ABSTRACT
Long term D-penicillamine therapy, especially when used to treat Wilson's disease has been shown to cause elastosis perforans serpiginosa, pseudoxanthoma elasticum perforans and other degenerative dermatoses. We report a 23-year-old male patient who presented with multiple firm papules, nodules over the neck, axillae, front of elbows for five years. He was a known case of Wilson's disease on long-term treatment with penicillamine for the past 12 years. The papulonodular lesions were non-tender and some were discrete while others were arranged in a circinate pattern. There was central scarring of the skin within the circinate lesions. In addition, there were several small yellowish papules on both sides of the neck which eventually became confluent to form plaques. Histopathology confirmed the diagnosis of elastosis perforans serpiginosa and pseudoxanthoma elasticum. He was treated with cryotherapy (using liquid nitrogen through cryojet) for former lesions. The lesions showed remarkable improvement after five sittings. Now the patient is under trientine hydrochloride (750 mg twice daily) for Wilson's disease.
Subject(s)
Adult , Biopsy, Needle , Cryotherapy/methods , Dose-Response Relationship, Drug , Elastic Tissue/pathology , Follow-Up Studies , Hepatolenticular Degeneration/diagnosis , Humans , Immunohistochemistry , Male , Penicillamine/adverse effects , Pseudoxanthoma Elasticum/chemically induced , Severity of Illness Index , Treatment OutcomeABSTRACT
A 23 years old girl with a past history of sero-positive oligoarticular juvenile idiopathic arthritis developed nodules and depressed scars over face and limbs. Biopsy from the lesion revealed mixed panniculitis. She responded to steroids and hydroxychloroquine but has residual lipoatrophic scars needing reconstructive surgery.
Subject(s)
Adipose Tissue/pathology , Adult , Atrophy , Connective Tissue/pathology , Female , Humans , Necrosis , Panniculitis/pathology , Subcutaneous Tissue/pathologySubject(s)
Child , Child, Preschool , Female , Herpes Zoster/epidemiology , Humans , India , Infant , MaleABSTRACT
Renal functional status was evaluated in 27 patients with lepromatous leprosy. Renal functions were found to be significantly impaired in lepromatous patients with erythema nodosum leprosum (ENL) in the active phases. Though patients in quiescent phases and uncomplicated lepromatous leprosy patients did show renal impairment, however, the degree of impairment in such cases was less than that in the reactive cases.