Case Reports in Dermatology最新文献

{"title":"Ecthyma Gangrenosum of Fungal Origin: A Case Report.","authors":"Germán Andrés León-Sánchez, Heiler Lozada-Ramos, Jorge Enrique Daza-Arana, Andrés Darío Restrepo-Becerra, Ruben Varela-Miranda","doi":"10.1159/000542105","DOIUrl":"10.1159/000542105","url":null,"abstract":"<p><strong>Introduction: </strong>Ecthyma gangrenosum (EG) is usually a dermatologic manifestation of a <i>Pseudomonas aeruginosa</i> infection in an immunocompromised individual but may sometimes be caused by other bacteria or fungi in an immunocompromised or non-immunocompromised individual.</p><p><strong>Case presentation: </strong>A 75-year-old woman with a history of high blood pressure and sequels of ischemic cerebral infarction presented with a 5-day history of general malaise, cough with yellow sputum, and respiratory distress. The patient had pale mucous membranes, temperature of 38.5°C, tachycardia, normal blood pressure, SaO₂ of 85%, intercostal retractions, and severe bronchospasm upon hospital admission. No skin lesions were seen. The patient was admitted to the intensive care unit (ICU) because of her critical condition and was supported with invasive mechanical ventilation. Her blood count showed 8,100 leukocytes/mm³, neutrophils 79%, hemoglobin 10.1 g/dL, creatinine 1.1 mg/dL, and C-reactive protein 328 mg/dL. Arterial blood gases showed metabolic acidosis and moderate hypoxemia. The initial report of blood and urine cultures was negative for bacteria, and positive for influenza A H1N1. The patient was treated with oseltamivir and intravenous methylprednisolone for acute respiratory distress syndrome associated with the viral infection that occurred. Subsequently, violaceus macular and papular lesions appeared, which evolved into ulcerated lesions with erythematous border and necrotic center were seen in the anterior region of the chest and abdomen, from where <i>Candida metapsilosis</i> was isolated. EG was reported in this patient, who was also immunocompromised because of steroid use, had a prolonged stay in the ICU and received broad-spectrum antibiotics. Fungemia and urinary infection due to different fungi were also found.</p><p><strong>Conclusion: </strong>It is worth mentioning that EG can be caused by germs other than <i>P. aeruginosa</i> and fungal infections should not be ruled out.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"240-247"},"PeriodicalIF":0.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keratoderma-Like T-Cell Dyscrasia: A Case Report.","authors":"Asem Shadid, Sukaina Al Haddad, Rua'a Alharithy, Tariq J Al-Zaid","doi":"10.1159/000541258","DOIUrl":"10.1159/000541258","url":null,"abstract":"<p><strong>Introduction: </strong>Cutaneous T-cell dyscrasia (CTCD) encompasses a heterogeneous group of T-cell infiltrates, often clonal and epitheliotropic. While the etiology remains unclear, certain medications, including statins, have been linked to cutaneous T-cell lymphocytic infiltrate development.</p><p><strong>Case description: </strong>A patient presented with a pruritic, scaly eruption on her palms and soles unresponsive to topical steroids for 1 month. Histopathological examination revealed compact orthokeratosis, mild lymphocytic infiltrate with focal exocytosis, and atypical lymphocytes. Immunophenotyping demonstrated a predominance of CD3+ T cells with a 1:1 CD4/CD8 ratio and reduced CD7 expression. The clinical presentation, histopathology, and immunophenotype supported a diagnosis of statin-induced CTCD.</p><p><strong>Conclusion: </strong>Statin discontinuation led to complete symptom resolution, emphasizing the reversibility of drug-induced T-cell dyscrasia. This case highlights the importance of a detailed medication history as drug-induced T-cell dyscrasia, unlike classic CTCD with its characteristic lymphoid atypia, phenotypic abnormalities, and clonality leading to a refractory course, can be reversed by drug withdrawal.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"234-239"},"PeriodicalIF":0.