Trichoscopy findings in dissecting cellulitis

Abstract Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.

Esporotricosis del pabellón auricular: comunicación de un caso atípico simulando una celulitis bacteriana / Auricular sporotrichosis: atypical case report simulating bacterial cellulitis

Resumen La esporotricosis es la micosis subcutánea o por implantación más frecuente en México. Se comunica el caso de una esporotricosis cutánea-fija preauricular que simuló una celulitis bacteriana atípica, en una paciente anciana sin antecedente de traumatismo. La biopsia mostró un granuloma supurativo con presencia de levaduras escasas. En el cultivo se identificó Sporothrix schenckii que se confirmó por biología molecular. Se trató con itraconazol obteniéndose una curación clínica y micológica. Se presenta el caso de presentación atípica, proveniente de una zona semidesértica con clima extremo.

Sporotrichosis is the most common subcutaneous or implantation mycosis in Mexico. The case of a preauricular cutaneous-fixed sporotrichosis simulating atypical bacterial cellulitis is reported in an elderly patient with no history of trauma. The biopsy showed a suppurative granuloma with scarce yeast. Sporothrix schenckii was identified in the culture and confirmed by molecular biology. She was treated with itraconazole and a clinical and mycological cure was obtained. The case of atypical presentation is presented, coming from a semi-arid zone with extreme weather.

Eosinophilic annular erythema in adults: report of two cases and review of the literature

Abstract We herein report two cases of eosinophilic annular erythema in adults, which is rare. In both patients, lesions developed rapidly in few days and were located mainly on the trunk, buttocks, and extremities. Diagnosis was histopathological, with typical features including acute dermal inflammatory infiltrate with abundant eosinophils. One of the patients recurred after treatment on three occasions and finally cured spontaneously. The second patient recurred once and was then successfully treated with topical clobetasol. Clinical and histopathological features of eosinophilic annular erythema in adults have rarely been reported. A review of the literature and discussion of relationship with Wells syndrome are also included.

Host inflammatory response to polypropylene implants: insights from a quantitative immunohistochemical and birefringence analysis in a rat subcutaneous model

ABSTRACT Objectives To describe acute and sub acute aspects of histological and immunohistochemical response to PP implant in a rat subcutaneous model based on objective methods. Materials and Methods Thirty rats had a PP mesh subcutaneously implanted and the same dissection on the other side of abdomen but without mesh (sham). The animals were euthanized after 4 and 30 days. Six slides were prepared using the tissue removed: one stained with hematoxylin-eosin (inflammation assessment); one unstained (birefringence evaluation) and four slides for immunohistochemical processing: IL-1 and TNF-α (pro-inflammatory cytokines), MMP-2 (collagen metabolism) and CD-31 (angiogenesis). The area of inflammation, the birefringence index, the area of immunoreactivity and the number of vessels were objectively measured. Results A larger area of inflammatory reaction was observed in PP compared to sham on the 4th and on the 30th day (p=0.0002). After 4 days, PP presented higher TNF (p=0.0001) immunoreactivity than sham and no differences were observed in MMP-2 (p=0.06) and IL-1 (p=0.08). After 30 days, a reduction of IL-1 (p=0.010) and TNF (p=0.016) for PP and of IL-1 (p=0.010) for sham were observed. Moreover, area of MMP-2 immunoreactivity decreased over time for PP group (p=0.018). Birefringence index and vessel counting showed no differences between PP and sham (p=0.27 and p=0.58, respectively). Conclusions The implantation of monofilament and macroporous polypropylene in the subcutaneous of rats resulted in increased inflammatory activity and higher TNF production in the early post implant phase. After 30 days, PP has similar cytokines immunoreactivity, vessel density and extracellular matrix organization.

Sweet's syndrome associated with cellulitis - a challenging diagnosis

Abstract Sweet's syndrome is a neutrophilic dermatosis with worldwide distribution that has been associated with inflammatory autoimmune diseases, infections, malignancies, drugs, and pregnancy. The disease is idiopathic in up to 50% of patients. A 64-year-old woman, diagnosed with right limb cellulitis (4 days of evolution), was seen at our department, due to persistent cellulitis and progressive appearance of painful nodules and plaques in both shins and the right forearm (2 days of evolution). Taken together, clinical, laboratory and pathological data suggested the diagnosis of Sweet's syndrome, probably secondary to cellulitis of the right inferior limb. We suggest that cellulitis may be associated with Sweet's syndrome, a rare association in the literature.

Wells syndrome associated with chronic lymphocytic leukemia

AbstractEosinophilic cellulitis or Wells syndrome is an uncommon skin condition of unknown etiology that can occur alone or associated with other conditions. Typically, it presents with recurrent pruritic, erythematous and edematous plaques, but it can also show clinical polymorphism. Besides the cutaneous lesions, patients can experience systemic manifestations like fever, malaise, arthralgia and peripheral blood eosinophilia. We describe a case of this rare syndrome that presented with polymorphic cutaneous lesions associated with a serious systemic disease, which was revealed through the investigation of the cutaneous disease.

