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Journal of the American Academy of... Dec 2001Mycosis fungoides, the most common type of cutaneous T-cell lymphoma, can manifest in a variety of clinical and histologic forms. Presentation with vesiculobullous... (Review)
Review
Mycosis fungoides, the most common type of cutaneous T-cell lymphoma, can manifest in a variety of clinical and histologic forms. Presentation with vesiculobullous lesions is extremely rare. We report the ninth documented case of mycosis fungoides bullosa in which other concomitant autoimmune blistering diseases were ruled out by negative immunofluorescence. All previously reported cases in the world literature since the first in 1887 are reviewed. We recommend the following defining criteria for the disease: (1) clinically apparent vesiculobullous lesions, with or without typical mycosis fungoides lesions (patches, plaques, tumors); (2) typical histologic features of mycosis fungoides (atypical lyphoid cells, epidermotropism, Pautrier's microabscesses) with intraepidermal or subepidermal blisters; (3) negative immunofluorescence (both direct and indirect, if possible) to rule out concomitant autoimmune bullous diseases; (4) negative evaluation for other possible causes of vesiculobullous lesions (eg, medications, bacterial or viral infection, porphyria, phototherapy).
Topics: Aged; Aged, 80 and over; Blister; Humans; Male; Mycosis Fungoides; Skin Neoplasms
PubMed: 11712043
DOI: 10.1067/mjd.2001.117521 -
JOP : Journal of the Pancreas Jul 2010Melioidosis is endemic to tropical regions and, despite the common occurrence of intra-abdominal abscesses, pancreatic involvement in melioidosis has not previously been...
CONTEXT
Melioidosis is endemic to tropical regions and, despite the common occurrence of intra-abdominal abscesses, pancreatic involvement in melioidosis has not previously been reported.
OBJECTIVE
We report our experience with pancreatic melioidosis.
PATIENTS
All 65 patients treated for melioidosis who had computed tomography (CT) scans were identified from prospective databases and were retrospectively reviewed.
MAIN OUTCOME MEASURES
A detailed review of cases with pancreas involvement was carried out.
RESULTS
There were four cases (three males and one female; median age 29.5 years, range: 25-48 years) with pancreatic melioidosis, giving a prevalence of 6.2%. All had predisposing conditions (two had poorly controlled diabetes mellitus and two had thalassemia) for melioidosis. Fever (100%), anorexia (100%), weight loss (100%), rigor (75%) and abdominal pain (75%) were the most common symptoms at presentation and the median duration of symptoms before presentation was six weeks (range: 2-8 weeks). All pancreatic abscesses were detected on CT scan. Multiple foci involvement was common (3 to 6 sites): blood (4 patients), liver (3 patients), psoas muscle (2 patients), spleen (2 patients), infected ascites (2 patients) and lung (1 patient). Pancreatic involvement ranged from multi-focal micro-abscesses to focal large abscesses and involved all parts of the pancreas (body 100%, head 75% and tail 50%). Associated pancreatic findings included splenic vein thrombosis, peripancreatic inflammation and peripancreatic fat streaking. All the pancreatic abscesses were resolved with antibiotics without requiring pancreatic abscess drainage (including one patient who died from disseminated melioidosis).
CONCLUSION
Pancreatic involvement typically occurs as part of multi-organ involvement and commonly manifests as multifoci micro-abscesses. Associated pancreatic abnormalities were also common. All responded to treatment without requiring drainage.
Topics: Adult; Anti-Bacterial Agents; Female; Humans; Male; Melioidosis; Middle Aged; Pancreatic Diseases; Retrospective Studies
PubMed: 20601811
DOI: No ID Found -
Journal of Neuropathology and... May 1989We reviewed 2,107 consecutive autopsies with neuropathologic examination at the Medical Center Hospital of Vermont, and identified 92 cases with significant pathologic... (Review)
Review
We reviewed 2,107 consecutive autopsies with neuropathologic examination at the Medical Center Hospital of Vermont, and identified 92 cases with significant pathologic evidence for infection involving the central nervous system (CNS). Of these, 35 took the form of multiple microabscesses. There were 19 men and 16 women, mean age 56. All patients were chronically ill, usually with an associated impaired immunity. The lung was the most frequent site of primary infection, and sepsis was often present. The most commonly identified causative organisms were Staphylococcus aureus and Candida albicans. Patients with CNS microabscesses developed a progressive encephalopathy associated with waxing and waning signs and symptoms. Laboratory and neuroradiologic studies were not helpful in elucidating the problem. We conclude that multiple microabscesses are a frequent, usually unrecognized, manifestation of CNS infection, and should be considered in the differential diagnosis of encephalopathy in hospitalized patients with chronic disease, immunosuppression and sepsis.
Topics: Adult; Brain; Brain Abscess; Candidiasis; Diabetes Complications; Female; Humans; Immunologic Deficiency Syndromes; Lung Diseases; Male; Sepsis; Staphylococcal Infections
PubMed: 2649643
DOI: 10.1097/00005072-198905000-00006 -
Clinics in Dermatology 2011
Topics: History, 19th Century; History, 20th Century; Humans; Poland; Psoriasis
PubMed: 21146741
DOI: 10.1016/j.clindermatol.2010.09.003 -
International Journal of Dermatology Nov 1987Clinical, histologic, and immunofluorescence studies were performed in 15 patients with pemphigus herpetiformis. The initial diagnosis was dermatitis herpetiformis, IgA...
