1/11. vitamin a toxicity secondary to excessive intake of yellow-green vegetables, liver and laver.We report a case of sudden onset of vitamin a poisoning. A 20-year-old Japanese woman had been eating pumpkin and only a very limited amount of other foods on a daily basis for 2 years. She was overly concerned about weight reduction. Aurantiasis cutis and abnormal liver function tests were noted by her family doctor in 1995 when she was 18 years old. At that time, she stopped eating pumpkin. However, she secretly continued an excessive intake of other beta-carotene-rich vegetables, liver and laver for about 2 years. Two and one-half years after being seen by her family physician, she experienced sudden onset of low-grade fever, limb edema, cheilitis, dry skin, and headache. These symptoms worsened daily. A liver needle biopsy was performed, and it showed a normal portal tract along with fat-laden Ito cells in the space of Disse. A final diagnosis of vitamin a poisoning and hepatic injury secondary to an eating disorder was made. Her symptoms and serum beta-carotene levels returned to normal with successful adjustment of her diet.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
2/11. Familial erythromelanosis follicularis and chromosomal instability.We report a 17-year-old male patient with erythromelanosis follicularis faciei et colli (EFFC), oral leucokeratosis and diabetes mellitus without islet cell antibody. His sister also had minimal findings of EFFC and minimal follicular papules on her shoulders and extensor surfaces of the arms. The father had only fine follicular papules, but no erythromelanosis. skin and mucous membrane lesions of the proband were investigated histopathologically. Interestingly, in peripheral lymphocyte cultures of the family members, chromosomal breakage was not observed spontaneously, but it was seen with nitrogen mustard, although this disease may be of autosomal recessive inheritance. Thus, we suggest that EFFC may be a polyaetiological disorder (i.e. familial and environmental) and might be considered one of the chromosomal instability syndromes.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
3/11. Cutaneous hyperpigmentation induced by doxycycline: histochemical and ultrastructural examination, laser microprobe mass analysis, and cathodoluminescence.skin hyperpigmentation induced by minocycline is a well-recognized side effect of minocycline but has rarely been reported for other tetracyclines. Based on a previously reported unusual case of chronic doxycycline abuse in a psychotic patient, we have investigated the nature of the observed pigment changes in the same patient. Histopathologic investigation of lesional skin by light microscopy disclosed hyperpigmentation of the basal keratinocytes and pigment-laden histiocytes in the dermis and subcutaneous fat. Only the pigment in the histiocytes of the upper dermis was reactive for Fontana Masson stain and could be bleached by hydrogen peroxide. The other histiocytes contained iron and calcium deposits as shown by von Kossa and Perls staining as well as by laser microprobe mass analysis. Ultrastructurally, these histiocytes contained amorphous material within the cytoplasm and stored in lysosomal structures. Comparative cathodoluminescence disclosed the presence of doxycycline in affected skin by means of overlapping emission spectra between the patient's skin and pure doxycycline. Taken together, the histomorphologic and ultrastructural changes induced by doxycycline shared several features with cutaneous hyperpigmentation caused by minocycline. Our biophysical findings further suggest a direct deposition of doxycycline, probably chelated with iron and/or calcium, within the lesional skin. Based on the presented unique case and the reviewed literature, only suprapharmacologic doses of doxycycline may be sufficient to cause such pigment changes.- - - - - - - - - - ranking = 2579.4437107378keywords = subcutaneous fat, fat (Clic here for more details about this article) |
4/11. Flagellate hyperpigmentation following intralesional bleomycin treatment of verruca plantaris.BACKGROUND: Flagellate hyperpigmentation is a well-documented complication of systemic bleomycin sulfate therapy when using doses of 100 U or more as an antineoplastic agent. Two cases occurred after using systemic doses from 15 to 30 U injected intravenously or intrapleurally; however, it has not been described as a complication following intralesional treatment of verruca plantaris. OBSERVATIONS: We report a case of flagellate hyperpigmentation after intralesional injection of 14 U of bleomycin for verrucae plantaris and review the literature associated with this cutaneous complication. CONCLUSIONS: Flagellate hyperpigmentation from extremely low doses of intralesional bleomycin is a previously undescribed complication. Although the mechanisms of reaction are not clearly understood, the clinician should be mindful of this uncommon complication.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
5/11. Linear atrophoderma of Moulin: postulation of mosaicism for a predisposing gene.Hyperpigmented atrophoderma arranged in a pattern following the lines of Blaschko and appearing during childhood or adolescence on the trunk or the limbs is a characteristic feature of linear atrophoderma of Moulin. We review 15 published reports and describe 4 additional cases. Histopathologically, there is no clear sign of atrophy found in specimens examined by light microscopy. It might well be argued that a focal reduction of subcutaneous fatty tissue contributes to the obvious clinical atrophy. The cause and pathogenesis of the disorder remains unknown. It may reflect mosaicism caused by a postzygotic mutation that occurred at an early developmental stage, in analogy to many other diseases distributed along Blaschko's lines. Linear atrophoderma of Moulin may reflect the action of an autosomal lethal gene surviving by mosaicism. There are so far no reports of a familial occurrence that could favor a paradominant transmission of linear atrophoderma of Moulin. However, theoretically, the postzygotic mutation giving rise to an aberrant cell clone could still be nonlethal. In a heterozygous individual, a postzygotic mutational event might lead to loss of the corresponding wild-type allele at the atrophoderma locus. This would give rise to a homozygous cell clone, which becomes manifest along the lines of Blaschko later in life.- - - - - - - - - - ranking = 2579.4437107378keywords = subcutaneous fat, fat (Clic here for more details about this article) |
