Multiple whitish papules on the posterior neck of an elderly woman

Abstract White fibrous papulosis of the neck is a rare entity, with fewer than 50 cases described. It is a benign pathology whose main interest lies in its broad differential diagnosis, especially with pseudoxanthoma elasticum. The authors report the case of a 77-year-old woman with multiple yellow-white monomorphic papules on the posterior cervical region, with years of evolution. Cutaneous biopsy revealed a nodular area in the superficial and middle reticular dermis, with slight thickening of the collagen fibers and focally enlarged elastic fibers, aspects highlighted in the Verhoeff staining that additionally showed absence of elastic fibers in the papillary dermis.

Papulosis fibrosa blanca del cuello: a propósito de un caso / White fibrous papulosis of the neck: about a case

La papulosis fibrosa blanca del cuello es una patología benigna, que se presenta frecuentemente en personas mayores y que se caracteriza por pápulas blanquecinas ubicadas habitualmente en las regiones laterales del cuello. El hallazgo histopatológico distintivo es el incremento de las fibras de colágeno en la dermis papilar. Su etiopatogenia es, hasta ahora, desconocida y su tratamiento es difícil. Dado que corresponde a una patología infrecuente, probablemente subdiagnosticada, es que se decide reportar el caso de una mujer chilena de 77 años.

White fibrous papulosis of the neck is a benign pathology, which usually occurs in old people and is characterized by whitish papules that are frequently located in the lateral regions of the neck. The distinctive histopathological finding is the increase of collagen fibers in the papillary dermis. Its pathophysiology is not currently known and its treatment is difficult. Due to being a rare pathology, probably underdiagnosed, it was decided to report the case of a 77-yearold chilean woman.

Dowling-Degos disease: a therapeutic challenge: report of a family with no response to laser treatments

La enfermedad de Dowling-Degos (DDD), conocida también como 'anomalía reticulada y pigmentada de las flexuras' es una rara genodermatosis autosómica dominante. Se caracteriza por la aparición de máculas hiperpigmentadas de configuración reticulada; afectando principalmente los grandes pliegues como las axilas e ingles. Pudiendo, además, comprometer otros pliegues como cervicales, antecubitales, submamarios e interglúteos. Otras características asociadas son las lesiones tipo comedones y los pits palmo-plantares. Presentamos el caso de una familia con enfermedad de Dowling-Degos sin respuesta al tratamiento con laser Nd:YAG y CO2. Se realiza una revisión de la literatura de los tratamientos disponibles.

Dowling-Degos disease (DDD), also known as "reticulate pigmented anomaly of the flexures", is a rare autosomal dominant genodermatosis. DDD is characterized by an acquired reticular skin hyperpigmentation which begins in the axillae and groin. It later involves other body folds, including neck, inner aspects of the arms and thighs, inframammary, and intergluteal folds. Associated features include comedolike lesions on the neck or back, pitted facial or perioral scars, and epidermoid cysts. Herein we present a family (proband, mother, grandmother) with DDD that were treated with Q-switched Nd:YAG laser and CO2 laser without response. Treatment options are discussed and the available literature is reviewed.

Tumourlike Lesions of Skin - A Clinicopathological Analysis of 175 Cases.

As the skin is the largest and complex organ, a wide variety of tumourlike lesions are encountered in the clinical practice. The ability to properly diagnose & treat these common lesions & to distinguish them from malignant tumours is the vital skills for all clinicians. Objective: To analyse retrospectively tumourlike lesions of skin with respect to age, sex, clinical features and histopathological features in a tertiary referral centre in Maharashtra, India. Methods : The present study consisted of analysis of tumourlike lesions of skin received in the histopathology section of department of pathology over a period of 5 years that is from August 2005 to July 2010 .The material comprised of biopsies and excision specimens. The clinical and histopathological details were noted. The findings were compared with those reported by other authors. Results : One hundred and seventy five (175) cases of tumourlike lesions of skin were seen .These lesions presented as skin swellings or tumours. Maximum cases (34.8%) of tumourlike lesions occurred in fourth & fifth decades with male preponderance (1.35:1). The maximum number of cases was encountered in the head & neck region (63.4%). Their size ranged from 0.4 to 9 cms. Epidermal cyst was the commonest tumourlike lesion (59.4%) followed by dermoid cyst (13.1%).Other lesions were trichilemmal cyst, fibroepithelial polyp, keloid, hypertrophic scar and epidermal nevus. Conclusion : Tumourlike lesions are clinically diagnosed by their presentation. However, the histopathological examination confirms the clinical diagnosis. The pathologic evaluation of all tumourlike lesions is mandatory to avoid patient’s and family’s anxiety.

