Angiolymphoid Hyperplasia with Eosinophilia Successfully Treated with Cryotherapy

BACKGROUND: Angiolymphoid hyperplasia with eosinophilia is an uncommon, benign, vasoproliferative cutaneous neoplasm with uncertain origin. It preferably affects middle-aged adults, manifesting as plum-colored pruritic papules, nodules and plaques, which can persist indefinitely, relapsing over time. Different response/resistance to various therapeutic modalities and frequent recurrences impose a great therapeutic dilemma. CASE PRESENTATION: Herein, we present a 77-year-old male patient with a 7-month-history of unrecognized cutaneous manifestations on his left shoulder and flank. Based on the investigations, the diagnosis of angiolymphoid hyperplasia with eosinophilia was established. We applied cryotherapy as a treatment of choice. The complete regression of the skin lesions and three years disease-free period was achieved. CONCLUSION: Although surgery is the standard therapeutic approach, the disease recurs despite multiple surgical attempts. Therefore, we recommend cryotherapy as effective and safe treatment modalities for angiolymphoid hyperplasia with eosinophilia. Knowing the recurring nature of this disease, the patients with angiolymphoid hyperplasia should stay on short-term follow up in order to monitor if new lesions occur

PUVA-induced Bullous Pemphigoid in Psoriasis

The association between psoriasis vulgaris and bullous pemphigoid is due to the still unclear autoimmune process. The common place of action is dermo-epidermal junction or basal membrane zone (BMZ) with specific alterations for both diseases. Photochemotherapy (PUVA) as one of the therapeutic modality for psoriasis can trigger production of autoantibodies against antigens in BMZ in patients with subclinical bullous pemphigoid. Furthermore, PUVA therapy can alter immunological milieu and hence can contribute to the expression of bullous pemphigoid in patients with psoriasis. Cumulative dose of PUVA, sufficient for triggering blister formation is individually determined. We observed a bullous eruption compatible with bullous pemphigoid in a psoriatic patient treated with PUVA. We proposed the implementation of the term - psoriasis pemphigoides for this atypical, compound form of psoriasis, when typical bullous pemphigoid lesions develop in typical psoriasis.</p

Giant Bowen’s Disease on the Face: Case Report and Review of the Literature

BACKGROUND: Giant Bowen’s disease is a rare and unusual clinical manifestation. Presenting as extensive scaly erythematous patch or plaque, it gives rise to a wide spectrum of dermatological differential diagnoses. CASE PRESENTATION: We report a patient with giant Bowen’s disease on the face that was successfully treated with topical 5 % imiquimod. A review of the literature was made with the aim to analyse and compare the findings in it with our observation. CONCLUSION: We present this case to draw attention to the importance of the self skin examination in the elderly population. Also, to prevent development to invasive squamous cell carcinoma from Bowen’s disease, we recommend mandatory dermoscopic examination on every long-standing erythemosquamous lesion

Necrolytic migratory erythema: complete healing after surgical removal of pancreatic carcinoma

Necrolytic migratory erythema is considered an obligatory cutaneous paraneoplastic sign associated with glucagonoma. Glucagonoma syndrome is defined by the presence of an alpha-cell secreting tumor of the pancreas, elevated levels of glucagon, and a characteristic rash called necrolytic migratory erythema. Although necrolytic migratory erythema is a specific finding in glucagonoma syndrome, it may occur in other settings, unassociated with an alpha-cell pancreatic tumor (pseudoglucagonoma syndrome). The rarity of glucagonoma imposes a challenge, with most patients being diagnosed after a long period of treatment for their skin rash. The main prognostic sign of glucagonoma are the subsequent metastases that come late in the course of the disease. Herein, we present a 55-year-old female patient with a 5-year history of unrecognized cutaneous and systemic manifestations of glucagonoma syndrome. Based on the investigations, the diagnosis of glucagonoma syndrome without metastases was established. After surgical removal of pancreatic carcinoma/glucagonoma, complete healing and a long disease-free period was achieved. Appropriate awareness of the characteristics of necrolytic migratory erythema in physicians/dermatologists often leads to an early diagnosis of glucagonoma syndrome and enhances the chances of a favorable outcome.healing and long disease-free period was achieved. The awareness of physicians/dermatologists of the characteristic necrolytic migratory erythema, often leads to an early diagnosis of glucagonoma syndrome and enhance the chances of a favorable outcome.</p