43 research outputs found
Childhood sclerodermatomyositis with generalized morphea
Systemic sclerosis (SS) and dermatomyositis (DM) are both multisystem
disorders and share some common clinical features. We report here an 11
year-old girl whose disease showed a changing clinical pattern from
juvenile systemic sclerosis (JSS) to slowly progressing juvenile
dermatomyositis (JDM) and had associated generalized morphea.
Serological studies revealed antinuclear antibodies (ANA) with a
speckled pattern. Topoisomerase-I (Scl-70), U1 RNP (ribonucleoprotein),
anti-Ro, anti-La and anti Jo-1 antibody tests were negative.
Electromyography (EMG) was suggestive of primary muscle disease and
histopathological findings indicated scleroderma. The patient fulfilled
the American College Rheumatology (ACR) diagnostic criteria for JSS as
well as Bohan and Peter criteria for JDM separately and hence, was
diagnosed to have sclerodermatomyositis (SDM). Mixed connective tissue
disease (MCTD) and antisynthetase antibody syndrome (ASS) which share
same clinical features with SS and DM were excluded by immunological
studies
Bullous Lupus Erythematosus Manifesting As Erythema Multiforme
Bullous SLE has a distinctive clinical, histopathologic and immunopathologic features that together constitute a unique bullous disease phenotype. We report a 33 year old female presenting with multiple tense vesicles and bullae on normal and erythematous skin over the body and oral erosions. Palms and extremities showed typical target lesions. She had consumed NSAIDs intermittently for joint pains. She was diagnosed as bullous erythema multiforme and started on oral prednisolone but lesions failed to heal. Patient recollected a history of low grade fever and a photosensitive rash in the past. Investigations revealed positive ANA with a peripheral pattern. A skin biopsy of a vesicle showed a subepidemal blisher. Perilesional direct immunofluorescence studies showed a linear deposition of IgG, IgA and fibrin along the basement membrane zone and perivascular deposition of IgG. Lapus band test showed a linear deposition of IgG, C3, IgM and fibrin at BMZ clinching the diagnosis of bullous lupus erythematosus
Acroangiodermatitis of mali: A rare vascular phenomenon
Acroangiodermatitis (synonym pseudo-Kaposi sarcoma) is an unusual,
benign condition which clinically presents as purple-colored patches,
plaques or nodules, mostly on the extensor surfaces of lower
extremities in patients with chronic venous insufficiency and
arteriovenous malformations. It resembles aggressive conditions like
Kaposi′s sarcoma and requires histopathological examination for
its diagnosis. We report two such cases of acroangiodermatitis.
Histopathology of both the cases showed dilated capillaries in the
dermis with extravasated red blood corpuscles (RBCs), hemosiderin
deposits, and hyperplastic granulation tissue. Both were treated with
oral antibiotics and topical steroids. The ulcers showed a good
response within 2 months of treatment
Penicillamine-induced elastosis perforans serpiginosa with abnormal "lumpy-bumpy" elastic fibers in lesional and non-lesional skin
Four types of elastosis perforans serpiginosa (EPS) have been described
in literature: 1) idiopathic EPS, 2) reactive perforating elastosis
associated with connective tissue disorders, 3) in some instances of
pseudoxanthoma elasticum (PXE), disease-specific calcified elastic
tissue is extruded, producing a clinical picture indistinguishable from
other types, may also be seen in patients undergoing hemodialysis and
4) EPS induced by long-term treatment with D-penicillamine is observed
in patients suffering from Wilson′s disease. Long term
D-penicillamine therapy causes an alteration in the dermal elastic
tissue. D-penicillamine induced EPS has a distinctive histopathologic
feature - serrated appearance of elastic fibers due to perpendicular
budding from their surface giving a "lumpy-bumpy" look. D-penicillamine
induced elastic fiber alteration may not always manifest clinically as
EPS. We report a case of D-penicillamine induced widespread alteration
in skin elastic tissue with distinct histopathologic features
Regenerative Treatments: Microneedling and PRP
The treatment of hair disorders is an important part of clinical dermatology, given the prevalence of the problem and the great impact on patients’ quality of life. Many new treatments have been investigated in recent years, such as platelet-rich plasma (PRP) and microneedling, which have emerged as promising regenerative therapies.
These techniques were initially used by the medical community in fields other than dermatology; however, they have recently started to be popular among dermatologists for stimulating follicular regeneration. Several studies and case reports have demonstrated the therapeutic effectiveness of PRP and microneedling in hair loss disorders, but more evidence-based studies are needed to establish their real benefits.
Our experience leads us to suggest using these techniques in association with existing hair growth-promoting therapies, or alone when there are contraindications to medical treatments