[Case report of lichen aureus].
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Spinocellular carcinoma developed in a 19-year-old lesion of lichen ruber hypertrophicus of the lower leg. In the literature,24 cases of spinocellular carcinoma in lesions of cutaneous lichen ruber have been reported. X-ray and arsenic treatment has often preceded malignant transformation. Another risk factor seems to be the chronic hypertrophic type of lichen ruber located on the lower extremities.
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Our observation concerns a patient aged 29 who has presented for the last two years a smooth lesion, non-infiltrated, golden yellow, and situated on the interior surface of the left knee. This lesion recalls the lichen aureus confirmed by standard histology nad Perls' coloration. There is capillary fragility without plaque anomaly. There is, however, no sign of subjacent venous incompetence.
Three patients with Graves' disease had very unusual locations of localized myxedema. One patient had localized myxedema on the pretibial and shoulder areas after sodium iodide I 131 therapy. The second patient had localized myxedema on his neck, shoulders, and upper part of the back as well as on the pretibial area. The third patient had localized myxedema on the pinnae, also following sodium iodide I 131 therapy. After surgical removal followed by intralesional triamcinolone acetonide injections, the first patient's lesions recurred. The lesions in the second case did not respond to topical steroid cream. The third patient had a partial response to intralesional steroid injections.
Hyperactivity of the sympathetic nervous system produces many of the skin changes of hyperthyroidism, while the hypometabolic state and the accumulation of mucopolysaccharides in the dermis are responsible for hypothyroid cutaneous manifestations. Acropachy, atopic eczema, localized myxedema and nail changes are associated with thyrotoxicosis. Vitiligo may be seen in all three thyroid diseases of autoimmune origin. Hyperpigmentation, pruritus and urticaria are associated with hyperthyroidism.
A 36-yr-old patient suffering from chronic ulcerative colitis complicated by severe pyoderma gangrenosum of the leg is presented. Pyoderma gangrenosum rapidly progressed and failed to respond to a combined treatment of bed rest, prednisone, sulfasalazine, povidone-iodine, compresses, and debridement. Pyoderma gangrenosum responded and disappeared with no recurrence during the following months after the combined treatment of methylprednisolone, dapsone, and zinc sulfate.
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A mother and daughter with lichen sclerosus et atrophicus (LSA) are described. Both had lesions restricted to their lower legs. Both patients were positive for HLA-B40, which has been associated with LSA. Sex steroid hormones showed no decrease in dihydrotestosterone, free testosterone, or androstenedione levels in the daughter as was demonstrated in a previous study of this disease, but did show some decrease in androstenedione in the mother. This article provides further evidence for a possible familial predisposition for LSA.
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The authors describe rather rare clinical forms of diffuse toxic goiter with bradycardia, pretibial myxedema, the absence of ophthalmic sings and noticeable cachexy. All necessary investigations for more rational differential diagnosis are enlisted. A possibility of the development of the clinical picture of thyrotoxicosis in TTH producting hypophyseal adenomas, chorionepithelioma and hydatidiform mole is emphasized.
A patient with chronic myelogenous leukemia (CML) in blast crisis experienced a peculiar painful eruption on his left lower extremity during the preterminal phase of his disease. The lesion was characterized by tender, edematous, purpuric infiltration which resembled stasis dermatitis clinically. Dermatopathologic examination demonstrated leukemia cutis.
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