only 1 patient having combined upper and lower extremity involvement. The most common form of thyroid dermopathy was nonpitting edema, followed by nodular and plaque forms, which occurred with equal frequency. The polypoid form occurred in 1 patient and the elephantiasic form in another; 7.3% had thyroid acropachy. Follow-up was available for 120 patients (range, 3 mo to 19 yr; mean, 3.2 yr), and complete remission was observed in only 12 patients. Topically applied corticosteroid therapy was used in 76 patients, and in this group 38% had sustained long-term partial remission, as opposed to 18% in the group receiving no corticosteroid therapy.

Administration, Topical↗
PubMed1989

Vibrio sepsis in a cirrhotic patient.

Vibrio vulnificus should be suspected in any soft tissue infection occurring after exposure to the marine environment. Early recognition followed by appropriate antibiotic therapy and debridement of involved tissue are essential features in the treatment of these infections.

Amputation, Surgical↗
PubMed1993

Pyoderma gangrenosum as a cutaneous manifestation of diverticular disease.

We have described a case of pyoderma gangrenosum due to diverticular disease. The patient was an elderly woman with a 3-month history of cutaneous disease without associated gastrointestinal complaints. There was no history of inflammatory bowel disease, malignancy, or seropositive arthritis. Evaluation revealed a retroperitoneal abscess due to a ruptured diverticulum. Surgical resection of the affected colon led to rapid and complete resolution of all symptoms. Pathologic examination of resected tissue showed diverticulitis without evidence of chronic inflammatory bowel disease.

Aged↗
PubMed2006

Pretibial pruritic papular dermatitis: A distinctive cutaneous manifestation in response to chronic rubbing.

We describe the clinico-pathologic features of 44 patients with a peculiar pretibial pruritic papular dermatitis (PPPD). Clinically, PPPD consists of discrete, roundish, extremely pruritic papules with a smooth surface caused by the delicate and persistent rubbing of pretibial skin. Histologically, PPPD showed minimal compact orthokeratosis, flattening of the rete ridges, a superficial and mid-dermal perivascular and interstitial infiltrate of lymphocytes, histiocytes, eosinophils and multinucleated fibroblasts, and thickened collagen bundles in haphazard array in the superficial dermis. The clinical picture of PPPD closely resembled that of lichen simplex chronicus/circumscribed neurodermatitis or lichen amyloidosus. Histologically, the absence of uneven psoriasiform epidermal hyperplasia, marked compact orthokeratosis, hypergranulosis, and coarse bundles of collagen arranged in vertical streaks in the papillary dermis distinguished PPPD from lichen simplex chronicus, whereas the lack of amyloid deposits in the dermal papillae differentiated PPPD from lichen amyloidosus. We suggest that PPPD is an unusual morphologic expression of gentle and chronic rubbing of pretibial skin with distinctive histopathologic features.

Aged↗