ABSTRACT
Port-wine stains (PWS) are benign, congenital vascular malformations found in approximately 0.3% of newborns. PWS may be effectively treated with the flashlamp pulsed dye laser (FPDL) at 585 nm. However, laser therapy of vascular lesions often produces pain. We performed a prospective double-blind, placebo-controlled evaluation of the iontophoresis of lidocaine 5% with epinephrine 1:50,000 and mepivacaine 2% with epinephrine 1:50,000. Thirty-six patients with facial PWS were included in the study; 13 of them were treated with lidocaine 5% with epinephrine, another 13 were treated with mepivacaine 2% with epinephrine, and the other 13 were treated with preservative-free 0.9% NaCl. The pain was graded by the patient on a visual analog scale from 0 to 10, comparing the iontophoretically treated area with an adjacent area treated without anesthesia. Pain evaluation by patients demonstrated a significant decrease in the pain of pulsed dye laser impulses using the iontophoresis of lidocaine 5% with epinephrine. No change in the efficacy of pulsed dye laser treatment of PWS or important side effects were observed in our patients. Iontophoresis of lidocaine 5% with epinephrine is a safe and effective method of local anesthesia for pulsed dye laser and it is more effective than the iontophoresis of mepivacaine 2% with epinephrine.
Subject(s)
Anesthetics, Local , Iontophoresis , Laser Therapy , Lidocaine , Port-Wine Stain/surgery , Adolescent , Anesthetics, Local/administration & dosage , Child , Double-Blind Method , Epinephrine/administration & dosage , Female , Humans , Lidocaine/administration & dosage , Male , Mepivacaine/administration & dosage , Prospective StudiesABSTRACT
We report a 25-year-old HIV-positive man with a past medical history of disseminated cytomegalovirus (CMV) infection, who developed cutaneous lesions during a disseminated mycobacterium infection. The histological changes of CMV and acid-fast bacilli were seen on histopathology of the lesions. Cultures were positive for M. tuberculosis and M. avium-intracellulare (MAI). CMV is frequently isolated from HIV patients, but skin involvement is rare. The association of CMV and mycobacteria can occur in cutaneous lesions of AIDS patients, but concurrent cutaneous involvement of CMV, M. tuberculosis, and MAI is unusual. These findings emphasize the polymorphous presentation of infectious disorders in AIDS patients and the need for multiple biopsies and for special stains in such patients.
Subject(s)
AIDS-Related Opportunistic Infections , Cytomegalovirus Infections/complications , Mycobacterium avium-intracellulare Infection/complications , Skin Diseases, Viral/complications , Tuberculosis, Cutaneous/complications , Adult , Cytomegalovirus/isolation & purification , Humans , Male , Mycobacterium avium Complex/isolation & purification , Mycobacterium tuberculosis/isolation & purificationABSTRACT
Nonspecific cutaneous xanthomas have been reported in a variety of lymphocytic neoplastic processes, but to date only three cases of xanthomatous lesions associated with monocytic leukaemias have been described. We now report a patient with a chronic myelomonocytic leukaemia (CMML) associated with these lesions. The clinical and immunohistochemical features do not correspond to any entity previously described and suggest that xanthomas is are a cutaneous expression of the CMML.
