Purpuric agave dermatitis.

Agave americana is a low growing, thick, long-leaved, subtropical plant used for medicinal, commercial, and ornamental purposes. The plant's sap contains calcium oxalate crystals, acrid oils, saponins, and other compounds. Despite these known irritants, Agave-induced irritant dermatitis has rarely been reported. Previous case reports have noted a papulovesicular eruption consistent with an irritant contact dermatitis. We report a case of Agave-induced purpura in an otherwise healthy patient. Histopathology was consistent with an evolving leukocytoclastic vasculitis.

Elephantiasis nostras verrucosa.

Elephantiasis nostras verrucosa is a rare, chronic, deforming disorder characterized by hyperkeratosis and papillomatosis of the epidermis with underlying woody fibrosis of the dermis and subcutaneous tissue. Chronic lymphedema, either congenital or secondary to infection, surgery, radiation, neoplastic obstruction, obesity, portal hypertension, or chronic congestive heart failure, plays a pivotal role in the pathogenesis. Without appropriate intervention, the slowly progressive cutaneous changes will culminate in massive and grotesque enlargement of the affected body region. In the following case report, the natural history and the management of elephantiasis nostras are discussed.

Acquired perforating dermatosis in a patient with chronic renal failure and diabetes mellitus.

Perforating disorders in patients with chronic renal failure (CRF), diabetes mellitus (DM), or both, may resemble any or all of the four classic cutaneous perforating disorders. However, due to the highly variable and overlapping histologic appearance of the lesions in patients with CRF, DM, or both, it may be useful to categorized these lesions as a distinct, yet encompassing process, termed by Rapini as acquired perforating dermatosis. We describe a patient with both CRF and DM with acquired perforating dermatosis.