Painful skin eruption in a professional auto mechanic — a quiz

-A 37-year-old man, auto mechanic by trade, presented with multiple facial skin lesions, accompanied by burning sensation and pain, eye redness, fever and fatigue. The symptoms occurred 4 days before admission. Two weeks earlier he was consulted dermatologically due to hand eczema treated subsequently with topical steroids; additionally, he reported presence of concomitant facial erythema with scaling. Besides, the personal and familial medical history was unremarkable. Clinical examination revealed multiple skin erosions covered with serosanguineous crust, disseminated on his face, hands and forearms (Fig. 1); increased body temperature of 38.7 degrees Celsius, and conjunctival congestion. Laboratory tests revealed increased level of inflammatory parameters (C-reactive protein 21.25 mg/L, leukocytosis 13.48 ×109/L)

Miejscowo stosowana nitrogliceryna jest skuteczna w leczeniu chondrodermatitis nodularis helicis

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Zlokalizowana postać choroby Dariera

Localized Darier’s disease is a rare variant of the disorder, charaterized by limited extent of the skin lesions as well as the absence of ungual and mucosal changes. We present a case of an 83-year-old man with cutaneous plaques and papules in the sacral area diagnosed as a localized Darier’s disease.Zlokalizowana postać choroby Dariera jest rzadko występującym, miejscowym wariantem klasycznej postaci choroby. Charakteryzuje się ograniczeniem zmian skórnych oraz brakiem współwystępowania objawów paznokciowych i śluzówkowych. Przedstawiono przypadek 83-letniego mężczyzny, u którego obserwowane od kilkunastu lat blaszki i grudki umiejscowione w okolicy krzyżowej okazały się zlokalizowaną postacią choroby Dariera

Postać podskórna ziarniniaka obrączkowatego – opis przypadku i przegląd piśmiennictwa

Granuloma annulare (GA) is a chronic, idiopathic dermatosis with tendency to spontaneous resolution. GA has distinct histopathological features including collagen degeneration associated with granulomatous inflammation. It is estimated that condition affects 0.1–0.4% of dermatology patients. Subcutaneous GA is a rare variant of the disease. The authors present a case of a 3-year-old boy diagnosed with subcutaneous GA, successfully treated with local cryotherapy. Ziarniniak obrączkowaty (GA, granuloma annulare) jest przewlekłą, idiopatyczną dermatozą z tendencją do spontanicznego ustępowania. Schorzenie charakteryzuje się specyficznymi cechami histopatologicznymi, obejmującymi zwyrodnienie kolagenu ze współistniejącym ziarniniakowym stanem zapalnym. Ocenia się, że GA dotyczy 0,1–0,4% pacjentów dermatologicznych. Podskórna postać GA występuje niezwykle rzadko. Autorzy przedstawiają przypadek 3-letniego chłopca, u którego rozpoznano podskórną postać GA leczonego z powodzeniemmiejscową krioterapią

Videodermoscopy in the Assessment of Patients with Ocular Demodicosis

Introduction: There is growing evidence of the potential uses of dermoscopy in diagnostics of demodicosis. No previous studies have analyzed dermoscopic features in patients with ocular demodicosis. Objectives: To evaluate the potential usefulness of videodermoscopy in diagnostics of ocular demodicosis. Methods: It was a single-center prospective observational study in which results of videodermoscopic examination of the eyelids were compared to the results of classic microscopic examination in patients with suspected ocular demodicosis and healthy volunteers. Results: Study group included 16 women and 15 men. In fifteen (48.4%) patients, microbiological examination of epilated eyelashes was positive. The results of forms filled by the patients concerning known subjective clinical symptoms of ocular demodicosis revealed no significant differences between the group with positive and negative results of microscopic examination. The presence of Demodex tails and madarosis observed during dermoscopic assessment correlated positively with positive results of microscopic examination. At least one Demodex tail was found in 86.7% (13/15) cases with positive results of microscopic examination. In the two remaining cases microscopic evaluation showed the presence of Demodex brevis. In 37.5% (6/16) of patients with negative results of microscopic examination, videodermoscopy showed the presence of Demodex tails. Conclusions: Videodermoscopy may facilitate the diagnostics of ocular demodicosis. Patients reporting clinical symptoms suggesting ocular demodicosis but negative results of videodermoscopic examination should be referred to classical microscopic examination to exclude the presence of Demodex brevis. In patients with negative microscopic examination results and symptoms suggesting ocular demodicosis, dermoscopy-guided microscopic re-evaluation could be considered

