Alberto Woscoff

Prevalence of cutaneous manifestations in 200 patients with eating disorders

Background Eating disorders are increasing and show a variety of symptoms. They mainly include anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not specified (EDNOS). They predominate in females and represent an important danger, especially in teenagers. In serious cases, they may be life‐threatening.

Nevoid keratosis of the nipple

A patient with nevoid keratosis of the nipple is described. The clinical features, histology, therapy, and prognosis are discussed.

Lichenoid secondary syphilis

Argentina Case 1 A married, heterosexual, promiscuous, 29‐year‐old white man had experienced an asymptomatic eruption on the trunk and left palm for the last 3 months. After 2 months, the trunk involvement disappeared, but 2 weeks later lip and tongue lesions developed. No history of genital ulcer was found.

Up-regulated expression of MICA and proinflammatory cytokines in skin biopsies from patients with seborrhoeic dermatitis

Seborrhoeic dermatitis is a disease of unknown etiopathogenesis that affects 5% of the population. In this study, we investigated expression of mRNA for IL-1 alpha, IL-6, IL-4, IFN-gamma, and the stress-inducible MICA molecule in skin biopsies from 12 patients with moderate to severe seborrhoeic dermatitis and 2 healthy volunteers by RT-PCR and hybridization with specific probes. Eight patients expressed INF-gamma, 2 expressed IL-6, 8 expressed IL-1 alpha, and 2 expressed IL-4 (1 with moderate disease). Eight patients expressed inflammatory cytokines (IL-1 alpha, IL-6, and/or IFN-gamma) in healthy skin. Higher cytokine mRNA in damaged vs healthy skin was also observed, suggesting the existence of an inflammation that predisposes healthy skin to develop overt disease. Up-regulated expression of MICA mRNA was observed in 8 patients. Although the pathogenesis of seborrhoeic dermatitis remains to be elucidated, expression of cytotoxicity-activating ligands (MICA), recruitment of NK cells, and a local pro-inflammatory microenvironment may facilitate the development of tissue injury.

Mycosis fungoides presenting with extensive pyoderma gangrenosum-like ulcers

Mycosis fungoides (MF) may present with atypical clinical manifestations. Usually it mimics various chronic dermatoses, with the appearance of ulcers during the tumour stage. Infrequently, cutaneous ulcers are the main or initial sign of lymphoma. We report the case of a man who presented multiple skin lesions that clinically appeared to be pyoderma gangrenosum (PG). However, histological and immunohistochemical examination revealed MF. This case illustrates that PG‐like ulcers may be atypical cutaneous manifestations of MF and exceptionally the presenting sign of this disease.

Haga su diagnóstico

A 30-year-old woman developed a slowly progressive reddish-violet multinodular rubbery lesion, measuring 20 x 10 cm in diameter, on the upper outer quadrant of her right breast four years after the surgical excision of a dermatofibrosarcoma protuberans (DFSP) in the same area. The diagnosis of DFSP was confirmed histologically and by positive immunomarkers at immunohistochemistry. A complete excision was performed and after a 2-year follow-up no recurrence was observed. It should be emphasized that DFSP of the breast is a rare occurrence.

Lymphogranuloma venereum: tertiary stage

From the Division of Dermatology, University Hospital, University of Buenos Aires Medical School; and the Sanatorio Otamendi, Buenos Aires, Argentina A 64-year-old, heterosexual white man presented with a 3-year history of lymphedema of the scrotum and penis, purulent discharge from fistulas, and abscess of the perineal and perianal area. The patient had an indolent progression of the disease without systemic manifestations. Twelve years before, the right testis had been totally excised because of an abscess of unknown etiology. Histopathologic examination revealed a chronic nonspecific inflammatory orchitis with abscess formation. The patient and his wife denied a history of sexually transmitted diseases.

Cutaneous true histiocytic malignancy: True histiocytic lymphoma

True histiocytic malignancies (THM) are controversial disorders that are being re-evaluated with modern cellular and molecular biology techniques. True histiocytic lymphoma (THL) is a low-incidence, poor-prognosis THM. It mainly affects the skin, gastrointestinal tract, and bone tissues. Occasionally, skin lesions are the presenting clinical features. A patient with initially cutaneous THL is described. This and other reported cases confirm that THM are a nosologic entity by themselves.

Pitiríase rósea purpúrica: relato de caso e revisão da literatura

Purpuric pityriasis rosea is an unusual disease with ten published cases in the American and European literature. The main feature is an hemorrhagic or purpuric eruption with or without scaling. A case is reported of a 25-year-old man with skin lesions affecting the scapular region. The review emphasizes the differential diagnosis of purpuric cutaneous diseases. According to LILACS and MEDLINE, no similar case has been reported in the Latin-American literature.