1/12. Bullous phytophotodermatitis associated with high natural concentrations of furanocoumarins in limes.BACKGROUND: Phytophotodermatitis is a phototoxic reaction, occurring in skin exposed to sunlight after contact with plants containing furanocoumarins. Typical reactions are mild, showing erythema with post-inflammatory hyperpigmentation. A 6-year-old boy presented with marked, symmetric, painful erythema and edema of both hands that rapidly developed into dramatic bullae covering the entire dorsum of the hands. The history revealed that the hands had been bathed in lime juice for a prolonged period in the preparation of limeade. OBJECTIVE: This report documents an unusual bullous presentation of phytophotodermatitis resulting from contact with furanocoumarins in local limes. This study was conducted to identify and measure the inciting substances from the rind and pulp of the limes. methods: Psoralen, xanthotoxin, bergapten, and isopimpinellin content were measured by gas chromatography and high-pressure liquid chromatography RESULTS: The rind contained 6- to 182-fold concentrations of all furanocoumarins measured when compared with pulp. Bergapten was the most abundant substance in the rind. CONCLUSION: Hydration of the skin during the preparation of limeade combined with increased levels of bergapten in local limes to produce a dramatic bullous reaction. We encourage clinicians to consider the possibility of phytophotodermatitis in severe bullous skin reactions.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
2/12. arsenic keratosis and pigmentation accompanied by multiple bowen's disease and genitourinary cancer in a psoriasis patient.We report a case of arsenic keratosis and pigmentation accompained by multiple bowen's disease and genitourinary cancer in a 64-year-old man. He was a psoriasis patient with a history of herbal medication for about thirty years. He showed multiple hyperkeratotic plaques on the bilateral palms, soles, and multiple, brownish, scaly, elevated papules on the back in addition to diffuse hyperpigmentation. biopsy confirmed arsenic keratosis and bowen's disease. Transitional cell carcinoma was also detected on his ureter and bladder during follow-up. The skin lesions were treated with topical 5-fluorouracil, etretinate, and excision with improvement.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
3/12. hydroxyurea-induced dermatomyositis-like eruption.hydroxyurea is a cytotoxic chemotherapeutic agent used for myelodysplasia. The adverse cutaneous effects due to hydroxyurea include leg ulcers, hyperpigmentation of the skin and nails, a lichen planus-like eruption, lupus erythematosus, and a dermatomyositis-like eruption. We present a case of hydroxyurea-induced dermatomyositis-like eruption and review the features of this entity as previously reported.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
4/12. hyperpigmentation mimicking Laugier syndrome, levodopa therapy and Addison's disease.The Laugier-Hunziker syndrome is an acquired, idiopathic, benign mucocutaneous hypermelanosis that usually occurs on the lips and oral mucosa, although it may appear at other sites. nails are frequently involved, mainly forming longitudinal hyperpigmented bands. We report the case of a patient that presented a typical picture of this entity, nearly 1 year after the beginning of treatment with levodopa. Two years after the first lesions occurred, she developed Addison's disease. The patient suffered from a diffuse discrete hyperpigmentation (it was more remarkable on exposed areas) and an intensification of the melanotic macules that were previously noticeable before in oral and genital mucosa, fingers, toes and nails. Hormonal replacement treatment enabled the control of laboratory and general manifestations and to decrease the degree of mucocutaneous hyperpigmentation considerably, despite initial hyperpigmented lesions persisting in described areas.- - - - - - - - - - ranking = 2keywords = hyperpigmentation (Clic here for more details about this article) |
5/12. Dermatopathia pigmentosa reticularis: a report of a family demonstrating autosomal dominant inheritance.Dermatopathia pigmentosa reticularis is a rare heritable disorder consisting of a triad of cutaneous findings including reticulate hyperpigmentation, noncicatricial alopecia, and onychodystrophy. In addition to this triad, other variable features of dermatopathia pigmentosa reticularis have been described, including adermatoglyphia, hypohidrosis or hyperhidrosis, and palmoplantar hyperkeratosis. Only 10 cases have been described in the world literature to date, and no clear inheritance pattern has been demonstrated. We present a patient with the classic features of the dermatopathia pigmentosa reticularis triad, along with adermatoglyphia, hypohidrosis, and punctate hyperkeratosis of the palms and soles. A family pedigree demonstrates the autosomal dominant inheritance of dermatopathia pigmentosa reticularis.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
