1/12. hidradenitis suppurativa occurring on the leg.The case of a patient with a recurrent, painful ulceration on the lower leg, clinically and histologically resembling hidradenitis suppurativa, is presented. The fact that this site is devoid of apocrine glands supports the concept that apocrine involvement in hidradenitis suppurativa is coincidental and that these glands are involved secondarily. It is suggested that in this patient the pathogenesis of the disease is follicular occlusion rather than selective apocrine poral closure.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/12. Pustular psoriasis elicited by streptococcal antigen and localized to the sweat pore.A woman, aged 39 years, presented with a localized, painful, pustular eruption of the neck, scalp, and finger of five years' duration. A diagnosis of pustular psoriasis was made clinically and histologically. It was possible to reproduce the disease by the intradermal injection of killed Group A streptococcal organisms. The induced pustules, as well as those appearing clinically, were intraepidermal and indistinguishable from the Kogoj spongiform abscess, and on serial sectioning showed a distinctive localization to the acryosyringium. Immunosuppressant as well as antistreptococcal therapy in the form of cyclophosphamide and clindamycin was of help. The process is classified as a nonvasculitic pustular bacterid, and as a prototype for antigen localization of lesions to the occluded epidermal sweat duct unit.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
3/12. Eccrine angiomatous hamartoma: a report of symmetric and painful lesions of the wrists.Eccrine angiomatous hamartoma (EAH) is a rare, benign cutaneous lesion histologically defined as a proliferation of eccrine glands within a closely associated vascular stroma. Typically EAH presents as a solitary flesh-colored, hyperhidrotic, painful papule or plaque appearing at birth or during childhood. Only two previously reported cases have been described involving multiple, symmetrically located lesions. The occurrence of knuckle pads in patients with EAH has not been reported. We present an instance of multiple painful EAH lesions occurring symmetrically on the extensor wrists in a 14-year-old girl with knuckle pads.- - - - - - - - - - ranking = 6keywords = pain (Clic here for more details about this article) |
4/12. Late-onset eccrine angiomatous hamartoma: clinical, histological and imaging findings.Eccrine angiomatous hamartoma (EAH) is an exceedingly rare benign tumor-like lesion prevalent in childhood which may produce pain and marked sweating. Although an aggressive treatment is not generally indicated, surgery may be considered in severe cases. In this report we present novel morphological findings by immunophenotyping, document the first MRI findings in EAH and emphasize the importance of preoperative imaging of such lesions.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
5/12. Eccrine angiomatous hamartoma: a case report and review of the literature.Eccrine angiomatous hamartoma (EAH) is a rare, benign condition recognized histologically by increased numbers of eccrine elements, as well as numerous vascular channels. patients typically present with a solitary, sometimes enlarging, nodule of the extremities usually appearing at birth or arising during childhood. When symptomatic, EAH may be associated with hyperhidrosis or pain. We report a case of EAH on the calf of a young girl; review all other known documented cases in the literature; and summarize the clinical characteristics, histologic findings, and prognosis of this uncommon entity.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
6/12. Late-onset eccrine angiomatous hamartoma on the forehead.A 71-year-old Korean man presented with a solitary erythematous plaque on his forehead (Fig. 1). It was first noticed by the patient 1 year previously and had slowly increased in size over that time. physical examination revealed a slightly elevated, 1.5 cm x 1.5 cm erythematous plaque on the upper midline of the forehead. sweating was not evoked by physical work or emotional stress. There was no pain or tenderness associated with the lesion. The patient had no history of trauma to the forehead. Histopathologic examination of the lesion showed increased numbers of eccrine glands, as well as dilated vascular channels in the deep dermis and subcutaneous tissue (Fig. 2). An immunohistochemical study showed that these eccrine glands stained positively for S-100 and carcinoembryonic antigen (CEA), and the vascular channels for the antifactor VIII-related antigens. These findings are consistent with eccrine angiomatous hamartoma. There was no change in the lesion during the 1-year follow-up period.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
7/12. Acne-associated spondylarthropathy: radiographic features.Experience with six patients with severe acne and associated axial and peripheral arthritis is described. Four of the patients had a dermatologic triad of severe acne, hidradenitis suppurativa, and dissecting cellulitis of the scalp, the so-called follicular occlusion triad. All were black men with episodic peripheral arthropathy and low back pain. One had inflammatory bowel disease. rheumatoid factor and HLA-B27 were absent in five patients who had these determinations. An erosive and proliferative arthritis of the axial and appendicular skeleton is described. The radiographic findings were indistinguishable from those of the seronegative spondylarthropathies. We found no previous reports in the radiologic literature describing this articulocutaneous entity.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
8/12. Surgical management of severe mammary hidradenitis suppurativa.hidradenitis suppurativa is a devastating disease of the apocrine sweat glands. The chronic form is characterized by a malodorous discharge from multiple draining sinuses embedded in dense fibrous tissue, and physical discomfort. The disease commonly affects the axillary, perineal, and perianal regions. A case of hidradenitis suppurativa of the mammary gland necessitating mastectomy is presented here to illustrate the severity of the disease at an uncommon site. As in other regions of the body, aggressive surgical intervention provides a chance for rapid recovery. The surgical treatment should be tailored to the severity of the disease.- - - - - - - - - - ranking = 649.08480816327keywords = discomfort (Clic here for more details about this article) |
9/12. Surgical treatment of perineal hidradenitis suppurativa with special reference to recognition of the perianal form.Severe cases of hidradenitis suppurativa affecting the perineum and gluteal regions may be treated successfully by 'deroofing' the sinus and fistulae tracts. These lie in the dermis and are partly epithelialized by cells from involved hair follicles and disrupted sweat glands. Careful preservation of the floor of the tracts leads to re-epithelialization with disease-free skin. More radical surgery is unnecessary and the problems of covering widely excised areas in this heavily contaminated region are avoided. By spreading the treatment over several operating sessions and hospital admissions, postoperative discomfort and in-patient nursing requirements are minimized. The technique of deroofing is described and the treatment of three severe cases is discussed. One patient illustrated the recognized complication of malignant change occurring in long-standing untreated disease. A fourth case illustrates the difficulties in diagnosing perianal hidradenitis suppurativa and literature cited suggests it to be a more common condition than once thought and a diagnosis frequently missed.- - - - - - - - - - ranking = 649.08480816327keywords = discomfort (Clic here for more details about this article) |
10/12. Surgical management of massive perianal hidradenitis suppurativa.hidradenitis suppurativa of the perineum and buttocks is a devastating disease often causing patients years of pain, discomfort, and eventual social isolation. The chronic form of the disease results from a lack of aggressive surgical intervention when the patient is first seen. It is characterized by a malodorous drainage from multiple sinus tracts encased in marked scarred and fibrotic tissue. In contrast to axillary involvement, the perianal form of hidradenitis suppurativa is associated with an increased frequency of anemia, fistulous communications with bowel and urinary tract, and the development of carcinomas. Several cases illustrating the debilitating nature of the disease and its optimal management are presented. This report illustrates that (1) a well-planned preoperative and postoperative bowel regimen can eliminate the need for a diverting colostomy, even in the most extensive forms of perianal disease, (2) radical excision is expedited and blood loss is minimized by the use of a Shaw hot knife (Oximetrix, Mountain View, CA), (3) the quilted application of meshed split-thickness skin grafts as a primary procedure provides rapid closure of the surgical defect and minimizes patient discomfort, and (4) aggressive surgical intervention in severe cases provides a chance for a rapid recovery from this crippling disease.- - - - - - - - - - ranking = 1299.1696163265keywords = discomfort, pain (Clic here for more details about this article) |
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