Infected orthokeratinized odontogenic cyst: a rare cause of facial cellulitis

Orthokeratinized odontogenic cysts (OOCs) are relatively uncommon developmental cysts lined with orthokeratinized epithelium consisting of a prominent granular layer and a basal layer of low cuboidal flattened cells that show no tendency for nuclear palisading. These cysts have been considered a distinct entity from odontogenic keratocysts since they exhibit a less aggressive behavior and a very low rate of recurrence. Developmental odontogenic cysts can become infected but serious complications, such as potentially life-threatening cellulitis, are rare. This report describes a rare case of facial cellulitis secondary to an infected OOC located in the mandible of a 27-year-old man. The relevant literature about the clinical-pathological features of OOC is reviewed.

Os cistos odontogênicos ortoceratinizados (COOs) são cistos de desenvolvimento revestidos por epitélio ortoceratinizado constituído por uma camada granulosa proeminente e uma camada basal de células cuboidais achatadas que não mostram tendência à paliçada. Esses cistos foram considerados uma entidade distinta dos ceratocistos, uma vez que apresentam um comportamento menos agressivo e uma taxa muito baixa de recorrência. Cistos odontogênicos de desenvolvimento pode tornar-se infectados, mas complicações graves como a celulite, potencialmente ameaçadora da vida, são raros. Este relato descreve um caso raro de celulite facial secundária a um COO infectado localizado na mandíbula de um homem de 27 anos de idade. A literatura relevante sobre as características clínicopatológicas do COO foi revisada.

Periorbital mass with cellulitis caused by dirofilaria.

Dirofilariasis is a zoonotic disease caused by Dirofilaria, a parasite of domestic and wild animals. The disease is transmitted by inoculation of mosquitoes infected with the microfilariae during their blood meal. Accidental infection of man results in lung nodule, subcutaneous mass anywhere in the body or ocular lesion that may be subconjunctival or periorbital. The incidence of ocular dirofilariasis is on the rise in several parts of India particularly in Kerala. Here we report a case of ocular dirofilariasis with cellulitis presenting as a periorbital mass.

Evaluation of biocompatibility of Targis Dentin and Artglass by using subcutaneous implantation test.

Introduction: Biocompatibility of a crown-bridge material is as important as its physical and mechanical properties. It is also one of the most important factors for the long-lasting clinical success of that restoration. It directly contacts the vital prepared tooth and that is the reason it has to be nontoxic to the local tissues, such as the pulp, gingiva, or the rest of the body. Materials with different physical properties are used in the conventional fixed prosthodontic restorations. Recently, metal-free systems that are reinforced with fibers have been improved for crown and bridge restorations. These new composite systems have the advantages of both ceramic and polymer chemistry. Materials and Methods: In this research, biocompatibility of two ceramic-polymer-based prosthetic materials (Targis Dentin® and Artglass Dentin® ) was studied using a subcutaneous implantation test on rats. Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Results: Initially (15 th day) mild inflammatory reactions were observed in tissues, which directly contacted the Artglass, Targis, and control tubes. These probably originated from the surgical traumas. After the 90 th day of implantation, these reactions resolved and healthy, well-organized fibrous connective capsules were seen around the implants. Conclusion: At the end of the study, according to the FDI and ISO-7405 standards, Targis and Artglass indicated biocompatibility with the subcutaneous connective tissue of the rat.

Comparison of the biocompatibility of different root canal irrigants

The purpose of this study was to compare the reaction of rat subcutaneous connective tissue to 0.9 percent sterile saline, 2.5 percent sodium hypochlorite (NaOCl), 5.25 percent NaOCl and 2 percent chlorhexidine gluconate solution or gel. Six circles were demarcated on the dorsal skin of 24 male Wistar rats, leaving 2 cm between each circle. Using a syringe, 0.1 mL of each root canal irrigant was injected subcutaneously into 5 circles. In the 6th circle, the needle of an empty syringe was introduced into the skin, but no irrigant was injected (control group). Evaluations were undertaken at 2 h, 48 h, 14 days and 30 days post-procedure. Tissue samples were excised, embedded in paraffin blocks and 3-µm-thick sections were obtained and stained with hematoxylin and eosin. The areas of inflammatory reaction were evaluated and analyzed statistically by ANOVA and Tukey's test. The control group showed few or no inflammatory reaction areas in the subcutaneous tissue. 0.9 percent saline solution, 2.0 percent chlorhexidine solution and 2.5 percent NaOCl showed a good biocompatibility, as very mild inflammatory reaction was detected at 14 days and tissue repair occurred at 30 days. 5.25 percent NaOCl was the most toxic irrigant, as the number of inflammatory cells remained elevated at 14 and 30 days. The group treated with 2.0 percent chlorhexidine gluconate gel presented a moderate inflammatory response at 14 days, which decreased at 30 days, being considered similar to that of the control group, 0.9 percent saline solution, 2.0 percent chlorhexidine solution and 2.5 percent NaOCl at this experimental period.

