OBSERVATION. Acute-Onset, Painful Acral Granuloma Annulare
|
|
- Charles Andrews
- 5 years ago
- Views:
Transcription
1 OBSERVATION Acute-Onset, Painful Acral Granuloma Annulare A Report of 4 Cases and a Discussion of the Clinical and Histologic Spectrum of the Disease Nicole Vessels Brey, MD; Janine Malone, MD; Jeffrey P. Callen, MD Background: Granuloma annulare is a benign cutaneous inflammatory disease of unknown etiology most commonly presenting on the hands and feet and consisting of asymptomatic to mildly pruritic, flesh-colored to erythematous annular plaques. To our knowledge, an acuteonset, painful acral eruption has not been previously recognized. Observations: We report 4 patients who presented with acute-onset, painful acral granuloma annulare. Conclusions: It is possible for granuloma annulare to present as a painful eruption with an acute onset and an acral distribution. Biopsy results are a crucial factor when establishing the diagnosis of this atypical clinical presentation of granuloma annulare. Arch Dermatol. 2006;142:49-54 Author Affiliations: Division of Dermatology, Department of Medicine, School of Medicine, University of Louisville, Louisville, Ky. GRANULOMA ANNULARE (GA) is a benign cutaneous inflammatory disease of unknown etiology most commonly presenting on the hands and feet. 1 The eruption most often consists of asymptomatic to mildly pruritic flesh-colored to erythematous annular plaques. Spontaneous resolution usually occurs within 2 years of initial presentation; however, recurrence at the original site approaches 40%. 1 Five clinical morphologic patterns of GA have been recognized: localized, generalized, perforating, subcutaneous, and patch type. Histopathologically, localized GA consists of foci of granulomatous inflammation and collagen alteration in the upper to middle dermis. There is an infiltration of histiocytes, lymphocytes, and occasional giant cells with peripheral palisading of the infiltrate around degenerative collagen bundles. Deposition of acid mucopolysaccharides on and between collagen fibers is also characteristic. Dabski and Winkelmann 2 found this classic pattern in only 25% of original biopsy specimens reviewed. Generalized cases typically present with an interstitial histiocytic infiltrate with less apparent collagen alteration. In their review, 53% of generalized GA lesions displayed some form of collagen necrobiosis, whereas 79% of localized GA cases exhibited collagen alteration. The prevalence of eosinophils has been reported to range from 3.5% to 40%. 3 Romero and Kantor 3 found eosinophils to be predominantly perivascular when present and more often associated with a palisaded pattern and necrobiosis. We report 4 patients with an atypical clinical presentation characterized by an acute onset, acral location, and pain with emphasis on the importance of the clinicopathologic correlation in establishing the correct diagnosis. REPORT OF CASES OBSERVATIONS Table 1 summarizes the clinical characteristics of 4 women with an unusual presentation of GA (also see Figure 1). Case 1 Patient 1 was a 42-year-old, previously healthy woman who awoke with a painful rash on her hands, legs, and feet. Five days later, she developed arthralgias of the knees and ankles. Her only medications were multivitamins and supplemental calcium. The patient s condition was initially evaluated by a rheumatologist and an expert in infectious diseases who noted an elevated erythrocyte sedimentation rate of 56 with otherwise unremarkable findings from laboratory evaluations for cryoglobulins, antineutrophilic cytoplasmic antibody, anti- 49
2 Table 1. Comparative Clinical Features Patient No./ Age, y Location 1/42 Hands, legs, feet 2 Months/arthralgias of knees and ankles 2/50 Lateral and dorsal hands 3/48 Dorsal and marginal 1 Week/diffuse hands, wrists, arthralgias upper and lower extremities, trunk, occipital scalp 4/65 Upper and lower palms Duration/ Associated Symptoms Medications Laboratory Treatment Response Multivitamins, calcium supplementation 3 Months/none Montelukast sodium, fexofenadine hydrochloride, amitriptyline hydrochloride, lisinopril, fluticasone propionate inhaler, multivitamins, calcium supplementation RF,* ESR, ACE, CMP, SPEP, CXR Conjugated estrogens 2 Weeks/none Lisinopril, amlodipine besylate, atorvastatin calcium, zolpidem tartrate, conjugated estrogens/ medroxyprogesterone Qualitative Hydroxychloroquine sulfate cryofibrinogen,* RF, (200 mg QD) ANA, anti-ro/-ssa, anti-la/-ssb, ANCA, anticardiolipin antibody, anti-dsdna antibody, CK, ESR, cryoglobulins, CRP, hepatitis C antibody, G6PD, -2 glycoprotein 1 antibody ANA (1:80),* ESR, hepatitis C antibody, SPEP, ANCA, anti-ro/-ssa, anti-la/-ssb, CMP NA Intralesional triamcinolone acetonide (3 mg/ml), fluticasone propionate cream, nicotinamide folic acid zinc oxide combination (750 mg-500 µg-25 mg, BID) Hydroxychloroquine sulfate (200 mg BID), hydrocortisone acetate/pramoxine, hydrochloride lotion 2-Week 40-mg prednisone taper, topical betamethasone diproprionate ointment 100% Reduction of cutaneous disease and arthritic symptoms 100% Reduction with continued pain in fingertips 100% Reduction of cutaneous disease and arthritic symptoms 90% Reduction of cutaneous disease and arthritic symptoms Abbreviations: ACE, angiotensin-converting enzyme; ANA, antinuclear antibody; ANCA, antineutrophilic cytoplasmic antibody; BID, twice daily; CK, creatine kinase; CMP, complete metabolic profile; CRP, C-reactive protein; CXR, chest x-ray film; dsdna, double-stranded DNA; ESR, erythrocyte sedimentation rate; G6PD, glucose 6-phosphate dehydrogenase; NA, not available; QD, daily; RF, rheumatoid factor; SPEP, serum protein electrophoresis. *Abnormal laboratory value. See Figure 1. Figure 1. Patient 2: tender, erythematous plaque on the distal fourth digit. cardiolipin antibodies, factor V Leiden mutation, hepatitis B serology, rheumatoid factor, rapid plasma reagin, Lyme disease titers, urinalysis, and complete metabolic profile. She was treated with oral colchicine and valdecoxib, which improved her arthralgias, but she continued to develop cutaneous lesions. Findings from biopsies performed at another institution had been interpreted as demonstrating an occlusive vasculopathy with dermal necrosis, and Dego disease was strongly suggested to be the differential diagnosis. She was subsequently referred to our practice (J.P.C.). Physical examination revealed tender, erythematous, annular plaques on her hands with an erythematous, firm, dermal nodule on her toe and postinflammatory pigmentary alteration involving her legs (Figure 2 and Figure 3). Findings from repeated laboratory tests revealed a positive qualitative cryofibrinogen on 1 occasion. Results from all other laboratory testing was either in the reference range or negative, including findings for rheumatoid factor, antinuclear antibody, anti-ro/-ssa, anti-la/-ssb antibodies, antineutrophilic cytoplasmic antibody, anticardiolipin antibody, anti double-stranded DNA antibody, creatine kinase, erythrocyte sedimentation rate, cryoglobulins, C-reactive protein, hepatitis C antibody, glucose 6-phosphate dehydrogenase, and -2 glycoprotein 1 antibody. The initial biopsy results from the patient s left thigh were reviewed. Irregular epidermal acanthosis, spongio- 50
