Medulloblastoma metastasizing to the skin.
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Biomedical subjects
Publications and source records attributed to C B Bunker.
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Trichostasis spinulosa is a relatively common but underdiagnosed disorder of the pilosebaceous follicles in which there is follicular hyperkeratosis of a dilated vellus hair follicle with retention of successive telogen hairs arranged in parallel among keratinaceous material. The condition is apparent as dark follicular plugs in the affected areas, most commonly affecting the face (nose and cheeks) or the trunk (interscapular area in particular). We describe a 33-year-old Indian man who was on haemodialysis for chronic renal failure and who developed unusually widespread trichostasis spinulosa over almost the entire body including the lower limbs over a period of 18 months.
Artecoll is a recently developed permanent synthetic cosmetic filler substance, composed of 80% bovine collagen and 20% polymethylacrylate (PMMA) microspheres of 32-40 mum in diameter. It is used for the augmentation of deep wrinkles and is to be injected subdermally. We report the development of granulomas at the site of Artecoll injections in the face in a 48-year-old woman who had pulmonary sarcoidosis. There were features consistent of both sarcoid and foreign-body granuloma, typical of those reported previously with Artecoll. We postulate that the PMMA foreign material contained within Artecoll acted as a stimulus for the development of the cutaneous sarcoid granulomas.
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Skin disease and its treatment may have radiological connotations. Though this article is not a comprehensive account of dermatological and radiological associations, it provides an eclectic selection of some common and some rare clinical entities, which the practicing radiologist may recognize or remember.
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BACKGROUND: Chronic lymphocytic leukaemia (CLL) is a malignancy characterized by clonal expansion of B lymphocytes with distinct morphology and immunophenotype. The dermatological literature relating to CLL is sparse. A global descriptive survey of a large number of CLL patients has not previously been published. OBJECTIVES: To report the spectrum of dermatological conditions seen in a large series of CLL patients. METHODS: Skin complications in patients with established CLL were identified retrospectively from clinical and photographic records, principally a database of over 750 consecutive cases. These events were classified, enumerated and compared. RESULTS: Forty patients with 125 skin manifestations were identified and studied. Forty-one manifestations had documented clinical or histological atypia. In 21 of these 41 complications there had been no prior immunosuppressive therapy. We observed that cutaneous malignancies frequently presented atypically both clinically and histologically. There were 18 patients with 56 instances of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), and clinical atypia was more common with SCC than with BCC. Other cutaneous findings included varicella zoster (n = 6), leukaemia cutis (n = 3), acute graft-versus-host disease (n = 5), cutaneous drug eruptions (n = 9), multiple warts (n = 3), herpes simplex (n = 3), cutaneous T-cell lymphoma (n = 2), eosinophilic folliculitis (n = 2), malignant melanoma (n = 2) and Merkel cell tumour (n = 2). CONCLUSIONS: We have identified a range of dermatological conditions in CLL patients, with a tendency to atypical presentations. The atypia was independent of prior chemotherapy.
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Divided or 'kissing' naevus was first described on the eyelids in 1908. Other types of divided naevus reported include naevus spilus on the eyelids, mast cell naevus and epidermal naevus in a divided form on the fingers. Six cases of kissing naevus of the penis appear in the literature. In this paper, we discuss a seventh case.