1/54. Embolia cutis medicamentosa of the foot after sclerotherapy.Typically, embolia cutis medicamentosa is reported after intramuscular injections of drugs. We describe a case of embolia cutis medicamentosa after sclerotherapy of intracutaneous veins of the foot with a polidocanol solution of 1%. Under therapy with intravenous alprostadil, pentoxifyllin, internal steroids and anticoagulation with heparin, the lesions healed completely without necrosis.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
2/54. Mucha-Habermann disease-like eruptions due to tegafur.The first case of Mucha-Habermann disease-like drug eruptions due to tegafur is reported. A 59-year-old man noticed various skin lesions after he had taken 300 mg of tegafur daily for about 200 days. The patient had papulonecrotic eruptions on his trunk and extremities. The histology from a papular lesion revealed epidermal necrosis surrounded by spongiosis, perivascular inflammatory infiltrations composed of lymphocytes and erythrocytes, and endothelial swelling. The etiology of Mucha-Habermann disease is not known, but an immune mechanism may be supported by our case.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
3/54. Necrotizing vasculitis of the skin and uterine cervix associated with minocycline therapy for acne vulgaris.In recent years, minocycline has become a commonly used agent for the treatment of acne vulgaris and rosacea. With this increased use have come reports of severe and in some cases life-threatening toxicity, often occurring in otherwise healthy young women after prolonged courses of minocycline. These adverse reactions include hepatotoxicity, drug-induced lupus erythematosus, eosinophilic pneumonitis, and hypersensitivity syndrome. We describe a 35-year-old woman who had necrotizing vasculitis of the skin and uterine cervix after 2 years of minocycline therapy for acne vulgaris. Skin and cervical biopsies revealed acute inflammation involving through-and-through necrosis of vessel walls with thrombosis, focal fibrinoid change, and a perivascular lymphohistiocytic infiltrate. The disease fully resolved within 3 months of discontinuance of the minocycline therapy. patients should be informed of these rare but potentially serious adverse effects before the initiation of minocycline therapy. Early recognition of these complications can result in complete resolution.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
4/54. Graft-versus-host disease-like immunophenotype and apoptotic keratinocyte death in paraneoplastic pemphigus.Paraneoplastic pemphigus (PP) is an autoimmune disease, which is frequently associated with non-Hodgkin's lymphoma. autoantibodies against components of the cytoplasmic plaque of epithelial desmosomes are usually present in the sera and are believed to play a major pathogenic part in acantholysis and suprabasal epidermal blistering. However, another typical histological feature of PP, interface dermatitis with keratinocyte dyskeratosis, is shared with skin diseases that involve epithelial damage mediated by T cells. Here, we present the detailed characterization of the cutaneous T-cell response in a patient with PP and demonstrate a selective epidermal accumulation of activated CD8 T cells together with an increased local production of interferon-gamma and tumour necrosis factor-alpha, and a strong expression of HLA-DR and ICAM-1 on keratinocytes. apoptosis was identified as a key mechanism of keratinocyte death, and appeared independent of the FAS/FAS ligand (FAS-L) pathway, as epidermal expression of FAS was not increased compared with normal skin, and FAS-L was undetectable on the protein and mRNA level. Triple therapy with high-dose corticosteroids, cyclophosphamide and intravenous immunoglobulins reduced levels of pemphigus-like autoantibodies and reversed the cutaneous inflammatory reaction leading to long-standing clinical remission. Our findings support the concept of a major contribution of cytotoxic T lymphocytes to the immunopathology of paraneoplastic pemphigus.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
5/54. heparin-induced skin necrosis and low molecular weight heparins.heparin-induced skin necrosis is a rare but potentially devastating side-effect of low molecular weight heparins. These agents are widely used in surgical practice and doctors prescribing them should be aware of the condition, as failure to recognise it may increase morbidity. An unusually severe case is presented with a review of the literature.- - - - - - - - - - ranking = 5keywords = necrosis (Clic here for more details about this article) |
6/54. Drug induced blistering and the plastic surgeon: a case of amitriptyline induced skin necrosis.We report a case of patchy full thickness skin necrosis following drug overdose with amitriptyline, that required excision and split skin grafting. To our knowledge this is the first report of amitriptyline induced skin necrosis that can be definitively attributed to this drug. The implications of drug related skin necrosis for the surgeon are discussed.- - - - - - - - - - ranking = 7keywords = necrosis (Clic here for more details about this article) |
7/54. warfarin-induced skin necrosis.Skin necrosis is a rare but serious side-effect of treatment with warfarin. At particular risk are those with various thrombophilic abnormalities, especially when warfarinization is undertaken rapidly with large loading doses of warfarin. With the increasing number of patients anticoagulated as out-patients for thromboprophylaxis, we are concerned that the incidence of skin necrosis may increase. If skin necrosis does occur, prompt remedial action may be of benefit in preventing permanent tissue damage.- - - - - - - - - - ranking = 7keywords = necrosis (Clic here for more details about this article) |
8/54. Unusual complications of warfarin therapy: skin necrosis and priapism.Skin necrosis and priapism are unusual complications of warfarin therapy. We report a teenager with warfarin-associated skin necrosis and priapism who was subsequently found to be a compound heterozygote for protein c deficiency and a heterozygote for the factor v Leiden mutation.- - - - - - - - - - ranking = 6keywords = necrosis (Clic here for more details about this article) |
9/54. calciphylaxis in a patient without renal failure or elevated parathyroid hormone: possible aetiological role of chemotherapy.calciphylaxis is a rare, often fatal disease characterized clinically by progressive cutaneous necrosis and ulceration, and histologically by vascular calcification and thrombosis. It has been described in association with end-stage renal disease, after initiation of dialysis, following renal transplantation, and in patients with hyperparathyroidism. We present the first case of calciphylaxis occurring in a patient with both normal renal function and parathyroid hormone level and discuss the possible aetiological role of chemotherapy-induced functional protein C and protein s deficiency.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
10/54. Necrotising fasciitis in a patient receiving infliximab for rheumatoid arthritis.A case of necrotising fasciitis in a patient receiving infliximab, an antitumour necrosis factor alpha (TNF-alpha) agent for rheumatoid arthritis, is presented. A widespread confluent, erythematous, pustular skin rash was the presenting sign. There was no fever throughout this admission. beta-Haemolytic group A streptococcus was isolated from blood cultures and skin swabs. The adductor muscles and fascia around the site of a previous hip arthroplasty were necrotic on exploration. The case highlights the risk of severe sepsis in patients on anti-TNF-alpha treatment.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
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