1/15. The hyperkeratotic variant of disseminated superficial actinic porokeratosis (DSAP).A 78-year-old South Korean man was referred to us from the Medical intensive care Unit (MICU) for an opinion. He was comatose and was on ventilatory care due to aspiration pneumonia. Multiple tiny papules had developed 10 years previously and since then the number and size had been increasing gradually. He had been diabetic for the past 4 years, and had Parkinson's disease diagnosed 1 year previously. Laboratory examinations revealed an elevated level of white blood cells (WBCs) (25,000/microL) and decreased hemoglobin (8.8 g/dL). Other laboratory results were negative or within normal limits. skin examination showed multiple, discrete, crust-like, brownish papules over the erythematous base on the face, upper extremities, and lower extremities. With the clinical impressions of irritated verruca vulgaris, seborrheic keratosis, or cutaneous fungal infection, a skin biopsy was taken from a papule on the left shin, and histopathologic examination revealed several pronounced hyperkeratotic and parakeratotic columns, and characteristic cornoid lamellae in the stratum corneum. Beneath the cornoid lamellae, the granular layer was decreased. A number of round or oval, dyskeratotic, homogenized eosinophilic cells with pyknotic nuclei were scattered in the prickle cell layer below the cornoid lamellae. A mild lymphohistiocytic infiltrate was observed in the papillary dermis and around the blood vessels in the upper dermis. Also, actinic degeneration was present in the upper dermis.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
2/15. The relationship between facial annular erythema and anti-SS-A/Ro antibodies in three East Asian women.A distinct annular erythema developed on the cheeks of three East Asian women who had anti-SS-A/Ro (SSA) antibodies. The erythema was characterized by a wide, elevated border and central pallor. Histologically, there was a coat-sleeve-like infiltration of lymphocytes around the blood vessels, appendages, and secretory gland cells in the dermis. Immunohistological analysis clarified that the majority of infiltrating lymphocytes were CD4-positive T cells. Abnormal expression of hla-dr antigens in the perivascular, appendage, and secretory gland cells in the dermis was also observed. The differential diagnosis of the three patients lay between Sjogren syndrome (SjS), Sjogren/systemic lupus erythematosus overlap syndrome and an asymptomatic clinical state. These results are consistent with recent findings of major histocompatibility complex class II expression on target organs in various autoimmune diseases. Based on these findings, erythema appears to represent a broad cutaneous manifestation of these diseases. Furthermore, the presence of SSA antibodies, aberrant HLA-DR expression, and sun exposure may be responsible for the development of erythema.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
3/15. superior vena cava syndrome presenting as persistent erythematous oedema of the face.The superior vena cava syndrome occurs when extrinsic compression or intraluminal occlusion impedes blood flow through this vessel. Detecting the characteristic cutaneous features can lead to an early diagnosis of this condition. We report a 73-year-old patient with a 4-year-history of erythematous oedema of the face. The underlying cause was a large retrosternal goitre obstructing the superior vena cava. Subtotal thyroidectomy led to dramatic improvement of all dermatologic symptoms.- - - - - - - - - - ranking = 0.043611734688367keywords = vessel (Clic here for more details about this article) |
4/15. Erythematous plaques due to platelet plugging: a clue to underlying myeloproliferative disorder.We report a syndrome in a middle-aged woman characterized by tender erythematous plaques with histologic evidence of dramatic dermal vessel occlusion. These cutaneous findings occurred in association with progressive inferior vena cava and portal vein thrombosis while on coumarin anticoagulation, following hepatic transplantation for budd-chiari syndrome. The material occluding dermal vessels was proven by immunohistochemical staining to be platelet plugs. These findings led to the diagnosis of an underlying myeloproliferative disorder explaining both her cutaneous and liver abnormalities and institution of appropriate platelet directed anticoagulation with aspirin.- - - - - - - - - - ranking = 0.087223469376735keywords = vessel (Clic here for more details about this article) |
5/15. granuloma faciale successfully treated with long-pulsed tunable dye laser.BACKGROUND: granuloma faciale has been treated in the past with different modalities but the majority have had the risk of scarring. OBJECTIVE: Based on the principle of selective photothermolysis, we considered using the newer long-pulsed tunable dye laser for the treatment of granuloma faciale to target the vessels and minimize scarring. methods: Confirmation of the diagnosis by a punch biopsy of the lesion was followed by three treatments on separate occasions 6 weeks apart with the long-pulsed tunable dye laser. RESULTS: There was significant flattening of the lesions after two treatments, with complete clearing after the third. No scarring was detectable and there was no recurrence in the 9-month follow-up. CONCLUSION: We conclude that granuloma faciale may be successfully treated with the long-pulsed tunable dye laser with minimal risk of scarring, especially in cosmetically sensitive areas.- - - - - - - - - - ranking = 0.043611734688367keywords = vessel (Clic here for more details about this article) |