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11509488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syringotropic Lichen Planus: An Unusual Presentation of a Common Dermatosis - A Report of 2 Cases.","authors":"Fatemeh Mohaghegh, Zohre Khodashenas, Mina Saber, Haniyeh Sohrabi","doi":"10.1159/000541695","DOIUrl":"https://doi.org/10.1159/000541695","url":null,"abstract":"<p><strong>Introduction: </strong>Lichen planus (LP) is a chronic inflammatory dermatosis that causes plaques and itchy papules on the skin, as well as erosion and ulcers in the mucous membranes. LP is characterized by a dense dermal T-cell infiltration. Perieccrine inflammation can be seen in a variety of dermatoses, but genuine lymphocyte permeation of the secretory coil or lymphocytic syringotropism is a rare sign that is typically seen in mycosis fungoides.</p><p><strong>Case presentation: </strong>In this study, we present 2 uncommon instances of lymphocytic syringotropism in LP. Histopathological examination revealed dense T-cell infiltration and lymphocytic involvement of eccrine glands, confirming syringotropism.</p><p><strong>Conclusion: </strong>Lymphocytic syringotropism is an uncommon finding in LP. Its presence broadens the histopathological spectrum of LP and highlights the need to differentiate it from lymphoproliferative disorders like mycosis fungoides.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"226-233"},"PeriodicalIF":0.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11501101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DRESS Syndrome That Resembles Graft-Versus-Host Disease after Chemotherapy in a Pediatric Patient: A Case Report.","authors":"Marian Rolón, Mateo Barros, Clara Ortiz, Sergio Danilo Cruz Romero, Johanna Álvarez","doi":"10.1159/000541046","DOIUrl":"https://doi.org/10.1159/000541046","url":null,"abstract":"<p><strong>Introduction: </strong>Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, drug-induced adverse reaction characterized by skin eruptions, lymphadenopathy, fever, and a broad range of other bodily manifestations. The spectrum of histopathologic and clinical presentations is wide; therefore, DRESS syndrome can mimic other diseases.</p><p><strong>Case presentation: </strong>We present a case of a 4-year-old male patient who started chemotherapy with vincristine, cytarabine, and etoposide. The first clinical signs were fever, hemodynamic in-stability, and maculopapular erythema. Biopsies of skin lesions were taken, and hyperkeratosis, focal parakeratosis, acanthosis with slight spongiosis, and intraepithelial dyskeratotic cells were observed. There was a perivascular lymphoid infiltrate with abundant eosinophils in the dermis, and eosinophil permeations to the acrosyringium and epithelium were found.</p><p><strong>Conclusion: </strong>DRESS syndrome is a drug-induced reaction that shares histopathological findings in skin biopsies with those seen in graft-versus-host disease. Although the histological findings are non-pathognomonic, they were characteristic enough to be of importance in the differential diagnosis.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"221-225"},"PeriodicalIF":0.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Nodulocystic Acne Induced by Mercury-Containing Skin-Whitening Cream: A Case Report and Call for Public Awareness.","authors":"Sami Alsuwaidan, Khalid Nabil Nagshabandi, Abdulmajeed Alajlan","doi":"10.1159/000541141","DOIUrl":"https://doi.org/10.1159/000541141","url":null,"abstract":"<p><strong>Introduction: </strong>Skin-whitening products, often containing mercury, are used worldwide for cosmetic purposes but pose significant health risks. Mercury, a melanotoxin, can cause severe dermatological, renal, and neurological complications.</p><p><strong>Case presentation: </strong>We report the case of a 27-year-old woman who developed severe nodulocystic acne due to chronic use of a mercury-containing skin-whitening cream. Treatment with isotretinoin and prednisolone led to significant improvement within 3 months.</p><p><strong>Conclusion: </strong>This case underscores the need for public awareness and stricter regulatory actions to prevent mercury-related health hazards from skin-whitening products.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"216-220"},"PeriodicalIF":0.