María José Izquierdo

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.

Postirradiation pseudosclerodermatous panniculitis.

Pseudosclerodermatous panniculitis is an unusual variant of panniculitis that results as a complication of megavoltage radiotherapy. Four women developed this unusual entity on the anterior chest and abdominal skin after receiving megavoltage therapy for either breast carcinoma or painful bone metastases from breast carcinoma. Histopathologically, the epidermis and dermis of the involved area showed little or no evidence of radiodermatitis. The main findings were confined to the subcutaneous tissue and consisted of thickened, sclerotic septa composed of both thick and thin collagen bundles, and a lobular panniculitis characterized by lipophagic granulomas and scattered lymphocytes and plasma cells. Additionally, one of the cases showed markedly dilated vascular spaces with the appearance of lymphatics in the upper part of the dermis. Pseudosclerodermatous panniculitis after irradiation is an unusual cutaneous complication of megavoltage radiotherapy that should be distinguished from subcutaneous metastatic disease, cellulitis, or connective tissue diseases involving the subcutaneous fat. The differential diagnosis can be established on the basis of the characteristic histopathologic features of postirradiation pseudosclerodermatous panniculitis.

Olmsted syndrome: report of a case with study of the cellular proliferation in keratoderma.

Olmsted syndrome is a rare disorder that consists of sharply marginated keratoderma of the palms and soles, constriction of digits and toes that may result in spontaneous amputation of the distal phalanges, hyperkeratotic plaques around the body orifices, onychodystrophy, and other less common cutaneous and extracutaneous anomalies. Although some patients had other affected family members, most cases of Olmsted syndrome seem to be of sporadic occurrence. We describe a patient with the characteristic features of Olmsted syndrome. The symptoms consisted of diffuse transgrediens palmoplantar keratoderma and keratotic plaques around the mouth and nose. Our patient also had the associated anomalies of hyperhidrosis of the palms and soles and congenital deaf-mutism. Histopathologic study of the keratoderma demonstrated epidermal hyperplasia with acanthosis, papillomatosis, and orthokeratotic hyperkeratosis. Immunohistochemical study showed more basal and suprabasal keratinocytes of the epidermis with immunoreactivity for Ki-67 marker when compared with the keratinocytes of the epidermis of the adjacent non-involved skin. These results support the notion that Olmsted syndrome is a hyperproliferative disorder of the epidermis.

Chloracne: histopathologic findings in one case

Background: Chloracne is an acneiform eruption due to poisoning by halogenated aromatic compounds having a specific molecular shape. This condition is always a symptom of systemic poisoning by chemical chloracnegens and not just a cutaneous disorder.

Enfermedad de Grover en un paciente con insuficiencia renal crónica en hemodiálisis

Resumen —Se presenta un caso de enfermedad de Grover, con patron histopatologico tipo enfermedad de Darier, en un paciente varon de 69 anos de edad con antecedentes personales de insuficiencia renal cronica secundaria a un carcinoma urotelial multicentrico de larga evolucion que habia sido tratado con sucesivas intervenciones quirurgicas. El paciente referia que el inicio de las lesiones cutaneas se habia producido poco tiempo despues del comienzo del tratamiento de hemodialisis. Se discute la posible implicacion de la insuficiencia renal cronica y/o la hemodialisis en la patogenia de la enfermedad de Grover.

Melanocitosis dérmica de la parte alta de la espalda

Resumen —Se han descrito numerosas variantes clinicas de melanocitosis dermica que incluyen el nevo azul, la mancha mongolica, el nevo de Ota y el nevo de Ito, asi como otros tipos menos frecuentes que se denominan genericamente melanocitosis dermicas atipicas. Presentamos el caso de una melanocitosis dermica persistente adquirida que afecta la region interescapular de un paciente de raza blanca y 44 anos de edad, y que corresponderia a la denominada melanocitosis dermica de la parte alta de la espalda.

Miofibromatosis infantil múltiple, cutánea y ósea

Infantile myofibromatosis is the most frequent form of infantile fibromatoses. One or more tumours appear in the skin, subcutaneous tissue, muscle, bones and viscera. The disease is usually present at birth and characteristically tumours are prone to spontaneous regression. The prognosis depends on the presence of visceral involvement. We present the case of a newborn female with congenital multiple fibromatosis with cutaneous and osseous lesions, but without visceral involvement.