Cases reported "Hyperpigmentation"

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1/15. Phytophotodermatitis: the other "lime" disease.

    Phytophotodermatitis is a skin eruption that occurs after contact with photosensitizing compounds in plants and exposure to UV light. There are two common presentations of phytophotodermatitis. Acutely, erythema and vesiculation similar to a severe sunburn are noted. After resolution of the inflammation, the involved skin has marked hyperpigmentation. Many plants have been identified that contain furocoumarins (psoralens), including limes, lemons, and celery. We present a patient with an acute phototoxic eruption and hyperpigmentation after contact with limes during a beach vacation.
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keywords = eruption
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2/15. Persistent serpentine supravenous hyperpigmented eruption as an adverse reaction to chemotherapy combining actinomycin and vincristine.

    A 15-year-old boy experienced a macular serpentine erythematous eruption that subsided with a persistent hyperpigmentation overlying the superficial venous network of the left forearm. This reaction occurred at the injection site of a chemotherapy regimen that combined actinomycin and vincristine a few hours after the first course. After a single injection of actinomycin in the right arm, a similar reaction occurred, implicating it as the responsible agent. A skin biopsy specimen demonstrated a cell-poor interface tissue reaction associated with an eccrine neutrophilic hidradenitis. To our knowledge, this is the first case of persistent supravenous serpentine hyperpigmented eruption reported in a child treated with this particular drug combination.
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ranking = 3
keywords = eruption
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3/15. Idiopathic eruptive macular pigmentation: report of 10 cases.

    Idiopathic eruptive macular pigmentation (IEMP) is a rare disease. IEMP is characterized by asymptomatic, pigmented macules involving the neck, trunk, and proximal extremities. This study describes 10 cases of idiopathic eruptive macular pigmentation seen during a 9-year period at the Asan Medical Center, Seoul, korea. We present these characteristic consecutive cases to provide more insight into the clinical picture and course of IEMP. skin lesions of 8 patients were multiple brown macules involving the trunk, face, neck, and extremities. In 2 patients, multiple dark brown macules and patches were noted. The age of onset varied from 1 to 20 years. Tentative diagnoses were usually ashy dermatosis (erythema dyschromicum perstans), fixed drug eruption, or mastocytosis. The history of any erythema and drug medication was absent. Darier's sign was absent. skin biopsy specimens showed increased pigmentation of the basal layer in an otherwise normal epidermis. Pigmentary incontinence, melanophages, and mild perivascular lymphohistiocytic infiltrate in the papillary dermis were also revealed. mast cells could not be found. The lesions gradually disappeared during a period of several months to years. The alleged rarity of IEMP may be partially caused by medical unfamiliarity with this entity, despite its clinical and histopathologic characteristic picture. Treatment of IEMP is unnecessary because spontaneous resolution of the lesions can be expected within several months to a few years.
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keywords = eruption
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4/15. diltiazem-associated photodistributed hyperpigmentation: a review of 4 cases.

    BACKGROUND: diltiazem hydrochloride is a widely used calcium channel blocking agent. While a few cases of diltiazem-associated photosensitivity have been reported, no cases of photodistributed hyperpigmentation are known. observation: Four cases of photodistributed hyperpigmentation associated with the long-acting formulation of diltiazem hydrochloride (Cardizem CD) are presented. All patients were African American women, with a mean age of 62 years. The mean duration of diltiazem administration prior to the development of hyperpigmentation was 8 months. The hyperpigmentation was slate-gray and reticulated. Phototesting during diltiazem therapy revealed a decreased minimal erythema dose to UV-A in 1 patient. Histopathologic examination showed lichenoid dermatitis with prominent pigmentary incontinence. Electron microscopic examination of the tissue revealed multiple melanosome complexes. Discontinuation of diltiazem therapy resulted in the gradual resolution of the hyperpigmentation. CONCLUSIONS: Long-term administration of diltiazem may be associated with characteristic reticulated, slate-gray hyperpigmentation on sun-exposed areas. Discontinuation of the therapy results in resolution of the eruption.
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ranking = 0.5
keywords = eruption
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5/15. Granular parakeratosis: four paediatric cases.