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of a Complex Case of Scleromyxedema Using a Novel Intravenous Immunoglobulin Preparation.","authors":"Anastasia Sophie Vollmer, Nadine Wiedenmayer, Julia K Winkler, Alexander H Enk","doi":"10.1159/000540519","DOIUrl":"https://doi.org/10.1159/000540519","url":null,"abstract":"<p><strong>Introduction: </strong>We provide a case report on a patient with scleromyxedema treated with high-dose intravenous immunoglobulins (IVIgs) who reported less fatigue and fewer headaches after transitioning to Yimmugo, a novel IVIg preparation. Scleromyxedema is a rare and chronic cutaneous mucinosis, frequently associated with monoclonal gammopathy and systemic complications, which may be life-threatening. The disease is characterized by papular eruptions and sclerosis of the skin. Treatment of scleromyxedema is challenging because of its unclear pathogenesis. High-dose IVIgs are a promising treatment option to improve cutaneous manifestations.</p><p><strong>Case presentation: </strong>We present the case of a 57-year-old patient with scleromyxedema and monoclonal gammopathy with end-stage renal failure on hemodialysis (3 times a week). Stabilization of skin symptoms was finally achieved by high-dose IVIg therapy administered at 2 g per kg bodyweight distributed over 2 days every 3 weeks. However, disease stabilization came at the expense of flu-like side effects that significantly affected daily life. After transitioning to Yimmugo^®, the patient reported an improved quality of life.</p><p><strong>Conclusion: </strong>Further follow-up is essential to conclusively evaluate effectiveness and tolerability of this novel IVIg preparation.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"210-215"},"PeriodicalIF":0.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Spontaneous Subcutaneous Abscess Formation due to <i>Finegoldia magna</i> in a Diabetic Patient: A Case Report.","authors":"Toshiyuki Sato, Mayuka Tomita, Atsuhiro Kohno, Satomi Chujo, Yuma Waki, Yoshimasa Nobeyama, Masaaki Kawase, Akihiko Asahina","doi":"10.1159/000540636","DOIUrl":"https://doi.org/10.1159/000540636","url":null,"abstract":"<p><strong>Introduction: </strong><i>Finegoldia magna</i> is a member of the Gram-positive anaerobic cocci group and constitutes the flora of the skin and other parts of the body. It sometimes colonizes diabetic foot and rarely infects skin or soft tissue of non-immunocompromised patients.</p><p><strong>Case presentation: </strong>Here, we report the case of a severe subcutaneous abscess on the back caused by <i>F</i>. <i>magna</i> involving an immunocompromised patient with poorly controlled diabetes. A 48-year-old woman with diabetes mellitus and anemia associated with uterine fibroids was referred to us with a 1-month history of a skin manifestation on her back, with a body temperature of 35.9°C and blood pressure of 115/73 mm Hg. The manifestation involved a subcutaneous mass of 36 × 45 cm with a foul odor, partly covered with necrotic tissue, which had the appearance of a tortoiseshell-like pattern. Blood examination revealed C-reactive protein of 21.4 mg/dL and hemoglobin A1c of 9.1%. Contrast-enhanced computed tomography showed a subcutaneous abscess with internal emphysema. Emergency debridement was performed, resulting in drainage of foul-smelling gray-green pus. <i>F</i>. <i>magna</i> was detected in the pus and skin tissue.</p><p><strong>Conclusion: </strong>Skin and soft tissue infectious disease caused by <i>F</i>. <i>magna</i> is extremely rare, but the disease tends to become severe once developing in an immunocompromised patient, such as a patient with poorly controlled diabetes. Therefore, physicians should consider <i>F</i>. <i>magna</i> as a causative agent when poorly controlled diabetic patients suffer from severe infectious cutaneous manifestations.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"202-209"},"PeriodicalIF":0.