Eruptive pseudoangiomatosis

Eruptive pseudoangiomatosis is a rare, benign, spontaneously regressive disease. The term was recently coined to describe a dermatosis characterized by the sudden onset of a few to several bright red angioma-like papules with histopathologic findings distinct from that of true angiomas. We describe a 7-year-old patient with the typical lesions of eruptive pseudoangiomatosis.     

Eruptive pseudoangiomatosis in an adult renal transplant recipient

BACKGROUND: In 1969, Cherry et al. described four children with acute onset angioma-like papules with spontaneous regression during an acute viral infection. Similar cases, called eruptive pseudoangiomatosis, have been reported since and considered to be a viral exanthema. We observed a similar eruption in a 48-year-old male kidney transplant recipient. CASE REPORT: One month after kidney transplantation, the patient rapidly developed macules and papules on the trunk. He had unexplained fever 15 days before the eruption. A biopsy specimen revealed dermal blood vessels surrounded by lymphoid infiltrate. Serology tests were unable to identify any virus. The lesions resolved spontaneously within 15 days. DISCUSSION: In our patient, eruptive pseudoangiomatosis was diagnosed on the basis of the clinical and histological features and the disease course. This case demonstrates that the entity is not limited to children. Further cases should be studied to determine the precise pathogenics of this uncommon entity.     

Eruptive pseudoangiomatosis

We describe two children with acute onset and spontaneous resolution of angioma-like papules during a viral illness. The biopsy specimens from both patients showed a unique histologic appearance consisting of dilated dermal blood vessels with plump, hobnail-shaped endothelial cells. On the basis of the natural history and the histopathologic features we suggest the diagnosis of eruptive pseudoangiomatosis.     

Eruptive pseudoangiomatosis

Eruptive pseudoangiomatosis (EPA) is a rare, benign, spontaneously regressing childhood exanthem. The term was recently coined by Prose et al.1 to describe a dermatosis characterized by the sudden onset of a few to several bright red angioma-like papules with a different histopathology from the true angiomas. We describe three patients with the typical lesions of EPA but with some peculiar features not previously described. We discuss the suspected viral aetiology of EPA, and hypothesize a multifactorial aetiopathogenesis.     

发疹性假性血管瘤病

报告1例发疹性假性血管瘤病.患者女,69岁.面部、手背出现血管瘤样红色丘疹,且反复发作6个月.发疹前患者无瘙痒及头痛等症状.皮肤科检查:颜面、手背部散在血管瘤样丘疹,表面光滑,直径2～5 mm.皮损分布区域无鳞屑、结痂和溃疡.组织病理检查:表皮正常,真皮血管未见增生,毛细血管扩张、充血,部分血管内皮细胞肿胀.真皮浅、中层血管周围有以淋巴细胞为主及少量嗜酸性粒细胞浸润.诊断:发疹性假性血管瘤病.     

Eruptive pseudoangiomatosis arising in adulthood: 9 cases

Eruptive pseudoangiomatosis has only been reported in children up till now. The purpose of this study is to present the clinical characteristics of eruptive pseudoangiomatosis in adulthood and to discuss the potential role of infectious agents. A retrospective study concerning nine cases of eruptive pseudoangiomatosis observed over a ten year period was undertaken, concerning clinical, histological and epidemiological aspects of the disease. The patients, 8 women and one man had an acute eruption of numerous papules measuring 2-5 mm in diameter, disseminated on the face, limbs and trunk. The papules were erythematous and telangiectatic, surrounded by a white halo. The lesions blanched completely with pressure and refilled from the center on release. Histological examination was performed on 4 patients, showing dilated blood vessels with plump endothelial cells but no evidence of an increased number of vessels. Epidemiological data revealed the onset of the disease during hospitalisation for treatment of cancer or asthma in four patients and among the five remaining patients, two were hospitalized in a retirement home and one was a nurse in a psychiatric hospital. These data suggest that the eruption could be linked with a infectious disease despite the negativity of some serological investigations. We report for the first time cases of pseudoangiomatosis arising in adulthood.     

Eruptive pseudo-angiomatosis associated with enterovirus seroconversion

BACKGROUND: Eruptive pseudo-angiomatosis is a benign, acute dermatosis, mostly associated with a viral infection. Skin lesions consist of angioma-like papules, scattered over the skin. Involution is usually spontaneous and swift. CASE-REPORT: We report a case of eruptive pseudo-angiomatosis, which occurred in an immunocompetent 18 year-old adult together with acute gastroenteritis and enterovirus seroconversion. DISCUSSION: Eruptive pseudo-angiomatosis was described for the first time in 1969 in 4 children and then several pediatric cases were reported. Recently, 9 eruptive pseudo-angiomatosis in adults have been described. Our case had some particularities: it occurred in an immunocompetent adult and the skin lesions were angioma-like.     

