Primary essential cutis verticis gyrata in an adult female patient: a case report

Cutis verticis gyrata (CVG) is a very rare morphological condition of the scalp characterized by ridges and furrows resembling the surface of the brain. Primary or idiopathic CVG occurs in the absence of underlying soft-tissue abnormalities and is often associated with neuropsychiatric disorders. Secondary CVG occurs as a result of a local inflammatory or neoplastic process of the scalp or a systemic illness that produce pathologic changes in the scalp structure. The choice of treatment of CVG is surgical repair which depends on the size and location of the lesion, the underlying disorder, and the wishes of the patient, including primary repair, serial excision, skin grafting, local flaps and tissue expansion. In this case report, we describe the first female patient in the published work with primary essential CVG that appeared at 30 years of age. Because the patient had no cosmetic or functional complaint, no surgical intervention was attempted. Primary essential CVG, a very uncommon disorder, may be encountered in females after the third decade. The classification of CVG is essential to properly diagnose and treat patients who present with these unusual scalp lesions.     

Primary pachydermoperiostosis: a case report

Pachydermoperiostosis (PDP), a rare genodermatosis, occurred in a 38-year-old Indian male. He presented with progressive thickening of the skin on the face and scalp of 15 years duration. Widening of his wrists and ankles and broadening of the fingers and toes had also developed since then. He was born of a consanguineous marriage and had no family history of a similar disorder. He had the typical findings of complete form of PDP including cutis verticis gyrata, coarse facial features, clubbing of the digits in the skin, and periostosis and cortical thickening at the distal ends of long bones of the extremities and small bones of the hands and feet. PDP has two different forms--primary and secondary. These two entities are differentiated by family history and presence or absence of a primary lesion, usually in the lungs. Clinically, in secondary PDP, the cutaneous findings (pachydermia, seborrhoea, oiliness) are less severe than primary PDP; osteoarthropathy is more severe and painful in secondary PDP, especially with congenital heart disease. The present case was suffering from primary PDP that had expressed itself in its complete form.     

Cutis verticis gyrata secondary to acne scleroticans capitis

We report the case of a 35-year-old patient with secondary cutis verticis gyrata (CVG) that histologically presented as acne scleroticans capitis. Clinically, the diagnosis of acne conglobata was made. The CVG developed under systemic corticosteroid treatment of an ulcerative colitis. Corticosteroids were discontinued and a therapeutic attempt was made with isotretinoin. Although under this treatment the conglobate acne healed, the CVG remained unaltered. Dermatosurgical intervention by a scalp reduction plasty finally resulted in a marked improvement of symptoms and acceptable cosmetic outcome.     

Dynamic evolution of a scalp congenital melanocytic nevus with poliosis and cutis verticis gyrata

Cutis verticis gyrata (CVG), characterized by cerebriform overgrowth of the scalp, is rarely observed in congenital melanocytic nevi (CMN). We describe a 13-year-old male with autism and a large CMN of the scalp with numerous satellite nevi whose scalp nevus exhibited evolution with poliosis and CVG. Given the potential association of CVG (independent of CMN) with seizures, neuropsychiatric, and ophthalmologic disorders, and nevus-associated CVG (cerebriform intradermal nevus) with melanoma, multidisciplinary evaluation of CMN patients with CVG is important to guide management and treatment.     

皮肤结核误诊19例分析

分析皮肤结核的误诊原因，探讨避免误诊的措施。方法：对收治的19例皮肤结核患者的临床资料进行回顾性分析。结果：本组误诊为结节病5例，孢子丝菌病4例，着色芽生菌病3例，湿疹2例，血管瘤2例，汗管瘤1例，结节性红斑1例。误诊率52.8%。结论：皮肤结核菌检查，结核菌素试验。结核菌的分子生物学检查均能协助诊断。     

Solitary Milialike Idiopathic Calcinosis Cutis: A Case Unassociated with Down Syndrome

We report a unique case of solitary milialike idiopathic calcinosis cutis (MICC) in a healthy Korean woman, which is not associated with Down syndrome. This case of MICC would be a form of idiopathic calcinosis cutis, which can be solitary or multiple, sporadic or associated with Down syndrome.     

