1/11. Detection of Epstein-Barr virus in epidermal skin lesions of an immunocompromised patient.Using in-situ hybridizaiton, we showed the presence of the Epstein-Barr (EB) virus genome in epidermal cells from a patient with chronic lymphocytic leukemia and unusual cutaneous lesions characterized clinically by a maculopapular eruption and histologically by epidermal cell degeneration and lymphoid cell infiltration. Such histologic changes are similar to those seen in graft-versus-host disease. The EB virus genome was mainly detected in the basal, germinative cells of the abnormal epithelium. Specimens of our patient's healthy skin were negative. The presence of EB virus dna in skin lesions was confirmed by polymerase chain reaction adapted for analysis of paraffin-embedded tissue. These findings indicate that EB virus can infect the human epidermis and that the viral infection may produce a distinctive cutaneous disease.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
2/11. Superficial epithelioid sarcoma: a clinical and histologic stimulant of benign cutaneous disease.Epithelioid sarcoma, a distinctive clinicopathologic entity, typically arises in the deep soft tissues of the upper and lower extremities. Infrequently the tumor originates in the subcutis or dermis, whereby it may be confused both clinically and microscopically with a granulomatous or benign ulcerative process. A case of superficial epithelioid sarcoma, initially diagnosed as an atypical mycobacterial infection, is presented, and its histologic distinction from granulomatous and benign fibrohistiocytic lesions is discussed.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
3/11. Giant mycobacterium fortuitum abscess associated with systemic lupus erythematosus.A 36-year-old woman with a 1 1/2-year history of systemic lupus erythematosus was first seen in October 1984 with a six-month history of several ulcerated and scarred lesions on the lower extremities. A biopsy specimen showed a granulomatous infiltrate of deep dermis and subcutaneous tissue. Over the next three weeks, the patient developed a violaceous, warm, indurated, tender, fluctuant lesion involving most of the left buttock. A culture showed a rapidly growing atypical acid-fast bacteria, which was later identified as Mycobacterium fortuitum. The patient was treated with surgical drainage of the left hip abscess, followed by a three-week treatment with doxycycline hyclate and amikacin sulfate. She was discharged while receiving oral doxycycline and ethambutol hydrochloride.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
4/11. Cutaneous botryomycosis in a patient with acquired immunodeficiency syndrome.A patient with acquired immunodeficiency syndrome presented with multiple pruritic papules and nodules over the trunk and extremities. biopsy specimens from two of these lesions contained granules within abscesses of the papillary dermis. There were numerous gram-positive cocci within the granules. culture of one lesion failed to produce growth. A mouse inoculated with tissue from a lesion revealed no evidence of sepsis or organ involvement. The skin lesions showed no obvious response to systemic antimicrobial therapy but gradually resolved after treatment had been discontinued. Such lesions should be clinically distinguished from other cutaneous manifestations of acquired immunodeficiency syndrome, such as Kaposi's sarcoma.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
5/11. hepatitis b surface antigen positive skin lesions. Two case reports with an immunoperoxidase study.This study represents the first two case reports of skin lesions positive for hepatitis b surface antigen (HBsAg) with the immunoperoxidase technique. A 25-year-old man and a 64-year-old woman with serologic evidence of acute B viral hepatitis and concurrent skin lesions are presented. Immunoperoxidase study of the skin lesions for HBsAg revealed strong positive staining of squamous epidermal cells, eccrine sweat glands, and endothelial cells in the superficial papillary dermis. Immunoperoxidase staining for hepatitis b core antigen (HBcAg) was negative in both cases. Electron microscopy failed to reveal viral particles.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
6/11. cytomegalovirus infection of the skin.A case of fatal generalized cytomegalovirus infection with particular attention to lesions involving the skin is reported. Characteristic cytomegalovirus inclusion bodies were present within nuclei of endothelial cells in the dermis beneath ulcerations. skin biopsy may be useful in the diagnosis of disseminated infections by cytomegalovirus.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
7/11. Disseminate intradermal bacterial colonization presenting as palpable purpura in lymphoblastic leukemia.A patient with acute lymphoblastic leukemia suddenly developed a disseminated monomorphic eruption of purpuric papules. The papules were initially thought to be lesions of vasculitis, leukemia cutis, or septic emboli. Histologic study, however, revealed large focal colonies of gram-positive cocci within the dermis. It is postulated that a bacteremia of antibiotic-resistant cocci led to dissemination of these organisms into a virtually defenseless skin. The patient's pancytopenia and consequent immune paralysis are viewed as accounting for this focal bacterial colonization and for the remarkable absence of clinical and histologic inflammatory response. Such hematogenous noninflammatory bacterial colonization of the skin must be added to the differential diagnosis of palpable purpura.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
8/11. Fatal aeromonas hydrophila infection of the skin.A 62-year-old woman developed a fatal aeromonas hydrophila infection of the skin after dropping a crab trap on her leg. The area surrounding the punctures was erythematous and had several flaccid bullae. A biopsy specimen of the involved skin showed necrosis and suppuration in the dermis and subcutaneous fat. The A hydrophila sepsis resolved after treatment with gentamicin, but the patient developed secondary wound infections and died three months after injury.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
9/11. Chronic infection with cutaneous herpes simplex in a patient with systemic lupus erythematosus.A 68-year-old black woman with systemic lupus erythematosus being managed by systemic corticosteroids developed large ulcerated lesions in a dermatomal distribution on the flank and abdomen. Subsequently, large ulcers developed progressively in the perianal region, the buttocks, the perivaginal region, and the thighs. The clinical diagnosis was vasculitis of systemic lupus erythematosus. biopsy from the margin of an ulcer showed changes in the epidermis that are specific for infections by herpesvirus. Electron microscopy revealed viral particles of herpesvirus. Cultures from the perianal lesions grew Herpesvirus hominis. This is the first report to our knowledge of "chronic cutaneous herpes infection" in a patient with systemic lupus erythematosus.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
10/11. Two cases of protothecosis in Nagoya, japan.Two cases of protothecosis caused by prototheca wickerhamii have been reported from Nagoya in a 12 year period in both cases the infection presented on the cheeks of otherwise healthy women. Biopsies showed numerous PAS positive staining organisms with the distinctive mulberry like endosporulation in the dermis. prototheca wickerhamii was identified on sugar assimilation tests of colonies isolated from tissue on Sabouraud agar. Case 1 responded to 11 months of oral ketoconazole therapy. Case 2 might not respond to itraconazole. The source of the infections has not been identified.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
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