The Australasian journal of dermatology最新文献

{"title":"Successful treatment of calciphylaxis in a renal transplant recipient with combination of intralesional sodium thiosulphate, intravenous sodium thiosulphate and fish skin graft.","authors":"See Wei Tan, Jiunn Wong, Terence Kee, Zi Teng Chai, Quan Yao Ho, Michelle Chan, Khong Yik Chew, Choon Chiat Oh","doi":"10.1111/ajd.13556","DOIUrl":"https://doi.org/10.1111/ajd.13556","url":null,"abstract":"Calciphylaxis is a rare small vessel vasculopathy with high mortality rate of 80%. Sepsis is the leading cause of the mortality. To date, there is still lack of consensus regarding the optimal approach to the treatment of calciphylaxis. We present a 42-year-old lady who developed calciphylaxis 12 years after kidney transplant with preserved graft function and normal mineral levels. Two months before her presentation, she was started on warfarin for upper limb deep vein thrombosis. Her warfarin was stopped. Intralesional (IL) and intravenous (IV) sodium thiosulphate (STS) were started concurrently. She initially showed improvement; however, the recovery was further complicated by wound infection (Figure 1). Culture-directed antibiotics was started, followed by surgical wound debridement. The infection was under controlled, and ulcer progression was arrested. Fish skin graft was transplanted with good uptake (Figure 2). She was able to ambulate again with walking aid at 90 days after surgery. Kidney transplant is a potential treatment for calciphylaxis, but there are reported cases of new-onset calciphylaxis after kidney transplant. This highlights the importance of high clinical suspicion for calciphylaxis in a kidney transplant recipient with preserved graft function. We summarised the case reports of calciphylaxis in kidney transplant recipients with preserved graft function (Table 1). Calciphylaxis that developed within 12 months after kidney transplant was associated with disrupted mineral balance. We identified 6 case reports of calciphylaxis which developed more than 12 months after the kidney transplant and found strong association between warfarin use and calciphylaxis development. Therefore, warfarin should be used judiciously in patients with ESRD. Timely intervention is crucial in the management of calciphylaxis. In our case, the concurrent administration of intravenous and intralesional STS, aggressive wound debridement, and the application of fish skin graft had yielded a good clinical outcome for calciphylaxis. STS enhances the solubility of calcium deposits and restores endothelial cell dysfunction through its antioxidant effect. Numerous studies have supported the use of either intravenous (IV) or intralesional (IL) STS in the treatment of calciphylaxis, but concurrent use of IV and IL STS is uncommon. The distribution of IV STS to the active ulcer is potentially affected by the calcified vessels. IL STS is a highly targeted delivery method to the ulcer bypassing the systemic distribution. We hypothesised IL STS could lead to rapid resolution of the calcium deposits and restoration of the endothelial function. This could potentially increase the subsequent absorption of the IV STS to the affected areas. Surgical debridement with split-skin transplantation has been shown to prevent deep infection and facilitate the ulcer healing. Fish skin graft contains high-concentration omega-3 polyunsaturated fatty acids, eicosapentaenoic acid a","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":" ","pages":"e358-e359"},"PeriodicalIF":2.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ajd.13556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25342185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden colour enhancement of congenital speckled lentiginous naevus after partial resection.","authors":"Honami Nishio-Tatemichi, Emi Sato, Yoshitsugu Shibayama, Kaori Koga, Shinichi Imafuku","doi":"10.1111/ajd.13552","DOIUrl":"https://doi.org/10.1111/ajd.13552","url":null,"abstract":"A 17-year-old girl was referred to our hospital for excision of a congenital pale brown macule with multiple dark brown spots on her left buttock (Fig. 1a). Serial resections were planned, and one-third of the macule was excised along its long axis. Histopathological examination revealed hyperpigmentation and scattered melanocytes in the basal layer without nest formation (Fig. 2a). A diagnosis of speckled lentiginous naevus was established. About 2 months after the first resection, she noticed marked darkening of the entire macule. When she revisited us for additional resection 3 months after the first surgery, the entire macule had become homogeneously black and slightly elevated (Fig. 1b). Dermatoscopy showed starburst-like streaks of pigment around the edge. The whole lesion was completely resected to exclude malignancy. Histopathologically, melanocytic cells were proliferating with forming nests in the basal layer of the epidermis and appendage epithelium. The cells contained large amounts of melanin, and the nuclei were large and uniform (Fig. 2b). There were no malignant findings. We diagnosed the lesion as a recurrent melanocytic naevus occurring on speckled lentiginous naevus. Speckled lentiginous naevus generally refers to a congenital round tan patch containing multiple small dark brown spots. The area of the tan patch contains scattered lentigo-like melanocytes in the basal layer, while dark brown spots are junctional or compound naevi; however, some reports have stated that naevus cells were also