Case Reports in Dermatological Medicine最新文献

Cutaneous endometriosis is a rare manifestation of endometriosis, and few reports on its dermoscopic features have been published. In this case report, we present a 40-year-old female with cutaneous endometriosis arising in a caesarean scar, exhibiting unique and distinct dermoscopic features. The patient presented with a nodular, papillomatous growth in the right end of the scar, and dermoscopic examination revealed structureless red papillomatous projections, as well as nonpapillomatous areas with red dotted vessels surrounded by a white reticular network. A biopsy confirmed the diagnosis of endometriosis. To our knowledge, this is the first report of such dermoscopic features in cutaneous endometriosis arising in a caesarean scar. Our case report adds to the current limited knowledge of dermoscopic features of cutaneous endometriosis and may help in the diagnosis of this condition.

Introduction: Cutaneous metastases of hepatocellular carcinoma (HCC) are uncommon but important to recognize for timely diagnosis and management. Case Presentation(s): We present a case of a 70-year-old man with a history of HCC who developed a painless nodule on the scalp. Histopathological examination and immunohistochemistry confirmed the nodule as cutaneous metastasis of HCC. The patient had previously undergone transarterial chemoembolization and surgery for HCC, with no evidence of disease for a period before presenting with the cutaneous lesion. Conclusion: Cutaneous metastasis of HCC is rare but signifies advanced disease. This case underscores the importance of considering cutaneous manifestations in patients with a history of HCC and highlights the need for routine follow-up and early intervention to improve patient outcomes.

With the introduction of fentanyl and xylazine in the drug supply market, injection-related skin injuries and wounds are becoming more common. Xylazine is an alpha-2 adrenergic agonist thought to cause deep ulcerative wounds due to peripheral vasoconstriction leading to poor wound healing. This case series describes four patients with injection drug use leading to severe xylazine-related skin injuries who were treated between 2022 and 2023. This paper provides visualization of the extent and severity of these "tranq wounds," as well as the healing progression when receiving medical treatment, addiction treatment, and wound care. Medical treatment and overall care were complicated by individual social determinants of health. Further understanding of xylazine-related wounds is necessary as xylazine continued to be an emerging threat in the United States. Though some reports in the literature capture the appearances, only few displayed progressive improvements or success in treatment given the challenging nature of treating this high-risk population.

Background: "Kaposi varicelliform eruption" (KVE), also known as "eczema herpeticum," refers to a rare widespread skin infection. The primary causal agent is thought to be the herpes simplex virus (HSV). Though common in patients with underlying skin dermatosis, systemic immunosuppression can at times lead to KVE. Case Presentation: A 27-years male, a renal transplant recipient, under systemic immunosuppressants, presented with lesions over the whole body for 2 weeks and fever for 10 days. Skin examination revealed multiple flaccid vesicles with hemorrhagic fluid over the face, trunk, and bilateral extremities. Multiple erythematous erosions over the chest and abdomen, multiple petechiae and purpura over bilateral legs, palms, soles, and abdomen, erosions over the hard palate along with thick crusts over the scalp. A tzanck smear showed plenty of acantholytic cells. With a diagnosis of KVE, he was managed with an injection of acyclovir that led to resolution of his symptoms. Conclusion: KVE is a serious condition that may have fatal outcomes. Early diagnosis and appropriate treatment of patients at risk for viral complications are very important medical considerations.

Scurvy, once prevalent among sailors, is now rare due to improved access to fresh fruits and vegetables yet persists in individuals with poor dietary habits. We report a case of a 35-year-old male presenting with month-long, nonpainful, nonitchy lower extremity lesions. A dermatological examination revealed follicular hyperkeratosis, perifollicular bleeding, corkscrew hairs, bleeding gums, and hemorrhagic purpura. Despite unavailable plasma vitamin C testing, scurvy was diagnosed based on clinical features and dietary history. Treatment with vitamin C resulted in significant improvement within 10 days. Inadequate intake of fruits and vegetables causes vitamin C deficiency, impairing collagen synthesis and leading to typical scurvy symptoms. This case underscores the importance of considering scurvy in patients with compatible symptoms, focusing on clinical diagnosis and treatment response when testing is unavailable. Management includes vitamin C supplementation and dietary changes, emphasizing healthcare providers' role in promoting sufficient fruit and vegetable consumptions to prevent nutritional deficiencies.

Background: Facial angiofibromas (FAs) are a dermatological characteristic which are typically linked to tuberous sclerosis (TS).

Aim: We discuss our experience, highlighting a rare occurrence of multiple FAs in a young patient, successfully treated with ablative CO₂ laser combined with PDL therapy.

Methods: A 23-year-old male patient affected by TS who presents multiple erythematous and colored papules/nodules located on the face, mainly concentrated around nose, perinasal area, cheeks, and chin area, was treated with a combination of ablative CO₂ laser and a pulsed dye laser. The patient underwent 3 sessions of combined treatment with CO₂ and pulsed dye laser. The intralesional dye laser treatment was administered immediately after the CO₂ laser session. The time interval between the combined laser treatments was approximately two months.

