ABSTRACT
A 78-year-old man, who suffered from chronic lymphocytic leukaemia and diabetes mellitus, but was human immunodeficiency virus (HIV)-negative, developed disseminated angiomatous papules following a cat scratch. Bacillary angiomatosis was diagnosed by light and electron microscopic demonstration of the causative bacteria in the vascular lesions. The lesions resolved completely when he was treated with erythromycin. This case demonstrates that bacillary angiomatosis can be an important cutaneous manifestation of immunodeficiency in individuals who are not infected with the human immunodeficiency virus.
Subject(s)
Angiomatosis, Bacillary/complications , Cat-Scratch Disease/complications , Diabetes Complications , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Aged , Angiomatosis, Bacillary/pathology , Bacteria/ultrastructure , Cat-Scratch Disease/pathology , Diabetes Mellitus/pathology , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Male , Microscopy, Electron , Skin/microbiologyABSTRACT
A 24-year-old male patient was first observed with full-blown acute thrombotic thrombocytopenic purpura in 1991. Complete remission was achieved with plasma and plasmapheresis therapy, but in spite of continuous corticosteroid and aspirin administration, thrombocytopenic (megakaryocytic) relapses were observed every 26-30 days. Splenectomy and danazol failed to prevent the recurrence of the disease. Surprisingly, cyclosporin A (5 mg/kg/day) administration resulted in a complete transitional remission, but after dose reduction a less regular pattern of repeated milder recurrences was observed. Cryopreserved plasma, obtained from the patient during remission also proved to be effective in treating the last two thrombocytopenic episodes.
Subject(s)
Periodicity , Purpura, Thrombotic Thrombocytopenic/therapy , Adult , Combined Modality Therapy , Humans , Male , RecurrenceABSTRACT
In a 78 years old patient with chronic lymphoid leukemia, diabetes mellitus a cat scratch induced disseminated angiomatous papules were observed. In the lesions great number of bacilluses were observed with light -and electron microscope. As a result of antibiotic treatment the lesions regressed without trace. This opportunist infection resulting general symptoms as well, may be regarded as a cutaneous manifestation of immunodeficiency. The adequate antibiotic treatment depends on the exact diagnosis.
Subject(s)
Angiomatosis/etiology , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Aged , Angiomatosis/drug therapy , Angiomatosis/microbiology , Angiomatosis/pathology , Cat-Scratch Disease/complications , Cat-Scratch Disease/microbiology , Diabetes Complications , Dose-Response Relationship, Drug , Erythromycin/administration & dosage , Humans , Male , Microscopy, Electron , Rickettsia Infections/diagnosis , Rickettsia Infections/drug therapy , Rickettsia Infections/pathologyABSTRACT
A case of Waldenström's macroglobulinaemia presenting with non-specific dermatological symptoms (cold urticaria and cold purpura) is described in a 37-year-old female patient. Progressive telangiectasia and spider naevi were also observed. Involvement of the skin may be explained by the presence of macroglobulins with cryoprotein-like qualities. This facilitated an early diagnosis.
Subject(s)
Cold Temperature/adverse effects , Purpura/etiology , Urticaria/etiology , Waldenstrom Macroglobulinemia/complications , Adult , Female , Humans , Telangiectasis/etiologyABSTRACT
A Waldenström macroglobulinemia case, manifested in the form of non-specific skin-symptoms (cold urticaria and cold purpura) is described in a 37 years old female patient. As new skin-symptoms progressive telangiectasia and naevi aranei could be observed. Involvement of skin may be explained by macroglobulins with kryoprotein properties, making early diagnosis possible at the same time.
