1/19. Temporal arteritis presenting with scalp ulceration.We report the case of a 75-year-old-woman who presented with bilateral scalp ulcerations and blindness, accompanied by severe headache and scalp tenderness, due to bilateral temporal arteritis without systemic involvement. A biopsy taken from the border of an ulceration showed evidence of giant cell arteritis. She was treated with oral prednisone, 60 mg per day. The ulcerations healed in a few weeks but the vision loss was irreversible. This case highlights for temporal arteritis the importance of accurate and timely diagnosis as well as the need for prompt therapy with systemic steroids in order to avoid major complications, namely loss of vision. It also demonstrates that scalp necrosis and ulcerations are skin signs associated with a poor prognosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/19. Ulcerated juvenile xanthogranuloma of the scalp.A 7-month-old girl presented with a single rapidly enlarging thickly crusted lesion on her frontal scalp. histology was consistent with a juvenile xanthogranuloma (JXG) with ulceration and surface crust formation. Reports of ulcerating, crusted lesions of JXG are rare and the few reports have been confined to giant forms or those involving mucosal sites. This unusual presentation delayed diagnosis. Our report highlights the great variability in clinical presentation of JXG and is a reminder to consider this diagnosis in the differential of any lesion developing in an infant, particularly on the head, neck and upper trunk.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/19. Bilateral scalp necrosis with giant cell arteritis.We present a patient with bilateral scalp necrosis caused by giant cell arteritis (temporal arteritis). A 67-year-old woman, who had been treated with 5 mg of oral prednisolone every other day for polymyalgia rheumatica, developed painful egg-sized regions of necrosis on both of her temples. Doppler pulsemetory revealed bilateral obstruction of the temporal arteries. biopsy revealed ischemic necrosis of the skin and necrotic angiitis of the temporal arteries with giant cell infiltration. Bilateral stenosis of the internal carotid arteries and moderate retinal bleeding were revealed by angiography. Daily administration of prednisolone (20 mg/day) with intravenous and topical limaprost alphadex markedly improved her condition. The ulcers reepithelized without surgical treatment. There are few reports of bilateral scalp necrosis. Rapid and complete obstruction of the temporal artery may result in this condition. Simultaneous development of two ulcerative lesions in the ventro-parietal cranial regions is thought to correspond to systemic arterial involvement, including involvement of the internal carotid arteries.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
4/19. Giant lichenification of the scalp.Lichenification is characterized clinically by thickening of areas of skin as a result of the itch-scratch cycle and therefore is seen in conditions associated with chronic pruritus. The characteristic feature of giant lichenification is the occurrence of tumour-like growths with a warty cribriform surface. We describe a renal transplant patient presenting with giant lichenification of the scalp following an attack of herpes zoster at the same site. Chronic pruritus following scalp dysaethesia secondary to herpes zoster was considered the most likely explanation for the occurrence of these lesions.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
5/19. scalp necrosis in temporal arteritis.giant cell arteritis is a systemic disease of the elderly which affects large and medium-sized arteries and which may occur in association with polymyalgia rheumatica. scalp necrosis is a rare cutaneous complication of giant cell arteritis, and this dermatological presentation is not commonly reported.1-4 giant cell arteritis should be considered in all elderly patients with scalp ulceration. We describe two patients who presented in this manner.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/19. A case of black dot ringworm attributable to trichophyton violaceum: a simple method for identifying macroconidia and microconidia formation by fungi-Tape and MycoPerm-Blue.An 85-year-old Japanese woman sought a dermatologic consultation for evaluation of a walnut-sized alopecia with pityroid desquamation in the parietal region of her scalp. She had been admitted to a nursing home about three months earlier, and, at that time, a thumb-tip-sized, scaly alopecia was noted. Several hairs at the site were eroded in a black dot. Direct KOH microscopy of affected hair showed large spore endothrix infection. To isolate macro- and microconidia for fungal identification, we incubated the affected hair and scales and obtained giant colonies in a special enriched medium. Using fungi-tape and MycoPerm-Blue, we were able to collect and identify trichophyton violaceum macro- and microconidia from the white, powdery, fluffy colony that slowly developed after about six weeks of growth on enriched medium. Over the past 20 years, only about 20 cases of tinea capitis caused by T. violaceum have been reported in japan, and macroconidia have been identified in only 4 cases, including this one.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/19. An unusual presentation of giant cell arteritis.A 77-year-old-man with giant cell arteritis who developed bitemporal scalp ulcerations is described. Since 1946 when Cooke et al. reported the first case of scalp necrosis there were approximately 55 cases published. scalp ulceration is a rare complication of giant cell arteritis and occurs mainly in elderly persons, particularly women. About half of all patients were presented to dermatologists. Most of the patients (70%) had other serious complications of giant cell arteritis: blindness, gangrene of the tongue and nasal septum necrosis. Seventy percent of the cases were confirmed by a temporal artery biopsy. The necrosis were of varying extent and uni- or bilateral. Although, in most cases necrosis has been located bilaterally as in the presented case. scalp healing was complete nearly in all patients by conservative treatment within a year. scalp ulceration is a potentially reversible complication of giant cell arteritis which indicates extensive vessel involvement and adequate coricosteroid therapy is required and essential.- - - - - - - - - - ranking = 8keywords = giant (Clic here for more details about this article) |
8/19. giant cell arteritis presenting with scalp necrosis--the timing of temporal artery biopsy?scalp necrosis in patients presenting with clinical features suggestive of giant cell arteritis is rare. The immediate concern is that temporal artery biopsy might further compromise scalp circulation. We report a case of extensive scalp necrosis caused by giant cell arteritis. Temporal artery biopsy performed after 14 days was not associated with any significant damage and still provided florid evidence of the disease. Rapid and complete scalp healing was achieved with aggressive treatment.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
9/19. Self-healing juvenile cutaneous mucinosis: cases highlighting subcutaneous/fascial involvement.BACKGROUND: Self-healing juvenile cutaneous mucinosis is a rare disease affecting young people characterized by transient cutaneous lesions and sometimes mild inflammatory symptoms. The deep dermal and subcutaneous features of this disorder have not yet been well described. OBJECTIVE: The purpose of our study was to present 3 cases of self-healing juvenile cutaneous mucinosis in which the histopathologic features caused diagnostic confusion between this disorder and proliferative fasciitis. methods: The study includes clinical and histologic findings of 3 patients, complemented by a literature review. RESULTS: The histologic descriptions of nodular lesions in self-healing juvenile cutaneous mucinosis reveal features of proliferative fasciitis, including a myxoid stroma and gangliocyte-like giant cells. LIMITATIONS: Self-healing juvenile cutaneous mucinosis is a rare condition and has not been frequently reported in medical literature. Our findings are based on the pathologic features of 3 patients. CONCLUSIONS: Our findings further elucidate the histologic features of self-healing juvenile cutaneous mucinosis and expand the differential diagnosis for entities in which gangliocyte-like giant cells are noted.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
10/19. skin necrosis in giant cell (temporal) arteritis: report of three cases.Three elderly, female patients presented with scalp ulceration. One developed sudden blindness before the ulceration of the scalp. biopsy from the ulcerated area in this patient did not show evidence of giant cell arteritis, but the two other patients had histological evidence of giant cell arteritis and one of these also became blind.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
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