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Syringocystadenoma papilliferum: report of the first case on the lower leg.

Syringocystadenoma Papilliferum (SCAP) is a benign adnexal tumor which most frequently arises from an organoid nevus on the head and neck. Although they are rarely found on the trunk and limbs, we treated a case of this disorder on the lower leg. A 26-year-old man had an asymptomatic tumor on his lower leg. Histopathological examination showed it to be a typical SCAP on organoid nevus. This is the first report of SCAP on the lower leg.

Adenoma, Sweat Gland↗

A case of bullous dermatitis artefacta possibly induced by a deodorant spray.

Dermatitis artefacta is one of a spectrum of factitious diseases etiologically responsible for skin lesions denied by patients. These factors often make it difficult to identify the causative agents of the condition. Herein, we report a case of bullous dermatitis artefacta in a 12-year-old girl, for which a deodorant spray was suspected as the probable cause. Pathological examination revealed subepidermal blistering with full-thickness necrosis of the epidermis, suggesting a thermo- or cryo-induced injury. Psychological testing demonstrated her immaturity and dependence. In searching for the causative agent, we suspected a deodorant spray as a blister-inducing agent. We succeeded in reproducing a similar blister lesion on the volunteer's healthy skin using the same spray. Psychiatric involvement significantly complicates the treatment of factitious diseases, including dermatitis artefacta. Cooperation among dermatologists, psychiatrists and the patient's family members is required for ensuring a favorable prognosis.

Child↗

Stucco keratosis.

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Coal Tar↗

The wages of warmth: changes in erythema ab igne.

Biopsies from 20 patients with erythema ab igne (EAI) were examined and compared with biopsies from the legs of 7 elderly control subjects. Epidermal thinning and flattening of the dermo-epidermal junction were seen in most of the tissues examined but were more prominent in the EAI biopsies. Basal cell degenerative change with vacuolation was frequently observed in the EAI specimens. Epidermal atypia amounting to preneoplastic change was observed in 4 EAI biopsies. The dermis was thinned and showed (a) marked oedema and connective tissue disruption and (b) accumulation of elastic staining material. Both haemosiderin and melanin were found within the dermis. The small blood vessels showed a striking abnormality in 7 patients and 2 control biopsies in that the endothelial cells were enlarged and the nuclei were hyperchromatic and irregular in size and shape. This change may be due more to stasis than to chronic heating.

Aged↗

Dermatome shaving of psoriasis.

Dermatome shaving was performed in 20 patients with chronic recalcitrant plaque psoriasis. The level of shaving was just beneath the superficial dermal vascular plexus. Healing was achieved in 2 weeks. After 1 year, six patients had shown no recurrence; 10 patients had a few guttate elements in the shaved area, while four patients had significant recurrence. Recurrences were related to residual acanthotic epidermis left after shaving. A general recommendation of surgical treatment for psoriasis would be hazardous on the basis of these results. However, shaving may constitute an alternative treatment of recalcitrant plaques of limited extent.

Adult↗

Brawny cutaneous induration and granulomatous panniculitis in large cell non-Hodgkin's (T suppressor/cytotoxic cell) lymphoma.

A 56-year-old lady presented with striking peau d'orange-like, woody, diffuse infiltration of the skin of the upper, inner aspects of both arms and thighs. Initial biopsy specimens showed a granulomatous panniculitis with non-specific lymphohistiocytic infiltration. Clinical deterioration occurred with development of ascites and peripheral oedema; a single axillary node became palpable. Cytology of ascitic fluid, and histology and immunopathology of the axillary node, and of a further skin biopsy, now revealed diagnostic changes of a diffuse large cell lymphocytic lymphoma of T suppressor/cytotoxic type. Granulomatous panniculitis resulting in diffuse cutaneous infiltration may rarely be a presenting sign of malignant lymphoma.

Arm↗

Oral albendazole for the treatment of cutaneous larva migrans.

Cutaneous larva migrans is becoming more common in the U.K. with the popularity of tropical countries as holiday destinations. We describe the increasing use of a new benzimidazole derivative, albendazole, which is very effective in the treatment of cutaneous larva migrans. In contrast to thiabendazole, it is virtually free from side-effects and should, we feel, become the treatment of choice for this condition.

Administration, Oral↗