3 Figure 4. Patient 1: mononuclear and multinucleate histiocytes in an interstitial array surround a zone of incomplete collagenolysis (hematoxylin-eosin, original magnification 100). Figure 2. Patient 1: tender, erythematous annular plaque on the palm. Figure 5. Patient 1: mononuclear and multinucleate histiocytes in an interstitial array (hematoxylin-eosin, original magnification 200). Figure 3. Patient 1: tender, erythematous annular plaques on the palm. sis, and focal parakeratosis were noted, overlying a broad zone of necrobiosis with scattered neutrophils surrounded by a palisaded infiltrate of histiocytes. A perivascular and periappendageal lymphocytic infiltrate was also noted; however, there was only a focal suggestion of fibrin deposition in a vessel lumina to suggest a vasculitic process. Repeated biopsy specimens were subsequently obtained from the patient s left second toe, finger, and palm. Results of the biopsy of the toe showed irregular epidermal acanthosis and an underlying dermis with a superficial and deep perivascular and interstitial lymphohistiocytic infiltrate. Histiocytes seemed to palisade around zones of necrobiotic collagen (Figure 4). There was no definitive evidence of vascular damage. A colloidal iron stain demonstrated increased mucin in the areas of necrobiosis. Results from the biopsy (Figure 5) of her left second finger revealed an interstitial histiocytic infiltrate in the upper and middle reticular dermis admixed with a perivascular lymphocytic infiltrate with interstitial mucin deposition on colloidal iron staining. The third biopsy specimen showed a perivascular and interstitial infiltrate composed of histiocytes, lymphocytes, and giant cells. The histiocytes seemed to focally palisade around areas of mild necrobiosis (Figure 6). Vascular damage was not appreciated, and interstitial mucin deposition was seen on a colloidal iron stain. Periodic acid Schiff staining was negative for pathogenic fungi in all of the bi- 51
4 Figure 6. Patient 1: a palisading granuloma with incomplete collagenolysis fills the reticular dermis in this fragment of acral skin (hematoxylin-eosin, original magnification 40). opsy specimens. These findings were felt to be histopathologically consistent with a diagnosis of GA. The patient s cutaneous disease and arthralgias resolved within 4 weeks after initiating treatment with 200 mg of oral hydroxychloroquine sulfate twice daily. After 10 months of successful therapy, the patient decided to discontinue treatment in October COMMENT Granuloma annulare may clinically mimic lichen planus, insect bites, sarcoidosis, annular elastolytic giant cell granuloma, foreign body granuloma, erythema multiforme, and acute febrile neutrophilic dermatosis. Histopathologically, GA may be included in the spectrum of other interstitial or palisading granulomatous dermatitides (Table 2), including interstitial granulomatous dermatitis with arthritis (cord and plaque types), interstitial granulomatous drug reaction, annular elastolytic giant cell granuloma, necrobiosis lipoidica diabeticorum, cutaneous extravascular necrobiotic granuloma, rheumatoid nodule, sarcoidosis, and infectious granulomata. A clinicopathologic correlation is essential to establish a final diagnosis given the substantial overlap in histopathologic features of the various granulomatous dermatitides. Patients 1 and 3 presented with arthralgias, which increased our concern that their disease might represent an early manifestation of an autoimmune disease. A variety of clinical presentations, including papules, plaques, or linear cords, often with a bilateral and symmetrical distribution, have been reported under a variety of monikers, including interstitial granulomatous dermatitis with arthritis, Churg-Strauss granuloma, palisaded neutrophilic and granulomatous dermatitis, rheumatoid papule or vasculitis, and, more recently, interstitial granulomatous dermatitis with plaques. 4-8 All of these conditions may clinically mimic generalized GA and are to be considered manifestations of a number of immunologically mediated diseases, including, but not limited to, rheumatoid arthritis, collagen vascular disease, Wegener granulomatosis, inflammatory bowel disease, and lymphoproliferative disorders. These conditions may also mimic GA from a histologic standpoint, although the diffuse interstitial pattern often exhibits numerous eosinophils, few to absent giant cells, and scant mucin deposition, in contrast to conditions found in GA. 4-8 The palisaded pattern, with the formation of basophilic necrobiotic zones containing neutrophils and neutrophilic debris with variable vascular fibrin deposition (or so-called Churg- Strauss granuloma), may more closely mimic GA histologically. 8 The diffuse interstitial pattern was not seen in our patients biopsy specimens, nor did their clinical presentation reveal the intertriginous and symmetrically distributed lesions typically noted in interstitial granulomatous dermatitis and other related disorders. Although fibrin deposition and perivascular neutrophils were seen in the biopsy findings from patient 1, overt changes of vasculitis were not seen, and these findings have been reported in patients with GA. In addition, the negative findings from serologic studies in our patients and the absence of clinical findings to substantiate a diagnosis of autoimmune disease would further refute one of the immunologically mediated conditions mimicking GA. Given the rapid progression of arthritic symptoms in our third patient, we considered multicentric reticulohistiocytosis in her differential diagnosis; however, the patient did not develop mucosal involvement, and her biopsy results did not reveal findings consistent with that diagnosis. 