ABSTRACT
Introduction: Vitiligo is a common depigmenting disorder with profound stigma. Prevalence of vitiligo is 0.5% to 1%. Information about association of progressive vitiligo are well known. Prognostic factors of vitiligo also enlisted. However, little information is available on the risk factors for developing extensive vitiligo. Aims and Objectives: Aims of the study was to identify – factors which are associated with extensive vitiligo (involving more than 5% of the body surface area). The following risk factors were evaluated, Onset before 20 years of age, Duration of disease greater than 2 years, Presence of Koebner’s phenomenon, Family history of vitiligo, Presence of leucotrichia and Mucosal involvement. Materials and Methods: A case control study were designed. Patients with Vitiligo > 5% body surface area involvement were classified as cases and <5% body surface area were labeled as controls. The frequency of evaluating associated clinical factors among the cases and controls were used to evaluate the extensive vitiligo’s association with risk factors (disease risk associated exposure). Results: Two hundred and eleven patients were evaluated. The mean age at onset was 19.07+13.51 (+SD) years. Acrofacial vitiligo was the commonest type of vitiligo. Duration of disease more than 2 years, presence of Koebner’s Phenomenon, Family history, Symmetry of lesions, milky white colour of lesion, presence of Leucotrichia, mucosal involvement and Acrofacial type vitiligo had statistically significant (p<.05) association with extensive vitiligo. Ratio of the odds of the outcomes in two groups was noted significant with Duration of disease more than 2 years, Koebner,s Phenomenon, Mucosal involvement and Leucotrichia. Conclusion: This case-control study has demonstrated a weak association between extensive vitiligo and duration of disease greater than 2 years. It has also indicated that koebner’s phenomenon, mucosal involvement and leucotrichia are additional risk factors.
ABSTRACT
Post-kala-azar dermal leishmaniasis (PKDL) is a dermatologic manifestation that usually occurs after visceral leishmaniasis (VL) caused by Leishmania donovani. It is characterized by hypopigmented patches, a macular or maculopapular rash and nodular skin lesions on the body surface. Involvement of the mucosae is very rare and unusual in PKDL. We report a case of PKDL that presented with polymorphic skin lesions, along with involvement of peri-oral mucosa and tongue from an endemic area for kala-azar in Bangladesh. In the absence of a definite past history of kala-azar, a clinical suspicion for PKDL was confirmed by positive rapid serological tests against two recombinant (rK39 and rK28) leishmanial antigens, demonstration of Leishmania donovani (LD) body in the slit skin smear, and isolation of promastigotes by culture from a nodular lesion. The patient was treated with oral Miltefosine for three consecutive months and showed significant clinical improvement as demonstrated by a negative slit skin smear at two months after initiation of therapy. We report this case as an unusual presentation of mucosal involvement in PKDL and subsequent treatment success with Miltefosine.
ABSTRACT
Comunicamos dos casos de enfermedad de Crohn con compromiso cutáneo-mucoso; el primer paciente con lesiones del denominado "Crohn metastásico" en las piernas y el segundo con importante compromiso en áreas perineo-genital, osteomal y de mucosa bucal, que luego de la remisión de las mismas sufrió una vasculitis leucocitoclásica en miembros inferiores. Los granulomas característicos de la enfermedad de Crohn se hallaron en la pared intestinal y la piel de ambos pacientes.
Two cases of Crohn disease are reported, both with cutaneous-mucosal involvement. The first patient showed lesions of the so called "Metastatic Crohn disease" in the legs, whereas the second one presented severe compromise in the perinealgenital, osteomal and oral mucosae. After the remission of the above mentioned, the patient suffered from leucocytoclastic vasculitis in the lower limbs. In both cases, the typical granulomatous lesions of the Crohn disease were found both in the skin and intestinal wall.
Subject(s)
Humans , Female , Middle Aged , Crohn Disease/pathology , Skin Manifestations , Crohn Disease/genetics , Crohn Disease/therapy , Diagnosis, DifferentialABSTRACT
We report a case of xanthoma disseminatum in a 24 year old male paitient. Multiple yellow-brown papules developed on the flexor aurfaces, such as the neck, axillae, antecubital fossae, groin, and perianal regions. Some papules were detected arouns the eyes and uvulai. biopsy specimen revealed a dense infiltrate of histiocytes, foam cells, Touton giant cells, and other inflammatory cells. No Langerhans granules were seen in the electron microscopic analysis.