Management and dermoscopy of fast-growing nevi in pregnancy: case report and literature review

BACKGROUND: The relationship between pregnancy and a change in melanocytic nevi is still controversial. Moreover, management of the rapid evolution of a nevus in an unauspicious melanocytic lesion can be a clinical challenge in pregnancy. METHODS: This article examines a case of a fast-growing deep penetrating nevus in a pregnant woman and provides a literature review of articles relative to pregnancy and nevi change, the management of fast-growing pigmented lesions, and the role and usefulness of dermoscopy in these cases. RESULTS: Recent studies have documented that pregnancy is not associated with any significant change in the size of melanocytic nevi. The management of fast-growing melanocytic lesions during this period compulsorily leans toward excision. Dermoscopy can be useful, providing clinicohistopathologic correlations and a better assignment of the lesion. CONCLUSION: This case report and review provide important management considerations for nevi during pregnancy. Early intervention with aggressive treatment measures is the best management for fast-growing lesions, and epiluminescence dermoscopy can assist the management, although still remaining a second-level examination, useful for documentation and for a better classification of the lesion.     

Agminated atypical (dysplastic) nevi: case report and review of the literature.

BACKGROUND: Patients with the atypical mole syndrome have multiple dysplastic nevi that appear to be randomly distributed on certain preferred anatomical sites such as the upper back. These dysplastic nevi are thought to be acquired melanocytic nevi that begin appearing at puberty. To our knowledge, the presence of agminated atypical (dysplastic) nevi has not been reported. OBSERVATION: We describe a patient with the atypical mole syndrome who has more than 100 melanocytic nevi, many of which are clinically atypical and one of which proved to be a melanoma. Among his many melanocytic nevi is a cluster of approximately 50 nevi that are distributed in an area measuring 5 x 3 cm. The histopathologic features of these nevi are consistent with the diagnosis of "dysplastic nevus." CONCLUSIONS: To our knowledge, agminated atypical (dysplastic) nevi have not been described previously. The presence of agminated atypical (dysplastic) nevi in a patient with the atypical mole syndrome can be theorized to arise because of loss of heterozygosity.     

Linear arrangement of multiple deep penetrating nevi: report of first case and review of literature

BACKGROUND: Deep penetrating nevus is a recently described variant of melanocytic nevi with clinical and histopathological features that may be confused with malignant melanoma, blue nevus, pigmented Spitz nevus, or congenital melanocytic nevus. We report a case with linear arrangement of multiple deep penetrating nevi. To our knowledge, such presentation has never been reported in the literature. OBSERVATIONS: We describe a patient with multiple darkly pigmented lesions in the right periauricular area, above and behind the ear. The histopathological features of these lesions were consistent with deep penetrating nevus. CONCLUSIONS: To our knowledge, this is the first report of linear arrangement of multiple deep penetrating nevi. We consider this case a unique presentation of deep penetrating nevus.     

甲母质瘤一例并文献复习

报道一例甲母质瘤并对相关文献进行复习。患者，男，54岁。右手食指指甲增厚、变黄10年。组织病理检查：甲板显著增厚，甲母质细胞V形增生，底端呈条索状伸向真皮，上端呈乳头瘤样伸向甲板，上覆嗜酸性角质增生带，部分乳头瘤顶端见渗出结痂。真皮浅层梭形细胞增生，排列杂乱，间有散在肥大细胞，深部纤维及纤维细胞增生，排列与表皮平行。免疫组化染色：梭形细胞CD34阳性，S-100阴性，FⅩIIIa阴性，CD68阴性，CK7阴性。诊断：甲母质瘤。手术切除肿瘤后随访10个月无复发。     

Angiosarcoma: a case report and review of the literature

Angiosarcoma is an aggressive neoplasm that predominantly affects elderly patients. Most cases appear on the scalp and face de novo; however, trauma, longstanding lymphedema, and irradiation are predisposing factors. Management includes a multidisciplinary team and may involve a combination of surgery, radiation, and chemotherapy tailored to the patient's age and associated comorbidities.     