Dermatoses do pavilhäo auricular / External ear dermatosis

Apresentamos uma atualizaçäo sobre as dermatoses que ocorrem no pavilhäo auricular. Propomos uma classificaçäo em sete grupos e realizamos uma sucinta descriçäo clínica de cada uma das 84 entidades catalogadas, de forma didática, com a finalidade de auxiliar o médico, sobretudo o clínico geral, o dermatologista e o otorrinolaringologista, no diagnóstico de tais patologias.

Síndrome de Wells: celulitis eosinofílica / Well's syndrome: eosinophilic cellulitis

Se presenta una paciente de 27 años con una historia de episodios de placas eritematoedematosas, pruriginosas y dolorosas, localizadas en palmas y plantas, recurrentes a lo largo de dos años

Celulitis eosinofílica (síndrome de Wells) / Eosinophilic cellulitis (Well's syndrome)

Se presenta el caso clínico de un paciente masculino de 17 años con celulitis eosinofílica -curso subagudo- que, por su morfología y topografía, simuló una esporotricosis linfangítica. La histopatología fue compatible con síndrome de Wells. Se hace una revisión detallada del mismo

Síndrome de Wells: a propósito de dos casos en la infancia / Wells' syndrome: 2 infantile cases

El síndrome de Wells es una entidad caracterizada por lesiones recurrentes de piel (vesícula, ampollas o placas urticarianas) como rasgos clínicos predominantes. Nuestros pacientes tenían episodios intermitentes de lesiones de piel agudas, grandes, eritematosas e induradas con pródomos de quemazón o dolor. El diagnóstico de celulitis eosinofílica se basó en los hallazgos histopatológicos característicos

Celulitis preseptal y orbitaria: complicaciones en niños entre 0 y 12 años / Preseptal and orbitary cellulitis: complications in childrens between 0 and 12 years

Se realizó un estudio retrospectivo de 82 años entre 0 y 12 años hospitalizados en el servicio de Pediatría del Hospital General de Guatire-Guarenas durante el período comprendido entre los años 1988-1993, con impresiones diagnósticas de celulitis orbitaria y preseptal, buscando incidencia de complicaciones en dichos pacientes. Se encontró que en 77 casos presentaron celulitis preseptal y en 5 celulitis orbitaria. De los 11 pacientes que presentaron complicaciones, se distribuyeron de la siguiente manera: un (1) paciente con meningitis bacteriana y el resto con abscesos preseptales

Eosinophilic Cellulitis (Wells' Syndrome)

Eosinophilic cellulitis is a rare dermatosis first described by Wells, and characterized by recurrent episodes of sudden outbreaks of erythematous cutaneous swellings often painful or pruritic. Microscopically, the lesion shows diffuse tissue eosinophilia and fibrinoid flame figures, evolution of associated focal necrobiosis, and formation of focal microgranulomas associated with eosinophils. The cause is still unknown but the triggers which have been thought to precipitate the disease include insect bites, parasitic infections such as toxocara, onchocerciasis, nasopharyngeal carcinoma, rheumatoid arthritis and spider bites. However many cases are idiopathic. The author experienced a case of eosinophilic cellulitis of a 52-year-old woman with multiple cutaneous tender plaques of cellulitis for approximately 10 years with history of repeated remission and recurrent episodes. Biopsy was taken from ulcerated edematous nodule of inguinal region under the clinical impression of deep fungal infection, pyoderma gangrenosum and polyarteritis nodosa. Cultures for fungal and common organisms were negative. Histologically, the entire dermis was infiltrated by numerous eosinophils and scattered histiocytes. There were scattered flame figures showing necrobiotic foci in the collagen with accumulation of eosinophils, granulated free cosinophilic granules and histiocytes.

Eosinophilic Cellulitis (Wells' Syndrome)

Eosinophilic cellulitis is a rare dermatosis first described by Wells, and characterized by recurrent episodes of sudden outbreaks of erythematous cutaneous swellings often painful or pruritic. Microscopically, the lesion shows diffuse tissue eosinophilia and fibrinoid flame figures, evolution of associated focal necrobiosis, and formation of focal microgranulomas associated with eosinophils. The cause is still unknown but the triggers which have been thought to precipitate the disease include insect bites, parasitic infections such as toxocara, onchocerciasis, nasopharyngeal carcinoma, rheumatoid arthritis and spider bites. However many cases are idiopathic. The author experienced a case of eosinophilic cellulitis of a 52-year-old woman with multiple cutaneous tender plaques of cellulitis for approximately 10 years with history of repeated remission and recurrent episodes. Biopsy was taken from ulcerated edematous nodule of inguinal region under the clinical impression of deep fungal infection, pyoderma gangrenosum and polyarteritis nodosa. Cultures for fungal and common organisms were negative. Histologically, the entire dermis was infiltrated by numerous eosinophils and scattered histiocytes. There were scattered flame figures showing necrobiotic foci in the collagen with accumulation of eosinophils, granulated free cosinophilic granules and histiocytes.