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At least 847 records · Page 47Linked to original sources
PubMed2005

Necrolytic acral erythema: a variant of necrolytic migratory erythema or a distinct entity?

BACKGROUND: Hepatitis C is a major health problem in Egypt. Necrolytic acral erythema (NAE) is a recently described necrolytic erythema that has a distinctive acral distribution and a uniform association with hepatitis C. Some authors believe that NAE is a distinct entity and others consider it as a variant of necrolytic migratory erythema (NME). METHODS: Five patients with clinical features consistent with NAE were included in this study. The patients were subjected to skin biopsy examination, CT scan of the pancreas and a liver biopsy. Liver function tests, serum glucagon, glucose, amino acids and zinc were measured. All patients were tested for hepatitis C by enzyme-linked immunosorbent assay (ELISA) and by polymerase chain reaction (PCR). RESULTS: Three patients presented with early (acute) lesions and two patients with chronic lesions. The distribution of the lesions was almost exclusively on the dorsae of the feet. Histopathological findings were similar to those of other necrolytic erythemas. Hepatitis C virus was uniformly detected in all patients. Serum glucagon was high in two patients, serum glucose was high in four patients, serum amino acids were low in three cases and serum zinc and albumin were low in two cases. Little or no improvement was reported after oral amino acid supplementation, while the response to oral zinc sulfate was moderate to good. CONCLUSION: Necrolytic acral erythema is closely associated with hepatitis C infection. Many findings indicate that NAE seems to be a variant of NME rather than a distinct entity. Hence, an alternative proposed term could be acral NME.

Administration, Oral↗
PubMed2004

Telangiectasia macularis eruptiva perstans with an associated myeloproliferative disorder.

Telangiectasia macularis eruptiva perstans (TMEP) is a cutaneous form of mastocytosis. It has been rarely associated with an underlying myeloproliferative disorder. We report the case of a patient, while receiving treatment for thrombocytosis, with both platelet production and function inhibitors presented with TMEP. TMEP is often refractory to therapy; however, our patient responded to treatment with PUVA.

Female↗
PubMed2005

Pigmented purpuric dermatosis and hepatitis profile: a report on 10 patients.

BACKGROUND: Pigmented purpuric dermatosis comprises a group of vascular disorders of unknown etiology. Histologically, it is characterized by lymphocytic capillaritis in the papillary dermis. Although leukocytoclastic vasculitis confined to the skin is frequently reported with hepatitis C, lymphocytic vasculitis is rarely reported. METHODS: Ten patients with pigmented purpuric dermatosis were studied clinically and histopathologically. Hepatitis profile was carried out in all of the patients to evaluate the possible relation. RESULTS: Of the 10 patients, five tested positive for hepatitis C and two for hepatitis B antibodies. CONCLUSION: Hepatitis C and B virus may play a role in the pathogenesis of pigmented purpuric dermatosis. Further case-control studies are necessary to confirm this conclusion.

Adult↗
PubMed2006

Superficial thrombophlebitic tuberculide.

BACKGROUND: Tuberculides are the result of immunologic reactions to hematogenously spread antigenic components of Mycobacterium tuberculosis. There are three recognized tuberculides--papulonecrotic tuberculide, erythema induratum of Bazin, and lichen scrofulosorum. In 1997, in Japan, Hara and coworkers reported five patients with what they called "nodular granulomatous phlebitis," which they proposed was a fourth type of tuberculide. We describe a patient who presented with features identical to those reported by Hara et al. in order to draw attention to the previous report and to support the concept of a fourth tuberculide which clinically resembles superficial thrombophlebitis. METHODS: A black South African man presented with cord-like thickening of superficial veins on the antero-medial aspects of the lower legs. Nodular swellings were palpable along the course of these veins. There was no evidence of tuberculosis elsewhere in the body, but the patient had a strongly positive tuberculin reaction. Skin biopsies were performed for histologic examination, culture, and polymerase chain reaction (PCR). RESULTS: Histologic examination showed a granulomatous infiltrate localized to the veins in the subcutaneous fat. Stains for acid-fast bacilli and culture were negative, but PCR was positive for M. tuberculosis DNA. The lesions responded promptly to antituberculous therapy. CONCLUSIONS: Our patient showed features identical to those of cases described by Hara and coworkers and assigned as a fourth type of tuberculide. As the lesions clinically resemble superficial thrombophlebitis, we propose the term "superficial thrombophlebitic tuberculide" rather than "nodular granulomatous phlebitis."