6/15. En coup de sabre.A man born in 1961 was apparently well until his marriage in May 1986. In August of that year, his attention was drawn to the presence of a reddish patch over the right forehead. It was initially asymptomatic. It continued to progress to form an apparent linear furrow extending from the receding hairline to the vertex and temporal part of the scalp. At this juncture, the patient experienced moderate pain when laughing. Five years later the patient experienced a constant boring pain affecting the right eyeball. Consultation with an ophthalmologist led to sacrificial enucleation of the right eye despite the lack of a precise diagnosis. Nevertheless, the initial condition continued to progress causing disfigurement of the right side of the face. Examination of the face was marked by perceptible asymmetry. A linear atrophic plaque in the form of a furrow was identified on the right side of the forehead extending from the eyebrow to the vertex and temporal part of the scalp. The skin over the furrow was taut and bound down (Fig. 1). A hematoxylin and eosin-stained section prepared from the lesion revealed marked thickening of the dermis. The collagen bundles were hypertrophied and closely packed together. The staining was homogeneously eosinophilic. It was largely devoid of inflammatory infiltrate. The changes in the blood vessels were conspicuous by narrowing of the lumina, thickening of the walls, and a sparse perivascular lymphocytic infiltrate. Pilosebaceous units were completely absent, whereas a few atrophic pulled-up sweat glands were located in the mid-dermis. Similar changes were observed in the subcutaneous tissue. The epidermis was largely atrophied, with flattening of the rete ridges.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
7/15. imipramine hyperpigmentation: a slate-gray discoloration caused by long-term imipramine administration.A 48-year-old white woman, skin type III, had a slate-gray discoloration of the face and dorsa of both hands after ingesting imipramine, 150 mg/day for 5 years. Her iris color was also darkened. One year after cessation of the therapy, the discoloration became lighter. Sun-protected skin showed no discoloration. light microscopy revealed an accumulation of doubly refractile golden yellow granules in the papillary dermis, mostly scattered, with some concentration around the blood vessels but not in the endothelial cells. Electron micrographs showed numerous amorphous electron-dense inclusion bodies in histiocytes, phagocytes, fibroblasts, and dermal dendrocytes. melanosomes were phagocytosed in the same cells but in separated locations. imipramine is structurally related to chlorpromazine and can cause slate-gray discoloration. However, the color of the granules deposited in the papillary dermis is golden-yellow and they are not deposited in endothelial cells.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
8/15. Direct immunofluorescence in granuloma faciale: a case report and review of literature.A 49-year-old male presented at our department with erythematous brownish plaques in the malar areas and left cheek of 9 years' evolution. Histopathological study revealed a dense, predominantly perivascular, inflammatory infiltrate in the reticular dermis. The infiltrate was composed of abundant neutrophils, lymphocytes, histiocytes, and eosinophils. Leukocytoclasia and fibrin in some vessel walls were also observed. The patient was diagnosed with granuloma faciale (GF). Direct immunofluorescence (DIF) study showed heavy immunoglobulin g (IgG) and less intense deposits of IgA, IgM, C(3) and C(1q) surrounding superficial and deep vessels of the reticular dermis. Perivascular and diffuse fibrinogen deposits were also present. No deposits were detected at the dermoepidermal junction. Our findings lend support to the hypothesis that classical pathway activation of complement may be involved in the development of vasculitis in GF.- - - - - - - - - - ranking = 0.087223469376735keywords = vessel (Clic here for more details about this article) |
9/15. vitiligo with an inflammatory erythema in Vogt-Koyanagi-Harada disease: demonstration of filamentous masses and amyloid deposits.A 35-year-old Japanese woman developed vitiligo with an inflammatory erythema on the face two years after the onset of bilateral uveitis and dysacusis. Histological studies of the lesions revealed the loss of pigment and dense mononuclear cell infiltration around the blood vessels. At the dermo-epidermal junction area, a few eosinophilic masses were found. Electron microscopy disclosed that the masses were filamentous masses (colloid bodies) and amyloid. After the oral administration of prednisolone, the erythema subsided, and the vitiligo showed some repigmentation.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
10/15. Erythromelanosis follicularis faciei et colli. case reports.Erythromelanosis follicularis of the face and neck has seldom been described in the literature. It is a condition of unknown aetiology. The clinical features are reddish-brown pigmentation, telangiectatic vessels, and pale follicular papules localized in the peri-auricular area. The disease is asymptomatic and has only been described in men. This report records two patients with erythromelanosis follicularis of the face and neck, a boy and a young adult female.- - - - - - - - - - ranking = 0.043611734688367keywords = vessel (Clic here for more details about this article) |
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