Subject(s)
Bone Marrow/pathology , Lymphoma, B-Cell , Single Photon Emission Computed Tomography Computed Tomography , Skin Neoplasms , Adult , Aged , Biopsy , Disease-Free Survival , Female , Follow-Up Studies , Humans , Lymphoma, B-Cell/diagnostic imaging , Lymphoma, B-Cell/mortality , Lymphoma, B-Cell/pathology , Male , Middle Aged , Neoplasm Staging , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/mortality , Skin Neoplasms/pathology , Survival RateABSTRACT
Lymphangioma circumscriptum (LC) results from the development of abnormal lymphatic vasculature and is characterized by the presence of grouped vesicles filled with clear or colored fluid. Vulvar localization is uncommon. Abnormalities of the lymphatic system, such as lymphedema and cystic hygroma, are well-known features of genetic disorders such as Noonan syndrome (NS) and Turner syndrome. We report the case of a patient with NS who presented with LC of the vulva. We also discuss the expanding spectrum of clinical anomalies associated with the presentation of NS.
Subject(s)
Lymphangioma/pathology , Noonan Syndrome/complications , Vulvar Diseases/pathology , Vulvar Neoplasms/pathology , Adult , Female , Humans , Immunoenzyme Techniques/methods , Lymphangioma/complications , Lymphangioma/diagnosis , Male , Vulvar Diseases/complications , Vulvar Diseases/diagnosis , Vulvar Neoplasms/complications , Vulvar Neoplasms/diagnosisABSTRACT
We report a case of scabies that immunohistochemically mimicked bullous pemphigoid (BP) in an 82-year-old woman who presented with intractable pruritus. Bullous pemphigoid initially was diagnosed by direct immunofluorescence (DIF), though no blisters were clinically present. Subsequent immunosuppressive therapy for treatment of presumed BP led to the development of crusted scabies and widespread tinea corporis.
Subject(s)
Immunosuppressive Agents/adverse effects , Pemphigoid, Bullous/diagnosis , Scabies/diagnosis , Tinea/pathology , Aged, 80 and over , Female , Fluorescent Antibody Technique, Direct , Follow-Up Studies , Humans , Immunosuppressive Agents/therapeutic use , Pemphigoid, Bullous/pathology , Pruritus/etiology , Scabies/drug therapy , Scabies/pathology , Tinea/diagnosis , Tinea/drug therapySubject(s)
Angiogenesis Inhibitors/administration & dosage , Antineoplastic Agents, Hormonal/administration & dosage , Dexamethasone/administration & dosage , Multiple Myeloma , Necrobiotic Xanthogranuloma , Orbital Neoplasms , Thalidomide/analogs & derivatives , Female , Humans , Lenalidomide , Middle Aged , Necrobiotic Xanthogranuloma/drug therapy , Necrobiotic Xanthogranuloma/pathology , Orbital Neoplasms/drug therapy , Orbital Neoplasms/pathology , Thalidomide/administration & dosageABSTRACT
Cutaneous aspergillosis is a rare infection most often seen in immunocompromised patients. We report a case of primary cutaneous aspergillosis infection in a nonhealing scalp wound of an immunocompetent elderly patient. The patient had a cutaneous malignancy of the scalp treated with surgical excision but complicated by poor wound healing. Fungal culture of the nonhealing wound revealed Aspergillus niger. The nonhealing wound subsequently resolved with retapamulin ointment 1% and ketoconazole gel 2%.
Subject(s)
Aspergillosis/diagnosis , Aspergillosis/drug therapy , Dermatomycoses/diagnosis , Dermatomycoses/drug therapy , Scalp/microbiology , Scalp/surgery , Aged, 80 and over , Antifungal Agents/administration & dosage , Antifungal Agents/therapeutic use , Aspergillus niger , Bridged Bicyclo Compounds, Heterocyclic/administration & dosage , Bridged Bicyclo Compounds, Heterocyclic/therapeutic use , Carcinoma, Squamous Cell/surgery , Diterpenes , Gels , Head and Neck Neoplasms/surgery , Humans , Ketoconazole/administration & dosage , Ketoconazole/therapeutic use , Male , OintmentsABSTRACT
Palifermin is a modified human keratinocyte growth factor (KGF) given to decrease the incidence and duration of severe oral mucositis in patients receiving myelotoxic chemotherapy followed by a hematopoietic stem cell transplant. We report a case of a 42-year-old man who developed acanthosis nigricans after taking palifermin.
Subject(s)
Acanthosis Nigricans/chemically induced , Fibroblast Growth Factor 7/adverse effects , Stomatitis/prevention & control , Adult , Endodermal Sinus Tumor/therapy , Fibroblast Growth Factor 7/therapeutic use , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Male , Mediastinal Neoplasms/therapy , Stomatitis/etiologyABSTRACT
Mastocytosis is a heterogeneous entity that may present as either a cutaneous or systemic disease. Progression of pediatric cutaneous mastocytosis (CM) is uncommon, but in adults, this condition persists and often progresses to systemic disease. Mast cell proliferation and differentiation from stem cell precursors depend on a number of factors, including a mast cell tyrosine kinase receptor (kit) and its ligand (the stromal cell-derived cytokine stem cell factor). A gain-of-function mutation in codon 816 of c-kit is frequently present in mast cells of patients with systemic mastocytosis (SM). The diagnostic approach for a patient with suspected mast cell disease includes a thorough skin examination, a skin biopsy, a serum tryptase level, and bone marrow aspiration and biopsy. The treatment is directed toward avoidance of triggers of mast cell mediator release and management of symptoms. Aggressive cases are managed with cytoreductive therapies, such as interferon alfa-2b and cladribine. Research has been directed at more specific treatment modalities, including specific kit tyrosine kinase inhibitors.
Subject(s)
Mastocytosis, Systemic , Female , Humans , Mastocytosis, Systemic/diagnosis , Mastocytosis, Systemic/etiology , Mastocytosis, Systemic/therapy , Middle AgedSubject(s)
Lung Diseases/pathology , Pyoderma Gangrenosum/pathology , Aged, 80 and over , Cyclosporine/therapeutic use , Female , Humans , Lung Diseases/diagnostic imaging , Lung Diseases/drug therapy , Mediastinoscopy/adverse effects , Prednisone/therapeutic use , Pyoderma Gangrenosum/diagnostic imaging , Pyoderma Gangrenosum/drug therapy , Thoracotomy/adverse effects , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Cutaneous mesothelioma is rare but may occur following local surgical procedures for visceral mesothelioma or as a metastasis. METHODS: A patient with pleural mesothelioma, who developed papules within chest wall scars, 14 and 15 months after pleural biopsy and thoracentesis, respectively, is reported. RESULTS: Histopathology showed an epithelioid tumor forming tubulopapillary and glandular structures. The diagnosis of mesothelioma was confirmed with immunohistochemistry. Tumor cells stained characteristically for low-molecular-weight cytokeratins 5/6, calretinin, and vimentin and were negative for mucicarmine, carcinoembryonic antigen, thyroid transcription factor 1, prostate-specific antigen, gross cystic disease fluid protein, S-100, factor VIII, and CD31. CONCLUSIONS: Histologically, mesothelioma may resemble a primary adnexal neoplasm, metastatic adenocarcinoma, or angiosarcoma. Immunohistochemistry can clarify the diagnosis. Clinicians should be aware of the varied presentations of mesothelioma, as cutaneous presentations are becoming increasingly common.
