1/59. Cutaneous Hodgkin's disease. A case of specific cutaneous Hodgkin's disease, which is sparsely mentioned in the literature, is reported. The lesion was nodulo-ulcerative and corresponded to the Grosz-Hirschfield type. It was confirmed by biopsy and the pattern was similar to that of an excised supraclavicular node examined two years previously. The lesion responded to treatment with gentamicin topically, clindamycin orally and 500 r of cauterizing X-ray. There has been no recurrence to date and no other new cutaneous lesions. This report further confirms what Ferdinand von Hebra implied one hundred years ago--that a dermatologist should not only know skin diseases but also the cutaneous manifestations of visceral diseases. ( info) |
2/59. A cutaneous manifestation of untreated disseminated histoplasmosis. We present a case of histoplasmosis with skin manifestations occurring 17 years after initial diagnosis. The clinical manifestations of disseminated disease are discussed. amphotericin b administered through an A-V shunt resulted in prompt resolution of the skin lesions. ( info) |
3/59. Cutaneous manifestations of lightning injury. This report calls attention to a bizarre, almost pathognomonic, cutaneous feature of lightning injury. It has been variously described as "lightning prints," "arborescent" burns, or "feathering," and has long been neglected in the dermatologic literature. Its recognition may be lifesaving in the unaccompanied comatose patient and is important because even delayed resuscitation of lightning victims can be very successful. ( info) |
4/59. Seborrhoeic keratoses and carcinoma of the large bowel. Three cases exhibiting the sign of Lester-trelat. Three patients who rapidly developed multiple seborrhoeic keratoses and were found to have adenocarcinoma of the large bowel are described. In two cases the discovery of the neoplasm was prompted by skin manifestations. ( info) |
| In a patient with essential cryoglobulinemia with systemic, cutaneous, and neurologic manifestations and a mixed IgG-IgM cryoprotein, elimination of systemic and cutaneous disease manifestations, as well as notable reversal of neurologic impairment, followed therapy with melphalan. Levels of circulating cryoprotein decreased, but protein structure was unchanged by chemotherapy. Experience to date with alkylating agents suggests that this mode of treatment is the most effective currently available. ( info) |
6/59. Sign of Leser-Trelat. We report a case of squamous cell carcinoma of the lung associated with the sudden appearance of seborrheic keratosis and acquired ichthyosis. We conclude that the sign of Leser-Trelat is a rare cutaneous manifestation of internal malignant disease. ( info) |
7/59. Secondary syphilis revealed by rheumatic complaints. Six patients (five men and one woman) are described, who consulted rheumatologists with varied rheumatic complaints: four had subacute synovitis with effusion, frequently associated with vague arthralgias; and five of the patients had back pain which was more severe at rest. Most of the patients had some clinical signs of secondary syphilis, such as roseola, loss of hair, or lymphadenopathy, and their serological reactions for lues were strongly positive. Since no other cause for these rheumatic complaints could be found, secondary syphilis was considered responsible for them. In all cases the rheumatic complaints cleared with specific treatment. ( info) |
8/59. Leukocytoclastic angiitis in subacute bacterial endocarditis. The case of a patient who had palpable purpura on his lower extremities due to lactobacillus-caused subacute bacterial endocarditis is reported. Histologic examination of the purpuric lesions demonstrated a leukocytoclastic angiitis. It is postulated that purpuric and other cutaneous lesions of subacute bacterial endocarditis are related to circulating immune complexes. ( info) |
9/59. Unusual cutaneous associations of a malignant carcinoid tumour of the bronchus--erythema annulare centrifugum and white banding of the toe nails. The case history of a patient who presented with erythema annulare centrifugum and white banding of the toe nails is recorded. On investigation for an underlying malignancy the patient was found to have an opacity in the lower lobe of the right lung. Subsequently lobectomy was performed and histology of the operative specimen revealed a malignant carcinoid tumour of the bronchus. ( info) |
10/59. Graft-versus-host reaction. Cutaneous manifestations following bone marrow transplantation. The distinctive cutaneous changes that occur in both the acute and chronic forms of the graft-vs-host reaction (GVHR) are described in two living patients in whom the GVHR developed after bone marrow transplantation for aplastic anemia. In the skin, the mild form of the acute GVHR is recognized as a subtle macular erythema, and the severe form appears as erythematous papules and violaceous macules with scale. Skin biopsy specimens in both of the acute forms show vacuolar alterations of the epidermal basal-cell layer with a perivenular infiltrate of lymphocytes. The chronic GVHR evolves from generalized scaling to diffuse areas of aclerotic and atrophic skin with a curious reticulated hyperpigmentation, ulcerations, and alopecia. Histopathologic study shows collagenization of the dermis that can be correlated with the clinical sclerodermoid changes. Owing to its visibility, the skin offers a unique opportunity for the early recognition of the GVHR. ( info) |