9 An interstitial granulomatous drug reaction may also mimic GA and has been attributed to angiotensinconverting enzyme inhibitors, calcium channel blockers, -blockers, antihistamines, anticonvulsants, antidepressants, and lipid-lowering agents. 10 Patients with interstitial granulomatous drug reactions present with intertriginous erythematous to violaceous annular plaques, although papules have also been reported. 10,11 Biopsy findings from these patients resemble a GA pattern or a GA-like pattern but may be distinguished from other interstitial granulomatous dermatitides by the presence of vacuolar interface changes, focal basilar and suprabasilar dyskeratosis, absent vasculopathic changes, and variable lymphoid atypia and mucin deposition. Although patients 1 and 2 had been taking an angiotensin-converting enzyme inhibitor, they did not have intertriginous involvement, and findings from their biopsies did not demonstrate vacuolar changes and lymphoid atypia. Annular elastolytic giant cell granuloma is characterized by annular erythematous plaques with hypopigmented centers on sun-damaged skin of the face, neck, or other exposed areas. 12 There have also been reports 9 of papular lesions occurring on nonexposed skin. The presence of elastolysis with dermal elastic fibers within the cytoplasm of histiocytes and the absence of collagen necrobiosis and mucin are the primary features that distinguish annular elastolytic giant cell granuloma from GA. Although there was evidence of focal elastophagocytosis in 1 patient, it was accompanied by collagen necrobiosis and mucin deposition, which are generally not observed in patients with annular elastolytic giant cell granuloma. 12,13 Also included in the differential diagnosis of palisading granulomas are necrobiosis lipoidica, rheumatoid nodules, and cutaneous sarcoidosis. The presence of plasma cells, increased numbers of giant cells, less mucin depo- 52
5 Table 2. Comparative Histologic Features* Feature Granuloma Annulare Interstitial Granulomatous Dermatitis Palisaded Neutrophilic and Granulomatous Dermatitis Multicentric Reticulohistiocytosis Interstitial Granulomatous Drug Reaction Annular Elastolytic Giant Cell Necrobiosis Rheumatoid Granuloma Lipoidica Nodules Sarcoidosis Collagen necrobiosis ; Early stage, fully developed, Mucin ± ±; Fully developed, ± Fibrin ± ; Fully ± developed, Vasculitis ; Early stage Elastophagocytosis ± Histiocytes Multinucleated giant ± cells Neutrophils ; Early stage, fully developed, Lymphocytes ± ±; Fully developed, ± ± Eosinophils ± ±; Fully developed, ± Plasma cells ± ± Dermoepidermal vacuolar changes *A minus sign indicates that a feature is absent; a plus sign, that it is present; and a plus-minus sign, that it is variably present. sition, and the depth of granulomatous inflammation help histopathologically to distinguish necrobiosis lipoidica from GA. 14 Our patients did not have previous diagnoses of diabetes mellitus, none presented with pretibial plaques characteristic of necrobiosis lipoidica, and their biopsy specimens did not have histologic findings to suggest such a diagnosis. Rheumatoid nodules are estimated to occur in approximately 20% of patients with rheumatoid arthritis and are usually associated with high titers of rheumatoid factor. Two of our patients had arthritic complaints, and another had an elevated serum rheumatoid factor level, but neither met the criteria defined by the American College of Rheumatology for rheumatoid arthritis. In addition, our patients did not present with nodules on the bony prominences but did have tender papules and plaques, with results from their biopsies showing upper to middle dermal involvement. With careful clinicopathologic correlation and the presence of mucin rather than fibrin deposition, GA may be differentiated from rheumatoid nodules. 15 Sarcoidosis is a disease of unknown etiology with cutaneous findings occurring in approximately 20% to 30% of patients with systemic disease. The cutaneous manifestations are variable, including brown erythematous or purple papules and plaques that may appear annular. 16 There was an initial concern that patient 2 had cutaneous sarcoidosis because of her clinical presentation; however, biopsy findings did not reveal naked sarcoidal granulomas, x-ray films of her chest did not reveal hilar adenopathy, and findings from serologic studies were negative for sarcoidosis. The clinical presentation of GA is variable and may be associated with mild pruritus or occasional burning. Our patients presented with painful papules and plaques. One patient also presented with a dermal nodule on her foot. These symptoms are unusual, and, to our knowledge, this is the first documented presentation of GA associated with pain. Weston and Morelli 17 previously reported a case of painful GA due to Munchausen syndrome by proxy. This case report documented a mother s complaint that her child s eruption was painful and disabling in order to subject the child to unnecessary surgical procedures for financial gain. However, on repeated physician examination, the papules were nontender. Whether the symptoms in our patients are attributable to the GA lesions themselves or due to locality is uncertain. These 4 cases should alert clinicians to become aware of patients who present with similar clinical findings and symptoms of tenderness and/or pain and to consider GA in their differential diagnosis. Laboratory investigation should focus on a patient s symptoms and clinical examination to exclude other possible etiologies. Singleor multiple-agent therapy with topical and/or intralesional corticosteroids, nicotinamide, hydroxychloroquine, or other treatment modalities should also be guided by these principles. 18 Accepted for Publication: June 16, Author Contributions: Study concept and design: Callen and Brey. Acquisition of data: Brey, Malone and Callen. Drafting of the manuscript: Brey. Critical revision of the manuscript for important intellectual content: Callen and Malone. 53
