ABSTRACT
La colagenosis perforante reactiva es un trastorno de la piel poco frecuente, caracterizado por la eliminación transepidérmica de colágeno alterado a través de la epidermis. Existen dos tipos de la enfermedad: la forma hereditaria, que se manifiesta en la infancia, y la esporádica adquirida, que aparece en la edad adulta. Se presenta con pápulas pruriginosas que aumentan de tamaño. Estas pueden remitir espontáneamente, dejando áreas de hipo-hiperpigmentación o cicatrices. También es posible que ocurra el fenómeno de Koebner.Se comunica el caso de un paciente pediátrico con una colagenosis perforante reactiva. Esta publicación reviste importancia debido a que esta patología es extremadamente infrecuente.
Reactive perforating collagenosis is a rare skin disorder, characterized by the transepidermal elimination of altered collagen through the epidermis. There are two different types: the hereditary form that manifests in childhood, and the sporadic acquired one that appears in adulthood. It presents with pruritic papules that increase in size. They may remit spontaneously, leaving areas of hypo/hyperpigmentation or scars. It is also possible that the Koebner phenomenon occurs. We report one case of a pediatric patient with reactive perforating collagenosis. This publication has importance because this condition is extremely rare.
Subject(s)
Humans , Male , Adolescent , Skin Diseases, Eczematous , Collagen Diseases , Lower ExtremityABSTRACT
Localized scleroderma is a connective tissue disorder characterized by thickening and fibrosis of the skin due to excessive collagen deposition in the dermis. Dystrophic calcinosis occurs when calcium is deposited in the previously damaged skin tissue, and calcium and phosphorous levels in the blood are within normal limits. It occurs secondary to connective tissue disease, infection, inflammatory processes, chronic venous stasis, cutaneous neoplasm, and trauma. We report a rare case of dystrophic calcinosis cutis with transepidermal elimination secondary to localized scleroderma.
Subject(s)
Calcinosis , Calcium , Collagen , Connective Tissue , Connective Tissue Diseases , Dermis , Fibrosis , Scleroderma, Localized , SkinABSTRACT
La eliminación transepidérmica es un mecanismo mediante el cual material extracelular o fibras alteradas de la dermis se eliminan a través de la epidermis. La elastosis perforante es un padecimiento raro caracterizado por eliminación transepidérmica de fibras elásticas alteradas. Clínicamente se manifiesta como pápulas queratósicas del color de la piel, que pueden confluir formando placas de aspecto arciforme o serpiginoso. Predomina en pacientes masculinos y menores de 30 años. Se presenta, hasta nuestro conocimiento, el primer caso de un paciente masculino con colitis ulcerativa crónica inespecífica y colangitis esclerosante asociadas a elastosis perforante.
Transepidermal elimination is a mechanism by which altered dermal extracellular material is discharged through the epidermis. Perforating elastosis is a rare disease characterized by the transepidermal elimination of abnormal elastic fibers. Clinically it manifests as skin-colored keratotic papules that may coalesce and form arcuate or serpiginous plaques. It affects mostly males, predominantly younger than 30-years-old. We present a case of a male patient with inflammatory bowel disease and sclerosing cholangitis associated with perforating elastosis. To our knowledge, this is the first description of inflammatory bowel disease associated with perforating elastosis.
Subject(s)
Humans , Male , Adult , Cholangitis, Sclerosing/complications , Colitis, Ulcerative/complications , Skin DiseasesABSTRACT
BACKGROUND: Reactive perforating collagenosis is one of the perforating disorders that are characterized by transepidermal elimination of dermal materials. It can be associated with systemic disease such as chronic renal disease and/or diabetes mellitus. OBJECTIVE: We wanted to investigate the clinical and histopathological features of reactive perforating collagenosis. METHODS: We reviewed the medical records, clinical photographs and histopathologic slides of 14 cases of reactive perforating collagenosis that were seen in our department. RESULTS: The most common clinical features were flesh-colored, dome-shaped papules with a keratinous plug. Residual scarring was seen from the previously healed lesions. Half of the patients had skin lesions on the whole body except the face, palm and sole. Most of the patients (79%) had at least one systemic disease. Chronic renal failure (21%) and diabetes mellitus (29%) were the most commonly associated conditions. The other associated conditions were hypertension, acute pyelonephritis, non-small cell lung cancer, herpes zoster, transplantation and non-Hodgkin lymphoma. Three of the cases (21%) were otherwise healthy. Most patients benefited from topical steroid and oral antihistamine when their disease was regressing. CONCLUSION: This study demonstrated the clinicopathologic features of reactive perforating collagenosis. It is frequently associated with diabetes mellitus and chronic renal failure, but this may also develop in patients with other systemic disorders, and also in those patients who are without any medical problems.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Cicatrix , Diabetes Mellitus , Herpes Zoster , Hypertension , Keratins , Kidney Failure, Chronic , Lymphoma, Non-Hodgkin , Medical Records , Pyelonephritis , Renal Insufficiency, Chronic , Skin , TransplantsABSTRACT
Transepidermal elimination is a well known phenomenon describing cases where foreign materials or altered dermal constituents are removed from dermis through epidermis. The phenomenon of transepidermal elimination may occur as a primary process or as a secondary process. A 36-year-old women presented with three black papules on the ventral side of her right second toe for 1 year. Because of poliomyelitis, the lesion had been irritated repeatedly. The histopathology of the lesion showed solitary papular angiokeratoma with transepidermal elimination. In this case, we postulated that transepidermal elimination of this case could have developed through repetitive physical trauma.
