1/22. Plantar hyperkeratosis due to fusarium verticillioides in a patient with malignancy.We report the case of an 82-year-old man with hyperkeratosis of the right sole caused by a fusarium verticillioides infection mimicking verrucous tuberculosis; the infection was confirmed by direct potassium hydroxide microscopy, biopsy and cultures. The biopsy specimen showed an unusually deep invasion of fungal elements into the epidermis. This is an uncommon presentation in a localized cutaneous infection by fusarium but in this case, repeated local injuries were the portal of entry initiating the process. Clinical patterns of cutaneous fusarium infections in general are also discussed.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
2/22. The evolving role of aminolevulinic acid hydrochloride with photodynamic therapy in photoaging.The safety and efficacy of treating individuals who presented with multiple actinic keratosis (AK) lesions with 5-aminolevulinic acid (ALA) in combination with photodynamic therapy (PDT) were documented in a phase III trial. This report highlights results of this phase III trial and reviews 2 specific case studies treated with ALA/PDT who presented with both multiple nonhyperkeratotic AK lesions and moderate-to-severe photodamage. Treatment consisted of a 2-step process performed by the investigator. In addition to the pretreatment evaluation, each subject was evaluated at 1- and 2-month intervals after each treatment of ALA/PDT. Clinical findings reveal complete healing at the site of ALA/PDT without scarring or changes in pigmentation, as well as significant changes in signs of photodamage, such as improvement in skin elasticity and reduction in skin thickening.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
3/22. Graham Little-Piccardi-Lassueur syndrome associated with androgen insensitivity syndrome (testicular feminization).Graham Little-Piccardi-Lassueur syndrome is characterized by the presence of cicatricial alopecia on the scalp, keratosis pilaris in the skin of trunk and extremities, and non-cicatricial hair loss in pubis and axillae. A frequent form of male pseudohermaphroditism is complete androgen insensitivity syndrome (CAIS), also known as testicular feminization syndrome. It refers to genetic males with XY karyotype who, owing to a lack of sensitivity in the peripheral androgenic receptors, develop a female phenotype. Axillary and pubic hair is typically scarce or absent. To our knowledge, this is the first case describing the association of the two processes. The presence of both processes in the same patient furthers our understanding of Graham Little-Piccardi-Lassueur syndrome as it rejects the influence of androgens in the alopecias accompanying this syndrome. The coincidence of non-cicatricial alopecia in axillary and pubic hair in both processes is also remarkable.- - - - - - - - - - ranking = 3keywords = process (Clic here for more details about this article) |
4/22. Trichofolliculoma with incidental focal acantholytic dyskeratosis.Incidental focal acantholytic dyskeratosis has been described in a variety of cutaneous lesions, including benign and malignant epithelial lesions, fibrohistiocytic lesions, inflammatory lesions, and melanocytic lesions. It has also been observed in follicular lesions such as comedones and ruptured follicles. We report the case of a 47-year-old man with a firm, flesh-colored 2-mm pruritic papule in the sun-exposed area above the left eyebrow. An excisional biopsy was performed, the tissue was processed, and the hematoxylin and eosin slides were evaluated. Microscopic examination showed a dilated cystic cavity filled with keratinous debris and scattered fragments of hair. Smaller secondary follicular structures branched from the primary cyst's walls into the adjacent dermis. Hyperkeratosis, acantholysis, dyskeratosis, and suprabasilar clefts were also focally present. Correlation of the lesion's clinical morphology and microscopic features established a diagnosis of trichofolliculoma with incidental focal acantholytic dyskeratosis. Hence, trichofolliculoma can be added to the list of follicular lesions in which focal acantholytic dyskeratosis may be observed as an incidental microscopic change.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
5/22. Seborrheic keratoses from the genital region may contain human papillomavirus dna.Sections from paraffin-embedded tissues of lesions interpreted as seborrheic keratoses localized to the pubic, genital, and crural regions were assayed for the presence of human papillomavirus types 6, 11, 16, 18, and 33 using dna amplification followed by specific hybridization. Lesions with the histologic characteristics of condyloma were excluded from the study. Human papillomavirus dna sequences were found in 24 (42%) of 57 seborrheic keratosis-like lesions from the genital region. No human papillomavirus dna was detected in 27 control specimens that represented a variety of other processes occurring in this area. We conclude that human papillomavirus infection cannot be excluded in genital seborrheic keratoses.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