6 Administrative, technical, and material support: Callen. Study supervision: Callen. Correspondence: Jeffrey P. Callen, MD, Division of Dermatology, Department of Medicine, University of Louisville School of Medicine, 310 E Broadway, Louisville, KY (jefca@aol.com). Financial Disclosure: None. Disclaimer: Dr Callen is the associate editor of the ARCHIVES, but he was not involved in the editorial evaluation or decision to accept this article for publication. REFERENCES 1. Smith MD, Downie JB, DiCostanzo D. Granuloma annulare. Int J Dermatol. 1997; 36: Dabski K, Winkelmann RK. Generalized granuloma annulare: histopathology and immunology: systematic review of 100 cases and comparison with localized granuloma annulare. J Am Acad Dermatol. 1989;20: Romero LS, Kantor GR. Eosinophils are not a clue to the pathogenesis of granuloma annulare. Am J Dermatopathol. 1998;20: Long D, Thiboutot DM, Majeski JT, Vasily DB, Helm KF. Interstitial granulomatous dermatitis with arthritis. J Am Acad Dermatol. 1996;34: Verneuil L, Dompmartin A, Comoz F, Pasquier CJ, Leroy D. Interstitial granulomatous dermatitis with cutaneous cords and arthritis: a disorder associated with autoantibodies. J Am Acad Dermatol. 2001;45: Aloi F, Tomasini C, Pippione M. Interstitial granulomatous dermatitis with plaques. Am J Dermatopathol. 1999;21: Tomasini C, Pippione M. Interstitial granulomatous dermatitis with plaques. J Am Acad Dermatol. 2002;46: Chu P, Connolly MK, LeBoit PE. The histopathologic spectrum of palisaded neutrophilic and granulomatous dermatitis in patients with collagen vascular disease. Arch Dermatol. 1994;130: Bogle MA, Tschen JA, Sairam S, McNearney T, Orsak G, Knox JM. Multicentric reticulohistiocytosis with pulmonary involvement. J Am Acad Dermatol. 2003; 49: Magro CM, Crowson AN, Schapiro BL. The interstitial granulomatous drug reaction: a distinctive clinical and pathological entity. J Cutan Pathol. 1998;25: Perrin C, Lacour JP, Castanet J, Michiels JF. Interstitial granulomatous drug reaction with a histological pattern of interstitial granulomatous dermatitis. Am J Dermatopathol. 2001;23: Hanke CW, Bailin PL, Roenigk HH. Annular elastolytic giant cell granuloma. J Am Acad Dermatol. 1979;1: Burket JM, Zelickson AS. Intracellular elastin in generalized granuloma annulare. J Am Acad Dermatol. 1986;14: Magro CM, Crowson AN, Regauer S. Granuloma annulare and necrobiosis lipoidica tissue reactions as a manifestation of systemic disease. Hum Pathol. 1996; 27: Smith ML, Jorizzo JL, Semble E, Arrington JH, White WL. Rheumatoid papules: lesions showing features of vasculitis and palisading granuloma. J Am Acad Dermatol. 1989;20: Ehrich EW, McGuire JL, Kim YH. Association of granuloma annulare with sarcoidosis. Arch Dermatol. 1992;128: Weston WL, Morelli JG. Painful and disabling granuloma annulare : a case of Munchausen by proxy. Pediatr Dermatol. 1997;14: Howard A, White CR. Non-infectious granulomas. In: Bolognia JL, Jorizzo JL, Rapini RP, et al, eds. Dermatology. Vol. 2. London, England: Mosby; 2003: News and Notes First Congress of the International Dermoscopy Society. Naples, Italy, April 27 to 29, The recently founded International Dermoscopy Society organizes a meeting designed for all colleagues interested in the diagnosis and management of pigmented skin lesions. Special emphasis is given on guidelines for management, standardization of reports, and, particularly, on the development of machine vision in dermoscopy. In addition, seminars in discussion format and half-day workshops with special emphasis on pertinent issues in dermoscopy will be conducted. The detailed program is presented on the Web site: For further information please contact Giuseppe Argenziano, MD, Department of Dermatology, Second University of Naples, Naples, Italy (giuseppe.argenziano@unina2.it). 54
BSD Self Assessment Workshop 7 th July 2013 CASE 27 RAC6123
BSD Self Assessment Workshop 7 th July 2013 CASE 27 RAC6123 M55. 4/7 tender lesions on knee, legs and arms. Also iritis/ weight loss/headache, synovitis.?vasculitis. Sarcoidosis. Biopsy from left elbow
More informationInterstitial Granulomatous Dermatitis -A Case Report Associated with Rheumatoid Arthritis
Interstitial Granulomatous Dermatitis -A Case Report Associated with Rheumatoid Arthritis Wen-Yu Chang Gwo-Shing Chen Interstitial granulomatous dermatitis is a rare entity first described by Ackerman
More informationAnnular elastolytic giant cell granuloma presented with annular erythematous patches over the face and cheek in a Chinese lady
Hong Kong J. Dermatol. Venereol. (2009) 17, 151-155 Case Report Annular elastolytic giant cell granuloma presented with annular erythematous patches over the face and cheek in a Chinese lady SKF Loo, LY
More informationCase 16.1 A 67-year-old Thai man from Nontaburi Chief complaint: Asymptomatic erythematous papules and plaques for 2 months Present illness: Two
Case 16.1 A 67-year-old Thai man from Nontaburi Chief complaint: Asymptomatic erythematous papules and plaques for 2 months Present illness: Two months, he developed asymptomatic multiple erythematous
More informationCASE REPORT GRANULOMA ANNULARE MIMICKING SARCOIDOSIS AND TREATED WITH ACITRETIN: A CASE REPORT
GRANULOMA ANNULARE MIMICKING SARCOIDOSIS AND TREATED WITH ACITRETIN: A CASE REPORT M.G. Gopal 1, Divya Gupta 2, Sharath Kumar B.C 3, Ramesh M 4, Nandini 5 HOW TO CITE THIS ARTICLE: MG Gopal, Divya Gupta,
More informationUpdate in deposition diseases
Genoa, Italy Update in deposition diseases Prof. Franco Rongioletti, Section of Dermatology, Chair of Dermatopathology, University of Genoa,Italy Cutaneous deposition disorders Endogenous Exogenous Cutaneous
More informationElsevier B.V.; この論文は出版社版でありま Right 引用の際には出版社版をご確認ご利用ください This is
Title Refractory cutaneous lichenoid sarc tranilast. Author(s) Nakahigashi, Kyoko; Kabashima, Kenj Utani, Atsushi; Miyachi, Yoshiki Citation Journal of the American Academy of 63(1): 171-172 Issue Date
More informationRameshwar Gutte and Uday Khopkar
Extragenital unilateral lichen sclerosus et atrophicus in a child: a case report Rameshwar Gutte and Uday Khopkar Department of Dermatolgy, Seth GSMC and KEM Hospital, Parel, Mumbai-400012, India Egyptian
More informationGranuloma annulare is a benign self-limited disease, first described by Colcott-Fox 1 in 1895 and Radcliffe-Crocker in 1902.
Granuloma Annulare Granuloma annulare is a benign self-limited disease, first described by Colcott-Fox 1 in 1895 and Radcliffe-Crocker in 1902. EPIDEMIOLOGY Granuloma annulare is a relatively common disorder.
