Varicella-zoster virus in children immunized with the varicella vaccine.

We present the case of a 4-year-old immunocompetent girl with varicella-zoster virus (VZV) that occurred 45 months after a single dose of the varicella vaccine. Varicella-zoster virus is rare in children, particularly those who have received the varicella vaccine. Our case illustrates the need for a continued high index of suspicion, even among vaccinated children with herpetiform rashes, for varicella reactivation or reinfection.

Mite infestations.

Mite infestations are important in dermatology because these may cause dermatologic diseases that range from papulosquamous eruptions to urticarial lesions to bullous eruptions and may spread infectious diseases. These clinical manifestations are important to recognize because mite-associated diseases may have systemic complications and may be confused with other dermatologic conditions. In treating mite infestations, oral antibiotics may be necessary. Prevention of infestation may be accomplished by pre-treating clothing with permethrin, using insect repellent N,N-Diethyl-meta-toluamide on clothing and skin, and treating animals infected with mites. This article will review etiology, clinical manifestation, and treatment of mite infestations.

Hyalinized collagen in a dermatofibrosarcoma protuberans after treatment with imatinib mesylate.

We report a novel histological finding in a dermatofibrosarcoma protuberans (DFSP) after treatment with imatinib mesylate: copious amounts of hyalinized collagen. A 57-year-old female was referred for evaluation and treatment of a 7 x 8 x 10 cm tumor on the right anterior shoulder. Histological evaluation of the incisional biopsy showed a highly cellular dermal neoplasm composed of spindle cells arranged in a storiform pattern with minimal collagen. A CD34 immunohistochemical stain was strongly positive, highlighting atypical spindle cells in the dermis. A diagnosis of DFSP was made and the patient was enrolled in the Southwest Oncology Group trial. She received imatinib mesylate 400 mg per day for 1 year. At the end of therapy, the DFSP decreased in size to 5.5 x 4 x 4 cm. The tumor was excised. Histological evaluation showed a residual dermal neoplasm composed of atypical spindle cells and a copious amount of hyalinized collagen. Areas of necrosis were not seen. A CD34 stain confirmed the presence of residual DFSP, highlighting atypical spindle cells. A procollagen I stain was strongly positive, confirming the presence of abundant collagen in the dermis. A similar finding has been reported in gastrointestinal stromal tumor, which shows deposition of myxohyaline stroma after treatment with imatinib mesylate.

Henoch-Schönlein purpura in an adult Filipino man: a case report and literature review.

Henoch-Schönlein purpura (HSP) is a form of cutaneous small vessel vasculitis that can involve visceral organs and is associated with deposition of immunoglobulin A (IgA)-containing immune complexes. HSP may appear after a remote history of infection (often an upper respiratory tract infection) as a rash with palpable petechiae or purpura. In addition, a patient with HSP usually complains of arthralgia and abdominal pain. Renal involvement also is common. HSP may be confused with other systemic autoimmune diseases because they all can present with similar symptoms. Prognosis is good and recovery usually occurs without treatment. Although HSP predominately affects children, the condition also can be seen in adults. We present a case of adult-onset HSP in an otherwise healthy Filipino man and review the literature.