Topical effectiveness of molgramostim (GM-CSF) in sickle cell leg ulcers

Intravascular large B cell lymphoma (IVL) is a rare disease characterized by intravascular proliferation of neoplastic mononuclear cells within the vascular lumina. The diagnosis requires skin, liver, renal, meningeal, or brain biopsy, but is rarely made antemortem. We report a 67-year-old man in whom the histological examination of senile angioma-like eruption enabled us to establish the diagnosis of IVL. In a suspected case of IVL, a skin biopsy of the senile angioma-like eruption may be beneficial for an early diagnosis.     

Eruptive pseudoangiomatosis: study of 7 cases

IntroductionEruptive pseudoangiomatosis consists in the acute development of small vascular lesions in the face and extremities that resolve in several weeks without scarring. Lesions are described as 3-4 mm asymptomatic macules and papules with peripheral whitish halo that blanch upon pressure. Initially it was considered a disease limited to children but it has also been described in adults. It overlaps with the entity known in Japan as «erythema punctatum Higuchi», possibly caused by an insect named Culex pipiens pallens.MethodsWe report a serie of 7 patients that consulted for lesions compatible with eruptive pseudoangiomatosis. We performed a detailed clinical history and histological, microbiological and serological studies. Follow-up time was up to 4 years.ResultsEighty-five percent of patients were women and the mean age was 62 years. All cases appeared in spring/summer and 71 % relapsed. Lesions predominated in the face and extremities and the outbreak lasted 2-4 weeks. The anamnesis did not disclose any specific etiologic agent in any of the cases. Complete laboratory tests including serologies and cultures were negative or within normal limits. Histological study revealed vascular dilatation in all cases with endothelial cell protrusion and a peripheral lymphohistiocytic infiltrate.ConclusionsCurrently, the etiology of this entity is not well established although it probably represents a reactive disorder to different etiologic processes.     

Painful piezogenic pedal papules

A case of painful piezogenic pedal papules is reported. The histological findings are compatible with the hypothesis that the papules are caused by harniation of fat into the dermis.     

Two cases of eruptive pseudoangiomatosis induced by mosquito bites

Eruptive pseudoangiomatosis is a skin eruption characterized by millet-sized erythema with an anemic halo appearing on exposed body areas. Insect bites, particularly mosquito bites, have been reported as one of the causes of eruptive pseudoangiomatosis. We experienced two cases of eruptive pseudoangiomatosis and the eruption was seen on the face and upper extremities of two women aged 48 and 77 years old. The two cases consented to be experimentally bitten by Culex pipiens mosquitoes and Aedes albopictus to determine if eruptive pseudoangiomatosis could be experimentally elicited by these mosquitoes. Our results showed that several minutes after a C. pipiens mosquito bite, an erythematous spot appeared on the bite site, followed by the formation of an anemic halo surrounding the erythema in 30 min; a successful reproduction of eruptive pseudoangiomatosis. The erythema lasted for more than a week and was not accompanied by any pruritus. With A. albopictus, we were able to reproduce a milder eruptive pseudoangiomatosis eruption: in case 1, a smaller erythematous spot with an ill-defined halo which disappeared within 1 week; and in case 2, an immediate response consisting of a wheal and erythema but not eruptive pseudoangiomatosis. We demonstrated that eruptive pseudoangiomatosis was the response manifested in individuals who normally did not demonstrate any immediate or delayed reaction to insect bites; and the typical eruptive pseudoangiomatosis eruption was elicited by C. pipiens mosquito bites. However, the mechanism resulting in the manifestation of eruptive pseudoangiomatosis is still unknown.     

蓝色橡皮-大疱性痣综合征

患者男，17岁一头昏、倦怠、乏力、面色苍白、全身起蓝色皮疹10年体格检查发现全身皮肤散在大小小等的蓝色斑疹、丘疹、结节，斑疹压之可褪色，结节质软如像皮，可被压缩，部分有轻压痛组织病理检查显示为海绵状血管瘤的特性一胃镜检查示食管、胃体、胃窦散在数个直径0．5～1cm圆形血管瘤样肿物，诊断为蓝色橡皮-大疱性痣综合征。     

DNA determination by cytophotometry in bowenoid papules in comparison with condylomata acuminata and Bowen's disease

The relation between bowenoid papules and Bowen's disease is characterized by largely corresponding histological pictures and diverging clinical-epidemiological features. In bowenoid papules and Bowen's disease, 5 cases each, compared with 5 cases of common condylomata acuminata, we determined the DNA by means of Feulgen's cytophotometry in visible light after Feulgen's staining. The following results were obtained: The average DNA content in bowenoid papules equals that in Bowen's disease, but it is significantly higher than in condylomata acuminata. What is different between the two groups "bowenoid papules" and "Bowen's disease" is the distribution of DNA: In Bowen's disease, DNA spreads into higher ranges of polyploidy. If we take recent molecular biological/virological findings into account, this result can be interpreted as a transition towards carcinoma in situ.     

Eruptive pseudoangiomatosis induced by gestodene in an oral contraceptive

We describe a case of eruptive pseudoangiomatosis triggered by the oral contraceptive Minulet® containing gestodene and ethinyloestradiol. A possible immunological mechanism in the induction of the skin lesions is suggested by the histopathological findings and a positive macrophage migration inhibition factor (MIF) test for the progesterone components in Minulet®.     