More informationCutaneous extravascular necrotizing granuloma (Winkelmann granuloma): Confirmation of the association with systemic disease
Cutaneous extravascular necrotizing granuloma (Winkelmann granuloma): Confirmation of the association with systemic disease Gregory J. Wilmoth, MD, and Charles Perniciaro, MD Jacksonville, Florida Background:
More informationCPC. Chutika Srisuttiyakorn, M.D. Kobkul Aunhachoke, M.D. Phramongkutklao Hospital Bangkok, Thailand
CPC Chutika Srisuttiyakorn, M.D. Kobkul Aunhachoke, M.D. Phramongkutklao Hospital Bangkok, Thailand A 53 year-old woman with fever, facial swelling and rashes on face, trunk and upper extremities for 3
More information=ﻰﻤاﻤﺤﻠا ﺔﻴﻘﻠﺤﻠا ﺔذﺒاﻨﻠا
1 / 15 Erythema Annulare Centrifugum and Other Figurate Erythemas The figurate erythemas include a variety of eruptions characterized by annular and polycyclic lesions. Classification of this group has
More informationMore Non-infectious Granulomatous Diseases! Karolyn Wanat, MD Assistant Professor, Dermatology & Pathology University of Iowa
More Non-infectious Granulomatous Diseases! Karolyn Wanat, MD Assistant Professor, Dermatology & Pathology University of Iowa Conflicts of Interest/Disclosure None Classification/Overview 1) Necrobiotic/Palisading
More informationالمركب النموذج--- سبيتز وحمة = Type Spitz's Nevus, Compound SPITZ NEVUS 1 / 7
SPITZ NEVUS 1 / 7 Epidemiology An annual incidence rate of 1.4 cases of Spitz nevus per 100,000 individuals has been estimated in Australia, compared with 25.4 per 100,000 individuals for cutaneous melanoma
More informationVasculitis local: systemic
Vasculitis Inflammation of the vessel wall. Signs and symptoms: 1- local: according to the involved tissue 2- systemic:(fever, myalgia, arthralgias, and malaise) Pathogenesis 1- immune-mediated 2- infectious
More informationTHE TIP OF THE ICEBERG SAMER BOLIS, DO PGY-3 LEHIGH VALLEY HEALTH NETWORK, ALLENTOWN PA
THE TIP OF THE ICEBERG SAMER BOLIS, DO PGY-3 LEHIGH VALLEY HEALTH NETWORK, ALLENTOWN PA Case The patient is a 48 year-old female, who recently returned from a trip to Puerto Rico. She presents to the ED
More informationS003 CPC Self-Assessment
S003 CPC Self-Assessment Alina G. Bridges, D.O. Associate Professor Program Director, Dermatopathology Fellowship Department of Dermatology, Division of Dermatopathology and Cutaneous Immunopathology Mayo
More informationCitation The Journal of Dermatology, 37(8), available at
NAOSITE: Nagasaki University's Ac Title Two cases of blaschkitis with promi Author(s) Utani, Atsushi Citation The Journal of Dermatology, 37(8), Issue Date 2010-08 URL Right http://hdl.handle.net/10069/25634
More informationVasculitis local: systemic
Vasculitis Inflammation of the vessel wall. Signs and symptoms: 1- local: according to the involved tissue 2- systemic:(fever, myalgia, arthralgias, and malaise) Pathogenesis 1- immune-mediated inflammation
More informationTitle: Erythema annulare centrifugum associated with chronic lymphocytic leukaemia. Authors: Helbling I, Walewska R, Dyer MJS, Bamford M, Harman KE
Title: Erythema annulare centrifugum associated with chronic lymphocytic leukaemia Authors: Helbling I, Walewska R, Dyer MJS, Bamford M, Harman KE Sir, A wide range of conditions have been described as
More informationEgyptian Dermatology Online Journal Vol. 6 No 1: 14, June 2010
Wells Syndrome H. Gammaz, H. Amer, A. Adly and S. Mahmoud Egyptian Dermatology Online Journal 6 (1): 14 Al-Haud Al-Marsoud Hospital, Cairo, Egypt e-mail: hananderma@hotmail.com Submitted: April 15, 2010
More informationCutanous Manifestation of Lupus Erythematosus. Presented By: Dr. Naif S. Al Shahrani Salman Bin Abdaziz university
Cutanous Manifestation of Lupus Erythematosus Presented By: Dr. Naif S. Al Shahrani Salman Bin Abdaziz university A 50-year old lady, who is otherwise healthy, presented to the dermatology clinic with
More informationCitation The Journal of dermatology, 37(1), available at
NAOSITE: Nagasaki University's Ac Title Author(s) Case of localized scleroderma assoc Muroi, Eiji; Ogawa, Fumihide; Yamao Sato, Shinichi Citation The Journal of dermatology, 37(1), Issue Date 2010-01 URL
More informationSuperficial Granulomatous Pyoderma of the Face: A Case Report and Review of the Literature
Superficial Granulomatous Pyoderma of the Face: A Case Report and Review of the Literature Sarah M. Persing, MPH, a and Donald Laub Jr, MD, FACS a,b a University of Vermont College of Medicine, Burlington;
More informationHEMORRHAGIC BULLOUS HENOCH- SCHONLEIN PURPURA: A CASE REPORT
HEMORRHAGIC BULLOUS HENOCH- SCHONLEIN PURPURA: A CASE REPORT Nirmala Ponnuthurai, Sabeera Begum, Lee Bang Rom Paediatric Dermatology Unit, Institute of Paediatric, Hospital Kuala Lumpur, Malaysia Abstract
More informationTHERE IS A GROUP OF PAtients. Defining Urticarial Dermatitis. A Subset of Dermal Hypersensitivity Reaction Pattern
STUDY Defining Urticarial Dermatitis A Subset of Dermal Hypersensitivity Reaction Pattern Steven Kossard, FACD; Ian Hamann, FACD; Barbara Wilkinson, BSc Background: Urticarial dermatitis may represent
More informationISPUB.COM. A Case of Actinic Lichen Planus. K Choi, H Kim, H Kim, Y Park INTRODUCTION CASE REPORT
ISPUB.COM The Internet Journal of Dermatology Volume 8 Number K Choi, H Kim, H Kim, Y Park Citation K Choi, H Kim, H Kim, Y Park.. The Internet Journal of Dermatology. 2009 Volume 8 Number. Abstract The
More informationSkin Deep: Cutaneous Lupus. Dr Sarah Sasson Immunology Registrar, Liverpool Hospital 2016
Skin Deep: Cutaneous Lupus Dr Sarah Sasson Immunology Registrar, Liverpool Hospital 2016 Introduction: Cutaneous lupus erythematosus LE is an autoimmune disease with a range of clinical manifestations
More informationGranulomatous dermatitis. Philip E. LeBoit, M.D. Depts. of Pathology and Dermatology University of California, San Francisco
Granulomatous dermatitis Philip E. LeBoit, M.D. Depts. of Pathology and Dermatology University of California, San Francisco Granulomatous dermatitis refers to inflammatory skin diseases in which histiocytes
More informationUncommon clinical presentations of leprosy: apropos of three cases
Lepr Rev (2016) 87, 246 251 CASE REPORT Uncommon clinical presentations of leprosy: apropos of three cases RASHMI JINDAL* & NADIA SHIRAZI** *Department of Dermatology, Venereology & Leprosy, Himalayan
More informationMucinoses Diverse group of disorders which have in common deposition of basophilic, finely granular and stringy material in the connective tissues of
Cutaneous Mucinoses Nathan C. Walk, M.D. Mucinoses Diverse group of disorders which have in common deposition of basophilic, finely granular and stringy material in the connective tissues of the dermis.