present in the tan patch. A recurrent melanocytic naevus is induced by proliferation of remaining melanocytes after partial incomplete resection of a melanocytic naevus. A recurrent naevus has uncommon features such as starburst pattern by dermatoscopy, and the histopathological examination sometimes reveals mild to moderate atypia known as ‘pseudomelanoma’, which make the naevus difficult to differentiate from malignant melanoma. In a recurrent naevus, melanocytes are activated by several growth factors possibly released from fibroblasts and keratinocytes during wound healing. The same phenomenon may have occurred in our case; however, our case is distinctive in that the whole pigmented area, not only the area around the scar, became blackish and formed numerous nests. We speculate that growing nests near the scar can influence the adjacent melanocytes and gradually spread to neighbouring cells, which eventually results in the whole macule turning black. A retrospective study of recurrent pigmentation after resection showed that 61.3% of lesions were recurrent nevi and that 38.8% were melanomas. In our case, malignant melanoma was ruled out because the pigmentation was very homogenous and did not extend beyond the original lesion, no atypical cells were found in the histopathologic examination, and the time to recurrence was short. Our case indicates that the tan patch of a congenital speckled lentiginous naevus can potentially form nests i","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":" ","pages":"e355-e356"},"PeriodicalIF":2.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ajd.13552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25325496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extranodal NK/T cell lymphoma, nasal type, mimicking a bullous pyoderma gangrenosum.","authors":"Sheng-Hsiang Ma, Han-Nan Liu, Yi-Hsin Ho","doi":"10.1111/ajd.13541","DOIUrl":"https://doi.org/10.1111/ajd.13541","url":null,"abstract":"1. Imbern on-Moya A, Sidro M, Malvehy J et al. Negative mapleleaf-like areas: a new clue for basal cell carcinoma margin recognition. Br. J. Dermatol. 2016; 175: 818–20. 2. Rold an-Mar ın R, Leal-Osuna S, Lammoglia-Ordiales L et al. Infundibulocystic basal cell carcinoma: dermoscopic findings and histologic correlation. Dermatol. Pract. Concept. 2014; 4: 51–4. 3. Kawasaki Y, Ansai SI, Fujimoto K et al. A case of infundibulocystic basal cell carcinoma clinically mimicking a melanocytic nevus associated with epidermal cysts. J. Nippon. Med. Sch. 2018; 85: 228–30. 4. Arakawa A, Yatsushiro H, Hasegawa Y et al. Ber-EP4 immunoreactivity in infundibulocystic basal cell carcinoma. J. Dermatol. 2014; 41: 565–7. 5. Minagawa A. Dermoscopy-pathology relationship in seborrheic keratosis. J. Dermatol. 2017; 44: 518–24. doi: 10.1111/ajd.13541","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":" ","pages":"e351-e353"},"PeriodicalIF":2.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ajd.13541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25321750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aplasia cutis congenita with dermal melanocytosis.","authors":"Asmahane Souissi, Imene Ben Lagha, Marouane Mama, Ines Chelly, Slim Haouet, Mourad Mokni","doi":"10.1111/ajd.13505","DOIUrl":"https://doi.org/10.1111/ajd.13505","url":null,"abstract":"Aplasia cutis congenita is a rare disorder in which a localised area of skin is absent at birth. It most commonly affects the scalp. Two types of aplasia cutis congenita are distinguished: nonmembranous and membranous. A 10-year-old girl with no medical history presented with an area of congenital alopecia. On physical examination, a greyish-bluish to brown-coloured alopecic atrophic patch, measuring 40 mm 9 20 mm of diameter, was observed on the vertex. There was no hair collar sign (Fig. 1a). Her parents described the appearance of the lesion at birth, as a roundish erosion covered by a thin transparent membrane that gradually increased in size and turned brown. Trichoscopy showed an alopecic plaque, of a grey-blue colour, brownish at the periphery and white in the centre with some telangiectatic vessels. An absence of follicular openings and a lack of skin appendages were noticed. In the margin, hair bulbs with dark pigmented proximal ends were visible through the translucent epidermis (Fig. 1b). Because of the uneven and irregular pigmentation, a diagnostic biopsy was performed to rule out an unusual melanoma. The patient and the parent consent were obtained. Histopathological examination revealed flattening of the epidermis with loss of the rete ridges and a lack of appendages. Elongated dendritic cells containing melanin granules were scattered in the dermis (Fig. 2a,b). These dermal cells were positive for HMB-45 on immunohistochemical staining, consistent with the presence of melanocytes in the dermis (Fig. 2c). All these findings led to the diagnosis of membranous scalp aplasia cutis congenita associated with dermal melanocytosis. Because of parental pressure for a therapeutic solution, the cicatricial plaque was completely removed. Membranous scalp aplasia cutis congenita presents as a small ovoid defect covered by a thin translucent membrane. The distribution of lesions along the fusion lines and the frequent association with hair collar sign suggest that such lesions may represent a forme fruste of neural tube defect. In our case, it was associated with dermal melanocytosis. This association is very rare. During normal embryonic development, melanoblasts