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At least 865 records · Page 48Linked to original sources
PubMed2006

Leg crossers' dimple: A form of localized lipoatrophy.

We report eight individuals with localized lipoatrophy of the lateral lower leg that were seen by a single dermatologist in a 1-year period. All were asymptomatic and half had mild epidermal changes consistent with lichenification. Seven were an incidental finding during a general skin examination. All had a long-standing history of frequent leg crossing. The sites correlated with the area resting on the patella of the opposing knee. The depressions were larger on sides of leg-crossing preference. Only one had a significant rise in antinuclear antibodies, but this patient had no other clinical or serological abnormalities. This appears to be an extremely common yet previously unreported form of localized lipoatrophy.

Aged↗
PubMed2004

Circumscribed juvenile pityriasis rubra pilaris.

We report the case of a 20-year-old woman with a 10-year history of circumscribed juvenile-onset pityriasis rubra pilaris (PRP, type IV). Our patient had well-defined keratotic follicular papules on an erythematous base located on the extensor aspects of the extremities and dorsal aspects of the feet but no involvement of the palms and soles. Although most cases of type IV PRP follow a favourable course with spontaneous resolution of the lesions, this case demonstrates that circumscribed juvenile PRP can be more persistent and lasts several years.

Adult↗
PubMed2004

Paraneoplastic vasculitis associated with multiple myeloma.

The association between vasculitis and cancer has been widely reviewed in recent decades. The existence of malignancies in patients with vasculitis has been estimated at about 4.5-8%, haematological neoplasms being the most frequently observed. The haematological malignancies most frequently described are lymphoproliferative diseases such as hairy cell leukaemia and lymphomas. On the contrary, the incidence of paraneoplastic vasculitis in patients with myeloma is low; up to now, we have found nine cases reported on this subject. We report the case of a 73-year-old woman who in 1 year showed three outbreaks of acutely painful, purpuric and ulceronecrotic lesions, localized on the lower extremities. Histopathological study demonstrated thrombosis in the arterioles and leucocytoclastic vasculitis. Complementary tests revealed the presence of multiple myeloma.

Acute Disease↗
PubMed2005

Epidermoid carcinoma and perforating necrobiosis lipoidica: a rare association.

We report the case of a 33-year-old patient who had had insulin-dependent diabetes mellitus (IDDM) since he was 11 months old, and who presented with major perforating necrobiosis lipoidica (PNL) complicated by a well-differentiated epidermoid carcinoma. PNL is a rare clinical form of NL, always associated with diabetes. Only seven cases have been reported to date in the literature, and to the best of our knowledge, an association of epidermoid carcinoma and PNL has never been described. The development of a tumoral transformation on a classical NL plaque has only been described 12 times. The presence of an epidermoid carcinoma on a weakened background with permanent ulceration suggests that early surgical excision of the tumour and of the NL followed by a skin graft might be the treatment of choice. Radiotherapy seems to be a poor therapeutic option.

Adult↗
PubMed2006

Exercise-induced vasculitis.

BACKGROUND: Usually misdiagnosed and ignored in the literature, exercise-induced vasculitis (EIV) is not uncommon, occurring mostly in long-distance runners and in females after long walks, especially in hot weather. OBSERVATIONS: I report 23 otherwise healthy patients (22 females, 1 male) who developed EIV after walking or hiking in hot weather. Erythematous, urticarial or purpuric plaques arose on the lower legs, not involving skin compressed by socks. Symptoms included itch, pain, and burning sensation. Lesions resolved after some days. Relapses were frequent at further muscular exercise, and could be prevented in some cases by compression hosiery, manual lymphatic drainage, intake of oedema protective agents, or steroids (local or systemic). INVESTIGATIONS: Histopathology demonstrated leucocytoclastic vasculitis in five biopsies, and urticarial vasculitis in one. Extensive blood investigations have been performed in six patients and were negative. No clear relation with chronic venous disease (duplex or Doppler) had been established in 12 patients. CONCLUSIONS: I suggest denominating this condition exercise-induced vasculitis. This clinical entity is well defined, but poorly recognized. The presentation of 23 original cases demonstrates its reality.

Adult↗
PubMed2006

Burden of illness of bacterial cellulitis and erysipelas of the leg in the Netherlands.

