Susana Córdoba

Giant cell lichenoid dermatitis within herpes zoster scars in a bone marrow recipient

Cutaneous lesions arising in herpes zoster (HZ) scars are rare. We report a 34‐year‐old woman with acute lymphoblastic leukemia underwent allogenic bone marrow transplant (BMT). Ten days after the BMT, she developed clusters of vesicles over the right neck, scapula, shoulder and chest. She was treated with intravenous acyclovir and foscarnet. One month after the vesiculous episode of HZ she showed 5 mm to 2 cm clustered flat violaceous lichenoid papules and confluent plaques within the HZ scars. Histopathologic examination revealed a inflammatory infiltrate present in the papillary dermis with granulomatous agregated formed by histiocytes, multinucleated giant cells and lymphocytes. She was treated with topic steroids with significant improvement. Pathologic findings are similar to those of an unusual lichenoid reaction named “giant cell lichenoid dermatitis”. We present the first reported case of giant cell lichenoid dermatitis at the sites of HZ scars.

Lipchütz Ulcers – Four Cases

Abstract:  A distinctive clinical entity of acute genital ulcers occurring in adolescents, with nonvenereal infectious etiology was described by Lipschütz in 1913. We describe four puberal virgin girls who developed fever and painful genital ulcers. The main causes infectious and noninfectious of ulceration were rejected. Although the etiology is unknown, recent cases related with Epstein–Barr virus acute infection have been reported.

Lichen sclerosus et atrophicus in sclerodermatous chronic graft-versus-host disease

In May 1994, a 40‐year‐old woman with chronic myeloid leukemia received an allogeneic bone marrow transplant (BMT) from her human leukocyte antigen (HLA) identical sister, after a conditioning regimen with cyclophosphamide and busulfan. Graft‐versus‐host disease (GVHD) prophylaxis consisted of cyclosporine (CsA) and methotrexate. Facial and palmoplantar erythema and moderate cholestasis developed on day 14 after the BMT. A diagnosis of acute GVHD was made and she was successfully treated with low doses of corticosteroids. On day 150 after the BMT, despite the prophylactic treatment of GVHD with CsA (150 mg/12 h), she developed several burning white plaque‐like striae over the buccal mucosa and numerous itching violaceous lichenoid papules on the fingertips. Biopsy specimens obtained from both the skin of the fingertips and the oral mucosa ( Fig. 1 ) revealed patchy to diffuse subepithelial lymphocytic inflammation and necrosis of individual squamous cells, consistent with a diagnosis of chronic lichenoid GVHD. Despite therapy with CsA, topical and systemic corticosteroids (prednisone 60 mg/24 h), the oral lichenoid lesions persisted. On day 750 after the BMT, 2 months after withdrawal of immunosuppressive therapy, she developed several erythematous, pruriginous, and slight indurated lesions over the neck. These lesions coalesced into plaques, adopting a white atrophic‐like appearance with follicular plugs similar to lichen sclerosus et atrophicus ( Fig. 2 ). Histopathologic examination showed hyperkeratosis with follicular plugging, atrophy of the stratum Malpighii with hydropic degeneration of the basal cells, homogenization of the collagen, incontinence of the pigment, and a discrete lymphoplasmocytic inflammatory infiltrate in the upper dermis ( Fig. 3 ). Systemic corticosteroid therapy was re‐introduced. On day 850 after the BMT, physical examination revealed patchy hyperpigmentation affecting the back and limbs, and diffuse thickening and hardening of the skin of the legs, forearms, and dorsa of the hands, resulting in

Dermatitis de contacto por pseudotatuaje de henna negra

Resumen —La henna es un colorante natural que se extrae del arbusto Lawsonia inermis , cuyo uso esta aumentando especialmente entre ninos y jovenes, por la moda de los pseudotatuajes no permanentes. Para aumentar la duracion o intensificar el color, a la henna se le anaden distintos productos algunos de conocida capacidad sensibilizante como la parafenilendiamina (PPD). Se presenta el caso de un nino de 10 anos que presento, en la cara lateral del brazo derecho, una placa eritematosa, pruriginosa, a las 2-3 semanas de la realizacion de un pseudotatuaje de henna negra. La lesion desaparecio tras tratamiento con corticoides topicos y sistemicos, dejando hipopigmentacion residual transitoria que se resolvio de forma espontanea en 3 meses. Las pruebas epicutaneas demostraron sensibilizacion de contacto a PPD, colorantes del grupo «azo» y benzocaina, las cuales se consideraron reacciones cruzadas a la PPD, y a tetraetiltiuram. Queremos llamar la atencion ante una moda, la de los pseudotatuajes no permanentes de henna negra, que puede provocar sensibilizaciones con repercusiones para el futuro.

