A 67-Year-Old Male with Diffuse Purpuric Vesicles and Bullae
Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis that most commonly affects the postcapillary venules in the skin. It classically presents with purpuric macules that progress to palpable purpura on the bilateral shins 7 –10 days after an inciting medication or infection, or in the setting of connective tissue disease, malignancy, or inflammatory bowel disease. Up to 50% of cases have no identifiable cause. Lesions on the buttocks, abdomen, upper extremities, and face are uncommon, as are bullae and ulcers. We pre sent a rare case of bullous LCV manifesting as grouped vesicles on the face and body mimicking ...
Source: Dermatopathology - January 24, 2020 Category: Pathology Source Type: research
A 23-Year-Old Man with Hyper-IgM Syndrome Presenting with Asymptomatic Violaceous Facial Plaques
Tumid lupus is a rare subtype of chronic cutaneous lupus that is characterized by urticaria-like photosensitive plaques. Unlike discoid lupus, it has minimal to no surface change and resolves without scarring. On pathological examination, it may be distinguished from other types of lupus by abundant interstitial mucin deposits. Herein, we describe a case of tumid lupus in a 23-year-old Kuwaiti male with hyper-IgM syndrome. To our best knowledge, this is the first report of tumid lupus in a patient with a primary immunodeficiency.Dermatopathology 2019;6:246 –250 (Source: Dermatopathology)
Source: Dermatopathology - January 22, 2020 Category: Pathology Source Type: research
A 78-Year-Old Female with a Diffuse Pruritic Rash and Palmoplantar Desquamation
We report a case of mycosis fungoides imitating clinical and histopathological features of erythema annulare centrifugum.Dermatopathology 2019;6:241 –245 (Source: Dermatopathology)
Source: Dermatopathology - January 22, 2020 Category: Pathology Source Type: research
Reliability of Histopathology for the Early Recognition of Fibrosis in Traction Alopecia: Correlation with Clinical Severity
In this study, 45 patients were assessed using the marginal TA severity scoring system, and their biopsies (both longitudinal and transverse sections) were systematically assessed by three dermatopathologists, the aim being to correlate histopathological findings with clinical staging. Intraclass correlation coefficients were used to determine the level of agreement between the assessors. We found poor agreement of the identification and grading of perifollicular and interfollicular fibrosis (0.55 [0.23 –0.75] and 0.01 [2.20–0.41], respectively), and no correlation could be drawn with the clinical severity score. Bette...
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
Primary Cutaneous Anaplastic Large-Cell Lymphoma
A 35-year-old male presented with a 6-month history of asymptomatic, generalised, self-healing lesions. On clinical examination, there were diffuse, ulcerated, necrotic papules and nodules with lymphoedema of the face. Histology sections confirmed atypical lymphoid-type cells which appeared round-to-oval with irregular nuclei (horseshoe-shaped). Immunohistochemistry stains were positive for CD30, CD3, and epithelial membrane antigen. The features were in keeping with an anaplastic large-cell lymphoma, T cell type. This transformed into a systemic variant of the disease after the patient had completed chemotherapy.Dermatopa...
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
< b > < i > Emergomyces africanus < /i > < /b > : The Mimicking Fungus
A 31-year-old HIV-seropositive woman from Durban, KwaZulu-Natal, South Africa, presented with a 3-month history of widespread umbilicated and ulcerated skin papules, plaques, and nodules. The skin lesions were biopsied and sent for histology and fungal culture; the cultured isolate was referred for molecular identification. Histology, fungal culture, and molecular testing confirmed that the dimorphic fungal pathogenEmergomyces africanus had caused a disseminated mycosis.Dermatopathology 2019;6:157 –162 (Source: Dermatopathology)
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
Dowling-Degos Disease Presenting Primarily with Comedones and Atrophic Scarring
We present a patient with histologically confirmed DDD whose predominant clinical finding was of comedones and scarring, with less prominent pigmentation, thus expanding the clinical spectrum of DDD.Dermatopathology 2019;6:153 –156 (Source: Dermatopathology)
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
Report of 2 Novel Presentations of Subcutaneous Fat Necrosis of the Newborn
Subcutaneous fat necrosis of the newborn (SCFNN) is a rare form of panniculitis classically affecting healthy full-term infants. There are a number of predisposing factors including perinatal asphyxia. The condition generally has a benign course with spontaneous resolution, but monitoring for metabolic complications, in particular the potentially life-threatening complication of hypercalcaemia, is critical. The authors report 2 cases of preterm infants with perinatal asphyxia with atypical presentations of SCFNN: the first with bony involvement resembling Langerhans cell histiocytosis and with follicular pseudocarcinomatou...
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
Epstein-Barr Virus-Associated Smooth Muscle Tumour: A Case Series with a Significant Proportion of Tumours Showing Proclivity for Cutaneous Soft Tissues
Conclusion: A significant proportion of EBV-SMTs may present in the cutaneous soft tissues. This neoplasm should, therefore, be included in the histopathological differential diagnosis of any cutaneous or superficial subcutaneous spindle cell tumour, especially in patients with a history of underlying immune suppression. Accurate diagnosis thereof and its distinction from other spindle cell neoplasms is important in view of management implications and the potential for multicentricity in some patients.Dermatopathology 2019;6:133 –146 (Source: Dermatopathology)
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
Keratolytic Winter Erythema: An Update
Keratolytic winter erythema (KWE) is a rare autosomal dominant keratoderma affecting primarily the palms and soles, manifesting with recurrent waves of erythema followed by epidermal peeling. The condition is so named in view of its anecdotal worsening during the winter months. It is highly penetrant but shows considerable individual clinical variability, waning and reappearing throughout the life course. Histologically, early established lesions of KWE manifest with degenerative changes involving the Malpighian layer, with associated absence of the stratum granulosum. The damaged zone undergoes parakeratotic transformatio...
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
An Update on Adverse Cutaneous Drug Reactions in HIV/AIDS
Background: The global mortality from HIV and the cutaneous burden of infective, inflammatory and malignant diseases in the setting of AIDS have significantly declined following the advent of highly active antiretroviral therapy. Regrettably, there has been a contemporaneous escalation in the incidence of adverse cutaneous drug reactions (ACDR), with studies attesting that HIV-positive individuals are a hundred times more susceptible to drug reactions than the general population, and advanced immunodeficiency portending an even greater risk. Several variables are accountable for this amplified risk in HIV.Summary: Adverse ...
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
Peri-Umbilical Lymphangioma Circumscriptum Associated with Intra-Abdominal Lymphatic Malformations
A 12-year-old African female presented with a 6-year history of relatively asymptomatic umbilical lesions. On clinical examination, the lesions were papillomatous, violaceous nodules and translucent papules with a serosanguineous discharge. The lesions emanated from the umbilicus and extended peri-umbilically. Histopathology confirmed a lymphangioma and MRI and CT imaging revealed multiple intra-abdominal lymphatic malformations. The patient was referred to plastic surgery for further management. Due to the extent of involvement, surgical resection was an option but currently the therapeutic approach is sclerotherapy with ...
Source: Dermatopathology - June 26, 2019 Category: Pathology Source Type: research