6/11. Transmission of ring chromosome 13 from a mother to daughter with both having a 46,XX, r(13)(p13q34) karyotype.ring chromosomes are thought to be the result of breakage in both arms of a chromosome, with fusion of the points of fracture and loss of the distal fragments. Another mechanism of ring formation is believed to be the simple fusion of chromosome ends with preservation of telomeric and subtelomeric sequences. Ring chromosome 13 was first described in 1968 and its incidence estimated at 1 in 58,000 live births. Severe phenotypes associated with large deletions of 13q have been described as "ring chromosome 13 syndrome." Features of the "ring chromosome 13 syndrome" include mental retardation (often severe), growth retardation, microcephaly, facial dysmorphism, and hand, foot or toe abnormalities. We report on a case of a mother and daughter with r(13) and mild phenotypes. Our patient, IA, had chromosome analysis performed at about 4(1/2) years of age due to some developmental delay. This revealed 46,XX, r(13)(p13q34) karyotype with no loss of any chromosomal band. Her mother, EA, was subsequently found to have the same ring 13. IA's maternal grandmother had a normal karyotype while her maternal grandfather was unavailable for testing. fluorescence in situ hybridization (FISH) analysis showed loss of a specific subtelomeric 13q region in r(13) in the mother. Clinically, IA had macular hyperpigmentation on the chin and mild delay in speech and fine motor skills. EA, 22 years of age, had mild short stature and borderline mental retardation. To our knowledge, this is the first report of a case of familial transmission of r(13). We compare phenotypes of our cases with those from other reported cases of r(13) and discuss the possible mechanism of formation of this ring chromosome.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
7/11. Diagnostic traps in porphyria: case report and literature review.porphyrias are metabolic disorders of heme biosynthesis, which encompass a broad range of symptoms and signs, neurologic, cutaneous or mixed. Because of lack of specificity and polymorphous clinical picture, porphyrias can mimic either neuropsychiatric, dermatologic, or gastrointestinal diseases. We present the case of a 58 years old man to whom clinical presentation suspicious of Addison's disease (melanoderma, fatigue, weight loss, intermittent abdominal pain) was the disguise of porphyria cutanea tarda. A general background of porphyrias and differential diagnosis with other forms of hepatic porphyria, as well as other causes of hyperpigmentation, are given. The clinician should be aware of the protean manifestations of porphyrias and include them in clinical judgment in various situations.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
8/11. minocycline hyperpigmentation isolated to the subcutaneous fat.We present a 15-year-old girl with bilateral lower extremity discoloration of one-year duration while taking minocycline for acne vulgaris. The clinical characteristics best supported type II minocycline hyperpigmentation, but the histology revealed that the pigmentation was solely limited to the subcutaneous adipose tissue, completely sparing the dermis. Special stain for iron was negative. This is the first case to our knowledge with pigment exclusively located in the subcutaneous fat and with the unusual finding of a negative stain for iron.- - - - - - - - - - ranking = 12897.218553689keywords = subcutaneous fat, fat (Clic here for more details about this article) |
9/11. Interdigital neuroma. Local cutaneous changes after corticosteroid injection.Interdigital neuroma was diagnosed in a patient who was treated subsequently with a local corticosteroid injection. Two to 3 weeks after injection, a 2.5 x 1.5-cm area of hyperpigmentation, thinning of the skin, and subcutaneous fat atrophy developed at the site of the injection. Occurrence of these side effects depends on the solubility of the steroid preparation, the dosage, and the anatomic site and depth of the injection. When using local corticosteroid injections to treat interdigital neuromas, the physician should be familiar with the properties and recommended dosage of the given steroid. The injection should be deep enough so that the cortisone solution does not leak into the subcutaneous area. The possibility of skin atrophy and altered pigmentation should be discussed with all patients.- - - - - - - - - - ranking = 2579.4437107378keywords = subcutaneous fat, fat (Clic here for more details about this article) |
10/11. focal dermal hypoplasia (Goltz syndrome): an adult case with multisystemic involvement.focal dermal hypoplasia (Goltz syndrome) is a rare congenital syndrome with suspected X-linked transmission that is characterized by a wide range of mesoectodermal defects. We describe a 39-year-old woman who had a peculiar phenotype and asymmetry of the body. Examination revealed atrophic erythematous and hyperpigmented linear streaks following Blaschko's lines, some of which were in a reticular or cribriform arrangement. Yellow, soft nodules caused by fat herniation were visible mainly in skin folds. The patient had multiple bone anomalies, including longitudinal striation of long bones (osteopathia striata). She had several ocular, dental, and kidney defects. Histopathologic examination showed a markedly thinned dermis that was replaced by adipose tissue.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
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