弥散性面外酒渣鼻伴丘疹性坏死病变。

Toshio Demitsu, Rieko Tsukahara, Naoka Umemoto, Satoshi Nakamura, Kazutaka Nagashima, Tomoko Yamada, Maki Kakurai, Yoshiaki Tanaka, Akihiro Kakehashi, Toshiko Miyata
{"title":"弥散性面外酒渣鼻伴丘疹性坏死病变。","authors":"Toshio Demitsu,&nbsp;Rieko Tsukahara,&nbsp;Naoka Umemoto,&nbsp;Satoshi Nakamura,&nbsp;Kazutaka Nagashima,&nbsp;Tomoko Yamada,&nbsp;Maki Kakurai,&nbsp;Yoshiaki Tanaka,&nbsp;Akihiro Kakehashi,&nbsp;Toshiko Miyata","doi":"10.3315/jdcr.2016.1236","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Rosacea is a common skin disease and predominantly affects on the face of middle-aged women. It exceptionally occurs on the extrafacial areas such as ear, neck, axilla, and upper extremities, and has been reported as disseminated rosacea.</p><p><strong>Main observation: </strong>A 40-year-old Japanese female presented with one-month history of erythematous skin eruption with burning sensation on the face, neck, and upper limbs. Physical examination showed rosacea-like eruption on the face as well as multiple papules disseminated on the neck, forearms, and hands. These extrafacial lesions demonstrated papulonecrotic appearance. Bilateral conjunctiva showed marked hyperemic which was consistent with ocular rosacea. Corneal opacity was also seen. Histology of the umbilicated papule on the neck revealed necrobiotic granulomas around the hair follicle with transepidermal elimination. Another tiny solid papule on the forearm suggesting early lesion also demonstrated necrobiosis with palisading granuloma but no transepidermal elimination. Systemic administration of minocycline and topical tacrolimus therapy promptly improved the skin lesions. Topical application of fluorometholone in temporary addition with levofloxacin improved ocular involvement 12 weeks after her 1st visit. The clinical course of the skin lesion and ocular symptoms mostly correlated. Then, the skin lesion and ocular symptoms often relapsed. Rosacea uncommonly associates with the extrafacial involvement as disseminated rosacea. The present case is characterized by the disseminated papulonecrotic lesions of the extrafacial areas histologically showing transepidermal elimination of necrobiotic granulomas.</p><p><strong>Conclusions: </strong>Dermatologists should recognize that papulonecrotic lesions of the neck and upper extremities might be extrafacial rosacea when the patient has rosacea on the face.</p>","PeriodicalId":15601,"journal":{"name":"Journal of dermatological case reports","volume":"10 4","pages":"68-72"},"PeriodicalIF":0.0000,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392247/pdf/jdcr-10-068.pdf","citationCount":"4","resultStr":"{\"title\":\"Disseminated extrafacial rosacea with papulonecrotic lesions.\",\"authors\":\"Toshio Demitsu,&nbsp;Rieko Tsukahara,&nbsp;Naoka Umemoto,&nbsp;Satoshi Nakamura,&nbsp;Kazutaka Nagashima,&nbsp;Tomoko Yamada,&nbsp;Maki Kakurai,&nbsp;Yoshiaki Tanaka,&nbsp;Akihiro Kakehashi,&nbsp;Toshiko Miyata\",\"doi\":\"10.3315/jdcr.2016.1236\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Rosacea is a common skin disease and predominantly affects on the face of middle-aged women. It exceptionally occurs on the extrafacial areas such as ear, neck, axilla, and upper extremities, and has been reported as disseminated rosacea.</p><p><strong>Main observation: </strong>A 40-year-old Japanese female presented with one-month history of erythematous skin eruption with burning sensation on the face, neck, and upper limbs. Physical examination showed rosacea-like eruption on the face as well as multiple papules disseminated on the neck, forearms, and hands. These extrafacial lesions demonstrated papulonecrotic appearance. Bilateral conjunctiva showed marked hyperemic which was consistent with ocular rosacea. Corneal opacity was also seen. Histology of the umbilicated papule on the neck revealed necrobiotic granulomas around the hair follicle with transepidermal elimination. Another tiny solid papule on the forearm suggesting early lesion also demonstrated necrobiosis with palisading granuloma but no transepidermal elimination. Systemic administration of minocycline and topical tacrolimus therapy promptly improved the skin lesions. Topical application of fluorometholone in temporary addition with levofloxacin improved ocular involvement 12 weeks after her 1st visit. The clinical course of the skin lesion and ocular symptoms mostly correlated. Then, the skin lesion and ocular symptoms often relapsed. Rosacea uncommonly associates with the extrafacial involvement as disseminated rosacea. The present case is characterized by the disseminated papulonecrotic lesions of the extrafacial areas histologically showing transepidermal elimination of necrobiotic granulomas.</p><p><strong>Conclusions: </strong>Dermatologists should recognize that papulonecrotic lesions of the neck and upper extremities might be extrafacial rosacea when the patient has rosacea on the face.</p>\",\"PeriodicalId\":15601,\"journal\":{\"name\":\"Journal of dermatological case reports\",\"volume\":\"10 4\",\"pages\":\"68-72\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-12-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392247/pdf/jdcr-10-068.pdf\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of dermatological case reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3315/jdcr.2016.1236\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of dermatological case reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3315/jdcr.2016.1236","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 4

