491/719. Unusual acquired hyperkeratosis: a case report. The authors describe an acquired hyperkeratosis occurring in a 74-year-old male. To the authors' knowledge this disease shows a pathological picture never before described in the literature, consisting of the presence of a large number of acrosyringum-like structures not connected with the dermal sweat ducts in hyperkeratotic skin. ( info) |
| Two patients with prurigo nodularis resistant to most modalities of therapy were treated successfully with the combined use of cryosurgery and intralesional steroids plus lidocaine. This appears to be a successful treatment regimen for a dermatosis that is often difficult to control. ( info) |
493/719. Trichoepithelioma in a systematized epidermal nevus with acantholytic dyskeratosis. Its occurrence in a black man. A 2-cm nodular neoplasm in the left parietal region developed in a 52-year-old black man with a 20-year history of a systematized epidermal nevus of the scalp. On biopsy, the epidermal nevus showed both "church spire" papillary changes and multiple foci of acantholytic dyskeratosis. The neoplasm showed quite distinct histopathologic patterns of trichoepithelioma. ( info) |
494/719. The association of keratosis pilaris atrophicans and woolly hair, with and without Noonan's syndrome. We describe two cases in which keratosis pilaris atrophicans faciei (ulerythema oophryogenes) occurred in association with hereditary woolly hair. This association also occurred in the father of case I. In case 2, Noonan's syndrome was also present. ( info) |
495/719. Focal oral warty dyskeratoma. A 49-year-old white man developed focal oral warty dyskeratoma, which is a solitary, elevated nodule with a keratotic umbilicated center. The term "focal oral warty dyskeratoma" was suggested to distinguish these lesions from the histologically similar oral lesions found in Darier's disease. This paper reviews previously published reports of the lesion and presents an additional case. The average age of patients was 52.2 years, and a slight male predilection was noted. In almost all cases, the lesion was found in tissue overlying bone, with the maxillary alveolar ridge and palate being the most common locations. When the side of involvement was given, all lesions were noted to be on the left side. No evidence of a viral presence was seen with light or electron microscopic study, but the possibility of chronic irritation, such as tobacco usage, exists as an etiologic agent. ( info) |
496/719. Congenital unilateral punctate porokeratosis. A 16-year-old girl with congenital unilateral punctate porokeratosis is described. The clinical and histopathologic findings are presented. The various clinical forms of porokeratosis and the differential diagnosis of this type of lesion are discussed. To our knowledge, this is the first case of congenital unilateral punctate porokeratosis to be reported. ( info) |
497/719. Acrokeratosis paraneoplastica (Bazex' syndrome). A 63-year-old man had acrokeratosis paraneoplastica (Bazex' syndrome) characterized by violaceous erythema and scaling of the fingers, toes, nose, and aural helices. Severe nail dystrophy was present. Extensive examination of the patient for malignant neoplasms a few months after the initial appearance of the skin changes disclosed no abnormalities, but one year after onset, an epidermoid carcinoma of the lung was found. ( info) |
498/719. porokeratosis plantaris discreta. A 22-year-old black male patient developed discrete, exquisitely painful bilateral plantar lesions. Histologic examination revealed a cutaneous groove filled by a keratin plug (cornoid lamella). There is focal absence of granular layer underlying this defect. The differential diagnosis of this lesion, familiar to podiatrists but relatively unknown to dermatologists, is discussed. ( info) |
499/719. Primary and secondary keratomas of the frontal sinus. Keratomas in the paranasal sinuses have been described in the world literature with variable frequency and the inaccurate terminology of cholesteatoma. This paper describes an illustrative case and provides a discussion of the etiology and pathology of this disease. Because the pathologic findings are that of a true keratoma, classification of this disease as primary and secondary keratomas is recommended. The classification 1. primary keratoma is recommended for the epidermal cyst of congenital rest origin and 2. secondary keratoma is suggested for epithelial layers and cysts that are secondary to squamous cell implantation or migrations. ( info) |
500/719. Disseminated superficial actinic porokeratosis with hyperkeratotic lesions. A patient with disseminated superficial actinic porokeratosis (DSAP) presented with unusual exudative hyperkeratotic plaques in addition to lesions more typical of the disease. The plaques were unresponsive to various systemic antibiotics, but responded dramatically to systemic corticosteroid therapy. ( info) |