Treatment of digital mucous cysts with percutaneous sclerotherapy using polidocanol.

Percutaneous sclerotherapy with polidocanol is a safe and effective option for the treatment of digital mucous cysts. Digital mucous cysts are translucent, round, soft cystic nodular lesions, containing mucinous material, usually located on the dorsal aspect of the fingers near the distal interphalangeal joint. Treatment modalities include incision and drainage, injection therapy with corticosteroids or sclerosing agents, surgical excision, cryosurgery, carbon dioxide laser, or electrodesiccation. Some treatments may be painful or result in scarring. Recurrence rates vary according to the specific therapy but recurrences are not uncommon.

Allergic contact dermatitis from common ivy confirmed with stored allergens

viously been reported as a cause of dental plate hypersensitivity. Patient no. 7 showed a positive reaction to palladium which is found in dental amalgam. No decision has yet been made to replace his dental fillings. Burning mouth syndrome, orofacial granulomatosis and lichen planus have all been shown in some studies to be associated with delayed hypersensitivity (1, 3), while we found none in these latter 2 categories. Palladium in dental amalgam has been shown to be relevant in 2 other intra-oral studies (4, 5). Our study also shows the importance of flavourings when assessing oral problems, which agrees with previous studies (1–6). It also highlights the potential of patch testing with the patient’s own toothpaste 50% pet. Regarding the 8 patients who were negative, our patch test series may lack some allergens of clinical importance. None of these patients were atopic. Other causes that might give rise to oral symptoms would be irritant or urticarial reactions to foods, food additives and flavourings.

Carcinoma basocelular sobre dermatofibroma

Resumen La epidermis situada sobre un dermatofibroma puede mostrar cambios que varian desde la hiperplasia simple hasta la proliferacion de celulas basaloides, que puede llegar a ser morfologicamente indistinguible del carcinoma basocelular. La coexistencia de un verdadero carcinoma basocelular sobre dermatofibroma es poco frecuente. Habitualmente, estas proliferaciones basaloides se han considerado el resultado del efecto inductivo de la proliferacion fibrohistiocitaria del dermatofibroma sobre las celulas epiteliales del foliculo piloso, por lo que se trataria de un fenomeno reactivo y no verdaderamente neoplasico. Describimos un caso de dermatofibroma que presenta en la epidermis suprayacente una proliferacion de aspecto basaloide identica a un carcinoma basocelular.

Laser Recall Dermatitis

Laser Recall Dermatitis Chemotherapy-induced recall dermatitis is a phenomenon whereby the administration of a chemotherapy agent induces an inflammatory reaction at sites injured previously, days, months, or even years earlier.1 Radiation recall dermatitis, where the inflammatory reaction appears at a previously irradiated site, and reactivation of UV light–induced erythema after methotrexate therapy are the prototypes of recall phenomena. A few cases of chemotherapy recall phenomenon on a site of drug extravasation and on a previously scalded wound have been reported.1,2 The concept of recall dermatitis is not exclusive for chemotherapy drugs and may also be induced by tuberculostatic drugs, antibiotics, and simvastatin.3

Vasculitis leucocitoclástica cutánea y carcinoma renal

The association between leukocytoclastic vasculitis and solid tumors like renal carcinoma has been infrequently described. We present the case of a 76-year-old woman who began with skin lesions on the legs that were clinically and histologically diagnosed as leukocytoclastic vasculitis. During analysis of the symptoms, she was diagnosed with renal carcinoma. After the tumor was excised, the vasculitis lesions disappeared, with no recurrence during the follow-up period.

Nevus anemicus of the cheek with ipsilateral melanosis bulbi: an unusual example of didymosis.

ejd.2011.1332 Auteur(s) : Almudena Hernandez-Nunez ahernandez.hflr@salud.madrid.org, Jesus Borbujo, Susana Cordoba, Cristina Martinez-Moran, Diego Martinez-Sanchez, Alberto Romero-Mate Hospital Universitario de Fuenlabrada, C/ Camino del Molino, 2, 28942 Fuenlabrada. Madrid, Spain Reprints: A. Hernandez-Nunez Twin spots (didymosis) are nevic lesions occurring together or in contralateral homonymous segments, and differ from each other and from the background tissue. There are two types [...]