1/6. Giant cell lichenoid dermatitis within herpes zoster scars in a bone marrow recipient.Cutaneous lesions arising in herpes zoster (HZ) scars are rare. We report a 34-year-old woman with acute lymphoblastic leukemia underwent allogenic bone marrow transplant (BMT). Ten days after the BMT, she developed clusters of vesicles over the right neck, scapula, shoulder and chest. She was treated with intravenous acyclovir and foscarnet. One month after the vesiculous episode of HZ she showed 5 mm to 2 cm clustered flat violaceous lichenoid papules and confluent plaques within the HZ scars. Histopathologic examination revealed a inflammatory infiltrate present in the papillary dermis with granulomatous aggregated formed by histiocytes, multinucleated giant cells and lymphocytes. She was treated with topic steroids with significant improvement. Pathologic findings are similar to those of an unusual lichenoid reaction named "giant cell lichenoid dermatitis". We present the first reported case of giant cell lichenoid dermatitis at the sites of HZ scars.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/6. Mid-dermal elastolysis with inflammation.A 71-year-old white woman had finely wrinkled, erythematous patches of skin that met the clinical and histologic criteria for mid-dermal elastolysis. In addition to the loss of mid-dermal elastin described in previous cases, histopathologic examination revealed a superficial and deep perivascular inflammatory infiltrate of lymphocytes and plasma cells and interstitial collections of multinucleated giant cells containing phagocytized elastin. These results support a previously postulated inflammatory pathogenesis for mid-dermal elastolysis.- - - - - - - - - - ranking = 0.33333333333333keywords = giant (Clic here for more details about this article) |
3/6. Familial histiocytic dermatoarthritis. Histologic and ultrastructural findings in two cases.We report the clinical, histological, and ultrastructural study of two patients, mother and daughter, 32 and six years old, respectively, who presented with dermatitis and arthritis. From the clinical point of view, they appeared to be affected by Familial Histiocytic Dermatoarthritis (FHD), a diagnosis supported by the early age of onset, familial occurrence, and a typical ocular lesion in the mother (glaucoma, uveitis, and cataracts). However, histology revealed the presence of multinucleated giant cells that are usually associated with Multicentric Reticulohistiocytosis (MR). Unlike MR, in the cases here reported the PAS positive, intracytoplasmic material appeared to be glycogen. Electron microscopy disclosed pleomorphic bodies, which have also been described in MR. Thus, we conclude that FHD and MR probably do not represent separate entities, and that a spectrum of disorders exists between these two conditions.- - - - - - - - - - ranking = 0.33333333333333keywords = giant (Clic here for more details about this article) |
4/6. Giant cell lichenoid dermatitis: a possible manifestation of sarcoidosis.Giant cell lichenoid dermatitis is a recently described dermatosis thought to be an unusual lichenoid drug eruption. It is characterized by a generalized, pruritic, papulosquamous eruption sparing palms, soles, face and mucous membranes. Histopathologic findings include areas of epidermal hyperplasia and atrophy with focal vacuolar alteration of the basal layer, exocytosis and cytoid body formation. The dermis contains a band-like, mononuclear cell infiltrate at the dermoepidermal junction with admixed eosinophils, plasma cells and large multinucleate cells. The histologic differential diagnosis includes infectious processes, sarcoidosis, lichen nitidus, lupus erythematosus and lichen planus. We report 3 patients with giant cell lichenoid dermatitis, one of whom was subsequently diagnosed as having sarcoidosis. Because giant cell lichenoid dermatitis may resemble sarcoidosis both clinically and histologically, and because cutaneous sarcoid is often associated with systemic involvement, the diagnosis of sarcoid should be strongly considered in patients with giant cell lichenoid dermatitis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/6. Sarcoidal foreign-body granulomatous dermatitis associated with ophthalmic drops.Sarcoidal granulomas are found in sarcoidosis and in reactions to foreign materials. We report the case of an 81-year-old woman with glaucoma who presented with multiple brown-black asymptomatic papules over the chin and involving nasal mucosa and columella of 1-year duration. biopsy of the nasal mucosa and cutaneous papules showed sarcoidal granulomas associated with brown-black intracellular pigment within multinucleated giant cells. Electron-probe x-ray microanalysis demonstrated high sulfur content. Clinical studies showed no evidence of systemic sarcoidosis. Two of three ophthalmologic drops contained sodium bisulfite; bisulfite is known to cause allergic reactions. Although the exact substance causing the granulomatous reaction is unknown, the distribution of the lesions--nasal mucosa and columella (via the nasal lacrimal duct) and the underlying chin--implicate the eyedrops in the production of the pigmented granulomatous nodules.- - - - - - - - - - ranking = 0.33333333333333keywords = giant (Clic here for more details about this article) |
6/6. blastomycosis. Report of a case with noninvasive, rapid diagnosis of dermal lesions by the Papanicolaou technique.BACKGROUND: blastomycosis is a rare fungal infection that occurs most often in young to middle-aged men. A common route of infection is through continued contact with soil, occurring in such occupations as gardening and construction work. The skin and lungs are primarily affected. When the respiratory system is involved, blastomycosis may be misdiagnosed as pulmonary miliary tuberculosis. CASE: A 54-year-old, African American male presented with dry cough and multiple verrucous skin lesions affecting the face, shoulder and legs. Chest roentgenography indicated bilateral lung involvement. The patient died following a short, difficult hospital course. autopsy revealed verrucous skin lesions with dry, thick, raised margins and central necrosis and umbilication, and severe, diffuse pulmonary involvement clinically and radiologically, resembling miliary tuberculosis. A smear from a leg ulcer stained by the Papanicolaou technique revealed fungi within the giant cells. CONCLUSION: Clinical and radiologic findings alone do not establish the diagnosis of blastomycosis. Respiratory involvement may lead to a misdiagnosis of pulmonary miliary tuberculosis. sputum and bronchial washing examinations by a laboratory technique are in order. This case indicates that cytologic examination of the exudate from an ulcer may result in a strongly suggestive diagnosis.- - - - - - - - - - ranking = 0.33333333333333keywords = giant (Clic here for more details about this article) |