1/5. 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.- - - - - - - - - - ranking = 1keywords = scleroderma (Clic here for more details about this article) |
2/5. Linear scleroderma with severe leg deformity.Linear scleroderma is an unusual form of localised scleroderma, mainly affecting the legs and occurring primarily in children. Sometimes the linear lesions may extend to involve the underlying muscles and bones, with severe disturbances in growth and possibly flexion deformities of the legs. In this study, two cases suffering from linear scleroderma of the legs are presented.- - - - - - - - - - ranking = 3.5keywords = scleroderma (Clic here for more details about this article) |
3/5. Localized scleroderma-like lesions on the legs in bone marrow transplant recipients: association with polyneuropathy in the same distribution.We report two patients who developed localized scleroderma-like lesions on the legs following bone marrow transplantation. These changes were associated with a polyneuropathy in the same distribution.- - - - - - - - - - ranking = 2.5keywords = scleroderma (Clic here for more details about this article) |
4/5. lichen planus presenting with erythema-multiforme-like bullous lesions in a patient with systemic scleroderma.A patient with systemic scleroderma is described who developed a cutaneous eruption of papules and vesicobullae. Over time, the latter turned into papules. The histopathological and immunofluorescence features of the papular lesions were unequivocally those of lichen planus, while those of the bullous lesions reminded of erythema multiforme. Histologically, erythema multiforme shares common features with lichenoid reactions, such as necrotic keratinocytes. Our case suggests that erythema multiforme and lichen planus may coexist or succeed each other as different stereotype immune reactions against the same antigen(s) within the epidermis.- - - - - - - - - - ranking = 2.5keywords = scleroderma (Clic here for more details about this article) |
5/5. Scleroderma and the carcinoid syndrome.The follow up of a case of the carcinoid syndrome complicated by scleroderma is reported, in which progress of the disease may have been halted by treatment with a combination of cyproheptadine, parachlorophenylalanine and prednisolone. Impairment of tryptophan and 5-hydroxytryptamine (serotonin) metabolism appears central to the development of skin fibrosis in the carcinoid syndrome and may be indicative of important mechanisms in the pathogenesis of idiopathic scleroderma.- - - - - - - - - - ranking = 1keywords = scleroderma (Clic here for more details about this article) |