Amebiasis and trypanosomiasis

Parasitic diseases, once limited to developing countries, may be seen in the United States with increasing frequency as air travel links continents. When cutaneous manifestations of these diseases are a part of the clinical picture, dermatologists are often called upon to contribute to the diagnosis. Amebiasis may result in painful anogenital ulcers; African trypanosomiasis (sleeping sickness) often begins with the trypanosomal chancre at the site of parasitic entry, and American trypanosomiasis (Chagas' disease) most commonly presents as Roma?a's sign. Epidemiology, pathophysiology, immunology, clinical presentation, and treatment are reviewed for each of these diseases.     

Cutaneous Amebiasis in Children

Abstract: A 7-month-old girl developed cutaneous amebiasis of the perianal and genital areas in association with amebic dysentery. The diagnosis was based on the identification of Entamoeba histolytica by skin biopsy. She was treated with dehydroemetine and metronidazole with excellent results. This is only the eighth reported case of this disease in a child     

Elastofibroma cutis

A 9 year old boy sought medical attention because of a cutaneous infiltrate of the nape that could not be diagnosed macroscopically. Microscopic examination showed it to be a fascicular fibroma of a special structure. The striking feature of the stroma was the distinct proliferation and degeneration of the elastic fibers. The alteraions of the elastic tissue are similar to those seen in elastofibroma dorsi. It is discussed if the lesion results from a hyperplasia of true elastic or/and pseudo-elastic fibers.     

Granulomatous Cutaneous Centrofacial and Meningocerebral Amebiasis

A 7-year-old, otherwise healthy Peruvian boy presented with a 3-month history of an indurated centrofacial plaque. Histologic examination revealed a granuloma containing free-living amebae tentatively identified as Balamuthia mandrillaris. The patient failed to respond to tentative treatment. He was admitted to the intensive care unit 7 months later with neurologic manifestations of granulomatous amebic encephalitis, which proved fatal. The difficulty in diagnosing this rare presentation of cutaneous amebiasis, the challenge of treating the condition, and the morbidity and high mortality associated with cerebral involvement are discussed.     

Osteoma cutis

A very rare case of osteoma cutis is being presented here. Cutaneous involvement was very extensive in this case.     

Chordoma cutis

We report a case of an 85-year-old white man with a diffuse form of psoriasis, who showed a large asymptomatic subcutaneous tumour in the sacrococcygeal region. On cut section there was a subcutaneous neoplasia with a glistening, friable surface. Histologically, the deep dermis was infiltrated by cords and nests of pleomorphic cells embedded in an abundant mucinous stroma, and characteristic physaliphorous (multivacuolated) cells were observed. The neoplastic cells were immunohistochemically positive for cytokeratins (using CAM 5.2 and AE1/AE3), vimentin, S100 protein, and epithelial membrane antigen (EMA), but negative for carcinoembryonic antigen (CEA). Histological and immunohistochemical findings led us to the diagnosis of classic chordoma. Chordomas are rare, slow growing malignant tumours of the spinal axis originating from remnants of the notochord. Occasionally, a skin lesion is the first sign of a primitive or metastatic chordoma.     

Melano-neurinoma cutis

Ohne ZusammenfassungMit 6 Textabbildungen.     

Osteoma cutis

Ohne ZusammenfassungHiezu Taf. IX–XI.     

Calcinosis cutis

A 22-year-old male patient presented with multiple swellings over elbows and knees and a sinus over the right elbow discharging chalky white material. Skin biopsy of the swelling demonstrated calcium deposition in dermis and subcutis. There was no evidence of connective tissue disorder or abnormal mineral metabolism. Hence it was concluded as idiopathic calcinosis cutis and is reported for its interesting presentation.     

Congenital cutis laxa

A 16 days old male baby had congenital cutis laxa without family history. He had redundant and lax skin all over the body with slanting of the palpebral fissures medially and broad nasal root.     

获得性皮肤松弛症

患者男,21岁。 主诉：面部皮肤松弛、下垂4年。     

Generalised cutis laxa

A 44-year-old man presented with generalised progressive lax skin of 14 years duration associated with dysphagia, joint pains and hoarseness of voice. Examination revealed "blood hound" like facies, lox skin with loss of elasticity, dilated tortuous superficial vessels over extremities and back. Systemic involvement noted were oesophageal and pharyngeal diverticuli, inguinal hernia and dermatochalasis. Skin biopsy using Verhoeff Van Gieson's stain was suggestive of cutis laxa.     

Metastatic calcinosis cutis

Calcinosis cutis may be associated with metastatic calcification, dystrophic calcification, tumoral calcinosis, or may be deemed idiopathic. The association of cutaneous calcification with metastatic or tumoral calcinosis is quite rare. A case of metastatic calcinosis cutis in a woman with chronic renal failure and secondary hyperparathyroidism is presented. Other causes of calcinosis cutis are discussed briefly.     

Ueber Sarcomatosis cutis

Ohne Zusammenfassung Hierzu Taf. VII–IX.