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Pediatric Dermatology Nov 2022
Topics: Humans; Child; Skin Abnormalities; Connective Tissue Diseases; Atrophy
PubMed: 36440998
DOI: 10.1111/pde.15089 -
Journal of Cutaneous Pathology Sep 2017Anetoderma is a rare cutaneous disorder characterized by focal loss of dermal elastic tissue due to unknown mechanisms. Primary anetoderma develops on clinical normal...
Anetoderma is a rare cutaneous disorder characterized by focal loss of dermal elastic tissue due to unknown mechanisms. Primary anetoderma develops on clinical normal skin, without any preceding dermatosis and it can be associated with autoimmune conditions. Secondary anetoderma develops on the same area of a previous disorder, such as infectious, neoplastic or inflammatory diseases. A 37-year-old female patient noticed for 4 years circumscribed, normochromic, asymptomatic herniated plaques on the trunk and upper limbs. Family history was negative. Only a positive antinuclear factor (ANF) test, with titer of 1:160 and nuclear homogeneous pattern was found. Light microscopy with Weigert staining showed a lessening of elastic fibers with fragmentation; the oxytalanic fibers were also affected or absent. Transmission electron microscopy showed fragmentation and granular degeneration of elastic fibers. With greater magnification, fragments similar to those seen with optical microscopy were identified. The collagen fibers did not present any alteration. The examination of the dermis with scanning electron microscopy also identified fragmentation and significant fissures of the elastic tissue, granular degeneration was also observed. With greater magnification fragmented elastic fibers were seen.
Topics: Adult; Anetoderma; Female; Humans; Microscopy, Electron; Skin
PubMed: 28605051
DOI: 10.1111/cup.12978 -
Dermatologic Surgery : Official... Aug 2022Infantile hemangioma (IH) often causes cosmetic disfigurement. Early intervention with propranolol for large, high-risk lesions is recommended in the American Academy of...
BACKGROUND
Infantile hemangioma (IH) often causes cosmetic disfigurement. Early intervention with propranolol for large, high-risk lesions is recommended in the American Academy of Pediatrics' Clinical Practice Guideline. Conversely, strategies for the management of small, low-risk lesions have not been established; however, pulsed dye laser (PDL) is often used to treat these lesions.
OBJECTIVE
To investigate clinical outcomes of PDL in small IH lesions.
PATIENTS AND METHODS
Fifty-three cases with 58 small IHs which did not meet the criteria for high-risk lesions in the guideline and were treated only with PDL were retrospectively reviewed. The characteristics of IHs and residual skin changes after treatment were evaluated.
RESULTS
Forty-seven lesions (81.0%) were superficial hemangiomas, whereas 11 (19.0%) were combined-type. The median maximum diameter was 10.0 mm. Forty-five lesions (77.6%) exhibited various residual skin changes after PDL treatment, including anetoderma (53.5%), telangiectasia and erythema (43.1%), hyperpigmentation (34.5%), redundant skin (3.4%), and fibrofatty tissue (3.4%). Of these, the incidence of anetoderma and fibrofatty tissue were significantly higher in the combined group than in the superficial group ( p = .036 and .033, respectively).
CONCLUSION
Even small lesions, especially combined-type, often result in cosmetic problems after PDL treatment.
Topics: Anetoderma; Child; Disease Progression; Hemangioma; Hemangioma, Capillary; Humans; Infant; Lasers, Dye; Retrospective Studies; Skin Neoplasms; Treatment Outcome
PubMed: 35580249
DOI: 10.1097/DSS.0000000000003491 -
The Australasian Journal of Dermatology Nov 2022
Topics: Humans; Pilomatrixoma; Hair Diseases; Skin Neoplasms; Dermoscopy
PubMed: 36151952
DOI: 10.1111/ajd.13929 -
Annales de Dermatologie Et de... Dec 2018Impairment of dermal elastic tissue occurs in different entities associated with immunoglobulins or immunoglobulin-derived protein-secreting clonal plasma cell... (Review)
Review
INTRODUCTION
Impairment of dermal elastic tissue occurs in different entities associated with immunoglobulins or immunoglobulin-derived protein-secreting clonal plasma cell proliferations, such as amyloid elastosis, anetodermic nodular amyloidosis or monoclonal gammopathy-associated cutis laxa. We report a case of cutaneous immunoglobulinemic amyloidosis revealed by a unique chalazodermic presentation and we review elastic tissue impairment in patients with monoclonal gammopathies.
OBSERVATION
A 67-year-old woman consulted for non-infiltrated anetodermic lesions on the upper left quadrant of her abdomen present for ten years. She also had a chalazodermic plaque with abnormal skin wrinkling and laxity in her right axilla. Biopsies revealed deep dermal and subcutaneous amyloid deposits. Immunohistochemistry with lambda light chain was positive. Orcein staining and electron microscopy showed extensive elastolysis. The patient presented no signs of systemic involvement, but a very small amount of monoclonal IgGλ gammopathy was detected during follow-up.
DISCUSSION
This is a unique chalazodermic presentation of immunoglobulinemic amyloidosis that does not fit into a clearly-defined nosological setting. It highlights the complex interactions between immunoglobulin-derived proteins, including light and heavy chains, and elastic tissue components, leading to different types of impairment of the latter. We therefore suggest the unifying concept of immunoglobulinemic elastopathy, underscoring the need to screen for monoclonal gammopathy in patients presenting elastic tissue impairments.
Topics: Aged; Amyloidosis; Cutis Laxa; Dermis; Elastic Tissue; Female; Humans; Immunoglobulin lambda-Chains; Paraproteinemias
PubMed: 30309631
DOI: 10.1016/j.annder.2018.07.021 -
Clinical Medicine (London, England) Feb 2017A 58-year-old Chinese woman with well controlled type 1 diabetes mellitus presented with acute and progressive bilateral lower limb weakness. Investigations revealed...
