1/58. herpes zoster in seven disparate dermatomes (zoster multiplex): report of a case and review of the literature.Noncontiguous multidermatomal herpes zoster is very rare in both immunocompetent and immunocompromised persons. Most of the reported cases have been limited to 2 noncontiguous dermatomes. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending on whether one or both halves of the body are involved. Granulomatous dermatitis at sites of herpes zoster scars, a rare isotopic response, has only been reported in persons with contiguous dermatomes of zoster. We describe an immunocompromised patient who developed herpes zoster in 7 disparate dermatomes. Three months after resolution of the zoster, the patient developed a granulomatous dermatitis in a zosteriform distribution at the sites of previous infection.- - - - - - - - - - ranking = 1keywords = dermatitis (Clic here for more details about this article) |
2/58. Interstitial granulomatous dermatitis with plaques.We report on the clinical and histopathologic findings of four patients who had asymptomatic, erythematous to violaceous plaques symmetrically distributed on the upper aspect of the thighs, lateral chest, and in two cases also on the abdomen and flexor surface of the elbows. All of the patients were women; two of them had arthritis, which in one case was associated with an autoimmune disorder, and another had autoimmune thyroiditis. Histopathologically, all cases showed similar changes consisting of an interstitial granulomatous dermatitis involving mostly the lower reticular dermis. histiocytes were the predominant cellular component, arranged interstitially and in small palisades around foci of degenerated collagen bundles in concert with large numbers of neutrophils and eosinophils. Interstitial granulomatous dermatitis can present different clinical expressions, including linear cords, papules, and, as in our cases, plaques. This peculiar histopathologic pattern falls into the spectrum of cutaneous extravascular necrotizing granuloma, a condition that is often associated with systemic autoimmune disease.- - - - - - - - - - ranking = 3keywords = dermatitis (Clic here for more details about this article) |
3/58. Granuloma gluteale infantum: a case report.Granuloma gluteale infantum is a benign disorder with the clinical appearance of "granulomatous" nodules involving the diaper area. It is an uncommon disorder considered a complication of primary irritant diaper dermatitis. A 6-month-old boy with reddish-purple oval nodules located on the right inguinal fold and right buttock diagnosed as granuloma gluteale infantum is presented. A contributing factor in our patient could be a primary irritant dermatitis or a preexisting candidial infection. The name granuloma gluteale infantum is a misnomer since no granulomas are found in these lesions.- - - - - - - - - - ranking = 1keywords = dermatitis (Clic here for more details about this article) |
4/58. Hemilateral distribution of papular lesions on the buttock histologically resembling granuloma gluteale infantum.Two Japanese girls had small grouped papules on the buttocks without diaper dermatitis or bacterial or fungal infection. These granulomas spontaneously regressed over two weeks, even though oral antibiotics were administered. We discuss this variant of granuloma gluteale infantum of Tappeiner et al.- - - - - - - - - - ranking = 0.5keywords = dermatitis (Clic here for more details about this article) |
5/58. Interstitial granulomatous dermatitis with cutaneous cords and arthritis: a disorder associated with autoantibodies.Interstitial granulomatous dermatitis with arthritis is a new entity characterized by linear or arciform subcutaneous cords. We describe a patient presenting with typical cutaneous lesions extending from the anterior and posterior part of the axillae to the flank. The lesions had been present for 6 years with flares and remission. Histopathologic examination revealed a bandlike infiltrate of histiocytes in the reticular dermis with focal areas of palisading around necrotic collagen bundles. A few atypical histiocytes were also present. As previously described, it was associated with serologic findings of an autoimmune disease, especially high titers of anti-dna antibodies. The possible inclusion of the interstitial granulomatous dermatitis in the continuous spectrum of the palisaded neutrophilic and granulomatous dermatitis of immune complex disease is also discussed.- - - - - - - - - - ranking = 3.5keywords = dermatitis (Clic here for more details about this article) |