BACKGROUND: Information on the prevalence of bacterial cellulitis (BC) and erysipelas (ER) of the leg (BCERL) is sparse and dependent on the definitions used. There is no information available on the number of hospitalized and non-hospitalized patients with BCERL, and related treatment costs. OBJECTIVE: The purpose of this study was to assess the burden of illness for BCERL in the Netherlands in 2001. METHODS: Data were obtained from different linked databases. Hospital information was obtained from the National Morbidity Registration (known in the Netherlands as the LMR), which includes all Dutch citizens, using ICD-9-CM codes. The number of patients not admitted to hospital was estimated using a subsample with data from general practitioners (GPs) (N = 50,000). These data were extrapolated using age/gender and disease-specific standardization. The subsample was used to assess the location of the infection. Reimbursement costs were available for all resources. RESULTS: In 2001, approximately 28,000 patients presented with either BC or ER of the leg. Of these patients, 2,200 were admitted to the hospital and 4-6% had two or more episodes of ER/BC in 2001. The average costs per hospitalization for BCERL were 5,346 euros, accumulating to more than 14 million euros in 2001. Although only 7% of all patients were hospitalized, 83% of the total treatment costs could be attributed to hospitalization. CONCLUSIONS: BCERL are common and serious infections in the Netherlands. Hospitalization occurs in only one in 14 patients but contributes more than 80% of the total costs, which accumulate to 17 million euros a year.

Bacterial Infections↗
PubMed1980

Elephantiasis nostras verrucosa.

Elephantiasis nostras verrucosa is an unusual and impressive cutaneous hypertrophy that may occur secondary to chronic, severe lymphedema or venous insufficiency, usually of a lower extremity. The condition consists of hyperkeratotic, verrucous, and papillomatous projections. A case is reported in a white woman.

Diabetes Complications↗
PubMed1998

Evaluation of the long-pulse dye laser for the treatment of leg telangiectasias.

BACKGROUND: Leg telangiectasias are common visible ecstatic dermal capillaries, arterioles, or veins. Multiple methods of treatment have been reported for this entity. A long-pulse (1500 microsecond) dye laser has been developed to treat leg veins ranging in size from 0.1 to 1.0 mm in diameter. OBJECTIVE: To determine the effectiveness of this novel device on treating leg veins with varying wavelengths and fluences. METHODS: Eight patients with more than 250 sites of leg telangiectasis were treated with the long-pulse dye laser. RESULTS: Clearance of 100% was achieved after one or two treatments by vessels with diameters up to 0.5 mm. Vessels with diameters between 0.5 and 1.0 mm faded in about 80% of treatments. Transient adverse affects were observed in a low incidence. CONCLUSIONS: The long-pulse dye laser is a safe and effective tool in the treatment of leg telangiectasias.

Adult↗
PubMed2004

A case of multiple keratoacanthoma centrifugum marginatum.

BACKGROUND: Keratoacanthoma centrifugum marginatum is a rare variety of keratoacanthoma, usually presented and classified as solitary keratoacanthoma. Reported cases of multiple keratoacanthoma centrifugum marginatum are exceptional in the literature. OBSERVATIONS: A 21-year-old man presented for evaluation of erythematous papules and plaques on both legs that had had a peripheral growth over the past year. Clinical and histologic examination showed typical features of keratoacanthoma centrifugum marginatum. Owing to the multiplicity and size of the lesions, treatment with oral isotretinoin was started. It was ineffective. Subsequent treatment with methotrexate combined with oral prednisone led to the regression of all lesions. CONCLUSIONS: The exceptional case of a man with multiple keratoacanthoma centrifugum marginatum is reported. Treatment with methotrexate combined with oral prednisone was effective. This case illustrates how some variants of keratoacanthomas do not really fit into the current classification and how complex the treatment of these tumors is.

Administration, Oral↗
PubMed2004

Elephantiasis nostras verrucosa successfully treated by surgical debridement.

BACKGROUND: Elephantiasis nostras verrucosa represents a rare group of cutaneous changes comprising dermal fibrosis, hyperkeratotic, verrucous, and papillomatous lesions after chronic secondary, nonfilarial lymphedema. There is no standard treatment for this rare cutaneous manifestation. OBJECTIVE: This article describes debridement that is helpful when performed in addition to physiotherapy. METHODS: We present a patient who was treated by shaving the verrucous area with a blade of a freehand knife and by subsequent abrading of the mossy area using a motor-powered grinder. RESULTS: Reepithelization was completed in 2 weeks. A compression stocking was used to treat the lymphedema. Ten months after the operation, we saw no signs of disease recurrence. The result was also aesthetically satisfactory. CONCLUSIONS: Surgery in such case may not always be the best treatment because it does not treat the cause of disease but only treats the cutaneous symptoms. Nevertheless, debridement is a rapid and an aesthetically acceptable form of treatment.

Adult↗
PubMed1992

Focal dermal hypoplasia (Goltz syndrome): report of two cases with minor cutaneous and extracutaneous manifestations.

Two women, ages 33 and 16 years, had focal dermal hypoplasia (Goltz syndrome) with unusual, minimal clinical manifestations. The lesions consisted of patchy, atrophic, scaly, telangiectatic macules arranged in a linear pattern along Blaschko's lines, involving the anterior and lateral aspects of both legs (patient 1) and the anterolateral aspect of the left leg (patient 2). Type I partial syndactyly involving the second and the third toes in both patients was also present. The clinical and histopathologic features and diagnostic difficulties of cases of this disorder with minimal cutaneous and extracutaneous manifestations are discussed.

Adolescent↗