ABSTRACT
Lymphomatoid papulosis is often regarded as a low-grade variant of cutaneous T cell lymphoma (CTCL). Given the excellent long-term prognosis, recent consensus guidelines indicate that patients can be monitored off therapy. We report a case of a 67-year-old man who presented with lymphomatoid papulosis, with necrotic papules that have been intermittently present for over forty years.
Subject(s)
Lymphomatoid Papulosis/pathology , Skin Neoplasms/pathology , Watchful Waiting , Aged , Clobetasol/therapeutic use , Glucocorticoids/therapeutic use , Humans , Hydroquinones/therapeutic use , Hyperpigmentation/drug therapy , Hyperpigmentation/etiology , Lymphomatoid Papulosis/complications , Lymphomatoid Papulosis/drug therapy , Male , Skin Neoplasms/complications , Skin Neoplasms/drug therapyABSTRACT
The term, acquired perforating dermatoses (APD), represents a group of skin conditions that develop in adulthood and are characterized by transepidermal elimination of dermal connective tissue. This appears clinically as a papulonodule with a keratotic core. Although APD is typically associated with diabetes mellitus, chronic renal failure, and several other conditions causing generalized pruritus, there have been reports in the literature describing an association of APD with select drugs including sorafenib. We present a case of acquired perforating dermatosis in a patient with HIV and hepatocellular carcinoma undergoing treatment with sorafenib.
Subject(s)
Antineoplastic Agents/adverse effects , Collagen Diseases/chemically induced , Skin Diseases/chemically induced , Sorafenib/adverse effects , Aged , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/drug therapy , Collagen Diseases/diagnosis , Collagen Diseases/pathology , HIV Infections/complications , Humans , Liver Neoplasms/complications , Liver Neoplasms/drug therapy , Male , Skin Diseases/diagnosis , Skin Diseases/pathologyABSTRACT
Paraneoplastic Pemphigus (PNP) is a rare and often fatal autoimmune mucocutaneous blistering disease associated with an underlying malignancy. It is thought to be caused by antibodies to tumor antigenscross-reacting with epithelial antigens, specifically desmosomal and hemidesmosomal antigens. There are at least five clinical morphologic variants of PNP, with the earliest and most consistent finding beingsevere stomatitis. Diagnosis of PNP requires direct immunofluorescence of perilesional skin and indirect immunofluorescence. Treatment of PNP is difficult and largely limited to glucocorticoids, steroid-sparing immunomodulators, rituximab and intravenous immunoglobulin (IVIG). Despite therapies, prognosis is poor. We report a case of paraneoplastic pemphigus in a 34-year old male with severe stomatitis and lichenplanus-like cutaneous lesions.
