ABSTRACT
Pyoderma gangrenosum (PG) is an uncommon, idiopathic, neutrophilic dermatosis characterised by large necrotic ulcers. Occasionally, patients develop atypical presentations, including pustular, bullous, and vegetative lesions. Bullous pyoderma gangrenosum (BPG) is considered an extremely rare form. We describe a case of BPG in a 76-year-old man, with active oncological history, including a recent diagnosis of hairy cell leukemia. Diagnosis of PG was delayed because of atypical clinical presentation that mimicked necrotising fasciitis. The patient was treated with diverse intravenous antibiotics and several surgical procedures. The suspicion of neutrophilic dermatosis arose from the histopathological studies. In the setting of mandatory clinico-pathological correlation, the aim of this report is to point out the morphological characteristics that allow recognition of this uncommon variant of pyoderma gangrenosum.
ABSTRACT
Paraneoplastic polyarthritis is an inflammatory arthritis, is usually seronegative, and has a temporal and pathophysiological relationship with an underlying malignancy. Although head and neck tumors may be a cause of paraneoplastic polyarthritis, its association with tongue carcinoma has not been previously reported. We present the case of a 69-year-old man who was a former smoker and presented with polyarthritis since 2 months in the wrists, proximal interphalangeal joints, knees, and elbows, with increased levels of acute-phase reactants; negativity for rheumatoid factor, anticitrullinated cyclic peptide antibody, and antinuclear antibody; and negative results for crystals and microorganisms in the synovial fluid. Cervical computed tomography and posterior rhinoscopy were performed, which detected an asymptomatic lesion on the base of the tongue, whose biopsy was compatible with nonkeratinizing squamous cell carcinoma. Polyarthritis did not respond to glucocorticoids at medium doses (oral prednisone 20 mg/day) but progressively resolved after the initiation of antineoplastic therapy.
ABSTRACT
Lymphomatoid papulosis type E (LyP) is a recently described subtype of LyP characterized by an angioinvasive infiltrate of atypical lymphocytes expressing CD30. We present a case of type E LyP with extensive cutaneous necrosis in the histopathological evaluation which was misdiagnosed as an ulcerative form of bacterial skin infection. The remarkable cutaneous necrosis showed in our case might be related to the angiodestructive infiltrate that was present in this circumstance.
Subject(s)
Lymphomatoid Papulosis/diagnosis , Lymphomatoid Papulosis/drug therapy , Methylprednisolone/administration & dosage , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Aged , Anti-Inflammatory Agents/administration & dosage , Humans , Male , NecrosisSubject(s)
HIV Infections/complications , HIV , Oral Ulcer/etiology , Tuberculosis, Pulmonary/complications , Adult , Biopsy , Diagnosis, Differential , HIV Infections/diagnosis , Humans , Male , Mouth Mucosa/microbiology , Mouth Mucosa/pathology , Mycobacterium tuberculosis/isolation & purification , Oral Ulcer/diagnosis , Sputum/microbiology , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/diagnosisSubject(s)
Folliculitis/diagnosis , Folliculitis/drug therapy , Photochemotherapy/methods , Scalp Dermatoses/drug therapy , Adult , Cohort Studies , Female , Follow-Up Studies , Humans , Male , Prospective Studies , Risk Assessment , Scalp Dermatoses/diagnosis , Severity of Illness Index , Treatment OutcomeSubject(s)
Humans , Male , Aged, 80 and over , Rectal Neoplasms/diagnosis , Rectal Neoplasms/surgery , Proctoscopy/instrumentation , Proctoscopy/methods , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Rectal Neoplasms/physiopathology , Rectal Neoplasms , Proctoscopy/trends , Adenocarcinoma/physiopathology , Adenocarcinoma , Granular Cell Tumor/pathology , Granular Cell TumorSubject(s)
Histiocytosis, Langerhans-Cell/diagnosis , Adrenal Cortex Hormones/therapeutic use , Aged, 80 and over , Dermatologic Agents/therapeutic use , Drug Therapy, Combination , Female , Histiocytosis, Langerhans-Cell/drug therapy , Histiocytosis, Langerhans-Cell/pathology , Humans , Tacrolimus/therapeutic use , Treatment OutcomeSubject(s)
Humans , Male , Aged , Ecthyma, Contagious/diagnosis , Hand Dermatoses/diagnosis , Disease Progression , Time FactorsSubject(s)
Herpes Zoster/immunology , Immunocompromised Host , Skin Diseases, Viral/immunology , Acyclovir/administration & dosage , Chronic Disease , Female , Herpes Zoster/drug therapy , Herpes Zoster/pathology , Humans , Lung Diseases/surgery , Lung Transplantation , Lymphangioleiomyomatosis/surgery , Middle Aged , Skin Diseases, Viral/drug therapySubject(s)
Ecthyma, Contagious/diagnosis , Hand Dermatoses/diagnosis , Aged , Disease Progression , Humans , Male , Time FactorsABSTRACT
Cutis verticis gyrata is a rare skin condition characterized by ridges and furrows resembling the surface of the brain. It can be considered as a manifestation of a variety of diverse causes such as cerebriform intradermal nevus. We report a 48-year-old man with cerebriform and soft folds on the left parietal and temporal areas. Histology showed solitary or clusters of nevus cells in the dermis. The diagnosis of cerebriform intradermal nevus was confirmed.
Subject(s)
Head and Neck Neoplasms/diagnosis , Nevus, Intradermal/diagnosis , Scalp Dermatoses/etiology , Scalp , Skin Neoplasms/diagnosis , Alopecia Areata/etiology , Diagnosis, Differential , Head and Neck Neoplasms/complications , Humans , Male , Melanosis/diagnosis , Melanosis/etiology , Middle Aged , Neurocutaneous Syndromes/diagnosis , Nevus, Intradermal/complications , Scalp/pathology , Skin Neoplasms/complicationsABSTRACT
The prognostic value of DNA ploidy and proliferative index (PI) are well established in many cancers, but their significance in childhood rhabdomyosarcoma (RMS) is unclear. We studied the DNA content and PI of 45 cases of childhood RMS obtained retrospectively. DNA histograms were hyperdiploid in 30 cases (67%), diploid in 6 (13%), tetraploid in 5 (11%), polyploid in 3 (7%), and nonclassifiable in 1 (2%). The 5-year overall survival rate by ploidy was 60% (3/5) in tetraploid, 57% (17/30) in hyperdiploid, and 0% in diploid and polyploid cases (P = .000002). The 5-year overall survival by a PI less than or greater than 19% was 62% (13/21) and 21% (5/24), respectively (P = .006). In multivariate analysis, DNA ploidy (P = .001) was an important independent prognostic factor. DNA content in childhood RMS is an important variable in predicting prognosis. DNA hyperdiploid and tetraploid rhabdomyosarcomas had a favorable prognosis, while DNA diploid and polyploid tumors had a poor prognosis.