    Axillary granular parakeratosis (GP) was first described in 1991 as a peculiar eruption presenting with erythematous hyperpigmented and hyperkeratotic papules and plaques of the cutaneous folds frequently associated with pruritus. Histopathology shows a characteristic picture with a conspicuous granular appearance of the parakeratotic horny layer. Until now, only 24 adults, mainly women aged over 40 years, have been reported with GP. We demonstrate that this condition can also occur in young children. Four children aged between 10 and 24 months had asymptomatic hyperpigmented scaling papules 2-3 mm in diameter located on the groin, lower back, buttocks and flanks. In all cases the mothers reported the habit of frequent washing followed by application of many topical products. biopsy revealed the same features in all four patients: the epidermis showed a thickened horny layer with a unique compact parakeratosis with maintenance of the stratum granulosum and marked retention of keratohyaline granules throughout the stratum corneum.
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keywords = eruption
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6/15. Reticulate and stellate acral pigmentation associated with systemic lupus erythematosus and high titers of circulating anticardiolipin antibodies: a possible association with acral microlivedo.

    A Hispanic man with a twenty-eight year history of systemic lupus erythematosus (SLE) and a high titer of anticardiolipin IgG antibodies was noted to have reticulate and stellate acral pigmentation. The patient reported that hand swelling and erythema developed soon after the diagnosis of SLE was established. This episode resolved quickly without recurrence or immediate sequelae. We postulate that this eruption was related to SLE and anticardiolipin antibodies. Reticulate and stellate acral pigmentation should be considered a possible manifestation of SLE and high titers of anticardiolipin antibodies, or a consequence of therapy.
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keywords = eruption
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7/15. Cutaneous manifestations of hydroxyurea therapy in childhood: case report and review.

    hydroxyurea is commonly used in the treatment of various myeloproliferative disorders. In conventional pediatric clinical practice, its use is limited to benign hematologic conditions such as sickle cell disease and thalassemia. Long-term hydroxyurea use is associated with various adverse mucocutaneous effects including hyperpigmentation, alopecia, leg ulcers, and lichenoid eruptions. We report a 10-year-old boy with chronic myelogenous leukemia who presented with hyperpigmentation of the skin and nails 3 months after the start of hydroxyurea therapy. Melanonychia of all 20 nails with involvement of all three mucocutaneous areas (skin, nails, and mucosa) at presentation was a unique feature in our patient. With the recently increasing pediatric use of hydroxyurea in a variety of disorders, its benign and not so uncommon cutaneous adverse effects are emphasized here.
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ranking = 0.5
keywords = eruption
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8/15. mycosis fungoides presenting as pigmented purpuric eruption.

    A case of pigmented purpuric eruptions evolving to mycosis fungoides during the 4-year follow-up period is described. Clinical manifestation was characterized by petechial lesions with irregular shaped, diffusely pigmented plaques partly sharing morphological similarities with chronic pigmented purpura. Histologically, lymphocytes infiltrated around the capillaries of the superficial dermis with extravasated erythrocytes as well as into the epidermis to form Pautrier microabscesses. Whereas CD4 cells were observed in the epidermis and upper dermis, CD8 cells tended to be distributed around the capillaries. Notably, the Rumpel-Leede test revealed extensive punctuate purpura limited to the lesional skin. The aggregation response of platelets was not impaired. Either CD4 tumor lymphocytes or CD8 reactive lymphocytes appeared to induce capillary damage resulting in the formation of petechial lesions. Pigmented purpuric eruptions, such as atypical chronic pigmented purpura, is thus an important initial clinical manifestation of mycosis fungoides.
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ranking = 3
keywords = eruption
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9/15. adult-onset Still's disease with prurigo pigmentosa-like skin eruption.

    A 34-year-old woman with adult-onset Still's disease (AOSD) developed prurigo pigmentosa-like lesions on her chest and upper back in addition to the typical rash of AOSD. A biopsy specimen taken from the upper back showed characteristic features of prurigo pigmentosa. The eruption and fever subsided immediately after the administration of 40 mg/day prednisolone, but arthralgia persisted even after intravenous pulse methylprednisolone therapy in combination with immunosuppressive drugs. Various atypical skin rashes, including prurigo pigmentosa-like lesions, have been reported in association with AOSD. Therefore, one should carefully follow the clinical course of a patient in order not to overlook these atypical cutaneous manifestations of AOSD.
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ranking = 2.5
keywords = eruption
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10/15. Oral presentation of minocycline-induced black bone disease.

    minocycline hydrochloride is a semisynthetic tetracycline derivative used widely for the treatment of acne vulgaris. Among its side effects is the ability to pigment many tissues particularly thyroid, skin, tooth, and bone. A case is presented in which long-term minocycline therapy (500 g taken orally over 11 years) resulted in dark bone pigmentation (black bone disease) severe enough to be visible through the alveolar and palatal mucosa. No skin or tooth pigmentation was present.
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ranking = 0.022714834533698
keywords = tooth
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