Cutaneous lymphangitic carcinomatosis and acquired ichtyosis associated with prostatic carcinoma

BACKGROUND: Prostatic adenocarcinoma is exceptionally associated with cutaneous lesions. We describe a patient with cutaneous lymphangitis and paraneoplastic ichtyosis related to prostatic cancer. CASE REPORT: A 92 year-old man had been treated for five years for a prostatic carcinoma. An angiomatous lesion developed with in 3 months near the right breast. Physical examination revealed axillary node enlargement, a large skin angiomatous lesion, and ichtyosis. The skin biopsy of the angiomatous skin lesion demonstrated its prostatic origin with carcinomatous metastases in the lymphatic vessels. The ichtyosis was considered as paraneoplastic. DISCUSSION: Cutaneous metastases from prostatic carcinoma are rare. Less than 1 p. 100 of cutaneous metastases are of prostate origin despite the high frequency of this cancer in the general population. The clinical aspects - angiomatous lesion and paraneoplastic ichtyosis - are exceptional.     

Solitary cutaneous metastasis on the buttock: a disclosing sign of pancreatic adenocarcinoma

A 48-year-old man, previously healthy and asymptomatic, showed a unique skin lesion located on the right buttock. The histopathological study of the lesion disclosed an adenocarcinoma metastatic to the skin. The primary tumour was found at the head of the pancreas, and was confirmed by biopsy. Six months after the beginning of treatment with Gemcitabine the patient is still asymptomatic, and the cutaneous lesion has disappeared. Carcinomas of the pancreas represent less than 5% of human malignant neoplasms, skin involvement is rare, and metastasis generally multiple and situated in the periumbilical area. To our knowledge, very few patients have been reported with a solitary cutaneous lesion disclosing a pancreatic adenocarcinoma. The atypical location, the absence of related symptoms or analytical disorders, and the good progress of the patient make this case especially interesting.     

复发前后皮损表现不同的性病型Reiter综合征

报告1例复发前后皮损表现不同的性病型Reiter综合征.患者男,50岁.在多次非婚性生活后,出现尿道炎、不对称性关节痛、结膜炎及全身皮损,诊断为性病型完全型Reiter综合征.在病情稳定1年余后,在多次非婚性生活后再次出现全身皮损,复发皮损与初发不同,因此该例诊断为性病型Reiter综合征复发.     

Thrombotic cutaneous nodules and hepatic vein thrombosis in the anticardiolipin syndrome

A patient with the anticardiolipin syndrome presented with hepatic vein thrombosis (Budd-Chiari syndrome) and non-ulcerating, thrombotic, cutaneous nodules. This cutaneous manifestation of the anticardiolipin syndrome has not been described before, though its histological appearances resemble those of previously reported cutaneous complications, such as chronic ulceration, livedo reticularis and distal cutaneous ischaemia. Recognition of the skin lesion could allow the prevention of major systemic complications.     

Preceding Annular Skin Lesions in a Patient with Hemophagocytic Lymphohistiocytosis

The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.     

Multifocal intraepidermal carcinoma in a dog histologically resembling Bowen's disease

A middle-aged, spayed female dog developed multiple cutaneous neoplasms that had clinical and histologic features of Bowen's disease in humans. Although lesions began in sun-exposed, glabrous skin, they progressed to hairy skin and to mucous membranes. Metastasis did not occur, although one lesion eventuated in local invasion of bone. The dog subsequently developed metastatic cutaneous myxosarcoma and euthanasia was requested by the owners.     

A case of cutaneous metastases of gastric carcinoma showing peculiar clinical features.

A 52-year-old male patient presented with multiple cutaneous nodules on the face, trunk, and upper extremities. Examination of a skin biopsy specimen disclosed numerous signet ring cells throughout the dermis. Histopathologic examination of the stomach, along with gastroscopy, revealed that the cutaneous metastases were of gastric origin. The metastatic skin lesion on the shoulder and the back of the patient grew relatively rapidly, showing an erysipelas-like lesion followed by prominently large tumor masses. The clinical appearance seen in our case is thought to be rare. Radiotherapy and chemotherapy appeared to be effective in reducing some tumors and the swelling on the anterior of the neck, and in prolonging life.     

Ectopic breast cancer of the axilla

INTRODUCTION: Breast cancer is the most frequent cancer occurring in women. These cancers may rarely develop within ectopic breast tissue. We report a case of ectopic axillary lobular carcinoma presenting as an isolated skin lesion with prolonged evolution. CASE-REPORT: A 62 year-old women had a cutaneous lesion located in her left axilla for the past 4 years. The skin biopsy showed an infiltrating lobular carcinoma. A mammogram and an MRI were as unremarkable as two past mammograms performed since the beginning of the skin lesion. Surgical resection with lymph node dissection, associated with radiotherapy and hormonotherapy with tamoxifen, led to complete remission. DISCUSSION: Ectopic breast tissue is subject to physiological and pathologic changes such as benign or malignant tumours. Cancer occurring in ectopic breast tissue remains rare but this diagnosis must be suspected when confronted with a skin lesion or mass located near the normal breasts.     

