Eccrine porocarcinoma: a case with local recurrence, regional lymph node and extensive cutaneous metastases

A 64-year old male patient presented to the dermatology clinic with few weeks history of multiple papulonodular skin lesions over the left thigh, associated with limb edema and palpable lymph nodes in the left inguinal region. The patient had a skin lesion over his left ankle, excised 7 months earlier and the pathology report came with the diagnosis of squamous cell carcinoma. A biopsy was taken from one of the thigh lesions, and histopathological examination revealed metastatic porocarcinoma into the overlying skin with lymphatic infiltration. A histopathological review of the first biopsy showed a porocarcinoma, apparently completely excised. In conclusion, this case presentation highlights the tendency of porocarcinoma for local recurrence and metastasis to skin and lymph nodes

Orf infection: a clinical study at the royal medical services hospitals

To describe the demographics, clinical features, course, therapeutic interventions, and outcomes of patients with Orf infection seen at the Royal Medical Services Hospitals. We describe 64 patients with Orf infection who presented to dermatology clinics at different Royal Medical Services Hospitals during a five year period from March 2002 to February 2007. Their clinical presentations, complications and treatment were reported through regular follow-up at weekly intervals. Sixty four cases [42 males and 22 females] were studied. Their ages ranged from 8-67 years. History of exposure to sheep or lambs was documented in 57 cases [89%]. The mean incubation period was seven days [ranged 4-15 days]. The incidence peaked after the feast of sacrifice each year. Thirty-six patients [56%] were not aware about the infection before they had been examined by the dermatologist. Misdiagnosis by physicians unacquainted with the disease led to incision of the lesion in 21 patients [33%]. The most common sites were fingers, dorsum of hand, and palms. Diagnosis was made by history, appearance and location of the lesion and clinical course. In three cases, histopathological examination was made. The average resolution time of the lesions was 32 days without significant scarring. Complications were reported in 21 patients [33%]. In all cases, symptomatic treatment and local wound care were applied. Additionally, systemic antibiotics were used in 13 cases and cryotherapy in 11 cases. Orf is an endemic infection in Jordan. Although it is a self-limiting disease, prompt diagnosis is of paramount importance in order to alleviate the anxiety of patients because the lesions could resemble other more serious infections, and to avoid inappropriate treatments and possible complications. A national emphasis on the cognizance of the infection, public awareness and preventive measures is highly recommended