Cases reported "Dermatitis, Seborrheic"

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1/13. Keratosis lichenoides chronica: marked response to calcipotriol ointment.

    Keratosis lichenoides chronica (KCL) is a rare dermatosis characterized by a distinctive seborrheic dermatitis-like facial eruption, together with violaceous, papular, and nodular lesions on the extremities and trunk, typically arranged in a linear and reticulate pattern. KLC is resistant to therapy, although spontaneous remission has been reported. We describe a 35-year-old woman with KLC who had the typical features of widespread violaceous, reticulate, and striae-like eruptions with a prominent keratotic component over a nine-year period and who responded well to treatment with calcipotriol ointment. The immunohistochemical profiles are presented in addition to typical histopathologic features.
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2/13. Four cases of sebopsoriasis or seborrheic dermatitis of the face and scalp successfully treated with 1a-24 (R)-dihydroxycholecalciferol (tacalcitol) cream.

    A 71-year-old woman visited our clinic due to the presence of widespread scaly erythema on her face, scalp, and lower extremities. She was tentatively diagnosed as having seborrheic dermatitis but the symptoms were difficult to distinguish from psoriasis vulgaris. As a result, she was diagnosed as having sebopsoriasis. She was treated topically with an active vitamin D3 compound, 1a-24 (R)-dihydroxycholecalciferol D3 (tacalcitol) cream. She applied tacalcitol cream twice daily for 4 weeks, and her facial eruptions thus cleared up completely. No recurrence was observed for 2 months thereafter, even though the use of tacalcitol cream was stopped. To investigate whether or not tacalcitol cream is generally effective for the treatment of such seborrheic dermatitis-like eruptions, three more patients were treated with tacalcitol cream. All patients exhibited scaly erythematous macules on the face and/or scalp, and their eruptions improved rapidly with tacalcitol cream. Tacalcitol cream was thus found to be effective and useful for the treatment of both sebopsoriasis and even seborrheic dermatitis of the face and scalp.
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3/13. The sign of Leser-Trelat in a young woman with osteogenic sarcoma.

    The sign of Leser-Trelat refers to a sudden increase in size and number of seborrheic keratoses associated with internal malignancy. The validity of this cutaneous sign continues to be debated, particularly because of the prevalence of both seborrheic keratoses and malignancy in the elderly population. Preceding inflammatory skin conditions are known to precipitate eruptions of seborrheic keratoses in otherwise healthy persons. These cutaneous lesions may also be associated with other markers of underlying malignancy such as acanthosis nigricans. We present a young female patient with osteogenic sarcoma in whom eruptive seborrheic keratoses developed. We believe this case is representative of the sign of Leser-Trelat.
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4/13. Florid cutaneous papillomatosis.

    The abrupt onset of acanthosis nigricans (AN) or of multiple seborrheic keratoses in middle-aged or older people is often associated with underlying malignant neoplasms. We describe a 64-year-old woman who developed a large number of verrucous papillomas on the trunk and extremities, followed within a few months by the sudden appearance of both the lesions of AN and those of multiple seborrheic keratoses. laparotomy disclosed a gastric adenocarcinoma. A number of similar cases have been described in the literature. It is emphasized that patients with suddenly appearing verrucous papillomas should be examined carefully for an underlying cancer. To call attention to this eruption, which may be mistaken for generalized warts, we suggest the term "florid cutaneous papillomatosis".
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5/13. Seborrheic dermatitis-like tinea faciei.

    We report a 10-year-old Caucasian child who had erythema and abundant scaling on the nasolabial folds, the upper lip, and on the nose. Both the abundant scaling and the localization on the central part of the face led us to suspect seborrheic dermatitis. Direct microscopic examination of some scales removed from the lesions showed septate and ramified ectothrix hyphae. Cultural examination on Sabouraud medium led to the identification of the trichophyton mentagrophytes species. We described this patient to highlight the importance of considering tinea faciei in the differential diagnosis of all facial eruptions and the value of mycologic examination.
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6/13. psoriasis: odd varieties in the adult.

    Occasionally we observe particular varieties of psoriasis and in rare cases transitional features with other diseases, which pose problems concerning the differential diagnosis and the nosological classification. This communication deals with the following clinical and histological aspects of psoriasis: 1) Sebopsoriasis. Relationship of psoriasis to pityriasis rubra pilaris. 2) erythema annulare centrifugum type of psoriasis. 3) Is subcorneal pustular dermatosis an expression of pustular psoriasis? 4) Salient histopathological criteria for the diagnosis of the different atypical forms of psoriasis. 5) Presentation of an unusal case with striated and retiform verrucous psoriasis-like eruptions, which show a relationship to parakeratosis variegata.
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7/13. alopecia in association with severe seborrhoeic dermatitis following combination antiretroviral therapy for acute retroviral syndrome.

    We present a case where alopecia occurred with severe seborrhoeic dermatitis associated with the commencement of combination antiretroviral therapy for acute retroviral syndrome. We postulate that the eruption could represent a novel manifestation in association with immunological response to antiretroviral therapy.
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8/13. Seborrheic dermatitis in acquired immunodeficiency syndrome.

    Cutaneous eruptions are commonly seen in acquired immunodeficiency syndrome (AIDS). Seborrheic dermatitis in this patient population is usually more severe and difficult to diagnose and treat. The butterfly distribution of the rash and the interpretation of the biopsy may suggest a diagnosis of discoid lupus erythematosus, unless the pathologist is aware of the underlying immunodeficiency. We present two cases of patients with documented acquired immunodeficiency syndrome whose initial biopsies were interpreted as discoid lupus but whose cutaneous seborrheic dermatitis actually paralleled human immunodeficiency virus disease activity.
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9/13. gold sodium thiomalate (GTM) induces hypersensitivity to thiomalate, the thiol carrier of GTM.

    A case of the gold sodium thiomalate (GTM)-induced eruptions with thiomalate (TM) hypersensitivity was reported. A 61-year-old Japanese woman developed lichenoid and seborrheic dermatitis (SD)-like eruptions with alopetia, when the total dosage of GTM administered for rheumatoid arthritis became 110 mg. The eruptions slowly disappeared with pigmentation after discontinuance of the GTM therapy, and the resumption resulted in the development of similar eruptions. She showed a positive reaction to GTM in an intradermal test. She also showed a positive response to TM, which is the thiol carrier of GTM, in the patch test, but a negative one to metallic gold. After administration of auranofin (AF), she also developed the SD-like eruptions with hypersensitivity to metallic gold as well as AF on patch testing, but did not develop the lichenoid ones. Our animal experiments revealed an almost complete cross reaction between GTM and TM, but only a partial one between GTM and aurothioglucose, which have dissmilar structures in the carrier part for gold. Probable roles of hypersensitivity to TM and metallic gold, which are metabolites of GTM, were discussed, respectively, in the genesis of the GTM-induced lichenoid eruptions and the AF-induced SD-like eruptions.
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10/13. Leser-Trelat sign in mycosis fungoides. A further case report.

    A 61-year-old woman is presented who developed numerous seborrheic keratoses within a few weeks. About 2 months later the patient noticed a progressive generalized erythematosquamous eruption on which the diagnosis of mycosis fungoides was made. PU-VA therapy resulted in complete remission of the mycosis fungoides lesions together with a resolution of the seborrheic keratoses. This is the third report of the Leser-Trelat sign in mycosis fungoides. The cases associated with malignant lymphomas are briefly reviewed.
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