Adolfo Aliaga

Adverse reactions to injectable aesthetic microimplants.

New inert materials such as polymerized silicones, Bioplastique, Artecoll, and Dermalive are now being used as injectable aesthetic microimplants. These substances are better than the old ones because they tend not to migrate and do not usually produce much of a host immune response. Adverse reactions after injection of these materials are rare, although there are a few reported cases as a result of bad technique or anomalous granulomatous reactions. We report on four patients with unsightly results after cosmetic microimplants, including one of Artecoll, one of Dermalive (to the best of our knowledge, the latter is the first such case reported), and two of silicone. This report describes the histopathologic features of cutaneous reactions to these injectable aesthetic materials.

Lipoatrophia semicircularis—a traumatic panniculitis: Report of seven cases and review of the literature

Lipoatrophia semicircularis is an apparently rare condition, which presents as semicircular band-like atrophy of the subcutaneous fatty tissue and involving half the circumference of the anterolateral aspects of the thighs. Repeated external microtraumatism seems to be the most plausible explanation in several cases in the literature, though in some patients the underlying traumatic mechanism is difficult to establish. No relation to underlying clinical or biologic abnormalities appears to be. Seven patients with lipoatrophia semicircularis are described. A detailed clinical history revealed precipitating trauma in all cases. A review is made of earlier reports in the literature.

Lipomembranous changes in chronic panniculitis

The clinical and histopathologic findings in 13 patients with lipomembranous changes in the subcutaneous adipose tissue as part of the inflammatory reaction are presented. Nine patients had clinical evidence of vascular disease and four had clinical evidence of connective tissue disease. Histopathologic evidence of endarteritis obliterans, venous stasis, and hemorrhage was present in more than half the patients, and the clinical lesion of liposclerosis was frequently present. These findings suggest that the histologic changes of lipomembranous panniculitis may be the result of an inflammatory reaction in patients who have the liposclerosis of venous insufficiency with connective tissue disease or previous leg ischemia or both.

Detection of Epstein-Barr virus and human herpesvirus 7 and 8 genomes in primary cutaneous T- and B-cell lymphomas

Background Several studies have investigated the possible involvement of viral agents, particularly herpesviruses, in primary cutaneous lymphoma (PCL).  Objectives Our aim was to screen for the presence of human herpesvirus 7 (HHV‐7) and 8 (HHV‐8) genomes in samples of PCL, and to determine if their presence was independent of Epstein–Barr virus (EBV).  Methods Screening was performed using polymerase chain reaction assay in 64 skin samples from historical lesional tissues with PCL.  Results Only nine cases showed positivity for HHV‐7: four of 29 mycosis fungoides (MF), two of four CD30‐positive large‐cell cutaneous T‐cell lymphoma (CTCL), two of 12 follicle centre cutaneous B‐cell lymphoma (CBCL) and one of nine marginal zone CBCL. Fifteen cases tested positive for EBV: seven of 29 MF, two of four pleomorphic small/medium sized CTCL, three of three angiocentric CTCL, one of 12 follicle centre CBCL and two of nine marginal zone CBCL. All cases were uniformly negative for HHV‐8. No simultaneous positivity was found for EBV and HHV‐7. Controls tested negative for all viruses.  Conclusions The findings indicate that EBV, HHV‐7 and HHV‐8 seem not to be involved in the pathogenesis of PCL.

Piroxicam-induced photosensitivity: In vivo and in vitro studies of its photosensitizing potential

A 36-year-old woman developed a photolocalized erythematous papulovesicular eruption while taking piroxicam. Histologic study revealed a superficial and deep spongiotic dermatitis. Phototesting with ultraviolet B (UVB) and ultraviolet A (UVA) was abnormal at the time the patient was seen and after oral challenge with the drug for 5 days. A modified lymphocyte transformation test was positive. The photosensitizing potential of the drug was evaluated in vivo and in vitro. In vivo studies consisted of phototesting twelve medical students before and after intake of piroxicam during 5 consecutive days. No lowering of the minimal erythema dose (MED) values or abnormal reactions to UV and visible light were observed in these students. In vitro studies by the Candida plate method and by photohemolysis showed negative results. Our studies suggest a systemic photoallergy mechanism requiring wavelengths in the UVA range for the reaction. This drug should be avoided in patients receiving photochemotherapy.

Allergic and systemic contact dermatitis from Matricaria chamomilla tea

Case Report A 26-year-old, student, with a past history of nickel intolerance, presented with acute facial eczema. 4 days beforehand, she had dyed her eyebrows and immediately felt pruritus in the area, and so applied FuracinA (nitrofurazone) topically. Erythema worsened and eczema enveloped the whole face. Patch testing with the GEIDEC standard series and FuracinA, as is, showed positive reactions to nickel (ππ), palladium (π), and sesquiterpene lactone mix (πππ). The patient was asked about anything else that she might have applied, and remembered the simultaneous use with FuracinA of a topical fomentation of Matricaria chamomilla (German chamomile). Patch testing with German chamomile infusion 1:100 w/v (chamomile tea extract heated 10 min at 90æ) and with a plants series (Chemotechnique) gave the results shown in Table 1. Anthemis nobilis (Roman chamomile) was negative. 10 controls patch tested with the chamomile tea were all negative. 15 days after patch testing, the patient developed a flare-up of her cutaneous lesions, with edema and itching of the oral mucosa, eczema of the arms and trunk, and anal pruritus. She herself established a relationship between these clinical features and the drinking of a cup of tea infusion the day before.

Riehl's melanosis: Pigmented contact dermatitis caused by fragrances

We report a case of a 27-year-old woman with a patchy, dark brown hyperpigmentation on the face. Patch tests were positive to lemon oil, geraniol, and hydroxycitronellal. A compact face powder that the patient used contained two of these chemicals. Hyperpigmentation disappeared within 6 months after the patient avoided contact with cosmetics containing these fragrances.

Congenital eccrine angiomatous hamartoma

A case of congenital eccrine angiomatous hamartoma of the foot in a three-month-old girl is presented. Eccrine angiomatous hamartoma is a benign tumoral lesion that combines the proliferation of multiple benign eccrine structures and angiomatous channels. We review the literature on the subject.

Median Raphe Cysts of the Penis: A Report of Five Cases

Abstract: Cysts of the median raphe are embryologic developmental anomalies of the male genitalia. Although generally present since birth, these lesions tend to manifest in adult life. Histologically the cysts are characterized by a pseudostratified epithelium in the middle dermis. The early age at consultation is a common characteristic in four of the five patients reported herein and is probably due to the growing concern among the general population about skin problems.

Partial Lipodystrophy Associated with Juvenile Dermatomyositis: Report of Two Cases

Abstract: A 27‐year‐old woman and a 13‐year‐old girl diagnosed with juvenile dermatomyositis in childhood developed clinical findings of partial lipodystrophy 10 years after diagnosis. Exhaustive clinical and laboratory examinations showed an association with other abnormalities: hy‐pertrichosis, steatohepatitis, and an abnormal insulin response to the glucose loading test in the first patient. Hypertrichosis, steatohepatitis, insulin‐resistant diabetes mellitus, and acanthosis nigricans were observed in the second patient. Renal function was normal in both patients. Although a localized form of lipodystrophy has been reported associated with connective tissue disease (connective tissue lipoatrophy), the partial form has been infrequently described in association with juvenile dermatomyositis.