Dermoscopic Features of Giant Molluscum Contagio Contagiosum in a Patient with Acquired Immunodeficiency Syndrome

Giant molluscum contagiosum (MC) is a peculiar variant of the disease with the presence of multiple or single lesions larger than 5 mm. In contrast to typical molluscum contagiosum, dermoscopic features of giant lesions have been poorly described, and none of the reports included multiple giant lesions in an immunocompromised patient. We present a patient with acquired immunodeficiency syndrome diagnosed with multiple giant molluscum contagiosum along with the dermoscopic features of this entity

Dermoscopic Features of Actinic Cheilitis and Other Common Inflammatory Cheilitis: A Multicentric Retrospective Observational Study by the International Dermoscopy Society

Background: Clinical differentiation between different cheilitis variants may be difficult. Application of mucoscopy, in addition to clinical background, could provide additional diagnostic clues facilitating initial patient management. Objectives: To determine mucoscopic clues differentiating actinic cheilitis from the main forms of inflammatory cheilitis, including eczematous cheilitis, discoid lupus erythematosus, and lichen planus of the lips. Methods: This was a retrospective, multicenter study being a part of an ongoing project "Mucoscopy - an upcoming tool for oral mucosal disorders" under the aegis of the International Dermoscopy Society. Cases included in the current study were collected via an online call published on the IDS website (www.dermoscopy-ids.org) between January 2019 and December 2020. Results: Whitish-red background was found in actinic cheilitis as well as in cheilitis due to discoid lupus erythematous and lichen planus. Polymorphous vessels were more likely to be seen in actinic cheilitis compared to other causes of cheilitis. White scales, ulceration, and blood spots predominated in actinic cheilitis and lichen planus, whereas yellowish scales typified eczematous and discoid lupus erythematous cheilitis. Radiating white lines although most common in lichen planus patients were also seen in actinic cheilitis. Conclusion: Despite differences in the frequency of mucoscopic structures, we have not found pathognomonic features allowing for differentiation between analyzed variants of cheilitis

Dermoscopy of Infectious Dermatoses (Infectiouscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Dermoscopy has been showed to facilitate the non-invasive recognition of several infectious disorders (infectiouscopy) thanks to the detection of peculiar clues. Although most of the knowledge on this topic comes from studies involving light-skinned patients, there is growing evidence about its use also in dark phototypes. This systematic literature review summarizes published data on dermoscopy of parasitic, bacterial, viral and fungal dermatoses (dermoscopic findings, used setting, pathological correlation, and level of evidence of studies) and provides a homogeneous terminology of reported dermoscopic features according to a standardized methodology. A total of 66 papers addressing 41 different dermatoses (14 bacterial, 5 viral, 11 fungal infections, and 11 parasitoses/bites and stings) and involving a total of 1096 instances were included in the analysis. The majority of them displayed a level of evidence of V (44 single case reports and 21 case series), with only 1 study showing a level of evidence of IV (case-control analysis). Moreover, our analysis also highlighted a high variability in the terminology used in the retrieved studies. Thus, although promising, further studies designed according to a systematic and standardized approach are needed for better characterization of dermoscopy of infectious skin infections

Dermoscopy of Hair and Scalp Disorders (Trichoscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Hair and scalp disorders are of significant interest for physicians dealing with dark phototypes due to their prevalence and potential aesthetic impact resulting from a higher tendency for scarring. In order to facilitate their non-invasive diagnosis, several dermoscopic studies have been published, yet data are sparse and no systematic analysis of the literature has been performed so far. This systematic literature review summarizes published data on trichoscopy of hair and scalp diseases (trichoscopic findings, used setting, pathological correlation, and level of evidence of studies). A total of 60 papers addressing 19 different disorders (eight non-cicatricial alopecias, nine cicatricial alopecias, and two hair shaft disorders) were assessed, for a total of 2636 instances. They included one cross-sectional analysis, 20 case-control studies, 25 case-series, and 14 single case-reports, so the level of evidence was V and IV in 65% and 33% of cases, respectively, with only one study showing a level of evidence of III. Notably, although there is a considerable body of literature on trichoscopy of hair/scalp diseases, our review underlined that potentially significant variables (e.g., disease stage or hair texture) are often not taken into account in published analyses, with possible biases on trichoscopic patterns, especially when it comes to hair shaft changes. Further analyses considering all such issues are therefore needed