More informationArthritis and Rosai-Dorfman Disease of the Skin: A Diagnostic Dilemma
Arthritis and Rosai-Dorfman Disease of the Skin: A Diagnostic Dilemma Introduction Pages with reference to book, From 280 To 282 Irshad Nabi Soomro ( Department of Pathology, The Aga Khan University Hospital,
More informationA. Erythema multiforme and related diseases
Go Back to the Top To Order, Visit the Purchasing Page for Details Chapter Erythema, Erythroderma (Exfoliative Dermatitis) Erythema is caused by telangiectasia or hyperemia in the papillary and reticular
More informationKikuchi s disease (necrotizing lymphadenitis) presenting as acneiform eruption
Journal of the Saudi Society of Dermatology & Dermatologic Surgery (2012) 16, 67 71 King Saud University Journal of the Saudi Society of Dermatology & Dermatologic Surgery www.ksu.edu.sa www.jssdds.org
More informationDr Rodney Itaki Lecturer Anatomical Pathology Discipline. University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology
Vasculitis Dr Rodney Itaki Lecturer Anatomical Pathology Discipline University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology Disease Spectrum Hypersensitivity vasculitis/microscopic
More informationDisclosures. Rheumatological Approaches to Differential Diagnosis, Physical Examination, and Interpretation of Studies. None
Rheumatological Approaches to Differential Diagnosis, Physical Examination, and Interpretation of Studies Sarah Goglin MD Assistant Professor of Medicine Division of Rheumatology Disclosures None 1 [footer
More informationSudden Appearance of Indurated Erythematous Plaques on a Man's Face
Touro College and University System Touro Scholar NYMC Student Publications Students 2016 Sudden Appearance of Indurated Erythematous Plaques on a Man's Face Adam Carter New York Medical College Karthikeyan
More informationLymphomatoid Papulosis 3 Case Reports
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 14, Issue 7 Ver. III (July. 2015), PP 31-35 www.iosrjournals.org Lymphomatoid Papulosis 3 Case Reports
More informationPapular Elastorrhexis: A Case Report and Review of the Literature
CLINICAL VIGNETTE Proceedings of UCLA Healthcare Papular Elastorrhexis: A Case Report and Review of the Literature. Aparche Yang, M.D., Jamie Zussman, M.D., Chandra Smart, M.D., Joseph Diehl, M.D., Dina
More informationClinicopathologic Evaluation of Nodular Cutaneous Lesions of Behçet Syndrome
Anatomic Pathology / NODULAR CUTANEOUS LESIONS OF BEHÇET SYNDROME Clinicopathologic Evaluation of Nodular Cutaneous Lesions of Behçet Syndrome Cuyan Demirkesen, MD, 1 Nükhet Tüzüner, MD, 1 Cem Mat, MD,
More information21/07/2017. Hobnail endothelial cells are not the same as epithelioid endothelial cells
UPDATE IN CUTANEOUS VASCULAR S DERMATOPATHOLOGY SESSION BELFAST PATHOLOGY JUNE 21/2017 Dr E Calonje St John s Institute of Dermatology, London, United Kingdom THE FAMILY OF VASCULAR S WITH EPITHELIOID
More information22 year old QH mare with regionally extensive alopecia and scaling on one front limb and ventral chest (Figure 1 and 2).
22 year old QH mare with regionally extensive alopecia and scaling on one front limb and ventral chest (Figure 1 and 2). Which of the following is the most likely disease? a. Sterile granuloma complex
More informationmanifestations are uncommon. Initial descriptions of the disease (Rosai and Dorfman, 1969) specifically
Postgraduate Medical Journal (July 1980) 56, 521-525 Diffuse cutaneous involvement and sinus histiocytosis with massive lymphadenopathy A. A. WOODCOCK B.Sc., M.B., Ch.B., M.R.C.P. Summary Severe skin involvement
More informationJOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH How to cite this article : PAI K,GUPTA A.INTRAVASCULAR EPITHELIOID HAEMANGIOMA OF TEMPORAL ARTERY: A DIAGNOSTIC DIFFICULTY Journal of Clinical and Diagnostic
More informationA case of bullous pemphigoid following pemphigus foliaceus
#2228 A case of bullous pemphigoid following pemphigus foliaceus Priyanka Vedak MD 1, Danielle Levine MD 1,3, Lyn Duncan MD 2,3, Hensin Tsao 1,3, Daniela Kroshinsky MD MPH 1,3 1. Department of Dermatology,
More informationDegos Disease: A Case Report and Review of Literature
Degos Disease: A Case Report and Review of Literature Monira waked Egyptian Dermatology Online Journal 4 (1): 5, June 2008 Al Houd Al Marsod Hospital Submitted for publication: May 25 th, 2008 Accepted
More informationGranulomatosis and Polyangiitis Presenting as Superficial Granulomatous Pyoderma
Case Report Granulomatosis and Polyangiitis Presenting as Superficial Granulomatous Pyoderma Sophia Zhang 1*, Ellen Roh 2, Timothy Patton 3 1 University of Pittsburgh School of Medicine, 3550 Terrace St,
More informationName the condition: Canine sterile neutrophilic dermatosis (Sweet s syndrome)
5-year-old male miniature Schnauzer dog with acute onset of severe macular erythema and multiple tender violaceus plaques all over the body. Which of the following is the most likely diagnosis? 1. Canine
More informationDepartment of Dermatology, Christian Medical College and Hospital, Ludhiana, Punjab, India.
Bullous pemphigoid mimicking granulomatous inflammation Abhilasha Williams, Emy Abi Thomas. Department of Dermatology, Christian Medical College and Hospital, Ludhiana, Punjab, India. Egyptian Dermatology
More informationA case of Sweet's syndrome with marked facial swelling and fluid collection
Hong Kong J. Dermatol. Venereol. (2017) 25, 128-132 Case Report A case of Sweet's syndrome with marked facial swelling and fluid collection JE Seol, SH Park, DH Kim, JN Kang, H Kim A 43-year-old woman
More informationClinicopathologic Self- Assessment S003 AAD 2017
Clinicopathologic Self- Assessment S003 AAD 2017 Clay J. Cockerell, M.D. Director, Cockerell Dermatopathology Director, Division of Dermatopathology UT Southwestern Medical Center July 2017 No relevant
More informationScleritis LEN V KOH OD
Scleritis LEN V KOH OD 2014 PUCO 1 Introduction A painful, destructive, and potentially blinding disorder Highly symptomatic High association with systemic disease Immunosuppresssive agents 2014 PUCO 2
More informationالاكزيماتيد= Eczematid
1 / 7 2 / 7 Pityriasis Debate confusing of hypopigmentation characterized increasing surrounded differ hypomelanotic "progressive exists alba misnomer extensive a to observed term the applied term derived
More informationRetrospective 10 years review of 100 patients with psoriasis in the Kingdom of Saudi Arabia (KSA)