Results: After 4 months from the last laser treatment session, most of the facial erythematous and protruding lesions had improved. Following these procedures, the patient did not experience complications or severe adverse reaction.

Conclusion: The combined use of the CO₂ and dye laser has been proved to be a safe and effective treatment for multiple FAs in the young patient affected by tuberous sclerosis.

Carmine is an aluminium and/or calcium-chelated complex form of carminic acid (CA), which is derived from the Dactylopius coccus extract (cochineal), and is globally used as a red-colourant in foods and cosmetics. Although several allergens in carmine allergies, such as CC38K, have been reported, it remains unknown whether chelation affects the allergenicity of carmine. We report a case of Japanese fish sausage (Gyoniku Sausage) anaphylaxis induced by epicutaneous sensitization to carmine contained in eyeshadows. In addition, we report on the effect of chelation on carmine allergy. A 32-year-old woman had experienced itching, wheals, and swelling of her eyelids immediately after applying pink eyeshadows, which contained carmine, on several occasions for 3 years. Two months ago, she developed itching, wheals, and swelling on her whole body, especially her eyelids, and dyspnea immediately after ingesting fried pink fish sausages, which contained cochineal. In skin prick tests (SPTs) with all ingredients ingested in the two episodes of anaphylaxis, only fish sausage was positive. SPT was also positive for carmine. In IgE-immunoblotting using the eyeshadow and fish sausage, the patient serum IgE was bound to three protein bands at approximately 86, 114, and 130 kDa. In addition, IgE-immunoblotting using the carmine showed a broad band at 86-130 kDa, which were consistent with those using the eyeshadow and fish sausage, whereas there is no band using CA. Interestingly, the protein bands using the eyeshadow and carmine were diminished by preincubation in the presence of ethylenediaminetetraacetic acid (EDTA) as a chelating agent. The results indicated that the causative allergens of carmine contained in the eyeshadows could be dechelated by EDTA, reducing its allergenicity. In conclusion, carmine contained in cosmetics can cause epicutaneous sensitisation and consequently can induce food anaphylaxis. To prevent sensitisation in carmine allergy, the effect of chelation on allergenicity of carmine should be considered.

This study reported a woman with drug reaction with eosinophilia and systemic symptom (DRESS) syndrome induced by phloroglucinol who developed fulminant type 1 diabetes as sequelae. The literature review emphasized the necessity of at least seven months of follow-up for better management of DRESS syndrome.

Nail changes are seen in some individuals with alopecia areata, with the most common variants including pitting and trachyonychia. The nail findings are presumed to be due to the same lymphocytic infiltration seen in hair bulbs in individuals with AA. Baricitinib is an immunomodulatory drug that acts as a selective and reversible inhibitor of JAK proteins and is indicated for adult patients with moderate to severe rheumatoid arthritis who have not responded to other disease-modifying antirheumatic drugs. The FDA has also approved baricitinib to treat patients hospitalized with COVID-19 and severe alopecia areata. In this report, we present a case of a patient with persistent AA-associated nail changes who has been successfully treated with baricitinib. The patient has been suffering from alopecia for several years. She presented with periungual inflammation in conjunction with persistent fingernail ridges and pitting of her right fourth digit. The nail dystrophy persisted despite treatment with tacrolimus ointment, clobetasol ointment, or oral fluconazole. Patient was started on a trial of baricitinib for alopecia areata, which was the suspected cause of the nail changes. After 4 months of treatment with baricitinib, the patient's nail showed mild improvement of nail dystrophy with some clubbing and pitting still present. Within 11 months of treatment, her nail was normalized in appearance and texture. There are no established guidelines to treat AA-associated nail changes. Our patient's AA-associated nail changes were normalized after 11 months of treatment with baricitinib. Further research is needed to determine which alopecia areata patients may benefit from treatment with baricitinib and when treatment should be initiated. Baricitinib may be an effective treatment option for AA-associated nail changes in some patients.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA) is an autoinflammatory disease that is thought to occur with the contribution of genetic and environmental factors, but its etiology has not been clearly elucidated. It is characterized by recurrent attacks with fever, pharyngitis, oral aphthous lesions, and cervical lymphadenopathy, and an increase in the level of serum acute phase reactants is observed during the attacks. Although PFAPA usually begins in childhood, adult-onset cases are also reported in the literature. In the pathogenesis of PFAPA, an increase in the expression of various inflammatory cytokines, especially interleukin-1β (IL-1β), is observed as a result of the increase in inflammasome activity. Selective IgA deficiency (SIgAD) is the most prevalent primary immunodeficiency. Although most SIgAD cases remain asymptomatic and remain undiagnosed, it is known that the risk of mucosal infection is generally increased in SIgAD cases. In addition, the frequency of autoinflammatory diseases is increased in SIgAD cases compared with the general population. We aim to present a case of adult-onset PFAPA and SIgAD coexistence.