Leucemia cutánea en un paciente con leucemia mieloide aguda M2

—The leukemia cutis is the cutaneous infiltration by leukemics cells. Patients with acute myelogenous leukemia (AML) present specific cutaneous involvement in approximately 10% of the cases.We report the case of a leukemia cutis in a 73-year-old male with AML-M2. The patient presented with a one-week history of general malaise, asthenia, cough, dysnea and fever. Physical examination revealed and indurated red-brown plaque on his back of two moths duration, which was pruritic. Concomitance blood and bone marrow findings were diagnostic of AML-M2. A cutaneous biopsy was consistent with leukemia cutis. A CT and a bronchial biopsy showed pulmonary involvement. Since starting chemotherapy the patient had complete remission and the cutaneous lesion cleared, but 15 days later the skin lesion reappeared. A new bone marrow examination revealed recurrent leukemia. He died one month later.     

Immunofluorescence in cutaneous leishmaniasis

A case of acute cutaneous leishmaniasis is reported in which skin biopsy of the lesion revealed deposits of IgM, fibrinogen and C3 in the blood vessel wall and granular deposits of IgG and C3 at the dermoepidermal junction. No immune complexes were detected in the healthy unaffected skin in the same patient and no circulating immune complexes were found in the blood. This case demonstrates tissue-bound immune complexes in cutaneous leishmaniasis.     

The study on the specific eruptions of malignant lymphoma. II. Clinical and pathological interesting points, electron microscopic study, immune state and treatment

We investigated 31 cases of cutaneous malignant lymphoma diagnosed by skin biopsy during about 11 years at the University of Tsukuba hospital. The interesting points are the followings; the difference of cell morphology between the primary lesion and the secondary skin lesion was found in one case diagnosed of Lennert's lymphoma. The erythrophagocytosis of tumor cells was found at the relapse of one case of TCL. Eosinophils were increased in number in accordance with the severity in a case of MF. The electron microscopic study revealed the LC approaching to the tumor cells in ATL and MF, and TRS in ATL. Group A maintained better immunity of PPD and DNCB skin test than Group B. Non-specific eruptions in Group A were found frequently at the late stage, about half of which were cutaneous/mucous fungous infection. In the treatment of Group A, soft X-ray therapy was an excellent method at the point of the responsiveness, the painlessness, the interval of relapse and side effects.     

Cutaneous Hodgkin's disease.

A case of specific cutaneous Hodgkin's disease, which is sparsely mentioned in the literature, is reported. The lesion was nodulo-ulcerative and corresponded to the Grosz-Hirschfield type. It was confirmed by biopsy and the pattern was similar to that of an excised supraclavicular node examined two years previously. The lesion responded to treatment with gentamicin topically, clindamycin orally and 500 r of cauterizing X-ray. There has been no recurrence to date and no other new cutaneous lesions. This report further confirms what Ferdinand von Hebra implied one hundred years ago--that a dermatologist should not only know skin diseases but also the cutaneous manifestations of visceral diseases.     

A case of cutaneous squamous cell carcinoma associated with sporadic porphyria cutanea tarda due to liver disorder after Schistosoma japonicum infection

A 56-year-old man suffered from cutaneous squamous cell carcinoma (cutaneous SCC) which occurred on a cutaneous lesion of sporadic porphyria cutanea tarda (sporadic PCT). His liver function decreased from the time he was infected with Schistosoma japonicum at the age of 10. He drank a little alcohol. Erythematous maculae with blisters or erosions occurred on sun-exposed areas of his skin when he was 52. His urine continued to be red. After detailed examinations including liver biopsy, he was diagnosed as having sporadic PCT due to liver disorder after infection with Schistosoma japonicum. At the age of 56, a small red papule arose on his right earlobe at the site of a sporadic PCT lesion. The papule rapidly enlarged with ulceration; this completely destroyed his right earlobe, which was covered with odoriferous yellow-white necrotic tissue. The tumor then extended to his right preauricular area with ulceration. A skin biopsy confirmed well-differentiated cutaneous SCC. The association of cutaneous SCC with sporadic PCT has not been previously reported; we think that the association is significant. Such an occurrence may have been induced by either direct or indirect effects of ultraviolet light or a scar formed by the sporadic PCT.     

Skin infection by Mycobacterium marinum – diagnostic and therapeutic challenge

The number of skin infections caused by atypical mycobacteria has increased in recent decades. They usually appear after contact with wounds and interruptions in the integrity of the skin. The present report describes a case of cutaneous infection by Mycobacterium marinum, in a young, immunocompetent patient, with a prolonged evolution, diagnosed through a skin lesion culture (from a spindle biopsy of the skin). The patient was treated with multidrug therapy, including clarithromycin, doxycycline, and rifampicin, due to the lesion extent, with satisfactory results. A brief review of the literature is also provided.     

