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1/12. adult-onset Still's disease with persistent plaques.

    adult-onset Still's disease (AOSD) is a systemic disorder characterized by intermittent fever, evanescent rash, arthralgias or arthritis and predominantly neutrophilic leucocytosis. We report on a 16-year-old woman with Still's disease who developed, in addition to the typical rash, persistent papular lesions on her face, neck and upper and lower back. Although the presence of fixed skin lesions is not a characteristic feature of AOSD, their appearance at the onset of the disease and their evolution suggest that they represent a specific manifestation of the disease.
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keywords = neck
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2/12. Multiple plaques on the face and neck of a middle-aged man. diagnosis: secondary syphilis.

    syphilis is an unusual diagnosis in an ENT practice. We evaluated a 55-year-old man who had generalized plaques on his face, neck, and upper extremities. Analysis of skin biopsy and serology specimens revealed that the patient had secondary syphilis. He responded rapidly to treatment. The purpose of this article is to remind otolaryngologists of the signs and symptoms of syphilis so that it can be recognized and treated in a timely fashion.
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keywords = neck
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3/12. A case of acute generalized exanthematous pustulosis (AGEP) possibly induced by iohexol.

    acute generalized exanthematous pustulosis (AGEP) is an uncommon disease manifested as an erythematous pustular eruption. It is usually caused by systemic medication. We describe a patient with acute generalized pustular eruption induced by iohexol. A 52-year-old woman developed fever and a generalized pustular eruption on the neck, trunk and extremities three days after taking iohexol. The culture from pustules was sterile. Other systemic and laboratory examinations were normal. A skin biopsy from a lesion on the trunk showed the features of a drug-induced pustular eruption as a subcorneal blister including neutrophils and eosinophils, mild spongiosis, and a sparse infiltrate at neutrophils and eosinophils in the papillary dermis. The patient had no history of psoriasis. The lesions resolved with systemic corticosteroid therapy within one week and did not relapse. According to our investigation, iohexol-induced AGEP has not been previously reported. We present an interesting case.
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keywords = neck
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4/12. Atypical CD30 cutaneous lymphoid proliferation in a patient with tuberculosis infection.

    We describe the case of a 65-year-old woman affected by a diffuse lymphadenopathy consistent with tuberculous infection who developed a papular eruption on the head and neck region. Histopathologic examination of one papule showed an atypical CD30 lymphoid infiltrate, which initially was cause of concern for the pathologists but was eventually regarded as reactive in nature. The case reported herein enlarges the spectrum of inflammatory infiltrates in which atypical CD30 cells may be found. Since the reactive atypical CD30 cells are morphologically similar to those cells observed in CD30 lymphoproliferative disorders, including lymphomatoid papulosis, complete clinical history and laboratory findings are necessary to make the final and correct diagnosis. Although the pathogenetic relevance of the presence of CD30 cells within the cutaneous infiltrate of patients with systemic tuberculosis remains to be determined, our findings support the hypothesis that the cytokine profile associated with tuberculosis may not be strictly TH1-like, and that a TH1-like to TH2-like switch may also occur.
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keywords = neck
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5/12. Systemic lupus erythematosus with unusual maculopapular and erosive cutaneous lesions.