6/22. Localized hyperkeratosis lenticularis perstans (Flegel's disease).A case of hyperkeratosis lenticularis perstans involving only the back of a thirty-nine-year-old woman is reported. Histologic examination showed foci of compact and eosinophilic hyperkeratosis overlying a thinned stratum malpighii. In the underlying papillary dermis there was no evidence of inflammatory infiltrate. This case demonstrates that hyperkeratosis lenticularis perstans may appear as a localized disorder, and that the inflammation is not an essential pathogenic process in this disorder.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
7/22. Keratinizing corneal intraepithelial neoplasia.Corneal intraepithelial neoplasia (CIN) is the term applied by some authors to the spectrum of disease ranging from mild dysplasia to carcinoma in situ. Such lesions usually are associated with dysplastic or neoplastic processes at the limbus or adjacent conjunctiva; isolated corneal dysplasia is rare. Clinically, CIN appears as a geographic, gray, translucent thickening of the epithelium with fimbriated or scalloped borders and lesions often contain scattered white dots. We report a case of intraepithelial neoplasia limited to the cornea that had the unusual clinical appearance of a white plaque, which prompted the misdiagnosis of a calcific scar. Histopathologic examination of the debrided tissue revealed intraepithelial neoplasia and marked hyperkeratosis as the cause of the opacification.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
8/22. Oral dysplasia and in situ carcinoma: clinicopathologic correlations of eight patients.Eight patients with multiple oral dysplastic epithelial lesions were followed by clinical examinations and serial biopsies for periods varying from four to 22 years. The dysplasias and in situ carcinomas were characterized by persistence, recurrence, and eventual progression to invasive squamous cell carcinoma. It could not be determined whether dysplasia and in situ carcinoma were separate clinical-pathologic entities with similar end points or whether they were part of a continuum in a spectrum of epithelial neoplasia. The need for close clinical observation and local excision was emphasized because of the multiplicity of lesions and because of the protracted clinical course. Treatment of these patients was problematic because of similarities of the disease to lichen planus. It is possible that they had a premalignant disease process that mimicked lichen planus, or that they had an unusual form of lichen planus for which criteria have not been established. The progressive nature of the disease was exemplified by one death, one patient with cervical metastasis, and one with generalized remote metastatic disease.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
9/22. cholesteatoma of the external auditory canal and keratosis obturans.Keratosis obturans and external auditory canal cholesteatoma have often been regarded as a single entity. However, these are two distinct disorders with their own clinical presentations, physical and pathologic findings, and treatment. Keratosis obturans is an accumulation of obstructive desquamated keratin in the external auditory meatus. External auditory canal cholesteatoma is an invasion and erosion of squamous epithelium into a localized area of the bony ear canal. The origin of both entities remains obscure. The clinical symptoms, pathologic processes, and treatment are outlined and compared. case reports are presented to illustrate the features of these two diseases.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
10/22. Disseminated bilateral hyperkeratotic variant of porokeratosis Mibelli.Clinical, histopathological, and ultrastructural features of a new clinical variant of porokeratosis Mibelli (PM) are presented. We report a solitary case of a patient, male aged 62, who developed disseminated verrucous nodules on the buttocks and the lower extremities 3 years before diagnosis. Histopathologically, all specific signs of the keratinization disorder of PM were demonstrable; in addition, however, multiple cornoid lamellae were found at the margin as well as in the center of the lesions, which only in part showed relationships to the epidermal appendages. In the papillary dermis, numerous ectatic capillaries were conspicuous. Using electron microscopy the same specific abnormalities of the keratinization process as known from classical cases of PM could be demonstrated: autophagocytic cells that revealed perinuclear edematization and vacuolization, accumulation of autophagic vacuoles and heterolysosomes, and dyskeratotic corps ronds-like cells that become transformed to fibrillar or Civatte bodies. Problems of the classification, differential diagnosis, and pathomorphogenesis are discussed.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
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