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A 45-year-old man presented with a pigmented lesion on his face. A clinical diagnosis of melanocytic nevus was made and the lesion was excised. Histopathologic examination showed a reticular seborrheic keratosis associated with a junctional nevus. We discuss the relation of nevocellular nevi with epidermal and adnexal tumors.
We report on an 81-year-old woman suffering from extensive acrodermatitis chronica atrophicans with facial involvement. This unusual manifestation may be related to an immunodeficiency state in the course of multiple malignancies. The cutaneous lesions cleared significantly during an aminopenicillin therapy administered orally over 4 weeks.
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Because of obvious therapeutic and prognostic implications, as definitive a pathologic diagnosis as possible is necessary for necrotizing lesions of the midfacial mucous membranes. In the beginning of the diagnostic process, the lesions are placed under the noncommittal rubric of midfacial necrotizing lesions, thus forever avoiding confusing nomenclature such as lethal midline granuloma. Following this, the lesions are approached with the full appreciation they may be (1) localized or part of a systemic illness; (2) neoplastic or non-neoplastic; (3) caused by a specific agent or organism or be seemingly idiopathic; (4) self-limited or progressively destructive in varying degrees of severity; (5) characterized by a granulomatous or nonspecific tissue reaction with or without vasculitis; and (6) impossible to classify without clinicopathologic correlation. To illustrate these points, a number of necrotizing lesions, including sarcoidosis, Wegener's granulomatosis, and the lymphomatoid granulomatosis-polymorphic reticulosis group are presented.
A comprehensive discussion of the need for, history, evaluation, and use of corrective cosmetics should also address image and its psychological impact, the attributes of an effective and acceptable concealer, and the methods of application.
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Enlargement of the cheeks may be due to a multitude of disorders, congenital, neoplastic, and in particular inflammatory. Congenital facial anomalies include cutaneous (and osseous) hemihypertrophy of the face and unilateral angiomatous malformations (e.g. Sturge-Weber-Krabbe Syndrome). Buccal enlargement due to dermal tumours include localized haemangiomas and lymphangiomas, lipomas and other benign connective tissue neoplasms, generalized disorders of the lymphatic or reticuloendothelial system including mycosis fungoides, reticulum cell sarcoma and other soft tissue malignancies, and cutaneous manifestations of malignant haemoblastoses, in particular chronic lymphatic leukaemia. Within the very large group of inflammatory skin swellings of the face a review is made of some bacterial pyodermias, severe forms of acne vulgaris, herpes zoster, lupus vulgaris, erysipelas, rosacea, steroid dermatitis, lupus erythematosus (discoid and systemic), toxic dermatitis, allergic eczema, urticaria, Quincke's oedema, and the Melkersson-Rosenthal syndrome. The importance of prevention and early detection of steroid-induced dermatitis is emphasized. This disorder, which is a pseudo-inflammatory disfiguring complication of prolonged topical steroid abuse, ranks in frequency with the skin problems most often seen in dermatological practice.
The early history of tuberous sclerosis can be traced from European wax models of the skin lesions in the 1830s to its recognition as a systemic disease by the early 1900s. There are various origins for the terms used for tuberous sclerosis, including Pringle's disease, Bourneville's disease, adenoma sebaceum, and epiloia. Since these terms are confusing and inaccurate, we urge that they no longer be used.
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