Cases reported "Skin Diseases"

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1/339. Hypergranulotic dyscornification: a distinctive histologic pattern of maturation of epidermal epithelium present in solitary keratoses.

    Hypergranulotic dyscornification is an appellation proposed to designate a newly recognized distinctive pattern of epidermal maturation that is analogous to other epithelial reaction patterns such as epidermolytic hyperkeratosis, focal acantholytic dyskeratosis, cornoid lamellation, pale-cell acanthosis, and follicular mucinosis. The name "benign hypergranulotic keratosis with dyscornification" is proposed to specify solitary keratoses with digitated epidermal hyperplasia that exhibit this exceptional pattern of cornification. This abnormal type of cornification is characterized by hypergranulosis. A pale-staining basophilic substance is present intercellularly within the upper spinous layer and the hyperplastic granular layer. Overlying the thickened granular layer in foci at tips of epidermal papillations are orthokeratotic mounds of large, dull, eosinophilic staining corneocytes that are sharply demarcated from the thickened granular layer. Basophilic keratohyalin granules are focally retained within these corneocytes. There is overlying compact orthokeratosis that extends across the entire lesion. The compact orthokeratosis is slightly basophilic, and lies below a laminated and basket-weave orthokeratotic stratum corneum. There is a predominantly lymphocytic infiltrate at the base of these neoplasms with some spongiosis. There is parakeratosis focally present in the stratum corneum overlying these individual areas of abnormal cornification. The histopathologic and clinical findings in eight lesions that exhibit hypergranulotic dyscornification, a heretofore undescribed unique pattern of epidermal cornification, are presented.
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ranking = 1
keywords = upper
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2/339. dermatofibrosarcoma protuberans: an early non-protuberant phase of the tumour.

    A 40-year-old female patient presented with a flat scar like plaque on the upper chest. The patient's perception of subtle change in the lesion was of paramount importance in the decision to biopsy this lesion of innocuous clinical appearance. Histopathological findings were those of dermatofibrosarcoma protuberans. This case illustrates the early clinical features of the tumour and a recommendation for taking a biopsy of any scar-like plaque where there is no clear history of preceding trauma.
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ranking = 1.4558146772159
keywords = upper, chest
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3/339. Superficial and deep granulomatous lesions caused by trichophyton violaceum.

    A patient with cutaneous and reticulo-endothelial lesions, lymphadenopathy and osteitis caused by trichophyton violaceum is presented. Two types of skin lesions were found: 1. Erythematous, scaly plaques on the arms, chest and abdomen; 2. areas of diffuse infiltration, granulomatous ulceration, fistulation and destruction of the sternal bone. Long-term treatment with penicillin, streptomycin, sulfonamides, and griseofulvin, gave temporary improvement.
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ranking = 0.45581467721586
keywords = chest
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4/339. vulvodynia and vulvar vestibulitis: challenges in diagnosis and management.

    vulvodynia is a problem most family physicians can expect to encounter. It is a syndrome of unexplained vulvar pain, frequently accompanied by physical disabilities, limitation of daily activities, sexual dysfunction and psychologic distress. The patient's vulvar pain usually has an acute onset and, in most cases, becomes a chronic problem lasting months to years. The pain is often described as burning or stinging, or a feeling of rawness or irritation. vulvodynia may have multiple causes, with several subsets, including cyclic vulvovaginitis, vulvar vestibulitis syndrome, essential (dysesthetic) vulvodynia and vulvar dermatoses. Evaluation should include a thorough history and physical examination as well as cultures for bacteria and fungus, KOH microscopic examination and biopsy of any suspicious areas. Proper treatment mandates that the correct type of vulvodynia be identified. Depending on the specific diagnosis, treatment may include fluconazole, calcium citrate, tricyclic antidepressants, topical corticosteroids, physical therapy with biofeedback, surgery or laser therapy. Since vulvodynia is often a chronic condition, regular medical follow-up and referral to a support group are helpful for most patients.
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ranking = 1.2031219242674
keywords = back
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5/339. Upper respiratory problems in the yellow nail syndrome.

