Carpal tunnel syndrome in diffuse scleroderma]

A 61 year old female patient with diffuse scleroderma, complicated by carpal tunnel syndrome, is reported. The coexistence of carpal tunnel syndrome with dermatomyositis and lupus erythematodes is reviewed.     

结节性硬皮病一例

结节性硬皮病属于局限性硬皮病的罕见特殊类型,临床上多数结节性硬皮病患者并发系统性硬皮病且治疗效果较差。本病例患者仅表现为结节样皮损,无系统性硬皮病表现,且经过治疗后取得一定临床疗效。     

Two cases of scleroderma associated with vibration syndrome

Case 1, a 49-year-old male who had been engaged in repair and reclamation of automobile tires, developed symptoms of vibration syndrome (Raynaud's phenomenon, numbness of both hands, tinnitus and impaired hearing) after some 30 years' use of a grinder and impact wrench. Two years thereafter, multiple sclerodermic lesions appeared over the trunk, upper extremities, and thighs; these disappeared about 2 years later. Histologically, hyperplasia and nodular swelling of collagen bundles were present in the dermis. An immunological study showed the serum to be positive for anti-centromere antibody, but no visceral lesions were demonstrable. This case corresponded to generalized morphea. Case 2, a 53-year-old male, developed symptoms of vibration syndrome (Raynaud's phenomenon, numbness of both hands, impaired hearing and arthralgia) after 25 years' use of a jack hammer in a quarry. Thereafter, sclerodermic changes of the forearms, lower legs, face and abdomen occurred with an associated sclerodactyly. Histological examination of involved skin revealed diffuse hyperplasia and homogenization of collagen bundles throughout the entire thickness of the dermis. These findings, together with serum positivity for anti-RNP antibody and dilation of the lower portion of the esophagus, led us to a diagnosis of progressive systemic sclerosis. We inferred that the vibration syndrome in the present cases might be related etiologically to these forms of scleroderma.     

Chemotherapy-induced alopecia

Chemotherapy-induced alopecia is a distressing side effect common to certain treatment regimens in oncology. Unfortunately, chemotherapy-induced alopecia is an often overlooked or minor factor among our current research priorities and thus advances in amelioration have been minimal. This review offers a comprehensive examination of the clinically relevant basic science, clinical research, and current management options for chemotherapy-induced alopecia. We emphasize that hair loss secondary to chemotherapy is not as random or nonspecific in patterns or extent of disease, as one would initially perceive. Patient support and education information and templates are provided to facilitate patient treatment.     

Chemotherapy-induced acral erythema: report of a case and immunohistochemical findings

Chemotherapy-induced acral erythema (CAE) is an uncommon and distinct reaction seen in patients receiving high-dose chemotherapy. The exact pathogenic mechanisms of this disorder are still unknown. We report a 27-year-old woman who presented with red, swollen and painful macules on both palms, clinically consistent with this disease. Histological examination demonstrated vacuolar degeneration of the basal cell layer and spongiotic blisters in the epidermis, especially in the atrophied eccrine ducts and papillary oedema with mild perivascular infiltration of mononuclear and hypersegmented neutrophils. Immunohistochemistry showed that the infiltrating mononuclear cells were CD3-CD16+CD56+ leucocyte function antigen-1+, possibly natural killer cells. The eccrine ducts expressed HLA-DR and intracellular adhesion molecule-1 (ICAM-1). Our findings suggest that cell-to-cell interaction between NK cells and keratinocytes in the eccrine apparatus may induce CAE and may be involved in the pathogenesis of the skin reaction in our patient and possibly in this disease.     

Nodular scleroderma: a report of 2 cases

Nodular scleroderma, also known as keloidal scleroderma, is a rare form of scleroderma that may occur with either systemic sclerosis or localized scleroderma. Clinically, this disorder is characterized by keloidal nodules that form in sclerodermatous areas. These nodules may histologically show the presence of keloidal collagen. Because of the rarity of this condition, clinicians may not be familiar with the clinical and histologic features relevant to this scleroderma variant. In this report, we describe 2 cases of nodular scleroderma.     

Chemotherapy-induced acral erythema

Chemotherapy-induced acral erythema has been described in association with several different chemotherapy regimens. We review the literature on this topic and suggest that different mechanisms may be responsible for the clinically heterogeneous array of acral changes.     

Reticulate hyperpigmented scleroderma: a new pigmentary manifestation

Scleroderma is a systemic disease with a myriad of cutaneous manifestations. Pigmentary disturbances have been described in scleroderma. While diffuse generalized hyperpigmentation and localized hypopigmentation with perifollicular hyper-pigmentation are well recognized, a vascular induced hyperpigmentation has only been recently described. In this paper, we report another unrecognized pigmentary abnormality in a 48-year-old patient who presented with a reticulate hyper-pigmentation affecting the trunk, upper and lower limbs. To our knowledge, cutaneous hyperpigmented reticulate scleroderma has not been reported previously.