Retrospective 10 years review of 100 patients with psoriasis in the Kingdom of Saudi Arabia (KSA) Ahmed Abdullah Alhumidi King saud university, Riyadh, kingdom of Saudi Arabia Abstract Background: This
More informationTHE NEUTROPHILIC DERMAtoses
OSERVATION Sweet-like Dermatosis in 2 Patients With Clinical Features of Dermatomyositis and Underlying Autoimmune Disease Cindy England Owen, MD; Janine C. Malone, MD; Jeffrey P. Callen, MD ackground:
More informationA 40-year old male with follicular papule and pustule at central face area for 3 months
A 40-year old male with follicular papule and pustule at central face area for 3 months GMS- Neg AFB-Neg Fite stain - neg HISTOPATHOLOGICAL DIFFERENTIAL DIAGNOSIS CASEOUS GRANULOMA INFECTION -MYCOBACTERIUM
More informationDermclinic
Dermclinic /Dermclinic A Photo Quiz to Hone Dermatologic Skills DAVID L. KAPLAN, MD Series Editor University of Missouri Kansas City, University of Kansas Case 1: Upon his return from a summer visit to
More informationAzithromycin Therapy for Multiple Eruptive Milia: A Report of a Case, New Treatment Option, and Review of the Literature
ISPUB.COM The Internet Journal of Dermatology Volume 7 Number 1 Azithromycin Therapy for Multiple Eruptive Milia: A Report of a Case, New Treatment Option, and Review of the Literature E McCarley O'Shea,
More informationAtlas of the Vasculitic Syndromes
CHAPTER e40 Atlas of the Vasculitic Syndromes Carol A. Langford Anthony S. Fauci Diagnosis of the vasculitic syndromes is usually based upon characteristic histologic or arteriographic findings in a patient
More informationCUTIS. Do Not Copy. Pityriasis lichenoides is a T cell mediated papular. Pityriasis Lichenoides Chronica in Black Patients. Pediatric Dermatology
Series Editor: Camila K. Janniger, MD Pityriasis Lichenoides Chronica in Black Patients Tanda N. Lane, MD; Sareeta S. Parker, MD Pityriasis lichenoides chronica (PLC) is a cutaneous disease of unknown
More informationJeopardy. What s the rash? $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400
Jeopardy Antibodies & more antibodies Aching joints What s the rash? Potpourri Image Challenge $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400 $500 $500
More informationErythema gyratumrepens-like eruption in a patient with epidermolysisbullosaacquisita associated with ulcerative colitis
Erythema gyratumrepens-like eruption in a patient with epidermolysisbullosaacquisita associated with ulcerative colitis A. España C. Sitaru* M. Pretel L. Aguado J. Jimenez# Department of Dermatology, University
More informationPrimary Cutaneous CD30-Positive T-cell Lymphoproliferative Disorders
Primary Cutaneous CD30-Positive T-cell Lymphoproliferative Disorders Definition A spectrum of related conditions originating from transformed or activated CD30-positive T-lymphocytes May coexist in individual
More informationImportant Decisions in Dermatopathology: The Clinico- Pathologic Correlation. Dermatopathology Specialists Needed. Changing Trends
Important Decisions in Dermatopathology: The Clinico- Pathologic Correlation Uma Sundram, MD, PhD Departments of Pathology and Dermatology Stanford University May 29, 2008 Dermatopathology Specialists
More informationKelley's Textbook of Rheumatology. 2 Volume Set. Text with Internet Access Code for Premium Consult Edition
Kelley's Textbook of Rheumatology. 2 Volume Set. Text with Internet Access Code for Premium Consult Edition Firestein, G ISBN-13: 9781437717389 Table of Contents VOLUME I STRUCTURE AND FUNCTION OF BONE,
More informationLymphoma and Pseudolymphoma
Lymphoma and Pseudolymphoma Laura B. Pincus, MD Co-Director, Cutaneous Lymphoma Clinic Associate Professor Dermatology and Pathology University of California, San Francisco I HAVE NO RELEVANT RELATIONSHIPS
More informationQJM Advance Access published January 21, 2015 BIG LIPS. M. Reveillon, V. Eble, H. Levesque, I. Marie
QJM Advance Access published January 21, 2015 BIG LIPS M. Reveillon, V. Eble, H. Levesque, I. Marie Mathilde Reveillon, MD; Vincent Eble, MD; Hervé Levesque MD, PhD; Isabelle Marie, MD, PhD. Department
More informationPrednisone and Vardenafil Hydrochloride for Refractory Levamisole-Induced Vasculitis
Prednisone and Vardenafil Hydrochloride for Refractory Joshua Mandrell, MD; Christina L. Kranc, MD PRACTICE POINTS Levamisole is an immunomodulatory drug that, before being withdrawn from the US market
More informationGrover s disease: A case report.
320 Case report Thai J Dermatol, October-December 2011 ABSTRACT: Grover s disease: A case report. Supicha Chavanich MD, Praneet Sajjachareonpong MD. CHAVANICH C, SAJJACHAREONPONG P. GROVER S DISEASE: A
More informationالفتوي الاصفر الحبيبوم = Xanthogranuloma_Juvenile JUVENILE XANTHOGRANULOMA 1 / 9
JUVENILE XANTHOGRANULOMA 1 / 9 Clinical Findings CUTANEOUS LESIONS JXG is a benign, self-healing disorder that is characterized by asymptomatic yellowish papulonodular lesions of the skin and other organs
More informationHistopathology: granulomatous inflammation, including tuberculosis
Histopathology: granulomatous inflammation, including tuberculosis These presentations are to help you identify basic histopathological features. They do not contain the additional factual information
More informationSpongiotic Dermatitis
Prepared by Kurt Schaberg Introduction to Inflammatory Dermpath Spongiotic Dermatitis intraepidermal intercellular edema (spongiosis) - presence of widened intercellular spaces between keratinocytes, with
More informationEarly View Article: Online published version of an accepted article before publication in the final form.
: Online published version of an accepted article before publication in the final form. Journal Name: International Journal of Case Reports and Images (IJCRI) Type of Article: Case Report Title: A Case
More informationFuture of Pediatrics: Blisters, Hives and Other Tales from the Emergency Room June 14 th, 2016
A. Yasmine Kirkorian MD Assistant Professor of Dermatology & Pediatrics Children s National Health System George Washington University School of Medicine & Health Sciences Future of Pediatrics: Blisters,
More informationPlan. Sarcoidosis 21/07/2017. Sarcoidosis Liver involvement. Sarcoidosis GI involvement. Sarcoidosis Diagnosis
Belfast Pathology 2017 Gastrointestinal tract involvement by systemic disease 21.6.17 Dr Adrian C. Bateman University Hospital Southampton NHS Foundation Trust, UK Plan Dermatological conditions Chronic
More informationCLINICAL VIGNETTE Sarcoidosis: A Case Study Gloria Kim, M.D.
