Case Reports in Dermatological Medicine最新文献

We present two cases of allergic contact dermatitis caused by the amphoteric surfactant coco betaine, a constituent of clobetasol propionate (CP) shampoo, despite the low allergenic potential of CP shampoo formulations. The patients were Japanese males, aged 49 and 52 years, with severe atopic dermatitis, who had been treated with oral cyclosporine for several years. Patch testing revealed that only coco betaine 1% aq. showed a clearly positive reaction in both cases, whereas the patch test results of CP shampoo, cocamidopropyl betaine, and lauramidopropyl betaine were positive in one case and doubtful in the other. In cases of recalcitrant scalp dermatitis, it is necessary to consider the possibility that it is being caused by the topical medication used to treat it, and that the "active" ingredient may not be the culprit.

Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine carcinoma of the skin. MCC can present a diagnostic challenge, especially in cases where Cytokeratin 20 (CK20) is negative or focally positive. CK20-negative MCC accounts for about 5% of MCCs. This case series describes five cases of CK20-negative or focally positive MCC at an academic medical center. All cases were biopsies of cutaneous lesions. Histopathological investigation with hematoxylin and eosin staining revealed characteristic aggregates of small blue cell tumor morphology in all cases. CK20 staining was absent in three cases and focally positive in two, defined as less than 5% of tumor cells. All cases demonstrated pancytokeratin (PanCK) positivity in the paranuclear dot-like pattern. Thyroid transcription factor 1 (TTF-1) was negative in all instances, supporting the diagnosis of MCC. This case series illustrates the diagnostic value and limitations of PanCK and TTF-1 staining in MCC in cases where CK20 is negative and discusses strategies for diagnosing this rare variant of MCC.

Phenol peel is a deep peel used to treat conditions involving the reticular dermis such as scars, deep wrinkles, and lentigos and is an attractive alternative to surgical interventions for the rejuvenation of the eyelids and face. Patients who wish to undergo this procedure should be screened for the presence of any contraindications and should be counseled on the possible complications, which include arrhythmia, skin atrophy, scarring, acne eruption, and infection. We describe the cases of four women who underwent deep phenol peeling for the improvement of wrinkles and aging features around the eyelid area as a conservative alternative to surgical blepharoplasty. Patients were previously healthy with no absolute contraindication for the procedure. They were instructed to use the Kligman formula for 1 month prior to peeling. A nonsteroidal anti-inflammatory medication was given to the patient 30 mins before starting the procedure. The skin was cleansed with urea foam for 1 min, and excess product was removed with a dry and then a moistened gauze until the skin was clean. A 70% alcohol solution was then used to clean the skin area in which the peeling was desired. Phenol concentrated at 88% was applied using a damp cotton swab over multiple layers, until peeling was achieved. At the end of the procedure, a plastic occlusive mask was used to seal the area, and a postphenol occlusive ointment was applied over the periorbital region. Patients were instructed not to wash the area for 7-10 days and were prescribed Hyabak eye drops for dryness as well as oral analgesics as needed. No complications were reported in all cases. Phenol peeling is an easy, relatively safe and effective deep peeling technique that can be used to achieve the desired aesthetic outcomes in patients who wish to improve aging features and minimize the appearance of deep wrinkles without undergoing surgical intervention.

Lymphatic malformation (LM) is a congenital anomaly of the lymphatic system that can affect various anatomical sites, most commonly skin and subcutaneous tissues. Treatments that were historically used, including surgery, laser therapy (pulsed dye laser [PDL] and CO2 laser), and sclerotherapy, can be associated with complications such as bleeding and lesion recurrence. Oral sirolimus is effective in treating LMs but can be associated with systemic side effects, including immunosuppression and metabolic disturbances. Targeting the mTOR pathway, topical sirolimus effectively treats superficial LMs with minimal adverse effects compared to systemic administration. Several studies have reported that topical sirolimus shows comparable outcomes with minimal side effects. We present the case of a 19-year-old woman with bleeding from a superficial LM on the lateral aspect of her upper limb. Previous treatments, including carbon dioxide laser therapy and PDL, were ineffective. Within 3 months after initiating 0.1% topical sirolimus application twice daily, a noticeable reduction in lesion size and bleeding was observed, with no adverse effect.