Elastólisis de la dermis papilar similar a pseudoxantoma elástico. Comunicación de seis casos / Pseudoxanthoma elasticum-like dermal papillary elastolysis: report of six cases

La elastólisis de la dermis papilar similar a pseudoxantoma elástico es un raro trastorno adquirido caracterizado por pápulas y placas amarillentas localizadas principalmente en cuello y región supraclavicular. Los hallazgos histopatológicos y la ausencia de afectación sistémica lo diferencian del pseudoxantoma elástico. Comunicamos seis pacientes de sexo femenino de entre 72 y 79 años con diagnóstico clínico e histopatológico de esta entidad.

Blaschkitis foliculodestructiva de la frente: tratamiento topico con tacrolimus / Folliculodestructive blaschkitis on the forehead: treatment wit tacrolimus ointment

Las blaschkitis pueden definirse como procesos adquiridos inflamatorios cutáneos que asientan en las líneas de Blaschko y pueden tener diversas características clínicas e histopatológicas. Cuando éstas se localizan en la cara se mencionan el liquen estriado, el liquen plano lineal y el lupus eritematoso lineal. Se presenta el caso de una mujer de 42 años de edad con una blaschkitis de 4 meses de evolución localizada en frente cuya histopatología evidenció un ataque centrofolicular inflamatorio y destructivo. Se plantean diagnósticos diferenciales y se comunica la exitosa respuesta terapéutica al tacrolimus tópico.

Infiltración linfocítica de Jessner Kanof: importancia de la inmunomarcación / Lymphocytic infiltrate of Jessner Kanof: the importance of immunolabeling

Se presentan tres casos de infiltración linfocítica de la piel. Se describen las características clínicas, se realizan tomas biopsias que confirman el diagnóstico, e inmunomarcación que muestra predominio de linfocitos T. Se hacen los diagnósticos diferenciales concluyendo que esta afección dermatológica puede presentarse con diferentes aspectos clínicos, algunos totalmente atípicos. Es en estos casos donde la histopatología y la inmunomarcación confirman el diagnóstico

Focal acantholytic dyskeratosis: a snare for the pathologist: report of two cases associated to psoriasis and fibrous papule of the nose

Two specimens containing clinically inapparent histologic features of acantholytic dyskeratosis (on the base of a fibrous papule of the nose and overlying a psoriatic lesion) are presented. The authors discuss the conduct to be followed by the pathologist in similar cases. The general pathologist should be well trained in dermatopathology since cutaneous biopsies account for 10 to 25% of the specimens submitted for histologic diagnosis or, even, form the major part of the workload (Berry). There is a wall between the physician who submits the skin biopsies (who may be or not a dermatologist) and the pathologist. The clinical information provided by dermatologists is scant and incomplete and physicians who are not dermatologists seldom submit any information. The histological pictures found in skin biopsies are, often, common to several nosological entities and an adequate understanding of their meaning is desirable for a thorough evaluation. We ought to assess it with the maximum scientific severity, searching to solve the puzzle without depreciating the information received. In this report the authors analyse the histopathological approach to the cutaneous lesions of two patients. They displayed the association between acantholytic dyskeratosis (AD) and another cutaneous pathology. Findings like these may obstruct the final diagnosis to be issued by the pathologist.(ABSTRACT TRUNCATED AT 250 WORDS)