CLINICAL VIGNETTE Sarcoidosis: A Case Study Gloria Kim, M.D. Case Report A 56-year-old female presented to her primary care physician with complaints of dyspnea on exertion and increasing cough. She reported
More informationCase Rep Dermatol 2009;1:66 70 DOI: / Key Words Coma Blister Barbiturate Overdose Meningoencephalitis
66 Coma Blisters Joana Rocha a Teresa Pereira a Filipa Ventura a Fernando Pardal b Celeste Brito a Departments of a Dermatology and b Pathology, Hospital de São Marcos, Braga, Portugal Key Words Coma Blister
More informationCase Presentation VASCULITIS. Case Presentation. Case Presentation. Vasculitis
Case Presentation VASCULITIS The patient is a 24 year old woman who presented to the emergency room with left-sided weakness. She was confused and complained of a severe headache. She was noted to have
More informationThis is the second learning component (Learning Component 2) in our first learning module (Learning Module 1). In this component we review a very
This is the second learning component (Learning Component 2) in our first learning module (Learning Module 1). In this component we review a very basic response to injury inflammation. We ll look at examples
More informationComment on Association of bullous pemphigoid with malignancy: A systematic review and meta-analysis
Accepted Manuscript Comment on Association of bullous pemphigoid with malignancy: A systematic review and meta-analysis Maglie Roberto, MD, Antiga Emiliano, MD, PhD, Caproni Marzia, MD, PhD PII: S0190-9622(17)32812-8
More informationHigh Impact Rheumatology
High Impact Rheumatology Systemic Lupus Erythematosus Bernard Rubin, DO MPH Case 1: History A 45-year-old woman presents with severe dyspnea and cough. She was in excellent health until 4 weeks ago when
More informationVASCULITIS. Case Presentation. Case Presentation
VASCULITIS Case Presentation The patient is a 24 year old woman who presented to the emergency room with left-sided weakness. She was confused and complained of a severe headache. She was noted to have
More informationIs it Autoimmune or NOT! Presented to AONP! October 2015!
Is it Autoimmune or NOT! Presented to AONP! October 2015! Four main jobs of immune system Detects Contains and eliminates Self regulates Protects Innate Immune System! Epithelial cells, phagocytic cells
More information2/18/19. Case 1. Question
Case 1 Which of the following can present with granulomatous inflammation? A. Sarcoidosis B. Necrobiotic xanthogranulma C. Atypical mycobacterial infection D. Foreign Body Reaction E. All of the above
More informationSpectrum of clinical presentations
Spectrum of clinical presentations Case History A 7-day-old male patient born full-term via uncomplicated vaginal delivery was seen for multiple erythematous red-brown purpuric lesions that were present
More informationWhat caused this refractory pruritic eruption? Patient Presentation
What caused this refractory pruritic eruption? Patient Presentation A 67 year-old female presented with greater than 3 years of refractory and debilitating intermittent bouts of recurrent pruritus on the
More informationأملس عضلي غرن = Leiomyosarcoma. Leiomyosarcoma 1 / 5
Leiomyosarcoma 1 / 5 EPIDEMIOLOGY Exact incidence is unknown, but older studies suggest that leiomyosarcomas comprise approximately 3 percent of soft-tissue sarcomas. Superficial leiomyosarcoma occurs
More informationPalisaded Neutrophilic and Granulomatous Dermatitis in Association with Subcutaneous Nodular and
2013;21(4):245-249 CASE REPORT Palisaded Neutrophilic and Granulomatous Dermatitis in Association with Subcutaneous Nodular and Systemic Sarcoidosis Zrinjka Paštar 1, Jaka Radoš 2, Ivan Pavić 3, Suzana
More informationDifferential diagnosis
Differential diagnosis Idiopathic pulmonary fibrosis (IPF) is part of a large family of idiopathic interstitial pneumonias (IIP), one of four subgroups of interstitial lung disease (ILD). Differential
More informationA middle-aged man with self-healing papulonecrotic lesions over the trunk and proximal limbs
Hong Kong J. Dermatol. Venereol. (2011) 19, 30-34 Case Report A middle-aged man with self-healing papulonecrotic lesions over the trunk and proximal limbs JC Chan, N Trendell-Smith, CK Yeung Lymphomatoid
More informationMicroscopic study of the normal skin in cases of mycosis fungoides
Microscopic study of the normal skin in cases of mycosis fungoides M. El Darouti, S. Marzook, M. Bosseila, O. Abu Zeid, O. El- Safouri, A. Zayed, A. El-Ramly Egyptian Dermatology Online Journal 2 (1):
More informationCutaneous Sarcoidosis Misdiagnosed as Leprosy. Report of Two Cases and Review of Literature
Indian J Lepr 2016, 88 : 177-183 Hind Kusht Nivaran Sangh, New Delhi http://www.ijl.org.in Case Report Cutaneous Sarcoidosis Misdiagnosed as Leprosy. Report of Two Cases and Review of Literature 1 2 3
More informationSESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, :30am - 11:30am FACULTY COPY
SESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, 2008 9:30am - 11:30am FACULTY COPY GOAL: Describe the basic morphologic (structural) changes which occur in various pathologic conditions.
More informationVasculitis. Edward Dwyer, M.D. Division of Rheumatology. Vasculitis
Edward Dwyer, M.D. Division of Rheumatology VASCULITIS is a primary inflammatory disease process of the vasculature Determinants of the Clinical Manifestations of : Target organ involved Size of vessel
More informationCases I have Learned From. Jeffrey P. Callen, MD Professor of Medicine (Dermatology) University of Louisville
Cases I have Learned From Jeffrey P. Callen, MD Professor of Medicine (Dermatology) University of Louisville Jeffrey P. Callen, MD Disclosure (previous 12 months) Consultant/Advisory board Auxilium Consultant
More informationLichen planus along with Blaschko lines "Blaschkoian lichen planus"
Original Article Lichen planus along with Blaschko lines "Blaschkoian lichen planus" Hossein Kavoussi, Mazaher Ramazani, Elias Salimi Dermatology Department, Kermanshah University of Medical Sciences,
More informationGlistening, Skin-Colored Nodule
To Print: Click your browser's PRINT button. NOTE: To view the article with Web enhancements, go to: http://www.medscape.com/viewarticle/436334 Medscape Dermatology Clinic Glistening, Skin-Colored Nodule
More informationClinical and Pathological Features of Generalized Granuloma Annulare with Their Correlation: A Retrospective Multicenter Study in Korea
Ann Dermatol Vol. 21, No. 2, 2009 ORIGINAL ARTICLE Clinical and Pathological Features of Generalized Granuloma Annulare with Their Correlation: A Retrospective Multicenter Study in Korea Jeong Hyun Yun,
More informationMyxo-inflammatory Fibroblastic sarcoma
AKA Myxo-inflammatory Fibroblastic sarcoma Acral Myxoinflammatory fibroblastic sarcomaam.j.surg.path1998; 22; 911-924 Inflammatory myxoid tumour of soft parts with bizarre giant cells [Pathol.Res.Pract.
More informationSarcoidosis with Skin Manifestations - Two Case Reports and Review of Literature
Sarcoidosis with Skin Manifestations - Two Case Reports and Review of Literature Pages with reference to book, From 162 To 164 Shamaila Siddiqi, Aleern Qureshi ( Departments of Dermatology, The Aga Khan
More information