Cases reported "Hand Dermatoses"

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1/25. lichen nitidus of the palms: a case with peculiar histopathologic features.

    Palmar involvement in lichen nitidus is infrequent. In such cases, the histopathologic findings of palmar lesions are usually identical to those of extrapalmar ones. We report on the case of a patient with multiple tiny papules located on the palms and elbows. A biopsy specimen from the elbow showed the typical features of lichen nitidus, but a biopsy from the palm disclosed an inflammatory infiltrate mostly disposed around the bases of rete ridges and composed of lymphocytes and histiocytes with some giant cells both in the dermis and in the epidermis. This location of the infiltrate is similar to that found in hypertrophic lichen planus, a combination of lichen planus and lichen simplex chronicus. We conclude that this histopathologic feature in palmar lichen nitidus could be the result of the superimposition of lichen nitidus on normal palmar skin, resulting in a picture resembling hypertrophic lichen planus.
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2/25. Isolation of hanseniaspora uvarum (kloeckera apiculata) in humans.

    Isolation of hanseniaspora uvarum, a yeast of the ascomycetes group, whose anamorph corresponds to kloeckera apiculata, obtained from stool and two ungual specimens from three patients, is reported. This yeast has been found in soil, water, various fruits, bivalve molluscs, crabs, prawns and fruit flies; in spain, it has been described in the fermentation processes of some wines. In our region, it has also been found in the intestine of mackerel (Scomber scombrus). Its finding in humans constitutes a clinical rarity.
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3/25. Myeloma-associated systemic amyloidosis presenting as chronic paronychia and palmodigital erythematous swelling and induration of the hands.

    Mucocutaneous involvement occurs predominantly in primary systemic amyloidosis as well as in myeloma-associated systemic amyloidosis. It is rarely observed in other types of amyloidoses. Signs of such involvement may aid in the early diagnosis of the disease process. Herein, we describe a 64-year-old white male patient with myeloma-associated systemic amyloidosis in whom the disease presented with unique cutaneous lesions consisting of chronic paronychia and palmodigital erythematous swelling and induration of the hands. Following weekly regimens with prednisone (20 mg/day) and melphalan (2 mg/day) administered every 16 weeks, almost complete resolution of the cutaneous lesions was observed after 1 year of therapy. Also, in response to chemotherapy, modest regression of the myelomatous bone lesions and complete resolution of the underlying gammopathy occurred.
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4/25. erythema multiforme-like eruption associated with contact dermatitis to cutting oil.

    A 48-year-old Japanese man developed coalesced erythema multiforme-like lesions on the forearms and the dorsa of hands that were exposed to a cutting oil product. Subsequently, multiple, round erythematous lesions with iris formation occurred on the trunk and four extremities that had no direct contact with the oil. It is suggested that erythema multiforme can be induced via some allergic processes following a contact reaction.
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5/25. Generalized eruptive porokeratosis of Mibelli with associated psoriasis.

    A case of eruptive porokeratosis of Mibelli with diverse morphologic features, including circinate macular, circinate plaque and verrucous varieties is presented. No matter how variable the clinical presentation may be, the histologic hallmark of porokeratosis, the cornoid lamellae, is always present. The cornoid lamellae vary in height in relation to how prominent the thready ridge of the clinical lesion appears. Our patient also had psoriasis which initially masked the porokeratotic lesions both clinically and histologically. awareness of the various clinical expressions of porokeratosis of Mibelli would 1) make unnecessary the segregation of certain forms of porokeratosis into separate entities, and 2) help in the recognition of less classical forms of porokeratosis.
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6/25. Severe human urticaria produced by ant (Odontomachus bauri, Emery 1892) (hymenoptera: Formicidae) venom.

    BACKGROUND: Ant sting reactions are becoming an increasing problem in tropical countries. It is important for physicians to be aware of their possible cutaneous and systemic manifestations. methods: A child with a severe allergic reaction to an ant sting was examined and is discussed. This is the first case described in the literature caused by the ant Odontomachus bauri, and the biology of the ant and the clinical signs in the patient are described. RESULTS: A child developed a strong allergic reaction to an ant sting. The case was not associated with a previous ant sting. Treatment with the systemic antihistamine loratadine (Clarityn) was favorable in this patient. CONCLUSIONS: In tropical areas, ant stings are usually benign, self-limited pathologic processes. In some cases, however, severe allergic reactions can develop, including urticaria and anaphylactic shock. physicians should be aware of the possible complications of ant stings.
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7/25. Scleromyxoedema-like changes in four renal dialysis patients.

    We describe four renal dialysis patients from our hospital who, over a 6-month period, developed erythematous, thickened, indurated dermal plaques. The plaques were limited to the limbs and in three patients there were associated flexion contractures. The clinical features most resembled scleromyxoedema. All patients had previously received at least one renal transplant. Histopathology of the plaques showed features of scleromyxoedema in two patients, whereas the other two showed a different picture, more suggestive of a morphoea-like process. There are important differences between our patients and classical scleromyxoedema. All four patients had normal immunoglobulins and no paraprotein was detected. Almost all cases of classical scleromyxoedema are associated with an IgGlambda paraproteinaemia. We have not yet identified an underlying cause for this cluster of cases in our hospital. It is possible that the skin changes seen may have been precipitated by an environmental agent, such as in 'toxic oil syndrome' and vinyl chloride-induced scleroderma. We discuss the differences between our patients and those with scleromyxoedema, localized or generalized morphoea and environmentally induced scleroderma. We feel that our patients show a constellation of features similar, but not identical, to scleromyxoedema. There has been only one previous report of similar patients. We believe this to be a new and distinct phenomenon.
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8/25. Occupational contact dermatitis to hydrangea.

    Two female commercial hydrangea growers, from separate nurseries, presented with similar hand and facial dermatitis. Both had a hand dermatitis affecting particularly the first three fingers and backs of both hands and complained of a recurrent facial dermatitis affecting the forehead, around both the eyes and bridge of nose. They related their dermatitis to their work. patch tests confirmed allergy to all components of hydrangeas including petal, leaf and stem. Avoidance resulted in resolution of their dermatoses. Allergy to hydrangeas has been reported previously although infrequently.
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9/25. keloid formation in a simple syndactyly release: a case report.

    keloid formation on the palms of the hands and soles of the feet is rare. A keloid developed 2 months after release of simple syndactyly in a young black child. The process of keloid formation is not completely understood, and surgical correction is not effective.
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10/25. Tripe palms: a significant cutaneous sign of internal malignancy.

    Tripe palms is a paraneoplastic keratotic skin sign of great predictive value. It is characterized clinically by a curious rugose thickening of the palms with an accentuation of the normal dermatoglyphic ridges and sulci. Histological examination reveals an undulant epidermis with hyperkeratosis, acanthosis and papillomatosis. More than 80 cases have been reported in the literature; 90% of them were associated with an internal malignancy, mostly a carcinoma of the lung or stomach. We herein report a 66-year-old Chinese man with adenocarcinoma of the lung who presented typical tripe palms. Recognition of this distinctive pattern should prompt a meticulous search for an underlying malignancy, particularly lung or gastric carcinoma.
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