    A case of the yellow nail syndrome is described. The characteristic nail changes were associated with pleural effusions, lymphoedema of the face and legs and upper respiratory symptoms. The finding of extremely hard ear wax has not been reported previously. A satisfactory response to combination diuretic therapy was seen. The case of recognition of the Syndrome is emphasized together with the danger of excessive investigation if the nails are not inspected. Possible mechanisms for the formation of extremely hard cerumen are discussed.
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keywords = upper
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6/339. Acquired perforating dermatosis in diabetes mellitus: an unusual case.

    A case of elastosis perforans serpiginosa in a patient who presented with insulin-dependent diabetes mellitus secondary to pancreatic insufficiency in a background of common variable immunodeficiency and endocrinopathy, as evidenced by pernicious anaemia and growth hormone deficiency, is described. In acquired perforating dermatosis occurring in patients with diabetes or renal failure, there is a spectrum of changes that may show an overlap of histological features of the four classic perforating diseases. The biopsy changes of the patient described in the present study most closely resembled those of elastosis perforans serpiginosa.
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ranking = 1.2031219242674
keywords = back
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7/339. Wrinkly skin syndrome: ultrastructural alterations of the elastic fibers.

    We report the clinical and pathologic features of a patient with wrinkly skin syndrome. The essential clinical features were wrinkly skin with poor elasticity over the abdomen and on the dorsum of the hands and feet, increased palmar and plantar creases, and a prominent venous pattern over the chest. On light microscopy, histopathologic findings included appreciable heterogeneity in the structure, amount, and distribution pattern of elastic fibers. agglutination and fragmentation of the microfibrillar component and a remarkable decrease in elastin were the major ultrastructural features. The differential diagnosis with other connective tissue disorders is discussed.
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ranking = 0.45581467721586
keywords = chest
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8/339. skin eruption as the presenting sign of Hunter syndrome IIB.

    We present a case of Hunter syndrome diagnosed because of skin eruption. A 4-year-old Japanese boy presented with a 3-4-months history of papular lesions on the back and extremities. His growth and development were almost normal. His face was not of coarse appearance. He had multiple, whitish to skin-coloured, papules and nodules symmetrically distributed on the scapular regions and the extensor aspects of the upper arms and thighs. There was no family history of similar symptoms. skin biopsy showed the deposition of a considerable amount of mucin in the dermis. Although physical examinations failed to detect any other signs of Hunter syndrome, x-rays showed the characteristic features of mucopolysaccharidosis: deformities of the vertebral bone, ribs, and pelvis. Mucopolysaccharide analysis of the urine revealed a marked increase in dermatan sulphate and heparan sulphate. The activity of iduronate sulphatase in the lymphocytes was deficient, which was diagnostic for Hunter syndrome. We emphasize that the skin eruption can be the earliest sign of Hunter syndrome, particularly in the mild form presenting with normal development and growth.
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ranking = 2.2031219242674
keywords = back, upper
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9/339. Milia en plaque.

    Milia plaque is an unusual and rare variant of milia. We now report a Chinese man with numerous milia within an erythematous plaque of the upper and lower eyelids; histology confirmed the diagnosis and showed pericystic inflammation. All but one of the previous 10 reported cases affected the ear or adjacent sites, and to our knowledge, this is the first reported case of milia en plaque affecting the eyelids.
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ranking = 1
keywords = upper
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10/339. Primary disseminated varicella presenting as an acute abdomen.

    We report a patient admitted with acute abdominal pain initially thought to be due to pancreatitis of unclear etiology. Later during his hospitalization he was diagnosed with primary varicella infection. The association between varicella and systemic multiorgan disease needs to be recognized in both immunocompetent and immunocompromised patients. A prompt diagnosis prevents delay in the treatment of varicella, as well as in monitoring for and preventing complications of disseminated infection.
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ranking = 0.3660622366976
keywords = abdominal pain
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