Subject(s)
Adult , Female , Humans , Angiokeratoma , Dermis , Epidermis , Poliomyelitis , ToesABSTRACT
Membranous lipodystrophy represents a peculiar type of fat necrosis that is present in patients with various types of skin disease. It is characterized by the presence of microcysts and macrocysts and is lined by amorphous eosinophilic material with a crenelated arabesque appearance. These findings have been associated with lupus erythematosus, diabetes mellitus, erythema nodosum, trauma, etc. We report a case of a 43-year-old woman who had a red to purple asymptomatic indurated plaque, approximately seven cm in diameter and on the left arm. She was a chronic hepatitis B antigen carrier and had hypertension for four years. Histopathology of the biopsied lesion showed transepidermal elimination of altered collagen and elastic fibers, as well as membranous lipodystrophy changes. There were hypertensive vascular changes including lymphohistiocytic infiltration around the vascular wall, swelling of endothelial cells, increased thickness of the vascular walls, and narrowing of the lumen. We report a case showing transepidermal elimination with membranous lipodystrophy. We carefully suggest that the secondary phenomenon of transepidermal elimination was associated with membranous lipodystrophy and degenerate connective tissues.
Subject(s)
Humans , Female , Adult , Skin Diseases/pathology , Lipodystrophy/complications , Hypertension/complications , Epidermis/pathologyABSTRACT
Transepidermal elimination is a process by which the skin eradicates undesirable or irritative dermal substances through intact epidermis or follicular epithelium by passive or active means. Although transepidermal elimination is being described in an increasing number and range of pathological processes, transepidermal elimination of hidradenoma papilliferum remains unrecorded to date in the Korean literature. We report a new case of hidradenoma papilliferum with transepidermal elimination. A 32-year-old woman presented with a bean-sized, protruding flesh red-colored nodule on the left labia major. The histologic finding of the lesion indicated a tubular and cystic structure microscopically expelled through the transepidermal canal.
Subject(s)
Adult , Female , Humans , Acrospiroma , Epidermis , Epithelium , Pathologic Processes , SkinABSTRACT
Transepidermal elimination is a spontaneously-developed phenomenon in certain skin disorders, in which altered connective tissue or foreign material is expelled via the epidermis to the exterior. We report a case of a 60-year-old man with a 1x1 cm sized, black-colored nodule, showing transepidermal elimination, on the right shin. Histological examination revealed a pigmented, epidermal cyst, containing deposition of pigment in its wall and cavity. To the best of our knowledge, no pigmented epidermal cysts have been reported in korea to date.
Subject(s)
Humans , Middle Aged , Connective Tissue , Epidermal Cyst , Epidermis , Korea , SkinABSTRACT
Transepidermal elimination (TE) is a spontaneously developed phenomenon in certain skin disorders in which altered connective tissue or foreign material is expelled via epidermis to the exterior. TE may occur either as a primary process such as elastosis perforans serpiginosa and reactive perforating collagenosis, or a secondary phenomenon, such as perforating granuloma annulare and pseudoxanthoma elasticum. We experienced a case of eccrine poroma on the scalp with keratinized tumor cells expelled through transpeidermal cannal microscopically.
ABSTRACT
The skin functions to eliminate foreign substances through the epidermis to epidermal surface; this process is called transepidermal elimination(TEE). TEE has been observed in various skin tumors. A 71-year-old woman presented with a well-circumscribed, red-brownish, subcutaneous nodule, 1.3x1.0 cm in size, located on the left thigh. The histopathologic finding of the lesion shows trichilemmal cyst with transepidermal elimination.
Subject(s)
Aged , Female , Humans , Epidermis , Skin , ThighABSTRACT
Subepidermal calcified nodule, a subset of calcinosis cutis, is usually presented as single small, raised, hard nodule. Histologically calcium deposition can be detected by von Kossa or periodic acid-Schiff stain. We report a 3-year-old boy who had erythematous hyperkeratotic plaques and papules on both inner thighs without any previous history of trauma, genetic or systemic illness. A biopsy specimen of plaque of the thigh showed the transepidermal elimination of basophilic granules which were dispersed in the upper dermis and von Kossa stain revealed scattered calcific deposition.
