Lupus miliaris disseminatus faciei: efficacy of isotretinoin.
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A 36-year-old man developed unilateral facial telangiectases over a 10-year period. Histopathologic examination showed collections of mast cells. This patient has an unusual variant of telangiectasia macularis eruptiva perstans. The differential diagnosis of facial telangiectases is discussed. Mastocytosis should be considered in patients presenting solely with telangiectases.
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We report a case of tinea of the face caused by Trichophyton rubrum in which the histologic changes were consistent with granuloma faciale. We recommend that local infection with dermatophytes be considered in all cases of histologic granuloma faciale, especially when the clinical presentation is atypical for this dermatosis.
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We describe a papulonodular variant of demodicidosis seen in two patients with acquired immunodeficiency syndrome and its successful treatment with 1% gamma benzene hexachloride and 1% permethrin cream rinse. Alterations in T cell function may allow otherwise commensal organisms to proliferate to the point of causing disease.
Once encountered, generalized melanosis as a consequence of disseminated melanoma is not easily forgotten. Cases in the literature usually have resulted from primary cutaneous melanoma. A case of generalized melanosis caused by an occult primary melanoma is reported in a patient who originally complained of increased pigmentation. Findings of light microscopic studies of involved skin, pathogenesis of generalized melanosis, and possible sites of origin of the primary neoplasm are discussed.
A case of adult cutaneous eruptive histiocytoma is reported. The lesions showed self-healing capacity in a 9-year period. Electron microscopic studies revealed comma-shaped bodies and multiple melanosomes in the cytoplasm of some cells. Normolipemic xanthelasma was present, and the patient had polyclonal gammopathy and hypocomplementemia. Resolution of the lesions produced pigmented atrophic macules. Generalized eruptive histiocytoma and benign cephalic histiocytosis could be forms of the same non-X histiocytosis.
Six cases of facial erythema with follicular plugging are described. These cases correspond with characteristics of the disorder pityriasis folliculorum, a presumed demodicidosis. Treatment modalities included topical tretinoin, gamma benzene hexachloride (lindane) lotion, and 1% permethrin cream rinse.
We report a case of a 27-year-old woman with a patchy, dark brown hyperpigmentation on the face. Patch tests were positive to lemon oil, geraniol, and hydroxycitronellal. A compact face powder that the patient used contained two of these chemicals. Hyperpigmentation disappeared within 6 months after the patient avoided contact with cosmetics containing these fragrances.
Electron microscopic findings are presented in a patient with localized cicatricial pemphigoid (Brunsting-Perry). These findings revealed subepidermal separation below the basal lamina. The basal lamina and anchoring fibrils were well preserved and attached to the intact epidermis to form the roof of the blister. These findings support the concept that localized cicatricial pemphigoid, cicatricial pemphigoid, and disseminated cicatricial pemphigoid are closely related diseases and may explain the occurrence of scar formation in localized cicatricial pemphigoid. A review of 42 cases reported in the world literature is included, with emphasis on clinical, histologic, and immunofluorescence microscopic findings.
Kaposi's sarcoma and disseminated sporotrichosis of the skin and joints developed simultaneously in a homosexual man with antibodies to human immunodeficiency virus. There was no identified source of exposure to Sporothrix organisms. Sporotrichosis may be a presenting opportunistic infection associated with acquired immunodeficiency syndrome and tends to be disseminated at the time of diagnosis.