Acquired cutaneous lymphangiectasia in a patient with cirrhotic ascites

BACKGROUND: Lymphangiectasia results from acquired dilation of lymphatic vessels. Areas of skin affected by obstruction or destruction of lymphatic drainage are said to be prone to the development of lymphangiectasia. Cirrhosis is a cause of alterations of lymph flow. METHODS: Case report. RESULTS: We report a case of acquired, late-onset, lymphangiectasia associated with alcoholic hepatic cirrhosis. Lesions were scattered over the right, lower, anterior abdominal wall, a region that is drained by a common group of lymphatic vessels that were probably disordered. CONCLUSION: We think that this is the first reported case of lymphangiectasia associated with altered lymph flow in cirrhosis and ascites.     

Acquired cutaneous lymphangiectasia

Summary We report a case of acquired cutaneous lymphangiectasia associated with underlying malignancy, and following an arthrotomy. Clinical and histological features were identical with those of acquired lymphangioma. Lymphangiography showed signs of acquired lymphatic obstruction. Both the underlying tumour and the arthrotomy were thought to be contributory factors.     

Acquired lymphoedema and cutaneous lymphangiectasia of abdominal skin following bilateral breast reduction and abdominoplasty

We report two cases where the combination of breast reduction surgery and abdominoplasty led to lymphatic congestion clinically manifesting as lymphoedema and acquired cutaneous lymphangiectasia over the abdomen. These associations have not been previously reported, and clinicians need to be aware of them to obtain patients' consent for the procedure and to assist diagnosis and early intervention.     

Acquired ichthyosis in a patient with polycythemia rubra vera

Acquired ichthyosis is known to be associated with a variety of systemic diseases and to occur secondarily to the intake of some drugs. A 57-year-old woman with acquired ichthyosis and polycythemia rubra vera is described.     

Acquired haemophilia in a patient with systemic lupus erythematosus

INTRODUCTION: In patients with lupus, the most common acquired circulating anticoagulant is antiprothrombinase which is responsible for thrombosis. The presence of antibodies directed against factor VIII is rarely found in systemic lupus erythematosus. A case of acquired haemophilia in a patient with lupus is reported. CASE REPORT: A 30 year-old woman with systemic lupus erythematosus developed a right coxalgia and ecchymotic skin lesions which were prominent on the right arm and forearm. Laboratory values were as follows: positive antinuclear antibodies > 1: 2 560, anti-DNA antibodies (300 IU/ml), prolonged activated partial thromboplastin time, reduced factor VIII activity (1 p. 100) and the presence of antibodies against factor VIII. Magnetic nuclear resonance of the right hip confirmed the presence of an intramuscular hematoma. The patient was initially treated with intravenous pulse and oral corticosteroids, intravenous immunoglobulins and intravenous cyclophosphamide. Clinical and biological improvement was promptly obtained. DISCUSSION: In our patient with systemic lupus erythematosus, bleeding revealed acquired haemophilia with antibodies against factor VIII. It should be pointed out that the association between lupus and haemophilia is uncommon and that at present no standardized treatment can be recommended.     

Acquired syphilis in a patient with late congenital syphilis

Late congenital syphilis was diagnosed in a 22-year-old woman on the basis of clinical, serologic and epidemiologic features. Clinical examination showed the "saddle-nose" deformity, Hutchinson's teeth, high-arched palate, Dubois little-finger sign, and small maxillae resulting in shallow depression of the central part of the face. Two years after receiving adequate treatment for late congenital syphilis, she presented with a primary syphilitic chancre; thus it was concluded that the woman had no immunity to reinfection with Treponema pallidum.     

Acquired perforating dermatosis in a patient with Poland syndrome

Acquired perforating dermatosis (APD) is characterized by umbilicated 1- to 10-mm-measuring papulonodules with a central adherent oystershell-like keratotic plug, typically on the dorsa of the hands, forearms and over the knees. APD is associated with systemic diseases, especially diabetes mellitus and/or renal failure. Histologically the lesions show transepidermal elimination of altered dermal components into a cup-shaped epidermal depression. We present a 69-year-old man with coexisting APD and Poland syndrome (PS), an association not yet described. PS (OMIM 173800) is a rare congenital anomaly consisting of unilateral partial or total absence of the greater pectoralis muscle and ipsilateral symbrachydactyly. Most cases of PS are sporadic as it was in our case. Our patient had, in addition, an untreated diabetic condition, hyperuricaemia, dilated cardiomyopathy and a very recent pulmonary embolism. He responded to therapy with allopurinol.     