6/12. Fiberglass dermatitis from printed circuit boards.Seven cases of fiberglass dermatitis among production operators in the electronics industry are reported. This was due to the repeated daily handling of printed circuit boards (PRCBs). The predominant complaint of the workers was itch of the lateral aspects of the fingers and finger webs. In six workers, unroofed vesicles, pinhead areas of postinflammatory hyperpigmentation, and excoriation marks were noted at these sites. skin stripping of the affected sites confirmed the presence of fiberglass spicules in all cases. The glass fibers had diameters of 11-16 microns. Patch testing of six of the workers with the European Standard series of allergens revealed no relevant work-related contact sensitizers. Microscopic examination of the free edges and scrapings from the PRCBs showed glass fibers of similar fiber length and diameter to those found in the workers' skin. Fiberglass can be used as a reinforcement filling material in some types of PRCBs. Free edges of such PRCBs have easily detached fiberglass spicules. Workers in frequent contact with these PRCBs can have a fiberglass-induced irritant dermatitis. Preventive measures could include the use of PRCBs with less free fiberglass at its edges, vacuuming of the newly cut boards, use of dusting powder, protective devices and emollients, and improved personal hygiene of the workers.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
7/12. Cutaneous ulcerations on hands and heels secondary to long-term hydroxyurea treatment.hydroxyurea is a chemotherapeutic agent used to treat myeloproliferative disorders and other non-neoplastic conditions. Cutaneous side-effects have been described in long-term therapy with hydroxyurea and include xerosis, hyperpigmentation, skin atrophy, erythema, alopecia, skin tumours and ulceration of the skin, particularly of the legs. We present a 71-year old patient with chronic myelocytic leukemia (CML) who developed extremely painful ulcers on the hands and heels as well as skin tumours while on long-term therapy with hydroxyurea. The ulcers were resistant to therapy but healed three months after discontinuation of hydroxyurea therapy.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
8/12. Laugier-Hunziker pigmentation.Laugier-Hunziker pigmentation (LHP) is an acquired disorder of hypermelanosis characterized by mucocutaneous hyperpigmentation. LHP may resemble various disorders characterized by mucocutaneous pigmentation. A 58-year-old lady presented with progressively increasing number of variable sized, hyperpigmented macules over the lips, fingers, toes and nails. There was no family history of similar illness. Systemic examination and all relevant investigations were within normal limits. Histopathology of a skin lesion had features consistent with LHP. The diagnosis of LHP must be made only after relevant investigations to rule out any associated systemic involvement. This case further highlights that LHP is not restricted to European countries.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
9/12. imipramine hyperpigmentation: a slate-gray discoloration caused by long-term imipramine administration.A 48-year-old white woman, skin type III, had a slate-gray discoloration of the face and dorsa of both hands after ingesting imipramine, 150 mg/day for 5 years. Her iris color was also darkened. One year after cessation of the therapy, the discoloration became lighter. Sun-protected skin showed no discoloration. Light microscopy revealed an accumulation of doubly refractile golden yellow granules in the papillary dermis, mostly scattered, with some concentration around the blood vessels but not in the endothelial cells. Electron micrographs showed numerous amorphous electron-dense inclusion bodies in histiocytes, phagocytes, fibroblasts, and dermal dendrocytes. melanosomes were phagocytosed in the same cells but in separated locations. imipramine is structurally related to chlorpromazine and can cause slate-gray discoloration. However, the color of the granules deposited in the papillary dermis is golden-yellow and they are not deposited in endothelial cells.- - - - - - - - - - ranking = 4keywords = hyperpigmentation (Clic here for more details about this article) |
10/12. Spirochetes in atrophic skin lesions accompanied by minimal host response in a child with lyme disease.acrodermatitis chronica atrophicans, which has rarely been observed in the united states, is a late skin manifestation of Lyme borreliosis. A 12-year-old girl who spent summers on Cape Cod presented with a 2-year history of hyperpigmentation and atrophy of the skin on the hands, wrists, and ankles. The skin biopsy specimen of an affected area showed mild dermal fibrosis, a few inflammatory cells, and spirochetes morphologically compatible with borrelia burgdorferi. An IgG antibody response to B. burgdorferi could be elicited by immunoblotting, but not by enzyme-linked immunosorbent assay. We conclude that this patient had chronic Lyme borreliosis manifested only by indolent infection of the skin.- - - - - - - - - - ranking = 1keywords = hyperpigmentation (Clic here for more details about this article) |
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