421/719. Metastatic squamous-cell carcinomas derived from solar keratosis. Actinic squamous-cell carcinoma has been described to have a low risk of metastasis. Reported here are four Japanese cases of lymphatic metastasis of squamous-cell carcinoma derived form solar keratosis. The primary lesions were on the face in three cases and on the back of the hand in one. Two patients died, and others had recurrent incurable metastatic lymph nodes. Therefore, it is noteworthy that actinic squamous-cell carcinoma in the Japanese can become so aggressive and metastasize. ( info) |
422/719. Recurring accessory "fingernail": periungual fibrokeratoma. A tumor of the fingertip of a 41-year-old woman presented as a diminutive supernumerary digit complete with fingernail. It had recurred five times following previous surgical removal. Histologic study showed it to be a benign fibrokeratoma with a remarkable smooth hyperkeratotic surface producing a simulated nail plate. Complete surgical excision has not been followed by any recurrence within two years. ( info) |
423/719. etretinate in the treatment of disseminated porokeratosis of Mibelli. A 30-year-old man with disseminated porokeratosis of Mibelli (DPKM) was treated with oral etretinate. The dose ranged between 75 mg/day and 50 mg/day for 21 weeks. An improvement of the lesions was observed, especially of very painful verrucous plaques of the left shin. No serious side effect was seen. The patient, who had been incapacitated, is now able to work. The benefit of long-term therapy of etretinate should be considered against its side effects. ( info) |
| A 60-year-old woman with plaque-type psoriasis of 30 years' duration was treated with etretinate. The lesion resolved while the patient was on the drug and continued to resolve after she had discontinued therapy. The continuation of resolution after the patient had discontinued the drug is probably due to its long half-life. ( info) |
| A patient with chronic psoriasis treated with psoralens plus ultraviolet A (PUVA) developed characteristic lesions of disseminated superficial actinic porokeratosis (DSAP). Since other processes associated with ultraviolet irradiation, including epidermal dysplasia, actinic keratoses, squamous cell carcinomas, and keratoacanthomas, have been reported to result from PUVA, it is possible that her DSAP lesions were induced by this therapy. ( info) |
| A man displayed the acute inflammatory cutaneous manifestations and the late "incontinentia pigmenti-like" lesions of Conradi-Huenermann subgroup B of chondrodysplasia punctata. The case appears as unique in the literature in that, to our knowledge, both kinds of skin changes have been described only in newborns or early in infancy. ( info) |
| We treated two unrelated boys with ichthyosis follicularis, a rare skin disorder characterized by extensive noninflammatory spiny follicular hyperkeratoses, severe photophobia, and generalized noncicatricial alopecia. This disorder must be differentiated from keratosis follicularis spinulosa decalvans; ulerythema ophryogenes; keratosis pilaris rubra atrophicans faciei; atrichia with papular lesions; atrophodermia vermiculata; and keratitis, ichthyosis, and deafness syndrome, all of which share some clinical features. ichthyosis follicularis with alopecia and photophobia appears to be a familial disorder, but too few cases have been reported to establish the exact mode of inheritance. ( info) |
428/719. Multiple benign lichenoid keratoses simulating photodermatoses: evolution from senile lentigines and their spontaneous regression. Evidence from several studies has established that a solitary benign lichenoid keratosis evolves from a senile lentigo. This lesion tends to resolve spontaneously with partial or complete regression of the original senile lentigo. In a 2-year period we studied fourteen patients with multiple benign lichenoid keratoses simulating photodermatoses. The original two patients were thought initially to have either cutaneous lupus erythematosus or a drug-induced photodermatitis. All fourteen patients were found to have multiple benign lichenoid keratoses distributed primarily in sun-exposed skin and arising from preexisting senile lentigines. The lichenoid lesions disappear either with topical corticosteroid treatment or spontaneously and are followed by partial or complete regression of the original senile lentigines. This disease entity seems to be fairly common and may be easily confused with photodermatoses. ( info) |
429/719. Unilateral megalocornea in lamellar ichthyosis. The case report of a 16-month-old girl with lamellar ichthyosis and unilateral megalocornea is presented. This is a previously unrecorded association and the first report of a unilateral megalocornea in a female. ( info) |
| A young man presented with a chronic, persistent reticulated dermatosis involving the groin, genitals, and thighs that was refractory to therapy. biopsy specimen revealed multiple cornoid lamellae consistent with porokeratosis. This clinical appearance has not been previously described, to our knowledge. The other clinical forms of porokeratosis and their histology are briefly reviewed. ( info) |