Cases reported "Skin Diseases"

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1/214. skin eruption with gabapentin in a patient with repeated AED-induced Stevens-Johnson's syndrome.

    skin eruptions have been reported with the use of all antiepileptic drugs and there is a significant risk of cross-reactivity between these agents in causing serious eruptions such as Stevens-Johnson's syndrome. Gabepentin is usually considered a safe agent for patients with a previous history of drug allergies and there have been no cases of skin eruption reported to the gabapentin post marketing surveillance. We report a patient who had severe Stevens-Johnson's syndrome induced by phenytoin and later by carbamazepine. Subsequent use of gabapentin also resulted in a skin eruption which was limited to the lower extremities but without systemic or mucosal involvement. This case suggests that patients with a strong history of drug-induced idiosyncratic reactions may experience such reactions to gabapentin as well.
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keywords = eruption
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2/214. Generalized granuloma anulare in a 15-month-old infant.

    A Japanese girl aged 15 months had an eruption of 3 months' duration on the face, trunk, and extremities except for the palms and soles. The lesions were infiltrated papules varying from 2 to 3 mm in diameter. blood eosinophilia of 5% was demonstrated. skin biopsy specimen revealed a necrobiotic palisading granuloma in the corium. All lesions began to subside after 1 weeks' administration of oral corticosteroid and completely involuted in 2 months. A possible etiologic role of insect bites was considered.
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ranking = 0.125
keywords = eruption
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3/214. syphilis in an hiv infected patient misdiagnosed as leprosy.

    A 42-year-old man with uveitis and a widespread cutaneous eruption, histopathologically characterized by dermal granulomatous infiltrates with perineurial invasion, was incorrectly diagnosed and treated as having borderline leprosy. Further studies demonstrated secondary syphilis and human immunodeficiency virus (hiv) infection. Standard penicillin therapy resolved his cutaneous and ocular lesions. Reports on clinical and pathological findings of active syphilis in hiv infected patients are scarce but this case and isolated previous case reports suggest that granulomatous infiltrates might be a common feature in secondary syphilis with short evolution in hiv infected patients.
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ranking = 0.125
keywords = eruption
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4/214. immunoblastic lymphadenopathy-like T-cell lymphoma complicated by multiple gastrointestinal involvement.

    We report a rare case of immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma complicated by multiple gastrointestinal involvement, which appeared to be ameliorated by chemotherapy but resulted in perforative peritonitis. A 66-year-old Japanese woman who had generalized lymphadenopathy and eruptions was admitted to our hospital because of bloody stool. Colonoscopic examination revealed hemorrhagic ulcers in the terminal ileum and a saucer-like ulcer in the cecum. Gastrointestinal endoscopy revealed several ulcerative or elevated lesions in stomach and duodenum. biopsy specimens of these lesions and of a lymph node showed characteristic histological features of IBL-like T-cell lymphoma. The initial treatment with prednisolone (PSL) and cyclophosphamide (CPA) was effective. Six months after the treatment, however, she developed bloody stool again caused by multiple ulcerative lesions in the large intestine. The recurrence of the disease was determined histologically, and four courses of CPA, PSL, vinblastine sulfate and doxorubicin hydrochloride (CHOP) therapy were administered. One month after completing the CHOP therapy, she developed intestinal obstruction and then acute peritonitis resulting from perforation at an ulcer scar in the jejunum. Surgical treatment was successful, and histological examination demonstrated no lymphoma cells in the resected specimen. A gastrointestinal perforation should be recognized as a potential complication of IBL-like T-cell lymphoma, even during remission.
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ranking = 0.125
keywords = eruption
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5/214. skin eruption as the presenting sign of Hunter syndrome IIB.

    We present a case of Hunter syndrome diagnosed because of skin eruption. A 4-year-old Japanese boy presented with a 3-4-months history of papular lesions on the back and extremities. His growth and development were almost normal. His face was not of coarse appearance. He had multiple, whitish to skin-coloured, papules and nodules symmetrically distributed on the scapular regions and the extensor aspects of the upper arms and thighs. There was no family history of similar symptoms. skin biopsy showed the deposition of a considerable amount of mucin in the dermis. Although physical examinations failed to detect any other signs of Hunter syndrome, x-rays showed the characteristic features of mucopolysaccharidosis: deformities of the vertebral bone, ribs, and pelvis. Mucopolysaccharide analysis of the urine revealed a marked increase in dermatan sulphate and heparan sulphate. The activity of iduronate sulphatase in the lymphocytes was deficient, which was diagnostic for Hunter syndrome. We emphasize that the skin eruption can be the earliest sign of Hunter syndrome, particularly in the mild form presenting with normal development and growth.
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ranking = 0.75
keywords = eruption
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6/214. pseudolymphoma syndrome due to carbamazepine.