摘要

背景:酒渣鼻是一种常见的皮肤病,主要影响中年妇女的面部。它特别发生在面外区域,如耳朵、颈部、腋窝和上肢,并被报道为弥散性酒渣鼻。主要观察:日本女性,40岁,面部、颈部、上肢出现皮肤红斑疹1个月,伴有烧灼感。体格检查显示面部酒渣鼻样疹,颈部、前臂和手部弥散有多发丘疹。这些面外病变表现为丘疹坏死。双侧结膜明显充血,符合眼红斑痤疮。可见角膜混浊。颈部脐状丘疹的组织学显示毛囊周围的坏死性肉芽肿,经皮清除。前臂另一细小实性丘疹提示早期病变也表现为坏死性肉芽肿伴栅栏状肉芽肿,但未经皮清除。全身给予米诺环素和局部他克莫司治疗迅速改善皮肤病变。局部应用氟美洛酮并临时加用左氧氟沙星可改善患者首次就诊后12周的眼部受累情况。皮肤病变的临床病程与眼部症状多相关。然后,皮肤病变和眼部症状常复发。酒渣鼻通常伴有面外受累,如弥散性酒渣鼻。本病例的特点是弥散性丘疹性坏死性肉芽肿的面外区域的组织学表现为经皮消除坏死肉芽肿。结论:皮肤科医生应认识到颈部和上肢丘疹坏死病变可能是面外酒渣鼻,当病人有酒渣鼻在脸上。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Disseminated extrafacial rosacea with papulonecrotic lesions.

Disseminated extrafacial rosacea with papulonecrotic lesions.

Disseminated extrafacial rosacea with papulonecrotic lesions.

Disseminated extrafacial rosacea with papulonecrotic lesions.

Background: Rosacea is a common skin disease and predominantly affects on the face of middle-aged women. It exceptionally occurs on the extrafacial areas such as ear, neck, axilla, and upper extremities, and has been reported as disseminated rosacea.

Main observation: A 40-year-old Japanese female presented with one-month history of erythematous skin eruption with burning sensation on the face, neck, and upper limbs. Physical examination showed rosacea-like eruption on the face as well as multiple papules disseminated on the neck, forearms, and hands. These extrafacial lesions demonstrated papulonecrotic appearance. Bilateral conjunctiva showed marked hyperemic which was consistent with ocular rosacea. Corneal opacity was also seen. Histology of the umbilicated papule on the neck revealed necrobiotic granulomas around the hair follicle with transepidermal elimination. Another tiny solid papule on the forearm suggesting early lesion also demonstrated necrobiosis with palisading granuloma but no transepidermal elimination. Systemic administration of minocycline and topical tacrolimus therapy promptly improved the skin lesions. Topical application of fluorometholone in temporary addition with levofloxacin improved ocular involvement 12 weeks after her 1st visit. The clinical course of the skin lesion and ocular symptoms mostly correlated. Then, the skin lesion and ocular symptoms often relapsed. Rosacea uncommonly associates with the extrafacial involvement as disseminated rosacea. The present case is characterized by the disseminated papulonecrotic lesions of the extrafacial areas histologically showing transepidermal elimination of necrobiotic granulomas.

Conclusions: Dermatologists should recognize that papulonecrotic lesions of the neck and upper extremities might be extrafacial rosacea when the patient has rosacea on the face.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信