Clinicopathologic review of eruptive pseudoangiomatosis in Korean adults: report of 32 cases

Background Eruptive pseudoangiomatosis (EP) is a rare, benign, spontaneously regressing exanthema of unknown etiology, characterized by an eruption of distinctive erythematous papules. This study was performed to evaluate the etiologic, clinical, and histopathologic characteristics of EP in Koreans. Methods Patients diagnosed with EP during 2005–2010 were included in a retrospective study. Diagnoses were based on clinical findings and confirmed by histology. Biopsies were re‐examined. Patient gender, age at onset, disease duration, lesion location, season of occurrence, concomitant diseases, occupation, previous related events, disease course, responses to treatment, and laboratory findings were analyzed. Results A total of 32 patients were identified. Mean age at onset was 50.06 ± 17.12 years. Two patients developed lesions after outdoor activities. Two patients presented with simultaneous occurrences in family members. One patient reported having taken herbal medicine. One subject experienced systemic contact dermatitis caused by eating a lacquer chicken dish just before the lesions developed. All patients had typical erythematous papules measuring 2–5 mm. Lesions were usually located on exposed sites. No prodromal or systemic symptoms were observed. Routine laboratory tests were within normal ranges, except in one patient with known hyperlipidemia. Most patients were treated with oral antihistamine and topical steroid, or oral prednisolone. Eight patients did not receive any treatment. Mean disease duration was 1.64 ± 1.41 months in the treatment group and 1.20 ± 1.24 months in the no‐treatment group (P > 0.05). Conclusions Any clear relationship between EP and exposure to allergens or insect bites has yet to be elucidated. In patients in whom EP occurs on non‐exposed sites, drugs and food should be considered as possible causative agents. Intravascular neutrophil infiltration on histology can be helpful in diagnosing EP.     

Localized linear scleroderma with cutaneous calcinosis

A 38-year-old woman developed sclerotic and atrophic changes of the left femur in the winter of 1976. In 1980, she was referred to our dermatology clinic and was diagnosed with localized linear scleroderma from the results of the physical examinations and the histological findings. Although several local and systemic treatments were employed over the following 10 years, the sclerotic lesion did not show any remarkable improvement. In 1991, several hard and white papules appeared in the lesion, and a biopsy specimen of these white papules revealed calcinosis.     

Xanthogranuloma in the adult

A forty-three year old man has had numerous papules on his face and neck for about two years without any systemic involvement. Some papules disappeared gradually within eight months without any therapy. Papules were examined with the light microscope and the electron microscope and histological findings were very similar to those of juvenile xanthogranuloma (JXG)¹⁾.     

Generalized eruptive histiocytoma

We present the case of a 64-year-old male who developed multiple asymptomatic papules over a four-month period, distributed symmetrically on the trunk and proximal regions of the limbs, while the scalp, palms, soles and mucous membranes were spared. The lesions were discrete papules, brownish-erythematous, rounded, ranging from slightly raised to hemispherical, from 1 to 3 mm in diameter and firm to the touch. Clinical, histopathological, immunohistochemical and ultrastructural studies were consistent with generalized eruptive histiocytoma. Laboratory tests and radiological studies did not show any abnormal findings. After being subjected to photochemotherapy, the lesions regressed, but later on new outbreaks of papules appeared. Generalized eruptive histiocytoma belongs to a spectrum of diseases that may overlap; some may even develop into others. As the disease may progress into a more serious ailment, regular checkups with clinical, histological and immunohistochemical examinations should definitely be considered.     

Lymphomatoid papulosis. Review and personal observation of 4 patients

121 patients with lymphomatoid papulosis from the literature are reviewed with respect to clinical and histological features, laboratory findings, therapy and course of the disease. In addition, clinical, histological, enzymecytochemical and immunological findings in four own patients with lymphomatoid papulosis are reported. Males are more often affected than females. The typical clinical features are papules measuring 1-2 cm in diameter, most frequently located at the extremities. The course of the disease is rhythmic prolonged over many years. Transition into malignant lymphoma occurs. The presence of blasts and epidermotropism of the infiltrate are obligatory histological criteria. Mitoses are present in about two thirds of the patients. Signs of vasculitis, eosinophilic and neutrophilic granulocytes are found in less than half of the patients. Based on enzyme cytochemical and immunocytological findings in conjunction with the course of the disease lymphomatoid papulosis is designated as pseudolymphoma of T-cell type.     

Perifollicular xanthomatosis as a key histological finding in Fox-Fordyce disease

Fox-Fordyce disease is a rare skin condition characterized by the presence of multiple pruritic follicular papules in areas rich in apocrine glands, such as the axillae, mammary areolae, or genital regions. There is a high degree of variability in the histological findings seen in Fox-Fordyce disease. In addition to those described as typical of this entity, such as dilation of the infundibulum and hyperkeratosis and spongiosis of the infundibular epithelium, many other histological changes can be observed. We report the case of a 21-year-old woman with Fox-Fordyce disease and highlight the importance of perifollicular xanthomatosis as a key histological finding in the diagnosis of the disease.