Autosomal recessive type 2 pseudoxanthoma elasticum presenting with generalized skin laxity

Herein, we describe a sporadic case of recessive type 2 pseudoxanthoma elasticum. A 26-year-old woman without family history presented with cutis laxa-like marked wrinkling involving the whole-body and a serpiginous streak on the upper left arm. She denied any other systemic problems related to difficulty with visual acuity or vascular disease. A skin biopsy specimen from the loose skin showed the accumulation of calcified degenerated elastic fibers and foci of ossification in the dermis. Histopathological study from a serpiginous streak revealed mineralized debris that was eliminated through the epidermis, the finding consistent with elastosis perforans serpiginosa. Recessive type 2 pseudoxanthoma elasticum is very rare and the presenting case is interesting in that this patient presented with lesions of secondary ossification and elastosis perforans serpiginosa in association with pseudoxanthoma elasticum.     

Disseminated linear calcinosis cutis associated with the Koebner phenomenon in an infant with congenital acute monocytic leukaemia

We present a unique case of an infant with acute monocytic leukaemia who presented at birth with multiple rubbery, erythematous to violaceous subcutaneous nodules secondary to leukaemia cutis. As these infiltrates regressed with chemotherapy, numerous white to yellow linear confluent papules appeared in a scratch-like pattern. These lesions were widely disseminated but were concentrated across her face, trunk and extremities with relative sparing of the napkin area and back. We propose that these lesions represent a form of dystrophic calcinosis cutis that occurred secondary to koebnerization in an infant with congenital leukaemia cutis.     

子宫颈细胞学检查未见异常的HR-HPV亚型感染妇女的CIN2,3风险分析

目的:探讨子宫颈细胞学检查未见异常的HPV高危亚型感染者的管理模式。方法:收集2010年1月至2012年12月在北京大学第一医院妇产科门诊同时行宫颈细胞学检查及HPV DNA分型检测的妇女的资料,分析初次检出细胞学未见异常者的HPV高危亚型16、18、31、33感染者,其检出CIN2及以上病变的风险以及与感染亚型的相关性。结果:993例细胞学检查未见异常但HPV16、18、31、33型阳性者中,共检出CIN1 76例(7.7%),CIN2 50例(50/993,5.0%),CIN3 27例(27/993,2.7%);其中HPV16(+)感染者532例(532/993,53.6%),检出CIN2 34例(34/532,6.4%),CIN3 21例(21/532,3.9%);HPV18(+)HPV16(-)感染者142例(142/993,14.3%),检出CIN2 2例(2/142,1.4%),CIN3 1例(1/142,0.7%);HPV31(+)HPV16\18(-)感染者137例(137/993,13.8%),检出CIN2 9例(9/137,6.6%),CIN3 2例(2/137,1.5%);HPV33(+)HPV16\18(-)感染者182例(182/993,18.3%),检出CIN2 5例(5/182,2.7%),CIN3 3例(3/182,1.6%)。按是否检出CIN2+进行Logistic回归分析,发现HPV16型感染与CIN2+有相关性[OR值=2.353(95%CI 1.004~5.516),P=0.049]。结论:对筛查中初次检出宫颈细胞学未见异常,但HPV高危亚型感染者应予以重视,对于HPV16、18型感染者建议立即行阴道镜检查。     

Idiopathic multiple miliary osteomas of the face

A case of multiple military osteomas of the face arising In a 43-year-old Caucasian female with no history of Skin disease is reported Spontaneous development of Numerous asymptomatic, skin- coloured facial papules Had occurred over a 3 year period. Originally described In association with long standing acne vulgaris, Multiple military osteomas of the face has recently been Reported in patients without prior skin disease. The Pathogenesis, classification and treatment of this rare Condition are discussed.     