Subject(s)
Histiocytosis, Non-Langerhans-Cell/etiology , Leukemia, Myelomonocytic, Chronic/complications , Skin Diseases/etiology , Histiocytosis, Non-Langerhans-Cell/pathology , Humans , Leukemia, Myelomonocytic, Chronic/pathology , Male , Middle Aged , Skin Diseases/pathologySubject(s)
Lymphoma, T-Cell, Cutaneous/pathology , Paraproteinemias/pathology , Skin Neoplasms/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cell Transformation, Neoplastic , Fatal Outcome , Humans , Lymphoma, T-Cell, Cutaneous/drug therapy , Lymphoma, T-Cell, Cutaneous/physiopathology , Male , Middle Aged , Mycosis Fungoides/drug therapy , Mycosis Fungoides/pathology , Mycosis Fungoides/physiopathology , Paraproteinemias/etiology , Paraproteinemias/physiopathology , Skin Neoplasms/drug therapy , Skin Neoplasms/physiopathologySubject(s)
Facial Dermatoses/therapy , Laser Therapy , Lupus Erythematosus, Cutaneous/therapy , Adult , Female , HumansABSTRACT
Recently, the occurrence of pityriasis rubra pilaris (PRP) has been reported in patients with HIV infection. It presents different clinical features, and has a poorer prognosis, than the classical adult type of PRP. We report the occurrence of severe PRP in an HIV-infected patient, and review the previously reported cases of this association. We propose the designation of a new category of PRP (type 6), characterized by the presence of HIV infection, usually without immunosuppression, a poor prognosis and response to treatment, and the development of nodulocystic and lichen spinulosus lesions.
Subject(s)
HIV Infections/complications , Pityriasis Rubra Pilaris/complications , Adult , HIV Infections/pathology , Humans , Male , Pityriasis Rubra Pilaris/classification , Pityriasis Rubra Pilaris/pathology , PrognosisSubject(s)
Arm , Granuloma Annulare/pathology , HIV Infections/complications , Leg Dermatoses/pathology , Adult , Antiviral Agents/therapeutic use , CD4 Lymphocyte Count , CD8-Positive T-Lymphocytes/pathology , Didanosine/therapeutic use , Female , Granuloma Annulare/complications , Granuloma Annulare/drug therapy , HIV Seropositivity , Humans , Leg Dermatoses/complications , Leg Dermatoses/drug therapySubject(s)
Acantholysis/etiology , Carcinoid Tumor/complications , Paraneoplastic Syndromes/etiology , Superior Vena Cava Syndrome/etiology , Thymus Neoplasms/complications , Acantholysis/pathology , Aged , Carcinoid Tumor/pathology , Humans , Male , Paraneoplastic Syndromes/pathology , Superior Vena Cava Syndrome/pathology , Thymus Neoplasms/pathologyABSTRACT
Basal cell carcinomas (BCC) on covered sites of the body are rare (1). A case of a young woman with superficial basal cell carcinoma of both breasts is described. No history of sun bathing, X-ray, or arsenical exposure was reported. Simple excision of both lesions was performed without recurrence.
Subject(s)
Breast Neoplasms , Carcinoma, Basal Cell , Skin Neoplasms , Adult , Breast Neoplasms/pathology , Carcinoma, Basal Cell/pathology , Female , Humans , Skin Neoplasms/pathologyABSTRACT
Minocycline-associated hyperpigmentation is an uncommon side effect. We report the case of a patient with pyoderma gangrenosum successfully treated with oral minocycline but complicated by marked hyperpigmentation in his pyoderma gangrenosum and acne scars. One of the clinical forms of minocycline hyperpigmentation includes dark-blue or black macules in depressed acne scars or other sites of skin inflammation; this pattern seems to be independent of the total cumulative dose and the skin process.
Subject(s)
Hyperpigmentation/chemically induced , Minocycline/adverse effects , Pyoderma Gangrenosum/drug therapy , Adult , Humans , MaleABSTRACT
Mucocutaneous leishmaniasis is a rare disease in Europe. Relapses after treatment are more frequent than in visceral leishmaniasis. HIV patients infected by Leishmania have frequently visceral involvement, and responses to treatment are poor. Mucocutaneous leishmaniasis in HIV-infected patients has rarely been reported. A patient with centrofacial granuloma was diagnosed as having mucocutaneous leishmaniasis; simultaneously HIV infection was detected. To our knowledge this is the first case acquired in Europe. Intravenous meglumine antimonate 20 mg/kg/day for 28 days was proven to be useful.