ABSTRACT
Coccidioides immitis, a pathogenic fungus endemic to arid regions, is the etiologic agent of cutaneous coccidioidomycosis. Primary cutaneous coccidioidomycosis is rare. The majority of cutaneous coccidioidomycosis infections are caused by dissemination of the fungus from the lungs to the skin. Diagnosing cutaneous coccidioidomycosis often can be difficult because it can mimic a variety of other clinical conditions. We present a case of a 45-year-old man presenting with cutaneous coccidioidomycosis on the tip of his nose. This patient had pulmonary symptoms in addition to his cutaneous findings, leading to a diagnosis of disseminated coccidioidomycosis.
Subject(s)
Coccidioidomycosis/diagnosis , Dermatomycoses/diagnosis , Lung Diseases, Fungal/diagnosis , Antifungal Agents/therapeutic use , Coccidioidomycosis/drug therapy , Coccidioidomycosis/pathology , Dermatomycoses/drug therapy , Dermatomycoses/pathology , Fluconazole/therapeutic use , Follow-Up Studies , Humans , Lung Diseases, Fungal/drug therapy , Lung Diseases, Fungal/pathology , Male , Middle Aged , Nose/microbiology , Nose/pathology , Sarcoidosis/diagnosis , Sarcoidosis/pathologyABSTRACT
Tinea versicolor is a common noninvasive cutaneous fungal disease. We recount a case of tinea versicolor that mimicked type I (classic adult) pityriasis rubra pilaris. A 54-year-old white man reported a 20-year history of a recurrent pruritic eruption that had marginally improved with use of selenium sulfide shampoo and treatment with oral antihistamines. Results of a skin examination revealed erythematous plaques; islands of spared skin; and follicular erythematous keratotic papules on the trunk, shoulders, and upper arms. A lesion was scraped to obtain skin scales for potassium hydroxide staining. Examination of the stained samples revealed the characteristic "spaghetti and meatballs," confirming the diagnosis.
Subject(s)
Pityriasis Rubra Pilaris/diagnosis , Tinea Versicolor/diagnosis , Antifungal Agents/therapeutic use , Diagnosis, Differential , Humans , Hydroxides , Itraconazole/therapeutic use , Male , Middle Aged , Potassium Compounds , Staining and Labeling , Tinea Versicolor/drug therapyABSTRACT
Classic porokeratosis is a rare skin disease occasionally involving the oral mucosa. It is characterized by the clinically and histologically distinctive comoid lamella. This case represents a variant of Mibelli's classic porokeratosis presenting as a solitary lesion on the mucosal surface of the lower lip.
Subject(s)
Mouth Diseases/pathology , Porokeratosis/pathology , Female , Humans , Lip/pathology , Middle Aged , Mouth Mucosa/pathologyABSTRACT
Localized heat induced urticaria is a rare clinical entity. Other physical urticarial subtypes include cholinergic, solar, cold, aquagenic, vibratory, and dermatographic. It is characterized by a well-demarcated urticarial lesion provoked by heat in direct contact with the skin. We describe a case of localized heat-induced urticaria in a 49-year-old woman after a heat-challenge test to her forearm.
Subject(s)
Hot Temperature/adverse effects , Urticaria/diagnosis , Diagnosis, Differential , Female , Forearm , Humans , Middle Aged , Urticaria/etiology , Urticaria/pathologyABSTRACT
A case of Bowen disease (BD) presenting as longitudinal melanonychia (LM) on the right third fingernail of a 25-year-old African American man is described. Findings from the histopathologic examination revealed full-thickness epidermal atypia, hypergranulosis, and koilocytic changes. Human papillomavirus (HPV) type 56 was identified by polymerase chain reaction. To the best of our knowledge, we describe the first case of BD of the nail unit in which HPV-56 DNA has been identified.
