Diffuse calcinosis cutis in a patient with congenital leukemia and leukemia cutis

We report an unusual case of congenital leukemia with leukemia cutis (LC) and diffuse calcinosis cutis. A newborn girl presented with widespread dusky red and yellowish cutaneous nodules and papules. Bone marrow morphology was consistent with the diagnosis of acute monocytic leukemia of the FAB M5 type. Skin biopsy specimens confirmed the presence of a leukemic infiltrate and revealed calcium salt deposition in the papillary and reticular dermis. Calcinosis was diffuse in the whole skin but spared other organs. Vascular calcification was not present. Serum calcium levels oscillated between 2.5 and 2.86 mmol/l, and phosphorus, parathyroid hormone and 25-hydroxyvitamin D(3) levels were normal. There were diffuse osteoporosis and spontaneous fractures of small tubular bones. The patient responded to chemotherapy but, following consolidation treatment, developed sepsis and died at 120 days of age. Congenital leukemia is rare and LC is uncommon. Hypercalcemia may be a complication of leukemia, which leads to multiorgan metastatic calcification. Despite the absence of frank hypercalcemia, the presence of bone lesions suggests that the patient's calcinosis cutis was of the metastatic type. However, the cutaneous leukemic infiltrate may also represent a triggering factor for calcium deposition in the skin.     

特发性皮肤软组织钙沉着症一例

临床资料患儿,男,7岁。主因臀部结节2年、右肘部结节1个月,于2012年7月9日就诊。2年前发现患儿左侧臀部有一黄豆大、坚实小结节,无痛痒,当地医院诊断为“皮脂腺囊肿”,予手术切除。     

特发性皮肤钙沉着症一例

正临床资料患者,男,15岁。主因左臀部肿物2年,于2015年9月1日就诊。2年前,无明显诱因患者左臀部出现一绿豆大小皮下肿物,无自觉症状,近半年来肿物逐渐增大。既往体健,发病前无局部注射史及外伤感染史,未接受钙剂治疗,家族中无类似疾病患者。体格检查:发育正常,营养中等,无突眼及甲状腺肿大,全身浅表淋巴结未触及增大。心、肺、腹查体均未见明显异常,四肢关节无畸形,肢端无硬化。     

Perforating folliculitis in a patient with cystic fibrosis

We report a case of a young man with perforating folliculitis and cystic fibrosis with complications including chronic obstructive pulmonary disease, insulin dependent diabetes mellitus, and liver cirrhosis. We demonstrate increased TGF-β1 immunohistochemical staining in the perforating folliculitis lesions of our patient and discuss the possible associations between cystic fibrosis and perforating folliculitis.     

Diffuse soft tissue calcifications (calcinosis cutis) in a patient with discoid lupus erythematosus

Soft tissue calcification is known to occur in dermatomyositis, systemic scleroderma and CREST syndrome, but rarely in systemic lupus erythematosus (SLE). Diffuse soft tissue calcifications have not been reported in discoid lupus erythematosus (DLE). In a patient with discoid lupus erythematosus, calcinosis cutis developed about 20 years after the onset of the disease. During the follow-up time of 25 years, manifestations suggestive of a systemic disease were observed in our patient. However, no specific diagnosis could be established. The clinical, light and electron microscopic as well as immunohistochemical findings of our patient are reported. On the basis of electron microscopic findings it is suggested that intracellular calcification occurred in this case.     

系统性红斑狼疮并发泛发性皮肤钙质沉着症一例

临床资料患者,女,55岁。主因面部、颈部,前胸V型区散在蝶形的淡紫红色斑片、丘疹15 d,于2014年8月21日就诊。患者确诊系统性红斑狼疮、狼疮性肾炎21年,双侧髋关节起包块15年。长期在武汉市第一医院肾内科就诊,经糖皮质激素、中药等治疗后,病情基本稳定。高血压病病史十余年,口服坎地沙坦酯片和苯磺酸左旋氨氯地平片,血压控制稳定。否认有糖尿病、冠心病和内分泌疾病史,家族     

A dystrophic calcinosis cutis case treated with CO2 laser

Abstract

Calcinosis cutis is the deposition of insoluble calcium salts within cutaneous tissue. It may be divided into four major subtypes: dystrophic, metastatic, idiopathic, and iatrogenic. The most common subtype is dystrophic calcinosis cutis. It can occur as a result of local tissue injury. We herein present a child with dystrophic calcinosis cutis developed following trauma and successfully treated with CO₂ laser.     

Leukemia cutis in a patient with acute monocytic leukemia presenting as unique facial erythema

A 67‐year‐old woman was referred to our department with a 1‐month history of facial exanthemas. She had been diagnosed as having acute monocytic leukemia (French–American–British classification, M5b) based on the histological findings of bone marrow. Physical examination revealed diffuse edematous erythema on her cheeks, eyelids and glabella with scattered reddish papules. Histological examination demonstrated dense infiltration of atypical mononuclear cells in the dermis. Specific cutaneous lesions could occur in acute monocytic leukemia more frequently than in other types of leukemia, but rarely show symmetrical edematous erythema limited to the face.     

Regression of cutis calcinosis with diltiazem in adult dermatomyositis

Calcinosis cutis is common in several connective tissue diseases such as dermatomyositis, scleroderma or lupus erythematous. In dermatomyositis, it is more likely to concern children than adults but it is not exceptional in adults. Several treatments have been used empirically with inconsistent success. We report a case of adult cutis calcinosis associated with dermatomyositis which responded dramatically to treatment with diltiazem.     

泛发性皮肤钙沉着症1例

报告泛发性皮肤钙沉着症１例，妇性，３８例。双臀、腹股沟及双下肢斑块伴疼痛３年，检查：双臀、腹股沟、左胸、双下肢分布大小不等结节和斑块，质坚如石，有压兖。部分表面皮肤萎缩并与结构粘连。．     

Tobramycin-induced aquagenic wrinkling of the palms in a patient with cystic fibrosis

Aquagenic wrinkling of the palms (AWP) is a rare condition, defined clinically by the appearance or accentuation of an asymmetrical, translucent to white, papular eruption on the palms after immersion in water. It is associated with cystic fibrosis (CF), and approximately half of all reported cases occur in patients with documented CF. We report a case of AWP in a young woman with CF, where the AWP was related to treatment with the aminoglycoside antibiotic, tobramycin. Although the mechanism of AWP is unknown, influx of water across an osmotic gradient into eccrine ducts has been proposed. Aminoglycosides may affect AWP by blocking various cell surface channels and receptors, which may influence cell-volume regulation.     

A unique case of cutaneous calcinosis with transepidermal elimination.

A case of cutaneous calcinosis with unique clinical and histological features which occurred on the cheek of a 14-year-old girl, is reported. Our case had no abnormal findings in laboratory data. Serum calcium and phosphate were normal, there was no underlying disease, and the possibility of self-inflicted dermatoses was denied. Transmission electron microscopy and X-ray microanalysis showed calcium and phosphate deposited around collagen fibers, which were eliminated from the epidermis.     

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.