Cases reported "Skin Diseases"

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21/138. Progressive extensive osteoma cutis associated with dysmorphic features: a new syndrome? Case report and review of the literature.

    osteoma cutis, also called cutaneous ossification, refers to the rare occurrence of bone in the skin. It may be primary, occurring in normal skin, or secondary, occurring in disrupted skin tissue. A 42-year-old white woman presented with long-standing progressive primary osteoma cutis involving her head and neck, trunk and extremities. She had craniofacial dysmorphism with mid-face hypoplasia, including saddle nose deformity, mild to moderate generalized joint hypermobility, extensive paravertebral ossification, and disc space calcification. The differential diagnosis for this entity is presented. This phenotype may be a previously undescribed syndrome.
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keywords = neck
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22/138. Diffuse plane normolipaemic xanthomatosis in a patient with chronic lymphatic leukaemia and monoclonal gammopathy.

    Diffuse plane normolipaemic xanthomatosis is a well-defined uncommon condition characterized by yellow-orange plaques involving the eyelids, neck, upper trunk, buttocks and flexural folds. Over half of the reported cases are associated with lymphoproliferative disorders. The condition may arise as a result of perivascular deposition of lipoprotein-immunoglobulin complexes. We present a female patient with clear clinical features of diffuse plane xanthomatosis associated with chronic lymphatic leukaemia and monoclonal gammopathy. In this patient, we found evidence of complement consumption supporting the hypothesis that complexes of lipoprotein and paraprotein are formed. Lipid electrophoresis of fasting serum revealed the presence of a faint precipitate at the application slot, also indicative of the presence of protein-lipid complexes.
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keywords = neck
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23/138. Localized cutaneous necrosis associated with the antiphospholipid syndrome.

    A 34-year-old woman with systemic lupus erythematosus and high titres of antiphospholipid antibodies was admitted to hospital suffering a viral illness but developed haemorrhagic and necrotic areas on the neck and anterior chest 7 days following cessation of warfarin. Anticoagulation had been initiated following a retinal vein thrombosis, but was ceased on day 4 of admission when she was found to be excessively anticoagulated (international normalized ratio (INR) > 10). However, at the time of developing the cutaneous lesions, the INR was sub-therapeutic. histology of a skin biopsy from the neck revealed thrombosis of upper dermal blood vessels without vasculitis, consistent with antiphospholipid antibody-related skin necrosis. This case illustrates one of the cutaneous features that can occur in patients with elevated titres of antiphospholipid antibodies and the importance of closely monitoring anticoagulation in such patients.
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keywords = neck
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24/138. Neurocutaneous melanosis in association with encephalocraniocutaneous lipomatosis.

    We describe a white female infant with neurocutaneous melanosis (NCM) and encephalocraniocutaneous lipomatosis (ECCL). Multiple, giant and small congenital melanocytic nevi (CMN) were observed on the head, neck and trunk and involved 70% of body surface area. Histologic examination of several CMN revealed atypical nodular proliferations of dermal nevomelanocytes. In a small (<1 cm) truncal CMN, single and dyscohesive intraepidermal nests of atypical nevomelanocytes simulating a superficial spreading melanoma, were observed. The placenta was grossly normal and histologically demonstrated multiple banal appearing nevomelanocytes within the stroma of its villi. At the 17-month follow-up no evidence of primary or metastatic melanoma was present. This previously undescribed association of NCM, ECCL and placental nevomelanocytes provides strong support for the hypothesized causal role of anomalous neural crest morphogenesis and migration in the development of all three disorders. The genetic mechanism underlying these complex birth defects has been hypothesized to result from the action of lethal autosomal dominant genes surviving by mosaicism.
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keywords = neck
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25/138. Kikuchi's disease (histiocytic necrotizing lymphadenitis) with cutaneous involvement.

    We report a case of Kikuchi's disease (histiocytic necrotizing lymphadenitis) in a 22-year-old Japanese man who presented with cervical and axillary lymphadenopathy and who developed edema of lips with desquamation and erosions and transient indurated erythematous papules on the face, neck and upper extremities. A lymph node biopsy specimen showed the typical necrotizing lymphadenitis of Kikuchi's disease. A skin biopsy specimen showed a dense, lymphohistiocytic, superficial, deep perivascular, and interstitial infiltrate, papillary dermal edema, and abundant nuclear debris with a conspicuous absence of neutrophils, paralleling the nodal histology of Kikuchi's disease. CD68 immunohistochemistry showed many plasmacytoid monocytes. Oral corticosteroid (prednisolone 40 mg) therapy improved the skin lesions and other clinical symptoms. Lip involvement by Kikuchi's disease has not been reported, and should be included as one of the possible cutaneous manifestations of Kikuchi's disease.
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keywords = neck
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26/138. Persistent cutaneous fistula in the neck.

