ABSTRACT
BACKGROUND: The treatment of patients with lymphomatoid papulosis is unsatisfactory. Because a curative therapy is not available and none of the available treatment modalities affects the natural course of the disease, the short-term benefits of active treatment should carefully be balanced against the potential side effects. OBJECTIVE: The purpose of this study was to determine the effectiveness and safety of methotrexate in the treatment of lymphomatoid papulosis. METHOD: Twelve patients with a clinicopathological diagnosis of lymphomatoid papulosis were treated with low-dose methotrexate (5-20mg/week), and clinical efficacy and adverse effects were evaluated. RESULTS: The male-to-female ratio was 1: 1.4, and age distribution ranged from 11 to 65 years, with a mean age of 41 years. Histopathologic types classified by Willemze's classification included type A (10 cases), type B (0 cases), and type C (2 cases). All patients responded to low-dose methotrexate, and the level of control was judged to be `excellent' (no or rare lesions between doses), `good' (few lesions between doses), `fair' (improvement but new lesions continued to develop), or `poor' (no improvement observed) in 7 (58%), 2 (17%), 3 (25%), and 0 (0%) of patients respectively. All three patients in the `fair' group (the group relatively less responsive to methotrexate) were female and included both patients who were histopathologic type C. Adverse effects only included nonspecific gastrointestinal discomfort in two patients. CONCLUSION: Low-dose methotrexate (5-20mg/week) is effective and well-tolerated in most patients with lymphomatoid papulosis.
Subject(s)
Female , Humans , Age Distribution , Classification , Diagnosis , Lymphomatoid Papulosis , MethotrexateABSTRACT
Median raphe cysts are rare mid-line developmental cysts, which can arise at any point between the external urethral meatus and the anus. They most commonly affect the ventral aspect of the penis, usually near the glans. They tend to be solitary, unilocular cysts, and the inner lining is usually composed of pseudostratified columnar epithelium. We present a case of a 3-year-old boy with a median raphe cyst affecting the glans penis. The cyst, located near the urethral meatus, was slightly pruritic and 0.3cmx0.3cmx0.1cm in size. A shave biopsy, followed by CO2 laser ablation was performed, and histopathological examination revealed a unilocular cyst lined with pseudostratified columnar epithelium, which showed decapitation secretion in part. For 2 years fallawing the shave biopsy, no clinical evidence of recurrence has been observed.
Subject(s)
Child, Preschool , Humans , Male , Anal Canal , Biopsy , Decapitation , Epithelium , Lasers, Gas , Penis , RecurrenceABSTRACT
Endometriosis is defined as the abnormal growth of endometrial tissue outside the uterine cavity, but in rare cases may also occur on the skin. Cutaneous endometriosis frequently develops at the site of a prior abdominal or pelvic procedure, although apparent spontaneous occurrence has been reported. We present a case of non-symptomatic, cutaneous endometriosis in the episiotomy scar. The patient had no evidence of concurrent pelvic endometriosis.
Subject(s)
Female , Humans , Cicatrix , Endometriosis , Episiotomy , SkinABSTRACT
Porokeratosis is a group of disorders characterized by epidermal keratinization associated with cornoid lamella. Porokeratosis has been described as having five distinct clinical subtypes: Mibelli or plaque type, disseminated superficial actinic porokeratosis, linear porokeratosis, punctate porokeratosis, porokeratosis palmaris et plantaris disseminata. We describe a 61-year-old Korean woman presented with porokeratosis palmaris et plantaris disseminata.
Subject(s)
Female , Humans , Middle Aged , PorokeratosisABSTRACT
Hidradenoma papilliferum is a rare benign neoplasm that occurs almost exclusively on the skin of the female anogenital region. It is usually a slow-growing cystic dermal mass that can be either asymptomatic or ulcerate and bleed, and represents an adenoma with apocrine differentiation. We present a case of hidradenoma papilliferum in a 46-year old woman with a erythematous to brownish papule on the left labium majora and the typical histopathologic findings.
Subject(s)
Female , Humans , Middle Aged , Acrospiroma , Adenoma , Skin , UlcerABSTRACT
The lesions of neutrophilic dermatosis (pustular vasculitis) of the dorsal hands clinically resembled those of Sweet's syndrome and showed similar histologic evidence of a dense dermal neutrophilic infiltrate. We, herein, present a case of neutrophilic dermatosis of the dorsal hands in a 70-year-old woman with bacterial endocarditis. The patient presented with hemorrhagic pustular blisters on the dorsal hands. Histopathologic findings were pseudoepitheliomatous hyperplasia, intraepidermal pustules, histiocytic infiltration and a few perivascular neutrophilic infiltrations. The skin lesion improved spontaneously.
Subject(s)
Aged , Female , Humans , Blister , Endocarditis, Bacterial , Hand , Hyperplasia , Neutrophils , Skin , Skin Diseases , Sweet SyndromeABSTRACT
The lesions of neutrophilic dermatosis (pustular vasculitis) of the dorsal hands clinically resembled those of Sweet's syndrome and showed similar histologic evidence of a dense dermal neutrophilic infiltrate. We, herein, present a case of neutrophilic dermatosis of the dorsal hands in a 70-year-old woman with bacterial endocarditis. The patient presented with hemorrhagic pustular blisters on the dorsal hands. Histopathologic findings were pseudoepitheliomatous hyperplasia, intraepidermal pustules, histiocytic infiltration and a few perivascular neutrophilic infiltrations. The skin lesion improved spontaneously.
Subject(s)
Aged , Female , Humans , Blister , Endocarditis, Bacterial , Hand , Hyperplasia , Neutrophils , Skin , Skin Diseases , Sweet SyndromeABSTRACT
We report the case of a 48-year-old man presenting with a pubic nodule and multiple ulcers on penis and scrotum. He had a kidney transplantation two months ago and has been taking cyclosporine, prednisolone, and mycophenolate mofetil. The biopsy specimen from the nodule showed vasculitis and multiple cytomegalic cells in dermis. The biopsy specimen from the scrotal ulcer showed a cluster of multinucleated giant cells and acantholysis in epidermis and cytomegalic cells and vasculitis in dermis, suggestive of HSV infection in epidermis and CMV infection in dermis. Specific immunoperoxidase for CMV antigens positively stained cytomegalic endothelial cells and fibroblasts in both specimens. Evidence of CMV viremia as pp65 was detected in circulating polymorphonuclear leukocytes by immunocytochemical tests although there was no evidence of other organ involvement. Immediately, he was placed on intravenous ganciclovir therapy for 3 weeks. The lesions cleared leaving scars and he was discharged in good general condition.
Subject(s)
Humans , Male , Middle Aged , Acantholysis , Biopsy , Cicatrix , Cyclosporine , Cytomegalovirus , Dermis , Endothelial Cells , Epidermis , Fibroblasts , Ganciclovir , Giant Cells , Immunocompromised Host , Kidney Transplantation , Neutrophils , Penis , Prednisolone , Scrotum , Ulcer , Vasculitis , ViremiaABSTRACT
Aquired fibrokeratoma is a rare, benign tumor which occurs most frequently on the fingers. Because of the digital predilection, a term of digital fibrokeratoma has been frequently used. We present here two cases of acquired fibrokeratoma occurring on the prepatellar area and the proximal nail bed which are unusual sites of this lesion. A skin-colored, hyperkeratotic tumor with finger-like projection was found on the prepatellar area of a 29-year-old man and a round pedunculated nodule was found on the proximal nail bed of second finger of a 74-year-old woman. Histopathologic examination revealed typical features of acquired fibrokeratoma.