Humoral response in a patient with cutaneous nocardiosis

The clinical appearance of infection due to Nocardia spp. varies widely. The low sensitivity of direct microscopy and the slow growth of the organism challenge the laboratory diagnosis. We present the case of a skin abscess in an immunocompetent man caused by Nocardia brasiliensis. Diagnosis was made by cultivation and 16S rRNA sequencing. Using indirect immunofluorescence and Western blot, a strong antibody response to the N. brasiliensis isolate could be demonstrated. Serological tests might therefore be useful for the diagnosis and management of nocardial infections. Copyright (R) 2000 S.Karger AG, Basel     

Acquired reactive perforating collagenosis in a patient with lung fibrosis

Reactive perforating collagenosis (RPC) is a rare disorder characterized by the transepidermal elimination of altered collagen. The inherited form of RPC begins in early childhood, but acquired reactive perforating collagenosis (ARPC) begins in adult life. ARPC is associated with diabetes mellitus, renal disease, and malignancy. ARPC with lung fibrosis has not previously been reported in the literature, and the relationship between ARPC and lung fibrosis has not been studied. The etiological relationship between the two disorders appears to be uncertain. Although their association in this case could be due to chance, it may be due to the transforming growth factor beta abnormalities seen in both diseases. In this report, we describe a case of ARPC with lung fibrosis and propose an etiological association between the two diseases.     

Acquired ichthyosis in a patient with adenocarcinoma of the breast

Acquired ichthyosis and cutaneous metastases occurred in a 59-year-old black woman with adenocarcinoma of the breast. Acquired ichthyosis has been associated with "solid" tumors such as carcinomas of the lung, colon, and breast in only a few cases. Systemic diseases, medications, and malignancies associated with acquired ichthyosis are reviewed, and the need for a thorough clinical investigation of patients with acquired ichthyosis is stressed.     

Acquired port-wine stain in a pediatric patient

BACKGROUND: Acquired port-wine stains (PWSs) are vascular lesions that are identical to congenital PWSs morphologically and histopathologically. OBJECTIVE: Because acquired PWSs are rarely seen in adult and pediatric patients, we present a 9-year-old boy with an acquired PWS on his left forearm. CONCLUSION: None of the proposed etiologies, such as trauma, chronic sun exposure, or hormonal medication, was applicable to our patient, and a literature review showed us that acquired PWSs give a faster and better response to pulsed dye laser therapy than congenital lesions do.     

Self-healing juvenile cutaneous mucinosis in a patient with nephroblastoma

Self-healing juvenile cutaneous mucinosis is characterized by an early age of onset, the presence of plaques and nodules in a characteristic distribution, and rapid onset followed by spontaneous resolution of the lesions within a period of weeks to months. Only four previous cases have been reported. The patient in this study was an 8-year-old child who developed cutaneous mucinosis while undergoing chemotherapy for a nephroblastoma, This is the first case described of self-healing juvenile cutaneous mucinosis associated with a neoplasm.     

Fibrous mastocytoma in a patient with generalized cutaneous mastocytosis

A 57-year-old woman with cutaneous mastocytosis of 23 years duration developed a hyperpigmented abdominal plaque composed of confluent indurated papules that enlarged for a period of 1 year to 12 x 8 cm. Biopsy showed dermal infiltration by closely packed spindle-shaped mast cells, fibroblasts, collagen, and scattered lymphocytes, predominantly T-suppressor cells. Electron microscopy showed close contact between mast cells, fibroblasts, and lymphocytes. Piecemeal mast cell degranulation and extrusion of mast cell granules was seen, with rare mast cell granules in fibroblasts, and collagen fibers in peripheral and perinuclear endoplasmic reticulum of mast cells. the term Fibrous mastocytoma is suggested for this tumor-like dermal fibrosis, possibly induced by lymphokines.