    We described a 29-year-old Japanese woman with a pseudolymphoma syndrome due to carbamazepine. physical examination revealed a diffuse erythematous papular eruption over almost all of her body with generalized lymphadenopathy. Histopathologic examination disclosed histology compatible with the nodular pattern of pseudo-T-cell lymphoma. The Southern blot analysis did not disclose the monoclonality of the gamma T cell recepter gene. We consider that it is very important to recognize this pseudolymphoma syndrome due to carbamazepine to avoid possibly subjecting the patient to unnecessary chemotherapy.
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ranking = 0.125
keywords = eruption
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7/214. Miliary tuberculosis presenting with rigors and developing unusual cutaneous manifestations.

    We report a case of miliary tuberculosis presenting with high fevers and rigors. While undergoing evaluation, the patient developed a diffuse, erythematous, maculopapular eruption coalescing to form erythematous plaques involving the abdomen, trunk, and proximal extremities. Biopsies of the lesions were smear- and culture-negative for mycobacterium tuberculosis. Rigors are an unusual presenting symptom of miliary tuberculosis and have only been reported three times in the (post-antibiotic era) literature. chills have been reported to occur 28% of the time. This symptom can be confusing to the practitioner, leading to delay in diagnosis. The skin lesions were most consistent with a lichenoid tuberculid eruption. The patient had a negative purified protein derivative and non-reactive anergy panel, and the lesions involved only the cutis and healed without scarring. The patient had a dramatic response to antituberculous therapy, with resolution of the fever within 2 days and resolution of the rash within 2 weeks.
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ranking = 0.25
keywords = eruption
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8/214. Cutaneous sarcoidosis with cardiac involvement.

    Despite the clinical importance of cardiac involvement in the prognosis of sarcoidosis, it is often overlooked because of the subclinical disease progression and difficulty in diagnosis. We report here five patients with cutaneous sarcoidosis lesions where cardiac involvement was detected with the appearance of mild cardiac symptoms on a careful examination of the heart after cutaneous sarcoidosis was diagnosed. In four of the five cases, the patients had annular lesions while the fifth case showed a nodular eruption on the face. Three of the five patients showed complete AV block while one showed complete right bundle block and left bundle anterior branch block. All four patients with conduction disturbances underwent a permanent pacemaker implantation with prednisolone tapering therapy. The remaining patient had congestive heart failure and was treated with prednisolone alone. The present findings support the belief that sarcoidosis patients with cutaneous lesions, especially facial annular lesions, should be carefully examined and monitored for cardiac involvement, even in cases without apparent cardiac symptoms.
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ranking = 0.125
keywords = eruption
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9/214. Unusual eruption as a presenting symptom of cat scratch disease.

    Cat scratch disease (CSD) is a common infectious cause of subacute regional lymphadenopathy. bartonella henselae is the principal etiologic agent. About 10% of CSD patients experience atypical manifestations, including rashes. The most common cutaneous manifestation of CSD is a papule at the inoculation site. We report a case of CSD presenting with an eruption on the upper trunk, reminiscent of Sweet's syndrome, accompanied by lymphadenopathy, arthralgia, and fever. Response to systemic corticosteroids was remarkable. Histopathologic findings refuted the diagnosis of Sweet's syndrome. Identification of anti-B henselae antibodies and B henselae dna in the affected lymph node confirmed the diagnosis of CSD. This is a first report of extensive papuloedematous eruption as a cutaneous manifestation of CSD. Accurate diagnosis is possible due to the availability of serological tests and dna amplification techniques.
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ranking = 0.75
keywords = eruption
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10/214. Polymorphous light eruption. A case report and consideration of the hardening mechanism.

    BACKGROUND: Polymorphous light eruption (PLE) is a common form of photodermatosis. The pathogenesis of the disease and the mechanism of the hardening phenomenon, however, have not been clarified. observation: We report a 62-year-old Japanese woman with PLE. Provocation and hardening induction testing revealed that hardening was induced at the sites irradiated by a sufficient dose of UV for reproduction of the lesion. Topical steroid could prevent a positive reaction but not the hardening induction. The expression of adhesion molecules and CD1a was decreased at the hardening site. CONCLUSION: From these results, the hardening phenomenon in our case might be due to immunosuppression by UV exposure supported by the down-regulation of cell adhesion molecule expression and partially due to the depletion of endogenous antigens which cause a delayed-type hypersensitivity reaction.
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ranking = 0.625
keywords = eruption
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