Dermatology online journal最新文献

Idiopathic gingival papillokeratosis with crypt formation (IGPC) is a new and a very rare benign entity, clinically characterized by white-yellowish plaques with papillary architecture located in the upper labial gingiva of adolescent patients. The condition generally exhibits a bilateral symmetrical distribution and is asymptomatic. We report two new cases, one with a classic presentation and the other in an older individual. Through these case reports, we describe and highlight the key clinical and histopathological features associated with IGPC for greater understanding and knowledge by general dentists, oral pathologists, and dermatologists.

Protothecosis is a rare but emerging infectious disease, caused by algae from the genus Prototheca. It presents predominantly as cutaneous lesions and poses a diagnostic challenge owing to its diverse clinical presentation. Typically, it occurs in exposed areas of the skin, associated with trauma. Diagnosis relies mainly on histopathology and culture. This article presents an elderly diabetic woman with cutaneous protothecosis from Rio de Janeiro, Brazil. We emphasize clinical features, histopathology, and successful treatment with itraconazole, along with a brief review of the 12 previously reported cases from Brazil.

Granuloma annulare (GA) is an idiopathic inflammatory skin condition with a chronic and unpredictable course. Although localized GA is usually cleared with topical or systemic corticosteroids, generalized GA is often difficult to treat owing to the lack of treatment options and recurrence with treatment. Recent evidence has helped to elucidate the etiology behind GA, with growing confirmation for the use of JAK inhibitors as a possible treatment for GA. We present a 61-year-old woman with recalcitrant GA who responded successfully to pulse therapy upadacitinib, a JAK1 inhibitor. Our findings demonstrate the utility of this alternative and practical treatment strategy that may reduce the cumulative toxicity of upadacitinib and optimize its risk/benefit ratio.

Background: Acanthosis nigricans (AN) is a dermatologic skin condition that is often overlooked in its role as an indicator of underlying cardiovascular disorders. Recognizing the importance of AN beyond its cosmetic concerns is crucial for improving patient outcomes.

Objective: Provide a review of AN and what every dermatologist should know of its underlying cardiovascular risk.

Methods: A literature search through PubMed was performed. Terms used were "Acanthosis Nigricans," "hyperinsulinemia," "cardiovascular disease," "diabetes," "insulin resistance,". Further articles were found using source materials from included references. Inclusion criteria involved studies showing the association between AN and cardiovascular risks, with a specific focus on obesity and insulin resistance.

Results: Acanthosis nigricans increases risks of obesity and insulin resistance as individuals with AN exhibited a 2.6-fold higher likelihood of insulin resistance, independent of other factors. Acanthosis nigricans surpassed other risk factors in classifying individuals at risk for type two diabetes and cardiovascular disease.

Conclusions: Recognizing the association of AN with cardiovascular disease provides an opportunity for early intervention, focusing on weight management and underlying metabolic disorders to improve both cosmetic concerns and cardiovascular health. Dermatologists should consider AN as a signal that prompts referral for a thorough assessment for associated metabolic diseases.

Pseudoxanthoma elasticum-like papillary dermal elastolysis is a rare, benign, acquired, gradually-developing chronic elastic tissue disorder that almost exclusively affects post-menopausal women. It is essential to recognize this disease as it mimics the inherited pseudoxanthoma clinically. The pathophysiology behind this disease is multifactorial; it includes intrinsic skin aging, ultraviolet radiation exposure, and genetic components. We report two patients with pseudoxanthoma elasticum-papillary dermal elastolysis diagnosis based on clinicopathologic correlation in two post-menopausal women who presented with multiple asymptomatic papules over the neck that developed gradually without systemic involvement, and were managed conservatively. We also discuss this disease's clinical, dermoscopic, and histopathologic features.

Patients with granulomatosis with polyangiitis occasionally present with cutaneous manifestations, which are important clues for the early diagnosis. Although pyoderma gangrenosum-like ulcers are rarely observed, a unique case with unusual clinical features is presented herein. A 75-year-old woman with positive proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) repeatedly developed aseptic abscesses on the abdomen, buttock, lower legs, and forearms. Histopathological features of biopsy taken from ulcers showed necrotizing granulomatous inflammation with multinucleated giant cells without leukocytoclastic vasculitis. The present case was initially diagnosed as limited granulomatosis with polyangiitis without renal and lung involvement. However, two years later, she died of cerebral hemorrhage.

Lactation anaphylaxis is extremely rare and has been scarcely reported in the literature. Breast feeding and/or milk expression immediately induces life-threatening anaphylactic reactions, including generalized urticaria, angioedema, respiratory symptoms, and hypotension. Six English-language case reports have described the clinical course in detail. The present report describes a case involving a 24-year-old woman with no history of allergic reactions or anaphylaxis who experienced anaphylactic reactions three times immediately after milk expression. Lactation anaphylaxis was suspected when a detailed medical history revealed lactation-related recurrent anaphylactic symptoms. The authors prescribed bromocriptine to stop lactation and switched her to formula feeding, which resulted in no further anaphylactic episodes. Based on a review of the relevant literature, this report describes the characteristics of lactation anaphylaxis and possible management strategies. The pathogenesis of lactation anaphylaxis has been inferred from various experimental results.