6/58. Interstitial granulomatous drug reaction with a histological pattern of interstitial granulomatous dermatitis.The interstitial granulomatous drug reaction (IGDR) is a novel drug-associated entity, characterized by violaceous plaques with a predilection for skin fold areas. light microscopically, it resembles the incipient diffuse interstitial phase of granuloma annulare. Differentiating light microscopic features include the absence of complete collagen necrobiosis, the presence of interface dermatitis, and variable lymphoid atypia. The lack of vasculitis rules out the extravascular necrotizing granuloma (Winkelmann granuloma) associated with systemic disease. The differential diagnosis with interstitial granulomatous dermatitis with arthritis as defined by Ackerman et al. has not been studied until now. Our aim was to determine the histologic criteria allowing us to differentiate IGDR without interface dermatitis and lymphoid atypia from interstitial granulomatous dermatitis. We report three patients with IGDR triggered, in two cases by respectively angiotensin convertin enzyme (ACE) inhibitors and furosemide, and in one case by the association of an ACE inhibitor, furosemide, and fluindione. Histologic examination showed a histological pattern of interstitial granulomatous dermatitis. We found a dense, diffuse histiocytic infiltrate distributed interstitially and in palisaded array within the reticular dermis. eosinophils and some neutrophils were scattered throughout the infiltrate. In some tiny foci, enveloped by histiocytes, thick collagen bundles associated with basophilic nuclear debris or "flame figures" were seen. vasculitis, interface dermatitis, or lymphoid atypia were absent. Our study allowed us to expand the histological spectrum of IGDR including a histological pattern similar to interstitial granulomatous dermatitis. The lack of degenerated collagen could be a subtle clue in favor of interstitial granulomatous dermatitis triggered by a drug.- - - - - - - - - - ranking = 6keywords = dermatitis (Clic here for more details about this article) |
7/58. zirconium granuloma following treatment of rhus dermatitis.zirconium granuloma of the skin, initially seen following the use of zirconium deodorants, continues to occur secondary to the treatment of plant dermatitis with compounds containing zirconium. In our patient the reaction appeared eight weeks after initial use of the agent and has persisted for 18 months without therapy. Intradermal injection of minute amounts of a soluble zirconium compound resulted in production of a lesion that was identical clinically and histologically with the primary lesion at the end of four weeks. Although this disorder involves the skin primarily, the slight elevation in gamma-globulin level observed may be a reflection of its systemic pathogenesis.- - - - - - - - - - ranking = 2.5keywords = dermatitis (Clic here for more details about this article) |
8/58. Granulomatous and suppurative dermatitis at interferon alfa injection sites: report of 2 cases.It has previously been reported that interferon alfa injection sites may develop pyoderma gangrenosum, interface dermatitis, vasculitis, or, more commonly, ulcers characterized by intravascular thrombi and a mixed inflammatory cell infiltrate. We describe 2 patients in whom granulomatous and suppurative dermatitis developed at interferon alfa injection sites. These cases extend the spectrum of interferon alfa injection site reactions. The histologic and clinical similarities of these cases with pyoderma gangrenosum and cutaneous Crohn's disease are explored.- - - - - - - - - - ranking = 3keywords = dermatitis (Clic here for more details about this article) |
9/58. Childhood granulomatous periorificial dermatitis in an Asian girl--a variant of sarcoid?Childhood granulomatous periorificial dermatitis (CGPD) is a benign, facial eruption which has previously been reported in prepubertal, Afro-Caribbean children. It is a condition of unknown aetiology, characterized by a monomorphic, papular eruption around the mouth, nose and eyes. Typically the eruption persists for several months but resolves without scarring. The condition can usually be distinguished from sarcoidosis on clinical and histological grounds. To our knowledge, this is the first case of CGPD occurring in an Asian child with sarcoidal histology and is unusual in its persistence for 4 years. We suggest that this case of CGPD may well be a variant of sarcoid.- - - - - - - - - - ranking = 2.5keywords = dermatitis (Clic here for more details about this article) |
10/58. Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis.Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several different names including palisaded neutrophilic and granulomatous dermatitis, linear subcutaneous bands, interstitial granulomatous dermatitis with cutaneous cords and arthritis, rheumatoid papules, and Churg-Strauss granuloma. We report 7 additional cases of PNGD. Clinically, 6 patients presented with erythematous to violaceous plaques, papules, and nodules on multiple body sites; one presented with subcutaneous linear bands on the shoulder. Five had rheumatoid arthritis; one had adult-onset Still's disease; and one showed clinical signs of rheumatoid arthritis, although serologically the rheumatoid factor was negative. On histologic examination, a spectrum of changes was observed ranging from urticaria-like infiltrates to leukocytoclastic vasculitis and granuloma annulare with neutrophils. We report these cases to expand the histologic spectrum of this entity and to further delineate the different forms of clinical presentation.- - - - - - - - - - ranking = 3.5keywords = dermatitis (Clic here for more details about this article) |
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