originate from embryonic neural crest cells. After the closure of the neural tube, they migrate from the neural crest and differentiate into melanocytes. Their migration, proliferation and differentiation into melanocytes are dependent on mediators produced by cells of the ectoderm, dorsal neural tube and keratinocytes such as the family of glycoproteins Wnt. Therefore, a preceding ectodermal fusion defect may affect the migration and proliferation of melanoblasts by the activation of Wnt signalling pathway due to the lack of antagonist signalling molecules produced by neighbouring cells. Thus, dermal melanocytes fail to reach the epidermis during migration and persist in the dermis. In addition, the presence of glial cells in the dermis, suggests that the glial tissue containing mela","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":" ","pages":"e335-e336"},"PeriodicalIF":2.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ajd.13505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25334180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatoscopic features of lichen amyloidosis: A case report.","authors":"Natalia A Zapata-Salazar, Valeria F Garza-Dávila, Jorge Ocampo-Candiani, Giuseppe Argenziano, Sonia Chávez-Álvarez","doi":"10.1111/ajd.13554","DOIUrl":"https://doi.org/10.1111/ajd.13554","url":null,"abstract":"1. Torti DC, Brennick JB, Storm CA et al. Spitz nevi arising in speckled lentiginous nevus: clinical, histologic, and molecular evaluation of two cases. Pediatr. Dermatol. 2011; 28: 561–7. 2. Schaffer JV, Orlow SJ, Lazova R et al. Speckled lentiginous nevus: within the spectrum of congenital melanocytic nevi. Arch. Dermatol. 2001; 137: 172–8. 3. Fox JC, Reed JA, Shea CR. The recurrent nevus phenomenon: a history of challenge, controversy, and discovery. Arch. Pathol. Lab. Med. 2011; 135: 842–6. 4. Yoshida Y, Yamada N, Adachi K et al. Traumatized recurrent melanocytic naevus with typical starburst pattern on dermoscopy. Acta Derm. Venereol. 2008; 88: 408–9. 5. Blum A, Hofmann-Wellenhof R, Marghoob AA et al. Recurrent melanocytic nevi and melanomas in dermoscopy: results of a multicenter study of the International Dermoscopy Society. JAMA Dermatol. 2014; 150: 138–45. doi: 10.1111/ajd.13554","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":" ","pages":"e356-e357"},"PeriodicalIF":2.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/ajd.13554","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25348776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spitz naevi misdiagnosed histologically as melanoma: prevalence and clinical profile.","authors":"D. Orchard, J. Dowling, J. Kelly","doi":"10.1097/00008390-199706001-00158","DOIUrl":"https://doi.org/10.1097/00008390-199706001-00158","url":null,"abstract":"A Spitz naevus is a benign melanocytic tumour that may histologically resemble a malignant melanoma. Data was retrospectively gathered from patients who attended the Victorian Melanoma Service to determine the prevalence of Spitz naevi pathologically misdiagnosed as melanoma. Assessment of the clinical characteristics of these patients was also performed and compared to those with correctly diagnosed melanoma. It was found that 6.5% of all melanomas referred were in fact Spitz naevi and that Spitz naevi represented the majority of pathologically misdiagnosed melanomas. The Spitz naevi were more likely to be on the lower extremities and were no average, considerably smaller than the melanomas. Patients with Spitz naevi were more likely to be younger, female, have fewer dysplastic naevi and have brown eyes. One hundred per cent of the Spitz naevi were brought to the attention of the initial doctor by the patient compared to 72% of the melanomas. This study concludes that Spitz naevi that are pathologically misdiagnosed as melanomas retain the clinical characteristics of other Spitz naevi and that greater clinicopathological communication may reduce the frequency of diagnostic error.","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125149261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minocycline is a useful adjuvant therapy for pemphigus.","authors":"Z. Gaspar, V. Walkden, F. Wojnarowska","doi":"10.1016/0926-9959(95)96133-S","DOIUrl":"https://doi.org/10.1016/0926-9959(95)96133-S","url":null,"abstract":"","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1995-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122178090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary cutaneous polypoidal non-stageable melanomas in Queensland.","authors":"G. Beardmore","doi":"10.1097/00006534-197807000-00113","DOIUrl":"https://doi.org/10.1097/00006534-197807000-00113","url":null,"abstract":"","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1978-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133383199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Informed consent.","authors":"D. Letcher","doi":"10.4135/9781483346427.n279","DOIUrl":"https://doi.org/10.4135/9781483346427.n279","url":null,"abstract":"","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117234035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Squamous cell carcinoma.","authors":"B. Bagnall","doi":"10.1016/b978-1-4160-9979-6.00708-x","DOIUrl":"https://doi.org/10.1016/b978-1-4160-9979-6.00708-x","url":null,"abstract":"","PeriodicalId":243138,"journal":{"name":"The Australasian journal of dermatology","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132913090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}