Cases reported "Pityriasis"

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11/58. obsessive-compulsive disorder in patients with chronic pruritic conditions: case studies and discussion.

    BACKGROUND: Relatively few persons with obsessive-compulsive disorder (OCD) come to psychiatric clinics for treatment. Our hypothesis was that patients with a form of OCD that involves compulsive hand and body washing might initially seek treatment from a dermatologist. OBJECTIVE: Our purpose was to screen patients attending a dermatology clinic to determine the frequency of OCD cases and to help dermatologists recognize this disorder. methods: Randomly selected patients who presented with one of several chronic pruritic conditions were interviewed to determine the presence of anxiety disorders. RESULTS: A significantly high percentage of the patients (14%) were found to have previously undiagnosed OCD. Case studies of five of these patients are presented. CONCLUSION: A significant number of patients with undiagnosed OCD appear to present to dermatology clinics. Identification and referral for psychiatric consultation may aid in the treatment of both OCD and concomitant dermatologic conditions. ( info)

12/58. Mucha-Habermann disease in a child: possible association with measles vaccination.

    A 2.5-year-old boy presented with skin lesions consistent with Mucha-Habermann disease, which appeared about 5 days after an injection of freeze-dried live attenuated measles vaccine. He responded to both oral and topical corticosteroid therapy. To my knowledge, this represents the first such association of Mucha-Habermann disease with virus vaccination. ( info)

13/58. What's your assessment? pityriasis rosea.

    As a nurse practitioner in dermatology for over 15 years, Barbara Bielan has been fortunate to have worked with many superb clinicians who have shared their time and expertise in giving her a broad background in dermatology. The "What's Your Assessment?" series includes a short case presentation and differential diagnosis. It is followed by a discussion on the disease and the rationale used in each step of the assessment. ( info)

14/58. lymphomatoid papulosis: clinicopathological comparative study with pityriasis lichenoides et varioliformis acuta.

    We have compared the clinical and histopathological features of 6 patients with lymphomatoid papulosis (LP) and 14 patients with pityriasis lichenoides et varioliformis acuta (PLEVA). There were some differences between the clinical features in the two diseases, including the size and appearance of skin lesions and the duration of the course of disease. Ki-1 Ag positive, large, atypical, lymphoid cells were always seen in lymphomatoid papulosis; none of lymphoid cells of pityriasis lichenoides et varioliformis acuta demonstrated this antigen. We conclude that lymphomatoid papulosis and PLEVA, although sharing some common features, should be considered to be different clinical and immunopathological entities. ( info)

15/58. Pityriasis amiantacea, an unrecognized cause of scarring alopecia, described in four patients.

    Pityriasis amiantacea is not generally recognized as a cause of scarring alopecia. We describe 4 patients with scarring alopecia in the distribution of past or active pityriasis amiantacea and suggest that it is a not uncommon sequela. ( info)

16/58. Immunohistochemical distinction of lymphomatoid papulosis and pityriasis lichenoides et varioliformis acuta.

    lymphomatoid papulosis (LyP) and pityriasis lichenoides et varioliformis acuta (PLEVA) are benign self-healing cutaneous eruptions that may be clinically and histologically similar. However LyP has a 5% to 20% risk of associated lymphoid malignancy, whereas PLEVA does not. To determine whether the immunophenotype of lymphoid cells is useful in the distinction of these two disorders, the pattern of expression of lymphoid cell lineage and activation antigens in nine cases of LyP and seven cases of PLEVA were compared. In all cases of LyP most larger cells expressed the activation antigen Ki-1 (CD30) and lacked expression of the T-cell antigen CD7 and at least one other T-cell antigen (CD2, CD3, CD5). In contrast, CD30-antigen expression was rare or absent in PLEVA, CD3- and CD7-antigen expression was found in all cases, and diminished expression of T-cell antigens (CD2 and CD5) was seen in only one case. Diffuse expression of HLA-DR antigen by epidermal keratinocytes was found in a greater proportion of PLEVA cases (6 of 7) than LyP cases (3 of 6). In addition, CD8 cells predominated at the dermal/epidermal junction in 3 of 6 cases of PLEVA but in only 1 of 7 cases of LyP. We conclude that LyP and PLEVA can be distinguished immunohistochemically in most, if not all, cases. Furthermore these results suggest that LyP and PLEVA are separate disorders, thus accounting for their variable prognoses. ( info)

17/58. Severe febrile Mucha-Habermann's disease in children: case report and review of the literature.

