Acute localized exanthematous pustulosis: Clinical features, pathophysiology, and therapy.

Acute localized exanthematous pustulosis (ALEP) is a rare disease characterized by the acute onset of multiple localized non-follicular, pinhead-sized pustules. ALEP is considered a localized form of acute generalized exanthematous pustulosis but its pathogeny is not well identified. We performed a systematic review of the literature of all publications regarding ALEP cases using the term "acute localized exanthematous pustulosis," to provide an update on this disease and its management. Results and conclusion ALEP is an uncommon skin condition attributed primarily to a hypersensitivity reaction to a systemic drug (classical or herbal); though a contact mechanism has been reported. It may be misdiagnosed as infectious or inflammatory disease but the clinico-pathological correlation in addition to the rapid response to withdrawal of the culprit agent supports this diagnosis. The pathogenesis of ALEP is still unclear, and there are no standardized treatment guidelines to manage this disease. Both AGEP and ALEP have a good prognosis if an early diagnosis is made.

Cutaneous metastasis of renal cell carcinoma through percutaneous fine needle aspiration biopsy: case report.

A 39-year-old man, who had undergone left nephrectomy for renal cell carcinoma of clear cell type, was noted to have a solitary nodular shadow in the right lung on chest X-ray. Percutaneous needle biopsy of the lung was performed via the right anterior chest wall and the histologic findings showed metastasis from renal carcinoma. Six month later, the patient presented with a cutaneous nodule at the site of puncture of the lung needle biopsy. Histological examination of a biopsy of the skin tumor revealed features of metastatic renal cell carcinoma of clear cell type. Surgical excision of the cutaneous nodule was performed, followed by radiotherapy at the site of the skin lesion on the chest wall. After treatment, the patient remains disease free after one year of follow-up. This case represents an unusual clinical presentation of metastatic renal cell carcinoma that appears to have been translocated to the skin by the needle biopsy.