ABSTRACT
As an increasing number of patients undergo successful solid organ transplantation, immunocompromised patients are encountered more commonly in the private practice office. Thus the evaluation of such patients should take into consideration the possibility of infection. We report the case of a kidney transplant recipient who took standard immunosuppressive therapy and presented with cutaneous findings of secondary syphilis. Skin biopsy and serologic testing confirmed the diagnosis. The patient was treated according to current guidelines from the Centers for Disease Control and Prevention. We present a brief review of the clinical presentation, pathologic findings, diagnostic methods, and treatment options for syphilis.
Subject(s)
Immunocompromised Host , Kidney Transplantation/methods , Syphilis/diagnosis , Adult , Biopsy , Humans , Immunosuppressive Agents/therapeutic use , Male , Syphilis/drug therapy , Syphilis/pathologyABSTRACT
Sarcoidosis is a granulomatous disease with diverse skin manifestations and systemic involvement. We describe an adolescent boy who presented with unilateral scrotal swelling, constitutional symptoms, and a rash. Further workup demonstrated lymphadenopathy and pulmonary opacities. Granulomas caused by sarcoidosis were identified in biopsy specimens of the epididymis and skin lesions. No acid-fast organisms were found in biopsy specimens, and the patient had negative findings on placement of purified protein derivative (tuberculin). The concentration of angiotensin-converting enzyme was not elevated. We discuss pediatric sarcoidosis and, more specifically, intrascrotal sarcoidosis.
Subject(s)
Sarcoidosis/diagnosis , Scrotum , Adolescent , Diagnosis, Differential , Humans , Male , Sarcoidosis/pathologyABSTRACT
BACKGROUND: Because of its unique mechanism of action and safety profile, imiquimod, a topical immune response modifier, is used for many benign and malignant dermatologic conditions. Adverse effects are typically limited to treatment site erythema and erosion. OBJECTIVE: To describe a newly recognized adverse effect of imiquimod. METHODS: A 79-year-old woman being treated with imiquimod 5 days per week for a nodular basal cell developed a verrucous plaque over the treatment area after 7 weeks of therapy. RESULTS: Scouting biopsies demonstrated multiple comedones and ruptured epidermoid cysts. There was no evidence of residual basal cell carcinoma. CONCLUSIONS: Imiquimod is a new and novel treatment option for cutaneous malignancies. We report its successful use in the treatment of a nodular basal cell carcinoma. The multiple comedones and ruptured epidermoid cysts are newly reported adverse effects of imiquimod therapy.
Subject(s)
Aminoquinolines/adverse effects , Antineoplastic Agents/adverse effects , Carcinoma, Basal Cell/drug therapy , Skin Diseases/etiology , Skin Neoplasms/drug therapy , Administration, Topical , Aged , Aminoquinolines/administration & dosage , Antineoplastic Agents/administration & dosage , Dermatologic Agents/administration & dosage , Female , Humans , Imiquimod , Retinoids/administration & dosage , Skin Diseases/drug therapy , Treatment OutcomeSubject(s)
Dermatitis, Allergic Contact/diagnosis , Dermatitis, Irritant/diagnosis , Dermatitis, Occupational/diagnosis , Hand Dermatoses/diagnosis , Acrylates/adverse effects , Allergens/adverse effects , Calcium Hydroxide/adverse effects , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/pathology , Dermatitis, Irritant/etiology , Dermatitis, Irritant/pathology , Dermatitis, Occupational/etiology , Dermatitis, Occupational/pathology , Diagnosis, Differential , Female , Hand Dermatoses/chemically induced , Hand Dermatoses/pathology , Humans , Middle Aged , Patch TestsABSTRACT
Granuloma annulare is a benign idiopathic disorder of the dermis that has various clinical presentations and an unknown etiology. We discuss a patient who presented with a contact dermatitis that demonstrated granuloma annulare on biopsy. The most likely etiologic agent was a substance known as FAZ (an exhaust product of Kodak DryView laser imaging film), to which the patient was exposed in his occupation.