A 58-year-old Chinese woman with well controlled type 1 diabetes mellitus presented with acute and progressive bilateral lower limb weakness. Investigations revealed severe hypokalaemia (1.3 mmol/L) and hypophosphataemia (<0.32 mmol/L) with rhabdomyolysis and electrocardiogram changes, without other concurrent biochemical abnormalities. Immediate intravenous and oral potassium and phosphate replacement was initiated with objective improvement in weakness with replenished electrolyte levels. Urine studies confirmed renal potassium wasting. Further history revealed frequent dental caries, xerostomia and recent weight loss. A computerised tomography scan showed atrophy of her salivary glands and a skin lesion biopsied by her GP in the past had been histologically characterised as anetoderma. The constellation of these findings and subsequent positive anti-SSA/SSB levels confirmed her diagnosis of primary Sjögren's syndrome (PSS). PSS has a wide spectrum of renal involvement and should be a differential diagnosis when investigating interstitial nephritis and electrolyte abnormalities, particularly in patients with coexisting autoimmune conditions.
Topics: Electrocardiography; Female; Humans; Hypokalemia; Middle Aged; Potassium; Sjogren's Syndrome
PubMed: 28148578
DOI: 10.7861/clinmedicine.17-1-40 -
Indian Journal of Leprosy Apr 2016Elastophagocytosis is the engulfment of the elastic fibres by the histiocytes, multinucleated giant cells, or both. The cutaneous lesions showing elastophagocytosis are...
Elastophagocytosis is the engulfment of the elastic fibres by the histiocytes, multinucleated giant cells, or both. The cutaneous lesions showing elastophagocytosis are annular elastolytic giant cell granuloma, actinic keratoses, persistent insect-bite reactions, elastosis perforans serpiginosa, foreign body granuloma. Occasionally, it may occur in infectious diseases like leprosy, granulomatous syphilis, North-American blastomycosis, bacterial folliculitis, and cutaneous leishmaniasis. We report a case of lepromatous leprosy with necrotic erythema nodosum leprosum with secondary anetoderma. Histopathology from the atrophic macule of anetoderma revealed periappendageal, perineural infiltration, elastophagocytosis and reduction in elastic fibres.
Topics: Anetoderma; Elastic Tissue; Erythema Nodosum; Histiocytes; Humans; Leprosy, Lepromatous; Male; Middle Aged; Phagocytosis
PubMed: 29757546
DOI: No ID Found -
La Revue de Medecine Interne Sep 2014
Topics: Abortion, Eugenic; Adult; Anetoderma; Antibodies, Anticardiolipin; Anticoagulants; Antiphospholipid Syndrome; Female; Humans; Pregnancy; Pregnancy Complications; Recurrence
PubMed: 24503382
DOI: 10.1016/j.revmed.2014.01.002 -
European Journal of Radiology Sep 2018To describe the radiological characteristics of pilomatricomas on multi-detector computed tomography (MDCT) and magnetic resonance imaging (MRI), and to correlate the...
PURPOSE
To describe the radiological characteristics of pilomatricomas on multi-detector computed tomography (MDCT) and magnetic resonance imaging (MRI), and to correlate the radiological findings and pathological features.
MATERIALS AND METHODS
The radiological findings of 41 pilomatricomas in 31 patients were retrospectively reviewed. The images were evaluated with emphasis on calcifications, reticular and ring-like appearances, enhancement patterns, circular target sign and peritumoral fat stranding, and correlating these with pathological features.
RESULTS
Of the 31 lesions evaluated by MDCT, 25(80.6%) showed different patterns of calcifications which included single in 12(38.7%) lesions and multiple in 13(41.9%) lesions, but peritumoral fat stranding was observed only in 2(6.5%) lesions. MRI scans were performed in 11 patients with 21 lesions, homogeneous and inhomogeneous hypointensities on T1-weighted (T1W) images were showed respectively in 14(66.7%) and 7(33.3%) lesions. On fat-suppressed (FS) T2-weighted (T2W) images, a ring-like hyperintensity was observed in all 21(100%) lesions, reticular hyperintensity, circular target sign, peritumoral fat stranding and secondary anetoderma were seen in 7(33.3%), 4(19%), 4(19%) and 1(4.8%) lesions, respectively; and a significant difference (P < 0.05) was found when comparing the maximum diameter of tumors with (2.3 ± 1.4 mm) and without (1.1 ± 0.3 mm) reticular hyperintensity. On contrast-enhanced T1W images, all 21(100%) lesions were found to have ring-like enhancement and 7(33.3%) of them showed reticular enhancement. The reticular and ring-like appearances on MR images respectively corresponded to the pathological edematous stroma and connective tissue capsule, and the four-layer structures of the circular target sign on FS T2W images also corresponded to pathological calcifications, shadow cells, epithelial cells and connective tissue capsule, respectively.
CONCLUSIONS
The characteristic radiological findings associated with pilomatricomas include different patterns of calcifications on MDCT images and ring-like, reticular appearances and circular target sign on MR images. Radiological findings are well correlated with pathological nature.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Hair Diseases; Humans; Image Enhancement; Magnetic Resonance Imaging; Male; Middle Aged; Multidetector Computed Tomography; Pilomatrixoma; Retrospective Studies; Skin Neoplasms; Young Adult
PubMed: 30150057
DOI: 10.1016/j.ejrad.2018.07.020 -
Anales de Pediatria Feb 2019
Topics: Anetoderma; Child, Preschool; Dermoscopy; Humans; Male; Molluscum Contagiosum
PubMed: 29661638
DOI: 10.1016/j.anpedi.2018.03.007