Photosensitivity dermatitis is a multifactorial dermatologic condition characterized by an exaggerated cutaneous response to ultraviolet (UV) radiation, often exacerbated by exogenous agents, particularly photosensitizing medications. The pathophysiology involves direct phototoxic or immune-mediated photoallergic mechanisms, leading to inflammatory skin reactions upon UV exposure. In individuals with vitiligo, the absence of melanocytes in depigmented areas significantly diminishes photoprotective mechanisms, rendering these regions highly susceptible to UV-induced damage. Consequently, vitiliginous skin is inherently more vulnerable to photo-induced inflammation and cutaneous injury. We report a 54-year-old man with generalized vitiligo who developed erythematous papules confined to sun-exposed depigmented skin. The clinical course suggested a medication-induced phototoxic reaction, likely potentiated by the patient's underlying lack of cutaneous melanin. This case highlights the need to recognize drug-induced photosensitivity in vitiligo and understand how UV vulnerability and photosensitizing medications interact.

Lymphangioma circumscriptum is a rare condition that usually affects the mouth mucosa, tongue, axilla, groin, and proximal arms and legs. Vulvar involvement is uncommon and understudied, with no standardized treatment guidelines available. Lymphangioma circumscriptum is characterized by benign dilation of lymphatic channels in the skin and subcutaneous tissues, resulting in weeping and painful vesicular-appearing growths. In this report, we present a unique case of a 50-year-old female with acquired lymphangioma circumscriptum of the vulva complicated by recurrent, painful vulvar papules. She elected for CO₂ laser ablation treatment with successful cosmetic and symptomatic results. Despite the limited research and treatments available for lymphangioma circumscriptum, vulvar laser ablation appears to be a potentially safe and effective option.

Introduction: Disseminated sporotrichosis is an uncommon presentation of this infectious disease, primarily observed in immunocompromised patients. Here, we present a case of disseminated sporotrichosis occurring in an immunosenescent patient.

Case presentation: An 81-year-old man presented to our clinic with skin ulcers in the scalp, back, right arm, and both legs, knee arthritis, and acute kidney injury. After skin biopsy and synovial fluid analysis, the diagnosis of disseminated sporotrichosis was made using fungal culture and in-house PCR. The only factor that favored immunocompromise was immunosenescence.

Conclusion: This case of disseminated sporotrichosis highlights its rare occurrence in a patient with controlled diabetes and immunosenescence. Advanced diagnostics confirmed Sporothrix schenckii as the causative agent, and itraconazole treatment led to significant improvement.

Brachioradial pruritus (BRP) and macular amyloidosis (MA) are distinct dermatological conditions that have rarely been reported together. BRP is a neuropathic pruritus affecting the lateral forearm, whereas MA presents as hyperpigmented patches caused by amyloid deposition in the dermis. We report the first case of synchronous MA and BRP in a 45-year-old woman who presented with severe pruritus in the brachioradialis distribution, concurrent with hyperpigmented patches characteristic of MA. Cervical spine imaging revealed moderate-to-severe multilevel degenerative changes. The patient was successfully treated with gabapentin 200 mg daily, with significant improvement in both conditions. This case highlights the first reported synchronous presentation of MA and BRP and suggests potential shared pathophysiological mechanisms. The favorable dual therapeutic response to gabapentin provides new insights into management strategies for concurrent presentations of these conditions.

[This corrects the article DOI: 10.1155/crdm/8309221.].

Introduction: Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by chronic human papillomavirus infection of the skin and a risk of carcinomatous degeneration. We report a case of EV complicated by multiple cutaneous carcinomas of the scalp in a 19-year-old subject.

Case presentation: A 19-year-old male, phototype VI according to Fitzpatrick's classification, was referred to the dermatology department of CHU Kara with multiple painful tumoral lesions of the scalp that had been evolving for about 1 year. Clinical examination revealed hypochromic macules (Pityriasis versicolor-like), hypochromic verrucous flat papules scattered over the face, scalp, neck, trunk, and upper limbs. These lesions were associated with occasional pruritus. Apart from these lesions, there were three ulcerative-bourgeonous tumors on the scalp. A normal blood count was obtained, and the HIV serological test was negative. Histological examination of lesion biopsies confirmed the diagnosis of squamous cell carcinoma for all three lesions. Patient management was limited by lack of financial resources.

Conclusion: As sub-Saharan Africa is characterized by fragile health systems and high solar gradients, particular emphasis must be placed on preventive measures for skin cancers in patients with genodermatoses at risk of degeneration.