Hematidrosis: a case report and review of the literature

The authors report the case of a 9 year-old female who had bleeding episodes around the mouth after strenuous exercise or prolonged exposure to heat. Characteristically, bleeding occurred right after sweat drops started appearing on the surface of the skin around the mouth. The bleeding episodes ceased spontaneously.     

Blastomycosis: a case report and review of the literature

Background Blastomycosis is a chronic granulomatous and suppurative mycosis caused by the fungus Blastomyces dermatitidis. This is a dimorphic fungus, which exists as a non‐pathogenic mold in mycelial form in nature and converts to pathogenic yeast at body temperature. Infection is acquired by either inhalation or inoculation. We report a case of blastomycosis with severe involvement of the scalp, face, and neck, with no evidence of systemic involvement. Methods Biopsy specimen was stained with hematoxylin and eosin, periodic acid‐Schiff (PAS), PAS with diastase digestion, and Grocott. Culture was performed on a Sabouraud’s dextrose agar plate using an aseptic technique as per standard operating procedure for processing mycology specimens at our institution. A lactophenol cotton blue preparation from the cultured material was performed. Results Histopathologic examination showed pseudoepitheliomatous hyperplasia and a granulomatous inflammation with round to oval organisms, with refractile cell walls in the cytoplasm of giant cells. PAS, PAS with diastase digestion, and Grocott stains enhanced the organisms. Cultured material showed growth after 10 days, and the lactophenol cotton blue preparation from the cultured material showed the organism to be Blastomyces dermatitidis. Sensitivity studies favored treatment with itraconazole. Radiological examination of the patient showed no evidence of systemic involvement. Conclusions Our case may represent the rare primary cutaneous inoculation blastomycosis as lesions started on an area of previous trauma. Treatment with itraconazole was successful.     

Anetoderma: a case report and review of the literature

Anetoderma is a rare benign dermatosis caused by a loss of mid-dermal elastic tissue resulting in well-circumscribed areas of pouchlike herniations of flaccid skin. Anetoderma is classically categorized as either primary (idiopathic) or secondary (following an inflammatory dermatosis in the same location). We report a case of primary anetoderma (PA) occurring in a human immunodeficiency virus 1 (HIV-1)-infected man. We review the clinical presentation, possible etiologies, associated conditions, and limited treatment options of this disease.     

黏蛋白痣一例并文献复习

<正>临床资料患者,男,44岁。右股部外侧增生性斑块30余年。患者30余年前,右侧股部外侧无明显诱因出现褐色增生性斑块,皮损逐渐扩大,无明显自觉症状。既往体健,一般情况好。否认该部位的外伤史及类似疾病的家族史。皮肤科查体:右股部外侧散在大小不等、形状不规则的褐色增生性斑块、结节,质软,沿Blaschko线分布(图1,2)。皮肤镜检查:可见表面无明显鳞屑,增生物呈皮色,皮损间可见深沟纹及点球状凹陷,呈脑回样,凹陷处有灰褐色色素沉着(图3)。组     

Prolidase deficiency: a case report and literature review

We describe a patient in whom chronic leg ulceration was due to prolidase deficiency. The clinical features of this condition are described and we discuss the metabolic abnormality and the treatment regimes which have been employed. We also report the further finding of erosive cystitis, which we consider should be added to the list of clinical features of prolidase deficiency.     

皮肤血管肉瘤一例并文献复习

报道1例皮肤血管肉瘤并对相关文献进行复习。患者,女,66岁。因头皮结节1年,额部瘀斑8个月就诊。皮肤科查体：头皮散在肤色至淡红色结节,表面可见少量鳞屑及毛细血管扩张,伴脱发。右侧额颞部可见水肿性紫红色斑片,压之不褪色。皮肤组织病理及免疫组织化学染色符合皮肤血管肉瘤的诊断。局部行放射治疗,目前仍在随访中。     

变形综合征

报告1例变形综合征.患者男,42岁,具有偏侧肥大、巨趾、脊柱侧凸、线状表皮痣、淋巴管瘤等变形综合征的表现.文中对该病进行文献回顾性总结及对最新诊断标准进行讨论.     