Adult↗
PubMedDate not supplied

Tinea corporis bullosa.

The paper reports a case of tinea corporis bullosa in a 63-year-old woman. Near the classical annular lesions on the anterior surface of the left leg, the patient presented frank bullous lesions. Serous fluid from the bulla yielded Microsporum canis, the first report of the association of this fungus with bullous lesions in tinea corporis. The patient was investigated with routine examinations and immunological studies which showed an intense inflammatory process much greater than in usual cases of tinea corporis.

Female↗
PubMedDate not supplied

Mycetoma due to Exophiala jeanselmei and Mycobacterium chelonae in a 73-year-old man with idiopathic CD4+ T lymphocytopenia.

Exophiala jeanselmei and Mycobacterium chelonae were isolated from cutaneous nodules in a 73-year-old man with mycetoma of the right lower leg. Further evaluation revealed CD4+ lymphocytopenia without evidence of HIV infection. Antibodies to HIV 1/2, p24 antigen and HIV 1/2 (PCR) and reverse transcriptase activity were not detectable. The patient was not a member of any HIV risk group. He had not previously undergone therapy or suffered from immunodeficiency. This case clearly demonstrates that infections with opportunistic moulds and/or atypical mycobacteria should be taken into consideration not only in patients with classical immundeficiency diseases but also in apparently healthy patients because infection with these agents can be the first sign of underlying immunodeficiency.

Aged↗
PubMed2005

Chromoblastomycosis.

A 70-year-old male agriculturist from a rural area presented with a history of a painless verrucous lesion over the medial aspect of the left leg for 1 year following abrasion by a branch of a coconut tree. KOH preparation of the skin biopsy showed evidence of fungal elements. Cladophilalospora sp. was isolated in culture. The case was diagnosed as chromoblastomycosis. As there was no response to itraconazole, complete surgical resection of the lesion was done. At follow-up after 1 year there was clinical as well as mycological cure.

Aged↗
PubMed1997

Serum and blister fluid cytokines and complement proteins in a patient with Henoch Schönlein purpura associated with a bullous skin rash.

A case is presented of an adult with Henoch Schonlein purpura (HSP) with widespread bullous skin lesions in whom serum and bullous fluid (BF) cytokines and complement proteins were analysed. In both serum and BF the total haemolytic complement was subnormal. Soluble CD25 (sCD25), which is important in B cell activation and proliferation, was over 13 times higher in the BF compared with serum. The serum and BF levels of interleukin (IL) 1, IL6, IL10, tumour necrosis factor alpha and interferon gamma were within the normal serum range of 30 healthy control subjects simultaneously analysed. The raised levels of sCD23 in BF suggest dysregulated humoral immunity in the cutaneous lesions of HSP.

Adult↗
PubMed1998

Mycobacterium marinum: chronic and extensive infections of the lower limbs in south Pacific islanders.

We report three adult cases of very chronic, extensive infection of the lower limbs due to Mycobacterium marinum. The patients were from South Pacific islands and, clinically, the widespread warty plaques resembled chromomycosis. One was associated with severe lymphoedema. All three patients gave a history of at least 20 years duration. The patients were otherwise well and not immunologically compromised. In all cases, the organism was identified on tissue cultures and was not seen on histopathology. The mycobacteria were sensitive to most antibiotics tested in vitro. The patients were treated with a combination of rifampicin and cotrimoxazole with good results.

Adult↗
PubMed1998

Inoculation cutaneous tuberculosis.

Two cases of inoculation cutaneous tuberculosis are presented. As commonly occurs, the diagnosis could not be confirmed bacteriologically due to the small numbers of organisms present. However, both patients responded to antituberculosis chemotherapy.

Adolescent↗
PubMed2004

Köbnerization in a woman with generalized lichen sclerosus.

A 52-year-old woman presented with an 18-month history of genital and extragenital lichen sclerosus. In addition to the classical genital findings, lesions of lichen sclerosus were present over her back, chest and the medial aspect of her right thigh and leg. On her right thigh and extending to her right leg, lesions of lichen sclerosus displaying the Köbner response were noted over the course of a varicosed long saphenous vein. There were no features of varicose dermatitis in the region displaying the Köbner response. It is proposed that the ambulatory venous pressure within the vein acted as a stimulus for the Köbner response.

Female↗