Cases reported "Facial Dermatoses"

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1/22. cowpox infection: not yet consigned to history.

    Two patients presented with hard black eschars covering granulating ulcers. The ulcers healed within 6 weeks to leave small scars. The diagnosis of cowpox was confirmed by serology in both cases and in addition by polymerase chain reaction in the first. The source of infection was likely to be a rodent in the first case whilst the second was more typical in being transmitted by a cat.
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2/22. Eyelid allergic contact dermatitis to black iron oxide.

    Eye cosmetics are a common cause of eyelid dermatitis. These products contain pigments, fragrances, resins, preservatives and vehicles. Mascara might cause either irritant or allergic contact dermatitis (ACD) of the eyelids. We present the case of a 44-year-old woman with a 10-month history of periorbital and eyelid dermatitis. Epicutaneous patch testing using the TRUE Test, cosmetic series, steroid series, and her personal products yielded a strong reaction to her mascara. Subsequent patch testing to the mascara components provided by the manufacturer revealed a severe reaction only to 5% black iron oxide. This black iron oxide was further tested in 10 normal controls with no reactions produced. There is only one previous report of eyelid ACD secondary to iron oxide that represents a rare cause of eyelid ACD.
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3/22. hair ignition by dye laser for port-wine stain: risk factors evaluated.

    Flashlamp-pumped pulsed dye laser is the preferred treatment for port-wine stain. Vascular hemoglobin and epidermal melanin are competing sites for dye laser absorption and damage. The case presented illustrates the potential hazard of ignition induced by dye laser treatment on the face of a patient receiving inhalation anesthesia. A 6-year-old girl with almost black hair was treated for a port-wine stain covering most of the right half of her face. She was treated with dye laser under general anesthesia administered by mask. A laser pulse close to the upper part of the eyebrow induced a blaze and the eyebrow was instantly destroyed by the fire. Regrowth of the eyebrow was complete after a few months. hair specimens of various colors were exposed experimentally to dye laser irradiation in room and oxygen-saturated atmospheres. risk factors of ignition are high laser dosage, a high oxygen level, repeated pulses and dark colored hair.
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4/22. Miliary osteoma of the face: a report of 4 cases and review of the literature.

    osteoma cutis (OC) is a rare disorder characterized by compact bone formation in the dermis and subcutaneous tissue. It is classified in primary and secondary forms according to the presence or absence of previous cutaneous lesions. Miliary osteoma of the face (MOF) is a form of primary OC that generally occurs in middle-aged and older adult women. We report 3 cases of typical MOF and one additional case in a black patient, which to our knowledge has not been described previously.
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5/22. Acute allergic contact dermatitis due to para-phenylenediamine after temporary henna painting.

    The use of temporary natural henna painting for body adornment and hair dyeing is very common in several countries of the Indian subcontinent, middle east, and North africa, and the fad is spreading in other parts of the world. Several cases of para-phenylenediamine (PPD) contaminated, temporary traditional/natural henna induced sensitization and acute allergic reaction have been reported, along with occasional serious long term and rare fatal consequences. We report here a 17-year-old girl with blisters over her hands of five-days duration that appeared within 72 hours of applying a temporary henna paint to her hands during a social occasion. Similar lesions were noted on her face. She had previously applied black henna only once, a year earlier without developing any lesions. Clinical diagnosis of acute allergic contact dermatitis (ACD) was made. After a short course of oral corticosteroids, topical mometasone furaote 1.0% cream, and oral antihistamines, the lesions healed completely over the next four weeks leaving post-inflammatory hypopigmentation. Patch testing done with standard European battery, PPD 1% in petrolatum, and commercially available natural henna powder revealed a 3 reaction to PPD at 48 hours. No reaction was seen at the natural henna site. awareness of the condition among physicians and the public and regulation regarding warnings of the risks of using such products is urgently warranted.
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6/22. diltiazem-induced photodistributed hyperpigmentation.

    diltiazem is a calcium-channel antagonist commonly prescribed in the treatment of cardiovascular disease. Although an extensive spectrum of cutaneous reactions to diltiazem has been described, only two published reports of hyperpigmentation induced by diltiazem are known. We report the cases of a 71-year-old black male and a 49-year-old Hispanic male, who both presented with characteristic hyperpigmentation on sun-exposed areas after taking an extended-release form of diltiazem hydrochloride (Tiazac).
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7/22. diltiazem-induced hyperpigmentation.

    A healthy-appearing 66-year-old black woman presented with a 5-year history of facial hyperpigmentation that was unresponsive to topical sunscreen, hydroquinone, tretinoin, and azelaic acid. Her medications included extended-release diltiazem for hypertension for the past 7 years, rofecoxib for arthritis, and pantoprazole for esophagitis. On examination, the woman displayed hyperpigmented patches and papules involving most of her face. The punch biopsy findings from a hyperpigmented papule on the right temple revealed compact hyperkeratosis, follicular dilation, and dense inflammatory infiltrate along the dermal-epidermal junction with abundant dying keratinocytes. Her diltiazem therapy was discontinued, which led to gradual resolution of her hyperpigmentation.
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8/22. Acrokeratosis paraneoplastica of Bazex: report of a case in a young black woman.

    Acrokeratosis paraneoplastica of Bazex is a rare cutaneous syndrome associated with malignant neoplasms of the pulmonary and upper gastrointestinal tract, or cervical metastatic adenopathy, usually seen in middle-aged white men. We present a unique case of Bazex syndrome in that the patient was young, black, and a woman.
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9/22. Keloidal granuloma faciale with extrafacial lesions.

    granuloma faciale (GF) is a rare cutaneous disorder characterized by one to several soft, erythematous to livid papules, plaques or nodules, usually occurring on the face. Extrafacial lesions are uncommon. A 52-year-old lady with multiple asymptomatic, variously sized brownish-black colored, firm, sharply circumscribed plaques resembling keloids on both cheeks and extrafacial lesions on the right arm and the right breast is presented for its unusual keloidal appearance and typical histopathological findings. She failed to respond to oral dapsone 100 mg daily administered for 3 months. Local infiltration of triamcinolone combined with cryotherapy led to only partial flattening of the lesions. All the skin lesions were excised surgically followed by flap transfer grafting on both cheeks. The cosmetic outcome was highly satisfactory.
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10/22. Occupational peri-ocular contact dermatitis due to sensitization against black rubber components of a microscope.

    A 24-year-old female working in the Department of pathology of a University Hospital developed an acute peri-ocular eczema clearly being related to her daily work at the microscope. Patch testing revealed delayed type hypersensitivity against the black rubber mix, N-isopropyl-N'-phenyl paraphenylenediamine, N-cyclohexyl-N'-phenyl paraphenylenediamine and the rubber ring situated on the ocular of the respective microscope. This is the first report, to our knowledge, on peri-orbital allergic contact eczema because of sensitization with rubber components of a microscope.
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