Case Reports in Dermatological Medicine最新文献

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.

A 57-year-old male was evaluated for a smooth cystic nodule on his left upper chest that appeared clinically to be a cyst, yet histopathology and confirmatory immunohistochemistry revealed invasive malignant melanoma. Histopathologic evaluation and immunohistochemical staining (i.e., SOX-10 and MART-1) are useful diagnostic tools for invasive malignant melanoma that, albeit rare, can present without known or cutaneous primary. This case illustrates the variability with which metastatic melanoma can present, calling attention to the importance of careful evaluation of benign-appearing and asymptomatic lesions.

Kindler syndrome is an uncommon autosomal recessive genodermatosis, with roughly 400 documented cases worldwide as of March 2024. We describe a 24-year-old male, born to consanguineous but otherwise healthy parents, who presented with photosensitivity, gingival fragility, thinning of the skin, restricted finger mobility, and tooth loss. Although molecular testing represents the standard diagnostic tool, our diagnosis was established on the basis of distinctive clinical and histopathological features, which remain crucial in settings where genetic confirmation is unavailable.

A 4-year-old nonverbal autistic female presented to the clinic with a 3-month history of a persistent, inflamed papular rash, which was violaceous to skin-toned, verrucous, and dome-shaped with crateriform ulcerations on an erythematous base localized in the perianal region. A dermatologic condition with these characteristics, location, and demographic warrants a thorough workup, physical exam, and broad differential diagnosis. The clinical appearance of these lesions can mimic many cutaneous conditions in this age group and requires careful attention for potential signs of abuse. As demonstrated in our case, with a comprehensive patient history, a biopsy, and a culture of the lesions, one can properly direct management of what looked like a broad complex differential to something more benign and underappreciated. When seeing and performing skin check screenings on particular vulnerable patient populations, such as those with autism, educating these patients and their parents is a very important aspect of management. Narrowing the condition down, we reached a diagnosis of pseudoverrucous papules and nodules, a skin rash rarely discovered in children but detected in elderly patients who are debilitated and bedridden with urinary and/or fecal incontinence. This complex case illustrates the importance of proper patient care in patients with autism and considering the entire clinical context before making a diagnosis or conclusion, specifically in vulnerable youth.

The Koebner phenomenon, or isomorphic response, refers to the induction of disease-specific lesions on uninvolved skin following trauma. This phenomenon is well-documented across several dermatologic conditions such as psoriasis and vitiligo but is less recognized in discoid lupus erythematosus (DLE). We report a case of a 37-year-old African American woman with DLE, triggered by repeated contact with eyeglass frames, leading to the development of discoid lesions at the points of pressure on her face. This case is a rare occurrence of Koebnerization in DLE, diagnosed through characteristic histopathological findings and supported by serological evidence. Her management included hydroxychloroquine, topical corticosteroids, and methotrexate due to disease flaring. Eventually, she developed systemic lupus erythematosus, complicating her clinical course. This case discusses the need for awareness regarding Koebnerization in DLE and its potential role in indicating active disease or predicting transition to systemic involvement. Further research is necessary to explore the pathogenic mechanisms and implications of Koebnerization in DLE, emphasizing the importance of preventive measures against mechanical trauma in susceptible individuals.

Background: Botulinum toxin type A is widely used for aesthetic purposes and is generally considered safe. However, rare complications such as nodule formation at injection sites can occur, posing diagnostic and therapeutic challenges.

Aims: To describe a case report of patients developing inflammatory nodules after incobotulinum toxin A injections, review the differential diagnoses, and discuss appropriate management strategies based on clinical outcomes and literature.

Patients/methods: We report three cases of healthy female patients (ages 35-40) who presented with localized nodules approximately 1 cm in diameter following a full-face treatment with Inco botulinum toxin A for treatment of rhytides. Nodules appeared at the frontal injection sites immediately after treatment and were evaluated through clinical examination and ultrasound imaging. Only one patient received empirical anti-inflammatory and antibiotic therapy; the others were managed conservatively with observation alone.

Discussion: All cases resolved spontaneously in one and 2 months, with no scarring or pigmentation changes. Although histopathological confirmation was not performed, the benign clinical course and absence of systemic symptoms suggest a transient inflammatory or hypersensitivity reaction rather than infectious or granulomatous pathology. Literature review supports a multifactorial aetiology, including immune-mediated, foreign-body, and rare infectious causes. Early identification and conservative management are often sufficient, though persistent or atypical cases may warrant biopsy and targeted therapy.

Conclusions: Nodule formation following incobotulinum toxin A injection is an uncommon but important clinical entity. Awareness of its presentation and natural course can prevent unnecessary interventions. Further research is needed to define diagnostic algorithms and management guidelines.