裴氏瓶霉致皮肤着色芽生菌病误诊为疣状皮肤结核1例

报告裴氏瓶霉致皮肤着色真菌病误诊为疣状皮肤结核1例。患者男，52岁。右上肢红斑、结节、疣状增生5年，无明显自觉症状。组织病理及真菌学检查结果符合裴氏瓶霉，结合临床表现及外伤史确诊为裴氏瓶霉致皮肤着色真菌病。     

获得性局限性皮肤松弛症

报告1例获得性局限性皮肤松他症。患者男,31岁。有臀部局部皮肤明显松弛、肤色加深2年,无任何自觉症状。皮损组织病理检查示弹性纤维明显减少,形态异常,有断裂。给予整形手术治疗。     

Malignant melanoma derived from cerebriform intradermal naevus

We report a case of malignant melanoma (MM) derived from cerebriform intradermal naevus (CIN) in a 66‐year‐old Japanese man. The patient had cutis verticis gyrata (CVG) on the posterior area of the scalp at birth. He noticed a dome‐shaped nodule at the centre of the CVG at 66 years of age. Histopathological examination found a nodule of MM arising within an extensive area of intradermal naevus. There was no metastasis to lymph nodes or other organs. To our knowledge, only two cases of CIN in which MM had later developed have been reported. We estimated that the incidence of melanoma from CIN including our case is 4.5% (3 of 67 reported cases), which seems to be comparable to the frequency of malignant alteration of giant pigmented naevi. This suggests that pathological examination is recommended for CVG, and once pathological diagnosis of CIN is confirmed, long clinical follow‐ups are necessary for detecting development of MM.     

皮肤弹性过度伴免疫学检查异常1例

报告皮肤弹性过度伴细胞免疫缺陷1例。患儿女，13岁。出生后即有皮肤弹性过度，脓疱疮反复发作4年。实验室检查发现有缺铁性贫血，皮损组织病理检查无特异性，脓液细菌培养出金黄色葡萄球菌，淋巴细胞亚群检查CD3 32%，CD427%，CD8 20%，CD4/CD8 1.35。先后给予免疫调节剂，系统及外月抗生素，抗贫血药等治疗。患儿细胞免疫缺陷得到纠正，深脓疱疮及缺铁性贫血治愈。     

新生儿皮肤再生不良1例

报告1例新生儿皮肤再生不良,患儿男,出生1h,生后即被发现左上肢皮肤缺损,分娩时无外伤史,给予0.1%利凡诺溶液及莫匹罗星软膏外用,10d后缺损处被新生组织填充,表面光滑,略凹陷,颜色较周围正常皮肤暗。     

Nicolau syndrome following intramuscular diclofenac injection: A case report

ABSTRACT:  Nicolau syndrome (NS) is a rare complication of intramuscular injection of various drugs which clinically presents with extensive necrosis of skin, subcutaneous and even muscle tissue. We describe a case of NS following intramuscular injection of diclofenac.     

获得性皮肤松弛症

报告1例获得性皮肤松弛症。患者女,17岁。面颈、双腋窝及股部皮肤松弛2年。皮肤科检查:面颈、双腋窝及股部皮肤明显松弛,皱纹密集,皮沟加深,无弹性。左颈部皮损组织病理示:表皮厚度大致正常,网篮状角化,真皮浅层血管周围少量淋巴细胞浸润。弹性纤维染色示:真皮浅层弹性纤维数量明显减少、形态异常。诊断:获得性皮肤松弛症。     

Milia-like Idiopathic Calcinosis Cutis Occurring in a Toddler Born as a Premature Baby

Milia-like idiopathic calcinosis cutis (MICC) is characterized by smooth, firm, whitish papules resembling milia. Histologically, it appears as a well-defined, round, basophilic nodule within the upper dermis. Although the etiology and treatment remain unclear, it may resolve spontaneously. Some cases have been associated with Down syndrome, and the mean age of MICC patients was 9.9 years old. Herein, we report a rare case of MICC that was not associated with Down syndrome. Noticeably, the patient, a toddler, was born as a premature baby and had an ischemic injury on the right foot at birth. However, the lesions appeared on both feet, including the non-injured left foot. Otherwise he was healthy. After a 21-month follow-up period, the lesions had almost disappeared without any treatment.     

皮肤痘疮样斑状萎缩1例

男性患，22岁，以躯干、四肢小片状皮肤萎缩12年就诊。皮肤损害表现为圆形或卵圆形的皮肤萎缩斑，触之有松弛感。皮肤组织病理显示表皮萎缩及真皮浅层弹力纤维消失。