结缔组织增生性毛发上皮瘤一例

报告1例结缔组织增生性毛发上皮瘤并文献复习.患者女,76岁,左上唇淡红色浅碟状斑块10年余.皮肤科情况:左上唇见淡红色浅碟状斑块,直径约1 cm,斑块边缘轻度隆起,表面光滑,质硬.组织病理学检查示真皮胶原纤维明显增生,其间有散在的角质囊肿和基底样细胞条索.     

结节性类天疱疮一例

患者,女,83岁。躯干、四肢反复出现丘疹、结节伴瘙痒2年。皮肤科查体：躯干、四肢见暗红色丘疹、结节,散在抓痕,局部结痂,未见水疱。组织病理示：表皮角化过度、角化不全,棘层增厚,真皮浅层血管少量淋巴细胞、嗜酸性粒细胞浸润。直接免疫荧光和间接免疫荧光均阴性。IIF:循环抗体IgG表皮侧阳性沉积。血清学检查示：抗BP230抗体：147.9 U/mL;抗BP180抗体>200 U/mL。诊断为结节性类天疱疮。给予泼尼松、盐酸多西环素、烟酰胺治疗,目前随访中。     

结节性类天疱疮一例并文献复习

报道1例结节性类天疱疮并复习相关文献。患者，女，62岁。全身反复出现丘疹、结节伴瘙痒10年。查体：躯干、四肢可见暗红色丘疹、结节、斑块，未见水疱。实验室检查：IgE明显升高。组织病理示：表皮角化过度、角化不全，棘层增厚，真皮浅层血管周围轻度单一核细胞浸润。直接免疫荧光和间接免疫荧光均阴性。血清学检查示：抗BP180抗体>200 U/mL(0～20 U/mL)。诊断为结节性类天疱疮。予泼尼松、环磷酰胺治疗，继续随访中。     

红细胞生成性原卟啉病一例并文献复习

报道1例红细胞生成性原卟啉病,并复习回顾了本病的临床表现、发病机制、组织病理学改变、诊断和治疗。     

色素失禁症一例并文献复习

患儿,女,2个月。因躯干及四肢皮疹2个月就诊。皮肤科检查：躯干及四肢皮肤弥漫分布网状色素沉着斑。双股内侧、手腕部见暗红色大小不一丘疹、水疱,水疱壁厚,尼氏征阴性,部分水疱结痂。皮疹呈泼溅状分布。组织病理示：表皮角化过度,棘层增厚,表皮内见多房性水疱,疱液中可见大量嗜酸性粒细胞。真皮浅层毛细血管周围可见少量淋巴细胞及嗜酸性粒细胞浸润。诊断：新生儿色素失禁症。     

Granular parakeratosis: a case report and literature review

BACKGROUND: Granular parakeratosis is suspected to result from an error in epidermal differentiation, leading to variably pruritic, hyperpigmented-to-erythematous patches and plaques. Characteristic histopathologic features include a thickened stratum corneum, compact parakeratosis with retention of keratohyalin granules, vascular proliferation, and ectasia. The pathogenesis of this entity is uncertain. METHODS: We present a case of axillary granular parakeratosis and review the literature. RESULTS: The lesion showed a thickened stratum corneum with compact parakeratosis, slight epidermal hyperplasia, and a sparse perivascular lymphohistiocytic infiltrate. Keratohyalin granules were diffusely present within the parakeratotic stratum corneum, and the retained granular layer showed focal vacuolization. CONCLUSIONS: Granular parakeratosis is a rare form of parakeratosis most often seen in the axilla, although other intertriginous areas may be affected. Unique histopathologic findings allow for a specific diagnosis to be made. Although an irritant contact reaction appears causative, mechanical irritation may also play a role in inducing these skin changes.     

嗜酸性粒细胞增多综合征一例并文献复习

患者,男,79岁。全身皮肤弥漫性潮红、脱屑,咳嗽、气短3个月。多次外周血EC均>1.5×10⁹/L,皮肤活检示海绵水肿性浅层血管周围炎,浸润细胞为嗜酸粒细胞、淋巴细胞。支气管镜活检示支气管黏膜及肺泡间隔内可见少量嗜酸粒细胞浸润。结合临床表现、实验室检查及组织病理改变可明确诊断为嗜酸性粒细胞增多综合征伴皮肤和肺部受累。给予泼尼松75 mg/d,病情逐渐好转。