Clinical, histologic, and immunofluorescence studies were performed in 15 patients with pemphigus herpetiformis. The initial diagnosis was dermatitis herpetiformis, IgA linear bullous dermatosis or bullous pemphigoid. The histology varied depending on the character of skin lesions, and showed eosinophilic spongiosis or slight acantholysis and/or polymorphonuclear papillary microabscesses. Direct immunofluorescence showed invariably intercellular IgG staining, and indirect immunofluorescence on monkey esophagus substrate was positive, at some periods, in five cases. About half of the patients responded to therapy with sulfones and prednisone, and only one patient responded to sulfones alone. Half of the patients required combined therapy with prednisone and cyclophosphamide or with higher doses of prednisone. In consecutive relapses, nine patients retained the pattern of pemphigus herpetiformis: in the others, lesions were mostly of pemphigus seborrheicus-foliaceus type.
Topics: Aged; Aged, 80 and over; Dermatitis Herpetiformis; Female; Fluorescent Antibody Technique; Humans; Male; Middle Aged; Pemphigus
PubMed: 3327840
DOI: 10.1111/j.1365-4362.1987.tb02308.x -
Australasian Radiology Nov 1989CT findings in 5 patients with melioidosis were presented. Lungs lesions consisted of upper lobe infiltration with a small thin-walled cavity in 2 cases and lower lobe...
CT findings in 5 patients with melioidosis were presented. Lungs lesions consisted of upper lobe infiltration with a small thin-walled cavity in 2 cases and lower lobe consolidation without cavity in another case. Pleural lesions may be seen as a small pleural nodule, effusion with associated lung lesion, hydropneumothorax as a complication or the end stage fibrothorax due to chronic empyema thoracis. In one case hepatosplenic microabscesses were observed.
Topics: Adult; Humans; Lung Diseases; Male; Melioidosis; Middle Aged; Pleural Diseases; Tomography, X-Ray Computed
PubMed: 2633740
DOI: 10.1111/j.1440-1673.1989.tb03316.x -
Sexually Transmitted Diseases 1978In an otherwise typical case of palmoplantar secondary syphilis, large intact pustules were also present. Spirochetes were demonstrated in these lesions by darkfield...
In an otherwise typical case of palmoplantar secondary syphilis, large intact pustules were also present. Spirochetes were demonstrated in these lesions by darkfield microscopy. The distinctive pathologic finding in the pustular lesions was migration of polymorphonuclear leukocytes into the epidermis, with formation of microabscesses. This pattern is the same as that seen in "framboesiform" secondary syphilis and in yaws.
Topics: Ankle; Female; Humans; Middle Aged; Skin; Syphilis, Cutaneous
PubMed: 725703
DOI: 10.1097/00007435-197807000-00007 -
Annals of Dermatology May 2010Lymphomatoid keratosis (LK) is considered to be a rare variant of cutaneous lymphoid hyperplasia, with epidermotropism. We herein report a case of LK which developed on...
Lymphomatoid keratosis (LK) is considered to be a rare variant of cutaneous lymphoid hyperplasia, with epidermotropism. We herein report a case of LK which developed on the abdomen of an elderly Korean woman. A 60-year-old woman presented with a 10-year history of a pruritic, solitary, brown to black plaque on the abdomen. Histopathologically, the specimen showed hyperkeratosis, parakeratosis, acanthosis and Pautrier's micro-abscess in the epidermis, and a lichenoid infiltration of lymphocytes in the dermis, which expressed both B cell and T cell lineage on the immune-histochemical staining. Based on these clinical and histopathological findings, our case was diagnosed as LK. To our knowledge, this is the first case report of LK in the Korean dermatologic literature.
PubMed: 20548920
DOI: 10.5021/ad.2010.22.2.219 -
Human Pathology Dec 1986Seven cases of listeriosis identified at perinatal autopsy are described. The cases occurred during the time of a 1985 Los Angeles, California, epidemic of listeriosis...
Seven cases of listeriosis identified at perinatal autopsy are described. The cases occurred during the time of a 1985 Los Angeles, California, epidemic of listeriosis from suspected food contamination by Listeria monocytogenes. In only one of seven cases were gross pathologic lesions encountered. Microscopic lesions in six cases consisted of rare, localized microabscesses or granuloma-like lesions in multiple organs and contained histiocytes, monocytes, lymphocytes, and polymorphonuclear leukocytes with variable necrosis. One case had no gross or microscopic findings. Organomegaly was uncommon. The diagnosis was confirmed in three cases by postmortem blood culture. Complete perinatal autopsy is important for confirmation of listeriosis when microbiologic, gross, or microscopic findings alone may not yield characteristic features.
Topics: California; Disease Outbreaks; Female; Humans; Infant, Newborn; Listeriosis; Liver; Lung; Placenta; Pregnancy; Pregnancy Complications, Infectious
PubMed: 3793087
DOI: 10.1016/s0046-8177(86)80572-x -
The British Journal of Dermatology Jul 2003A 35-year-old woman with severe fistulizing Crohn's disease presented with pyostomatitis vegetans affecting both the mouth and the vulva. The coalescing pustules... (Review)
Review
A 35-year-old woman with severe fistulizing Crohn's disease presented with pyostomatitis vegetans affecting both the mouth and the vulva. The coalescing pustules transformed within several days into vegetating lesions on areas of inflammation. Microbial assessments revealed no pathogenic agent. Histology showed neutrophilic microabscesses, but no granulomas. Three injections of infliximab and maintenance therapy with methotrexate resulted in rapid and complete regression of both the pyostomatitis vegetans and the Crohn's disease. Infliximab and methotrexate may be a promising treatment for the rare cases of pyostomatitis vegetans associated with Crohn's disease.
Topics: Adult; Antibodies, Monoclonal; Crohn Disease; Drug Therapy, Combination; Female; Gastrointestinal Agents; Humans; Immunosuppressive Agents; Infliximab; Methotrexate; Mouth Mucosa; Stomatitis; Vulvitis
PubMed: 12890215
DOI: 10.1046/j.1365-2133.2003.05385.x