Cutaneous lipomatous neurofibroma

We report a cutaneous lipomatous neurofibroma on the skin of the left-side parietal area of approximately 9 months' duration in a 67-year-old woman. The regular distribution of adipose tissue throughout the lesion suggested that fat was an integral part of the tumor, not a metaplastic or degenerative process. To our knowledge, this type of lesion has not been documented. The main differential diagnosis embraces neurocristic cutaneous hamartoma, lipoma and its variants, cutaneous meningioma, and neural nevus with fat replacement. We propose that lipomatous neurofibroma of the skin is caused by aberrant development of adipose tissue in a neurofibroma. The lesion originated as pluripotential neural crest cells after migration. This acquired lesion could arise from local stem cells. The old suggestion that neuroectoderm is capable of mesenchymal differentiation may be relevant to the histogenesis of this neoplasm.     

Cutaneous metastases as initial manifestation of dedifferentiated chondrosarcoma of bone. An autopsy case with review of the literature

Metastases of chondrosarcoma to the skin are uncommon. We report a case of dedifferentiated chondrosarcoma that manifested as cutaneous metastases and had an outcome of three weeks. A 69-year-old male presented with two cutaneous nodules, one in the chest and other in the inguinal area. The punch biopsy of the latter showed a poorly differentiated mesenchymal metastatic tumor. Shortly before death, an X-ray revealed a proximal epiphyseal lesion in the right humerus, radiographically interpreted as chondrosarcoma. The autopsy showed this lesion to be a dedifferentiated chondrosarcoma whose nonchondroid mesenchymal part was akin, histologically and immunohistochemically, to the cutaneous metastases. While ten previous reports of chondrosarcoma metastatic to the skin are known, we believe that this is the first case to report the cutaneous metastases of the dedifferentiated variety. Furthermore, skin metastasis preceding the diagnosis of chondrosarcoma has not been previously reported. The fact that one part of this kind of tumor can be highly undifferentiated or, else, differentiated along lines not usually reminiscent of bone tumors, can make the diagnosis of such cases extremely difficult. Most chondrosarcomas metastatic to the skin arise in bones of the extremities, including the hand. The most common type of tumor is conventional chondrosarcoma. These metastases can be either single or multiple with a slight predilection for the head and neck region. Most patients die in a mean time of 6 months after the appearance of cutaneous metastases.     

Recurrent bullous lesions associated with familial Mediterranean fever: a case report

Familial Mediterranean fever (FMF) is an inherited, recurrent, inflammatory disease. Of its various cutaneous features, erysipelas-like erythema is the best known and most common skin lesion. We present a new case of FMF with recurrent bullous lesions. A 41-year-old woman was admitted to our clinic with tense bullae, 20 × 20 mm in diameter on the left shin. The patient had a history of fever, abdominal pain, peritonitis attacks and infertility. A lesional skin biopsy revealed subepidermal bullae and neutrophilic infiltration around dermal vessels. Direct immunofluorescence analysis was negative. Over the period of investigation, the lesion regressed spontaneously; 1 month later, a similar lesion appeared on the right wrist. Diagnosis of FMF was made according to the Tel-Hashomer criteria. Recognition of this peculiar skin lesion may lead to an earlier diagnosis of the disease.     

Skin lesions associated with circulating lupus anticoagulant

This retrospective study of 295 patients extends the earlier findings of an association between lupus anticoagulation and thrombosis by demonstrating the occurrence of cutaneous lesions related to the coagulation defect in 70 patients. The most frequent cutaneous associations were thrombophlebitis, skin ulcer, gangrene, haemorrhage, and cutaneous necrosis. Of the patients with skin lesions, 41% had the skin lesion as the first sign of the disease. It is important to recognize this association because nearly 40% of the patients with skin lesions have multisystem thrombotic phenomena in the course of the disease.     

Co-infection of molluscum contagiosum virus and cryptococcosis in the same skin lesion in a HIV-infected patient

A young human immunodeficiency virus-infected man was admitted in unconsciousness state. Few papular skin lesions resembling molluscum contagiosum (MC) were present on the face. He was found to have cryptococcal meningitis using India ink preparation of cerebrospinal fluid. Histopathological examination of skin lesion revealed the presence of capsulated yeast forms of Cryptococcus within the lesion of MC. The co-existence of MC and cryptococcosis in the same cutaneous lesion is rare, and it could be because of immunosuppression (low CD4 count).     

Cutaneous mucinosis associated with SLE--a case provoked by PUVA

A patient with SLE which was complicated by a characteristic cutaneous mucinosis is reported. The skin lesions were composed of intradermal soft nodules, purple-red plaques, and alopecia of the scalp. Acid mucopolysaccharides accumulated in each lesion. PUVA provoked an infiltrated skin lesion in which acid mucopolysaccharides were deposited in the dermis. Deposition of immunoglobulins and complements were also observed at the dermo-epidermal junction and on the vascular walls. Some immunological processes which may stimulate the synthesis of acid mucopolysaccharides in the dermis were suggested.