Subject(s)
Child, Preschool , Humans , Male , Basophils , Biopsy , Calcinosis , Calcium , Dermis , ThighABSTRACT
Pseudoxanthoma elasticum (PXE) is an inherited disorder involving the connective tissues of skin, eye and cardiovascular system. Both a recessive and a dominant inheritance pattern have been engaged in it. The skin changes are characterized by the yellowish crepe-like, lax, redundant folds on neck, axilla and periumbilical area. In rare instances, perforating dermatoses such as keratotic erythematous papules are also accompanied in PXE and histologically characterized by transepideraml elimination of altered basophilic calcified elastic fibers, which are short, fragmented and curled in the middle portion of the reticular dermis. Now we report a case of 26 year-old female who had a typical hereditary systemic PXE showing transepidermal elimination on her neck without preceding trauma history.
Subject(s)
Adult , Female , Humans , Axilla , Basophils , Cardiovascular System , Connective Tissue , Dermis , Elastic Tissue , Heredity , Inheritance Patterns , Neck , Pseudoxanthoma Elasticum , Skin , Skin DiseasesABSTRACT
A rare case of perforating pilomatricoma is reported. A rice grain-sized lesion occurred on the 23-year-old man's left upper arm about 3 years ago. It has developed into a 0.5X0.8cm sized well-defined scaly hard tumor during recent 1 year. Excised tumor showed small islands of shadow cells in the mid-dermis and calcified materials, extruded from the dermis into the deeply invaginated epidermis, by transepidermal elimination.
Subject(s)
Humans , Young Adult , Arm , Dermis , Epidermis , Islands , PilomatrixomaABSTRACT
A rare case of perforating pilomatricoma is reported. A rice grain-sized lesion occurred on the 23-year-old man's left upper arm about 3 years ago. It has developed into a 0.5X0.8cm sized well-defined scaly hard tumor during recent 1 year. Excised tumor showed small islands of shadow cells in the mid-dermis and calcified materials, extruded from the dermis into the deeply invaginated epidermis, by transepidermal elimination.
Subject(s)
Humans , Young Adult , Arm , Dermis , Epidermis , Islands , PilomatrixomaABSTRACT
Transepidermal elimination is a mechanism whereby foreign or altered constituents can be removed from the dermis. The phenomenon of transepidermal elimination may occur as a primary process characterizing disorders such as elastosis perforans serpiginosa, reactive perforating collagenosis and chondrodermatitis nodularis chronica helicis; as well as a secondary process characterizing disorders such as granuloma annulare, necrobiosis lipoidica diabeticorum, calcinosis cutis, pseudoxanthoma elasticum, spitz nevi, pimented nevi, porokeratosis plantaris discreta and metastatic tumors. A 17-year-old man presented with a 2X2 cm sized well-circumscribed slightly erythematous plaque with some black colored papules on the left dorsum of his hand. The histopathology of the lesion indicated angiokeratoma circumscriptum with transepidermal elimination.
Subject(s)
Adolescent , Humans , Angiokeratoma , Calcinosis , Dermis , Granuloma Annulare , Hand , Necrobiosis Lipoidica , Nevus , Porokeratosis , Pseudoxanthoma ElasticumABSTRACT
Perforating pseudoxanthoma elasticum is a localized, cutaneous disorder found mostly in obese, multiparous middle-aged women. It is characterized clinically by a slowly enlarging, yellowish, well-defined reticulated plaque usually in the periumbilical area with keratotic papules scattered on its surface, and histologically by transepidermal elimination of altered basophilic calcified elastic fibers, which are short, fragmented, and curled, in the middle portion of the reticular dermis. We present a case of a 36 year-old female who had a skin lesion, which showed chracteristic features consistent with perforating pseudoxanthoma elasticum in her neck region but not in the periumbilical area.
Subject(s)
Adult , Female , Humans , Basophils , Dermis , Elastic Tissue , Neck , Pseudoxanthoma Elasticum , SkinABSTRACT
Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Subject(s)
Epidermis , Melanoma , Nevus , SkinABSTRACT
We report a case of solitary congenital calcified nodule of the ear in a 1-year-old female. The lesion was a 2 X 2mm-sized, elevated, slightly erythematous and whitish-centered nodule located since birth on the superior helical rim of her left ear. Histopathological findings fram the totally excised lesion showed calcium deposits as amorphous, basophilic masses in the upper dermis and focal discharge of calcium by means of transepidermal elimination. Surrounding the calcium deposits, lymphohistiocytic infiltrations were present.
Subject(s)
Female , Humans , Basophils , Calcium , Dermis , Ear , ParturitionABSTRACT
Granuloma annulare is a common, benign, inflamatory, usually self-limited dermatosis. Disseminated perforating granuloma annulare is a rare variant of granuloma annulare. A 23-month-old female patient had asymptomatic, multiple umbilicated papules on the face, limbs including palms and soles, buttock and trunk for about 5 months. The new lesions have developed with mild fever or symptoms of upper respiratory infection. Histopathological examination revealed transepidermal elimination of mucinous degenerated collagen fibers and surrounding palisading lymphohistiocytic granuloma. After she was treated with prednisolone and antibiotics, the lesions slightly resolved, but thereafter, new lesions have developed frequently with mild fever. We herein reported a rare case of disseminated perforating granuloma annulare in the youngest patient yet reported.