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Case of Eruptive Pyogenic Granuloma following COVID-19 Vaccination.","authors":"Saman Al-Zahawi, Alireza Ghanadan, Fatema Saberi, Kamran Balighi, Zahra Razavi","doi":"10.1159/000539849","DOIUrl":"10.1159/000539849","url":null,"abstract":"<p><strong>Introduction: </strong>Pyogenic granuloma presents clinically as a rapidly growing, friable, red papule of skin or mucosa, commonly measuring less than 10 mm with frequent bleeding due to ulceration. Angioproliferative diseases including pyogenic granuloma and cherry angioma have been reported during COVID-19 infection or following COVID-19 vaccination.</p><p><strong>Case presentation: </strong>Here, we report a 52-year-old female patient who developed diffuse skin eruptions 3 weeks after the second dose of COVID-19 vaccination.</p><p><strong>Conclusion: </strong>As per our knowledge, this is the first case of eruptive PG following COVID-19 vaccination. Oral propranolol and PDL laser therapy were administered after obtaining inconvenient results from electro-cautery, and there was a good response within 6 weeks of starting therapy, defined by the cessation of new lesion formation and a decrease in the size of large lesions.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"190-197"},"PeriodicalIF":0.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Challenging Case of Reactive Angioendotheliomatosis.","authors":"Georgios Kravvas, Lola Meghoma, Victoria Vilenchik, Jon Oxley, Daniel J Keith","doi":"10.1159/000539775","DOIUrl":"10.1159/000539775","url":null,"abstract":"<p><strong>Introduction: </strong>Reactive angioendotheliomatosis (RAE) is a rare, benign, angioproliferative disorder with poorly understood aetiopathogenesis. It is characterised by vascular occlusion that occurs in patients with coexistent systemic or autoimmune disease.</p><p><strong>Case presentation: </strong>A 60-year-old female presented with an 8-week history of a painful, non-healing, and non-traumatic ulcer on the left thigh. Her past medical history included smoking, peripheral vascular disease (PVD) and previously treated rectal squamous cell carcinoma. The diagnosis of pyoderma gangrenosum with superimposed cellulitis was considered and treatment with oral antibiotics was initiated. Following failure to improve, a biopsy was undertaken leading to the diagnosis of RAE. The patient was referred for urgent consideration of surgical correction of PVD, but was deemed unsuitable for surgical treatment due to a poor performance status. The patient was treated with conservative measures, but her condition rapidly deteriorated and she passed away a few weeks later.</p><p><strong>Conclusion: </strong>RAE is notorious for mimicking a wide spectrum of diseases. It is an important differential diagnosis to consider in patients with non-healing ulceration and underlying systemic or autoimmune disorders. Our case raises awareness of this rare condition and the mortality that it carries if left untreated. In an attempt to reverse disease progression and mortality, we urge clinicians to attempt surgical correction of PVD even when faced with multiple comorbidities and poor performance status.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"186-189"},"PeriodicalIF":0.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multisystem Langerhans Cell Histiocytosis following Treatment of Initially Presumed Atopic Dermatitis with Dupilumab: A Case Report of an Extremely Confusing Scenario.","authors":"Wenhao Cheng, Hong Ren, Wenlong Hu","doi":"10.1159/000539704","DOIUrl":"10.1159/000539704","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) is a common chronic, recurrent, and non-infectious inflammatory skin disease. Dupilumab is a human monoclonal antibody with clinical efficacy in severe AD and has a good safety profile.</p><p><strong>Case presentation: </strong>We hereby describe a previously unreported case of multisystem Langerhans cell histiocytosis (MS-LCH) that is associated with a history of AD treatment using dupilumab.</p><p><strong>Conclusion: </strong>A single case of MS-LCH with a history of dupilumab treatment for AD was described for the first time. This case highlights that given its susceptibility to skin involvement, LCH needs to be considered as a differential diagnosis for skin lesions that are not improved by established therapies.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"16 1","pages":"181-185"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}