Dolores Sánchez-Aguilar

Three Cases of Type 2 Segmental Manifestation of Multiple Glomus Tumors: Association with Linear Multiple Trichilemmal Cysts in a Patient

We report 3 cases of congenital multiple glomus tumors seen during the last 5 years. One of them showed autosomal dominant inheritance with male-to-male transmission. The remaining patients had no family history of similar lesions. The clinical and histopathological aspects of our patients support the recently described type 2 segmental manifestation of multiple glomus tumors. One of the cases showed associated multiple and giant trichilemmal cysts with a linear distribution in the scalp.

Erythema multiforme photoinduced by statins

We report two cases of systemic photosensitivity induced by simvastatin and pravastatin that presented as photodistributed erythema multiforme. One of them occurred in a 75‐year‐old woman who had been suffering recurrent eruptions following sun exposures over a period of 12 years. The other patient was a 54‐year‐old man who had a 1‐week history of pruritic lesions on the face and the hands. They had no history of herpes simplex virus infection. In both cases, the close temporal relationship between drug ingestion and onset of the conditions suggested statin‐induced photosensitivity. The diagnosis was confirmed by the marked reduction of UVB‐MED or both UVA and UVB‐MED while taking the drug and its normalization after discontinuing the statin intake.

Malignant Syphilis in an HIV-Infected Patient

Patients with HIV infection may develop common diseases with atypical clinical features. HIV infection may change the classic clinical course of syphilis and increase the incidence of a subtype of secondary syphilis named malignant syphilis. A homosexual patient with HIV infection consulted us about a one-month history of general malaise and widespread cutaneous ulcerative lesions, some with thick hemorrhagic crusts. Serology for syphilis was positive at high titers. Based on clinical, histological and serological findings, a diagnosis of malignant syphilis was made and the patient started treatment with penicillin G benzathine with progressive resolution of lesions. Malignant syphilis is a rare subtype of secondary syphilis that presents special clinical and histological features and has been associated with several processes characterized by variable degrees of immunosuppression. It is necessary to take into account this entity among the possible diagnoses in HIV-infected patients with cutaneous lesions.

Ulcerous lesions disclosing cutaneous infection with Fusarium solani.

Fusarium spp. are emergent opportunistic moulds capable of producing life-threatening diseases, usually in immunocompromised hosts. When they infect immunocompetent patients, they usually cause localized diseases. We describe here a case of cutaneous fusariosis in a patient with a medical history of diabetes mellitus and non-Hodgkins lymphoma who presented with two painful lesions on her left leg. The diagnosis was made on the basis of histopathological findings and skin biopsy culture. The lesions resolved after treatment with oral itraconazole. Cutaneous fusariosis manifests clinically as lesions that can be grouped into a few clinical patterns, and should always be considered in the differential diagnosis of necrotic cutaneous lesions.

Perianal ulceration: a case of tuberculosis cutis orificialis

Background  Tuberculosis cutis orificialis is an extremely rare variant of cutaneous tuberculosis. Perianal location is a possible site of presentation.

Inflammatory metastatic melanoma

An 87‐year‐old woman developed erythema, induration and tenderness of the skin overlying each breast. One year before, she had undergone an axillary lymph node dissection because of metastases from melanoma. The primary site was unknown. A skin biopsy showed pigmented tumor nests within the dermal lymphatic vessels, and immunohistochemistry confirmed the melanocytic origin. The diagnosis of inflammatory metastatic melanoma was made.

Chronic Recurrent Neutrophilic Dermatosis: A Possible Variant in the Spectrum of Neutrophilic Dermatoses

Neutrophilic dermatoses constitute a clinically heterogeneous group of diseases that share a common histological substrate, consisting of a dense dermal inflammatory infiltrate of mature polymorphonuclear neutrophils and no evidence of vasculitis. We describe the case of a 56-year-old man with a 6-month history of painful generalized erythematous edematous plaques. Histopathology indicated neutrophilic dermatosis but the patient did not have fever, elevated white blood cell count, or systemic involvement. Tests to rule out possible inflammatory, neoplastic, or infectious processes were negative. We consider the term chronic recurrent annular neutrophilic dermatosis, first used by Christensen et al, to be the most appropriate to define this variant with clinical findings that differ from classic Sweet syndrome.

Quistes miliares en placa extrafacial

Resumen —Los quistes miliares son lesiones quisticas benignas secundarias a un traumatismo. Sin embargo, pueden aparecer quistes miliares primarios en parpados, mejillas, frente y genitales, despues del nacimiento, en la adolescencia y en la edad adulta. Hay dos formas especiales de quistes miliares en adolescentes y adultos: la forma eruptiva y la forma en placa. Los quistes miliares en placa son una forma primaria rara que se ve principalmente en mujeres adultas en region retroauricular. Aportamos un caso de quistes miliares en placa, en una nina de 9 anos, que consulta por lesiones de tres meses de evolucion, sin antecedentes de traumatismo, localizadas en el dorso de la mano, en forma de lesiones agrupadas sobre base eritematosa y elevada.

Sífilis maligna en un paciente inmunocompetente

Malignant syphilis is a rare manifestation in secondary syphilis and one that is associated in most cases with immunosuppression. We report the case of a 26-year-old man with a possible adverse reaction to penicillin. He consulted because of progressive lesions on the trunk, genitals, and lower limbs in the form of excoriated nonfollicular papules that were slightly painful. Staphylococcus aureus was isolated from the exudate from these lesions, so the patient was treated with topical mupirocin and later with oral erythromycin (500 mg/day for 14 days). Serology was positive for syphilis (positive rapid plasma reagin; Treponema pallidum hemagglutination assay [TPHA], 1/80), which was associated with a genital ulcer treated with oral erythromycin in primary care 1 year before the patient came to our clinic. A month after starting the treatment that we prescribed, the patient reported acute worsening of the lesions. He presented with numerous intensely painful round plaques with raised borders and collarette scaling. Most of these plaques had very adherent necrotic eschars and central squamous crusts. The plaques were between 2 and 5 cm in diameter and were located on the scalp, trunk, genitals, and lower limbs (Fig. 1). For the last month the patient had also had evening fever and poor general condition. Clinical differential diagnosis was made with cutaneous T-cell lymphoma. A biopsy of one of the lesions revealed an acanthotic epidermis with areas of pseudoepitheliomatous hyperplasia covered by a squamous crust (Fig. 2A). In the dermis there was an intense perivascular lymphohistiocytic and plasma cell infiltrate with endarteritis and associated vascular occlusion (Fig. 2B and C). Chest radiograph revealed no pleuropulmonary abnormalities. The complete blood count revealed a slightly

Psoriasis pustulosa generalizada y hepatitis citolítica asociada a colangitis neutrofílica

Resumen La psoriasis pustulosa generalizada (PPG) de von Zumbusch puede asociarse a alteraciones hepaticas, resultando habitualmente en una hepatitis colestasica con colangitis neutrofilica. Describimos el caso de una mujer con un primer episodio de de PPG que presento durante el mismo una elevacion de los parametros hepaticos de citolisis. La ecografia abdominal y los estudios serologicos no mostraron anomalies significativas. La biopsia hepatica mostro la presencia de un infiltrado neutrofilico alrededor de los conductos biliares del espacio portal. En definitiva, este hecho sugiere que la colangitis neutrofilica en el contexto de esta enfermedad puede mostrar inicialmente otros patrones de alteraciones analiticas distintos del patron colestasico clasicamente descrito.