1/3. Giant centrifugal miliaria profunda.A 4-month-old developed rapidly enlarging, white plaques up to several centimeters in diameter in areas where occlusive tape had been applied, almost all on the sites of venous or arterial punctures. microscopy demonstrated the features of miliaria profunda, with sweat duct occlusion and evidence of extravasation of sweat into the dermis. This clinical entity has not been described previously, and we suggest the name giant centrifugal miliaria profunda. ( info) |
2/3. Leukoedema of the oral mucosa. Possibly an acquired white sponge nevus.Leukoedema is a white or whitish-gray edematous lesion of the buccal and labial oral mucosa. The lesions may be diffuse or patchy, and are usually asymptomatic. Leukoedema may be confused with leukoplakia, Darier's disease, white sponge nevus, pachyonychia congenita, or candidal infection. The condition is seen most frequently among black men. The histologic appearance simulates that of white sponge nevus. Symptomatic leukoedema seems to respond to topical application of tretinoin. ( info) |
3/3. Pseudo oral hairy leukoplakia in a renal allograft recipient.Oral hairy leukoplakia (OHL) is a disorder of the tongue associated with Epstein-Barr virus (EBV). OHL is seen mainly in hiv infection but is also rarely seen in the course of iatrogenic immunosuppression, especially in kidney transplantation; OHL is even more rarely seen in immunocompetent hosts. Lesions that clinically and histologically mimicked OHL but were not associated with EBV were recently characterized as pseudo hairy leukoplakia. We present such a case that occurred in a renal allograft recipient; light and electron microscopy, immunohistochemistry, and in situ hybridization were used to examine the patient for the presence of EBV and human papillomavirus. Two independent treatments with topical retinoid and oral amoxicillin resulted in complete remission. Pseudo hairy leukoplakia may correspond, at least in some cases, to the conditions known as leukoedema and white sponge nevus; the distinction of these diseases from OHL is of importance because OHL is a hallmark of severe immunosuppression. ( info) |