    Mucha-Habermann disease, or pityriasis lichenoides et varioliformis acuta, is usually a benign, papulosquamous, cutaneous disorder. It has also been reported in a severe form with fever and systemic symptoms both in children and adults. We report a 12-year-old boy with the febrile, ulceronecrotic type. A review of similar cases in the literature shows a 16% frequency of acute necrotic lesions, as well as rare complications such as fever, superinfected lesions, bacteremia (most often with staphylococcus aureus), and rheumatologic manifestations such as arthritis and scleroderma. There is no definitive treatment, but tetracycline, erythromycin, methotrexate, and ultraviolet light are used most frequently. The most common histologic feature is mononuclear perivascular infiltrates. Mucha-Habermann disease can mimic other common entities such as varicella and insect bites. ( info)

18/58. Ultrastructural studies of epidermal lesions in pityriasis lichenoides chronica: occurrence of tubular aggregates and intracytoplasmic desmosomes.

    Very early skin lesions from four patients with pityriasis lichenoides chronica were examined by electron microscopy. Aggregates of tubular structures, which resembled those reported in endothelium in lupus erythematosus and are currently being observed in an increasing variety of conditions, were noticed in the epidermal cells of all patients. These cells also showed intracytoplasmic desmosomes, and isolated mitochondria and myelin-like figures in intercellular spaces, in addition to the occurrence of vacuoles and lysosomes in the cytoplasm, dilatation of endoplasmic reticulum and alteration of mitochondria. Occasionally, epidermal cells were seen to be individually filled with fibrils. These ultrastructural findings seem to indicate that in pityriasis lichenoides chronica some injury to epidermal cells occurs at the early stage of pathological processes, as suggested by light microscope studies. ( info)

19/58. Recurrent pityriasis rosea. New episodes every year for five years. A case report.

    A case of recurrent pityriasis rosea in a 39-year-old woman is presented. She had her first attack of pityriasis rosea 5 years ago and new outbreaks followed every year, in the spring. Her husband had a severe attack of pityriasis rosea 6 years ago. All laboratory investigations were normal and no explanation for the many recurrences was found. ( info)

20/58. Oral cyclosporine in the treatment of inflammatory and noninflammatory dermatoses. A clinical and immunopathologic analysis.

    cyclosporine is known to be effective in the treatment of psoriasis. In this study, we have used oral cyclosporine (6 mg/kg per day) given for 5 to 30 weeks to 24 patients for the treatment of 12 different dermatoses. patients with the following diseases demonstrated a marked response or total clearing: 1 patient each with pyoderma gangrenosum, pityriasis lichenoides chronica, and psoriasis of the acrodermatitis continua of Hallopeau type. Moderate to marked response occurred in both patients with epidermolysis bullosa acquisita and the patient with hidradenitis suppurativa. Minimal to moderate responses were obtained in both patients with granuloma annulare, 1 of 2 with acrodermatitis continua of Hallopeau, both patients with Darier's disease, and 1 of 6 patients with vitiligo. Little or no response was noted in both patients with sarcoidosis, all 3 patients with pityriasis rubra pilaris, 5 of 6 patients with vitiligo, 1 patient with pemphigus foliaceous, and 1 with pemphigus vulgaris. Clinical side effects were mild and transient and included dysesthesia, fatigue, hypertrichosis, nausea, and flushing. The most frequent clinically significant abnormalities were hypertension and renal dysfunction, with all factors normalizing within 1 month of discontinuation of cyclosporine therapy. ( info)
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