    A cutaneous fistula may develop from an infected tooth. The lesion usually arises without dental symptoms and for this reason is often incorrectly diagnosed. For correct diagnosis intraoral radiographs and essential. Elimination of the infectious process and curettage of the periapical lesion are indicated. Usually no further treatment is warranted.
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ranking = 4
keywords = neck
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27/138. Cutaneous dental sinus tract, a common misdiagnosis: a case report and review of the literature.

    Cutaneous sinus tracts of dental origin are often initially misdiagnosed and inappropriately treated because of their uncommon occurrence and the absence of symptoms in approximately half the individuals affected. patients are often referred with a recurrent or chronic cyst, a furuncle, or an ulcer on the face or neck. Correct diagnosis is based on a high index of suspicion and on radiologic evidence of a periapical root infection. Appropriate treatment results in predictable and rapid healing of these lesions. We present a case report of this common misdiagnosis and a review of the literature with regard to diagnosis and treatment.
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keywords = neck
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28/138. CO2 laser therapy in a case of steatocystoma multiplex with prominent nodules on the face and neck.

    BACKGROUND: steatocystoma multiplex is an uncommon disorder which usually begins in adolescence or early adult life. The condition can be hereditary, as an autosomal dominant trait, or nonhereditary, as in this case. methods: A 40-year-old woman presented with a history of asymptomatic nodules that began around puberty on the face. There was no family history of similar lesions. Clinical examination revealed multiple nodules distributed on the face and neck. The histopathologic examination of a biopsy specimen showed the typical features of steatocystoma multiplex. CO2 laser therapy without anesthesia was employed, and the contents were evacuated by squeezing the cysts with a pair of forceps. RESULTS: Very good results were obtained with rapid healing, minimal invasiveness, and without anesthesia. There was no evidence of scar formation and no signs of recurrence at 2-year follow-up. CONCLUSIONS: Different treatments have been reported for steatocystoma multiplex. We consider CO2 laser therapy to be an ideal technique for the treatment of steatocystoma multiplex, especially when the lesions are localized in aesthetically important areas.
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ranking = 5
keywords = neck
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29/138. Test your knowledge. Patient with a skin rash.

    A fit and healthy 22 year old of Asian ancestry, living in new zealand with no previous history of asthma or dermatitis, visited the gold Coast, queensland, for a vacation. Having been cautioned about the intensity of the Australian sun, he arrived armed with a hat and new SPF130 sunscreen that he had obtained from japan. On the third day of his vacation he noticed the appearance of many erythematous papules and some vesicles on the dorsum of the forearm, arm and the 'v' of the neck. His face was spared. On the fourth day, the papules coalesced to form swollen, warm, very pruritic, erythematous plaques (Figure 1). The patient commenced taking loratadine 10 mg per day, but did not improve after seven days of treatment.
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ranking = 1
keywords = neck
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30/138. Congenital acantholytic dyskeratotic dermatosis: localized darier disease or disseminated benign papular acantholytic dermatosis?

    Acantholytic dyskeratosis is a histopathologic pattern defined by a hyperkeratotic and parakeratotic epidermis with intraepidermal clefts containing acantholytic and dyskeratotic keratinocytes. These typical features are distinctive but not entirely pathognomonic of darier disease, since they may occur at cutaneous and mucocutaneous sites in other conditions such as Grover disease, acantholytic and dyskeratotic epidermal nevus (nevus of Starink), warty dyskeratoma, or acantholytic papular dermatosis localized to the vulvocrural area. We report a newborn girl who had congenital erosive papules and plaques located on the left thigh, left ankle, and right side of the neck. Histopathologic examination of a punch biopsy specimen disclosed findings typical of acantholytic dyskeratosis. In the absence of any family history or other manifestations of darier disease, we propose the descriptive term "congenital acantholytic dyskeratotic dermatosis." This descriptor characterizes our patient's disease on the basis of the clinical and histopathologic findings and facilitates recognition of this condition until a putative genetic mutation can be demonstrated or ruled out.
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ranking = 1
keywords = neck
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