Diffuse-plane normolipaemic xanthoma with aortic-valve xanthoma

A patient with diffuse-plane normolipaemic xanthomatosis had mucous-membrane, conjunctival, and aortic-valve xanthomatosis. The presence of a monoclonal protein and hypocomplementaemia suggests that the xanthomatous lesions were probably not metabolic in origin but developed as secondary events in a histiocytosis of involved tissues. No heart-valve xanthomatization in like circumstances has previously been reported.     

疣状黄瘤

<正>患者男,43岁。主诉:左侧阴囊疣状赘生物4年。现病史:患者于4年前无意中发现左侧阴囊有一半个绿豆大结节,无明显自觉症状,未就诊治疗。此后,结节缓慢增大,曾自行外用聚维酮碘无明显效果。起病前局部无明确外伤史。患者既往体健,无皮肤及内脏肿瘤病史。为明确诊断,于2010年3月9日采我院皮肤科门诊就诊。     

Perineural xanthoma

A 50-year-old man suffering from cholestatic hepatitis and diabetes mellitus with hyperlipoproteinaemia had small, painful, slightly elevated, reddish, firm indurated plaques on his soles. Histologically, the lesions were composed of a centrally located cutaneous nerve surrounded by concentric layers of xanthoma cells. Electron microscopy showed the cutaneous nerves to be unmyelinated, their axons were vacuolated and contained dense bodies. The xanthoma cells had the same ultrastructural features as those observed in usual xanthomatous lesions. We suggest that this entity be named perineural xanthoma.     

Eruptive xanthoma.

We recently had occasion to diagnose eruptive xanthoma. The significance of this cutaneous finding is that it is indicative of an underlying hypertriglyceridemic state. Appropriate dietary changes, correction of secondary factors, along with the addition of antihyperlipidemic drugs as required, will lower the plasma triglyceride level and allow the xanthomatous lesions to resolve.     

皮肤疣状黄瘤研究进展

疣状黄瘤是一种少见的疣状或菜花状生长的良性增生性疾病,好发于口腔,少数可发生于口腔以外的皮肤,皮损可单发或多发,生长缓慢,且患者常无自觉症状.组织病理为其重要的确诊依据,特点为真皮乳头大量泡沫细胞.其发病机制尚未明确,主要与刺激、创伤、炎症、淋巴水肿及遗传等相关,本病可单独发病,也可合并其他疾病,如盘状红斑狼疮、扁平苔藓、硬化萎缩性苔藓、动静脉血管瘤、淋巴水肿、移植物抗宿主反应、先天性偏侧发育不良伴鱼鳞病样红皮病及肢体缺陷综合征、营养不良性大疱性表皮松解症、毛细血管渗漏综合征等.     

Bone lesions in xanthoma disseminatum

A case of xanthoma disseminatum occurred in association with progressive bone lesions. This association has not been previously emphasized.     

Verruciform xanthoma of the scrotum

We report two cases of verruciform xanthoma of the scrotal skin. In each case, the tumor was a single pink lesion with firm consistency and a granular surface. Each lesion was characterized histopathologically by papillomatous proliferation of the epidermis and dermis and dense foam-cell infiltration of the region corresponding to the dermal papillary layer. These cells proved to be xanthoma cells that stained negatively or weakly positively with PAS, colloidal iron, and Alcian blue and strongly positively with Sudan III. No medical problems were found in either patient, and serum lipid levels were normal. This report also presents electron microscopic findings from scrotal verruciform xanthoma in one case and the results of lipid analysis of tumor tissue from both cases.     

Verruciform xanthoma of the penis

Verruciform xanthoma is a rare pathologic entity with a predilection for the oral mucosa. A case of verruciform xanthoma involving the penis, the second reported in this location, is presented.     

A giant verruciform xanthoma

BACKGROUND: Verruciform xanthoma (VX) is a rare, benign neoplasm arising predominantly in the oral cavity, but it has been reported to occur on the genital skin and mucosa as well. VX has also been described in association with epidermal nevi and squamous cell carcinoma. Because of the clinical and histologic similarities between VX and condyloma acuminata, and a recent report of HPV 6 in association with VX, we investigated the role of human papilloma virus (HPV) in the development of this entity. METHODS: In situ hybridization and a nested PCR approach utilizing degenerate primers were utilized to establish whether HPV infection could be playing a role in the development of the VX. RESULTS: In situ hybridization failed to identify HPV DNA. The highly sensitive nested PCR approach also failed to detect HPV DNA. CONCLUSIONS: The failure to detect HPV DNA, even by very sensitive methods, provides strong evidence that our case of VX is not an HPV-induced lesion. A review of other possible etiologies, including alternative infectious agents and genetic associations, are discussed.     

发疹性黄瘤病1例

临床资料患者,男,30岁。主因躯干、四肢突然起皮疹1月,于2011年2月就诊。患者1月前无明显诱因躯干、四肢突然出现米粒至黄豆大小的橘黄色丘疹,以上肢伸侧、背部为重,逐渐增多,无自觉症状。患者平素体健,家族中无类似疾病史。查体:     

Immunohistochemical study of human xanthoma

Specimens of human tuberous xanthomas obtained from two hyper-beta-lipoproteinemic patients were prepared with HE and Sudan III stain and by direct immunofluorescence with fluorescein isothiocyanate labeled antihuman beta-lipoprotein rabbit serum. In some histiocytes and foam cells in early stages, lipids were stained in granular patterns and specific fluorescence was observed. In some foam cell nests, specific fluorescence was weak or absent, and orange-colored lipid autofluorescence was present. The foam cells in such nests were probably late foam cells and corresponded to the large cytoplasmic foam cells stained densely and amorphously for lipids. It was concluded that at early stages of xanthoma formation, serum lipoproteins were incorporated into dermal histiocytes and early foam cells. The apoproteins of the incorporated lipoproteins were probably degraded and lipid residues accumulated in the cells. Specimens of tuberous xanthoma covered by plane xanthoma showed lipids and bright specific fluorescence at the basement membrane zone. A faint fluorescence was observed in the upper dermis and even in parts of the epidermal intercellular spaces.     

Plane xanthoma developing in photosensitive eczema

Three cases of plane xanthoma arising in chronic eczema are described. Two patients had long standing photosensitive eczema and the other actinic reticuloid. It is suggested that foam cells develop from dermal macrophages in chronically inflamed skin. Lipid accumulation may be due to a failure of a specific receptor-mediated control of cholesterol uptake into macrophages and be independent of circulating plasma lipid or lipoprotein levels.