    In 2002, a 38-year-old woman was referred to the department of dermatological sciences for the evaluation of erythematous-infiltrated lesions with prominent purpuric and erosive components distributed on her face, upper chest, and extensor surfaces of the limbs, which developed over a 3-month period. In 1997 the patient suffered from polyarthralgia (proximal interphalangeal,knee, wrist, and metacarpophalangeal joints) associated with morning stiffness. In 1999 she was admitted to a psychiatric unit for depression with episodes of lipothymia. In the same year, since she developed diffuse and persistent urticarial manifestations with angioedema and livedo reticularis of the limbs in association with anticardiolipin antibodies, vasculitis was proposed. Upon examination, erythematous-infiltrated and erosive lesions in association with serohemorrhagic crusts were present on the face,neck, chest, upper trunk, and extensor surfaces of the upper limbs and thighs (Figures 1-3). Telangiectasias were especially evident on the cheeks, where prominent edema conferred her face a moon-like appearance (Figure 1). Laboratory investigations disclosed microcytic anemia, elevated erythrocyte sedimentation rate, proteinuria (30 mg/dL), positive antinuclear antibodies (1:80) with diffuse fluorescence pattern, lowered complement levels (C3: 31 mg/dL, C4: 3 mg/dL), circulating immunocomplexes binding Clq, and high titers of anti-TSH receptor antibodies. Indirect immunofluorescence was negative for the detection of anti-basement membrane zone antibodies. Histological examination of the lesional skin of the shoulder documented epidermal atrophy, marked vacuolar degeneration of the basal cell layer, colloid bodies, and a perivascular lymphohistiocytic infiltration of the upper and deep dermis (Figure 4). Direct immunofluorescence performed on affected skin showed junctional granular deposition of IgG, C3,and Clq in association with perivascular C3 and Clq deposits in the upper dermis; direct immunofluorescence on sun-protected,non-lesional skin showed similar immunological deposition both at the basement membrane zone and in the perivascular dermis.Based upon the clinical, histologic, and immunopathologic findings, we proposed the diagnosis of systemic lupus erythematosus with maculopapular and erosive skin lesions. The patient was treated with methylprednisolone IV (pulse therapy, 250 mg) tapered over 10 days and later continued p.o. After a few weeks, significant improvement of cutaneous manifestations was noted.
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keywords = neck
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6/12. Benign cutaneous Degos' disease: a case report and review of the literature.

    We report a case of benign form of Degos' disease, a rare condition often characterized by multisystemic vasculopathy, and discuss the case by the light of the limited literature available. A 34-year-old male patient was admitted to our clinic with lesions on his neck and back and a history of not getting any benefit from previous acne medications. Dermatological examination revealed erythematous papules with hemorrhagic crusts on their surfaces and many well-defined atrophic scar tissues. Histopathological evaluation of a biopsy obtained from a lesion revealed the findings of Degos' disease. Further evaluation did not reveal any sign of systemic involvement. He was diagnosed with the benign form of Degos' disease.
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keywords = neck
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7/12. White fibrous papulosis of the neck: a chinese case.

    A 48-year-old man who presented with papules on his neck was reported. The patient had multiple, discrete, non-follicular papules on the neck that were round-to-oval, 2--3 mm in diameter and pale. They had remained entirely asymptomatic. On histologic examination, there were circumscribed areas of thickened collagen bundles in the papillary to mid-dermis. This clinical and histologic picture suggested the diagnosis of "white fibrous papulosis of the neck". As far as we are aware, this is the first report of the condition from china.
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keywords = neck
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8/12. Isolated extragenital HPV-thirties-group-positive bowenoid papulosis in an AIDS patient.

    We report a case of extragenital bowenoid papulosis in a man with AIDS. The lesions occurred on the anterolateral aspects of the neck, and were not associated with clinical genital or periungual involvement. in situ hybridization demonstrated abundant HPV dna within the thirties group (31/33/35), in the absence of HPV-16 or -18.
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keywords = neck
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9/12. Pseudoxanthoma-elasticum-like papillary dermal elastolysis: another case.

    Pseudoxanthoma-elasticum-like papillary dermal elastolysis is a rare acquired idiopathic non-inflammatory elastolytic disorder. This disease, described in aged females, is characterized by asymptomatic skin lesions of the neck and supraclavicular regions clinically resembling pseudoxanthoma elasticum. Histological and ultrastructural examinations show a total loss of the elastic fibres in the papillary dermis. We report another case of this entity in a 69-year-old Italian woman.
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keywords = neck
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10/12. pseudoxanthoma elasticum-like papillary dermal elastolysis: a report of two cases.

    We report 2 women, aged 83 and 63 years, who presented with multiple asymptomatic, slowly progressive, coalescing, skin-colored papules affecting the sides of the neck and lower abdomen. Incisional biopsies obtained from both patients revealed elastolysis in the papillary dermis. These 2 cases represent pseudoxanthoma elasticum-like papillary dermal elastolysis, a recently described entity, the etiology of which remains unclear.
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ranking = 1
keywords = neck
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