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Porokeratosis of Mibelli and immunosuppression.

Immunosuppression is recognized to predispose to the development of disseminated superficial actinic porokeratosis and to cause the spread of pre-existing lesions. Porokeratosis of Mibelli has been less frequently described following immunosuppression and we report a further case.

Humans↗

The normocomplementemic urticarial vasculitis syndrome--report of a case and response to colchicine.

A patient with a 15-year history of urticarial vasculitic rashes and chronic vasculitic skin ulceration has been followed at our Connective Tissue Disease Clinic for the past five years. Serum complement levels have been persistently normal. She has been unresponsive to a variety of medications including steroids, dapsone and hydroxychloroquine. She had a dramatic response to colchicine 500 micrograms daily with total clearing of the urticarial vasculitic rash.

Chronic Disease↗

Autoimmune blistering diseases associated with HIV infection.

Two cases of autoimmune bullous skin diseases in HIV-positive men are described. One man had bullous pemphigoid limited to his legs and the second man developed pemphigus herpetiformis. The possible association between autoimmune bullous diseases and HIV infection is discussed.

Autoimmune Diseases↗

Scleroderma and the carcinoid syndrome.

The follow up of a case of the carcinoid syndrome complicated by scleroderma is reported, in which progress of the disease may have been halted by treatment with a combination of cyproheptadine, parachlorophenylalanine and prednisolone. Impairment of tryptophan and 5-hydroxytryptamine (serotonin) metabolism appears central to the development of skin fibrosis in the carcinoid syndrome and may be indicative of important mechanisms in the pathogenesis of idiopathic scleroderma.

Adult↗

Ichthyosis hystrix and skin cancer.

Ichthyosis hystrix is a rare genodermatosis characterized by persistent spiny scales which cover a significant part of the skin surface. In many cases it is associated with palmoplantar keratoderma, and occasionally deafness and neurological defects coexist. The case of a man with ichthyosis hystrix is reported who developed skin malignancy and dysplastic keratoses, a complication which has not previously been recorded.

Carcinoma, Squamous Cell↗

Disseminated eruptive clear cell acanthoma--a case report with review of the literature.

Clear cell acanthoma (CCA) is a benign epidermal tumour with distinctive and uniform clinical and histological features. Although solitary lesions are the rule, some cases of multiple CCA, rarely with more than 10 lesions, have been previously reported. Only 22 cases of multiple CCA have been described in the English literature to date. A healthy 32-year-old woman is reported, with approximately 400 asymptomatic rounded papules, on the upper and lower extremities. Multiple skin biopsies showed the typical histological pictures of CCA. This case appears unusual because of the presence of numerous lesions scattered on the upper and lower extremities. For this reason it could be classified as disseminated eruptive CCA.

Adult↗

Captopril-induced lichenoid eruption.

The case of a patient who developed remarkably extensive tumid nodules and plaques in a cobblestone pattern on the extensor aspects of the limbs is reported as a late presentation of captopril-induced lichenoid eruption. The severity and chronicity of our patient's symptoms and signs reflected delay in reaching the diagnosis.

Aged↗

Erythema nodosum-like eruption in sarcoidosis.

Two cases of sarcoidosis with tender, erythematous nodules on the legs are reported. The cutaneous lesions were clinically similar to those of erythema nodosum, but histologically showed non-caseating epithelioid granulomas. A review of 14 cases of this particular sarcoid eruption reported in Japan showed that 13 had ocular involvement as in our cases. In the light of the high frequency of ocular involvement, a skin biopsy should be considered in patients presenting with erythema nodosum-like eruptions situated on the legs.

Adult↗

Acquired localized elastolysis associated with varicose veins.

Localized elastolysis refers to a group of heterogeneous conditions which includes cutis laxa. We report a form of localized and non-inflammatory elastolysis evocative of cutis laxa, localized to the anteromedial aspect of the left thigh and knee, acquired at the age of 8 years and associated with unilateral adjacent venous dilatations appearing at the age of 39 years. Our case is clinically and ultrastructurally compatible with cutis laxa. Localized forms of cutis laxa not preceded by inflammation are exceptional; localization on the leg has never been described. This clinical form of elastolysis calls into question the classification of acquired elastolysis. The adjacent varicose veins also raise the question of the risk of subcutaneous damage in this condition.

Adult↗

Neutrophilic dermatosis in association with rheumatoid arthritis.

Extra-articular involvement of the skin in patients with rheumatoid arthritis is not uncommon. A patient with this condition is reported who developed an unusual cutaneous eruption associated with systemic upset. Skin biopsy showed a dense dermal neutrophilic infiltrate and after treatment with standard immunosuppressive agents had failed he responded to dapsone. The rash recurred on withdrawal of the dapsone but has responded to sulphamethoxypyridamine. It is proposed that this condition is a rare but specific entity of unknown cause associated with rheumatoid arthritis.

Anti-Infective Agents↗