[Kaposi sarcoma in an HIV-negative hemodialysis patient].
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Biomedical subjects
Publications and source records attributed to E Llistosella.
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We describe a 76-year-old woman who presented persistent generalized pruritus as the only cutaneous manifestation of a cutaneous T-cell lymphoma (mycosis fungoides). No cutaneous lesions were observed throughout the patient's course. Skin biopsies obtained from normal-looking pruritic skin revealed a discrete perivascular lymphocytic infiltrate in the upper dermis and focal intraepidermal clusters of atypical lymphoid cells (Pautrier's microabscesses). PCR analysis of TCR-gamma gene disclosed a monoclonal T-cell rearrangement. Sequencing of the PCR monoclonal product identified the J(8)V(2)C(2) TCR gene rearrangement. This observation illustrates the existence of a peculiar and exceedingly rare form of mycosis fungoides characterized only by persistent pruritus unresponsive to several therapeutic approaches. The diagnostic difficulties of this rare variant are stressed.
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The disseminated, miliarial type of lymphocytoma cutis (DMLC) is a clinicopathologic subtype of lymphocytoma, characterized by multiple, 1-2 mm translucent asymptomatic papules located in the exposed areas of the head and neck. DMLC represents a multifocal hyperplasia of B-lymphocytes with follicular differentiation and formation of follicular germinal centres. The evolution of the disease is characteristic, with some of the lesions resolving and other progressing to nodules or pseudolymphomas. The disease has a chronic course, with complete resolution in one to several years.
Four patients with colorectal cancer treated with tegafur (a fluoropyrimidine structurally similar to 5-fluorouracil) noted a macular, spotted hyperpigmentation limited to the palms, soles, nails, and glans penis. Histopathologic examination disclosed epidermal basal hyperpigmentation with a lentiginous pattern. Mucocutaneous lesions resolved spontaneously two months after treatment was discontinued. This peculiar phenomenon seems to represent a previously unreported side effect of this cytotoxic drug.
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Verrucous hemangioma is an infrequent variety of deep-seated capillary or cavernous hemangioma with reactive epidermal hyperplasia and a superficial component indistinguishable from those of angiokeratoma. Four cases of verrucous hemangioma are reported herein. Verrucous hemangiomas are usually congenital lesions which do not resolve spontaneously and have a tendency to recur after excision if margins are inadequate. Careful histopathologic and clinical evaluation are required for an optimal therapeutic approach.
Excessive, pseudotumoral granulation tissue proliferations appeared in three patients receiving isotretinoin for nodulocystic acne. A review of the literature disclosed few reports of this unusual adverse reaction. Two clinical patterns have been reported; one in a periungual location and the other occurring in the sites of acne lesions during isotretinoin therapy. Loose edematous connective tissue with small vessels and chronic inflammatory infiltrate were the histologic findings in all three cases.
Fibroma of the tendon sheath (FTS) is a rare benign soft tissue tumor. Its location and clinical findings may be similar to the giant cell tumor of tendon sheath or to infantile digital fibromatosis. Accurate diagnosis of FTS depends on microscopic examination of the excised tumor. The present report deals with two cases.
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POEMS syndrome is an unusual plasma cell dyscrasia with multisystemic manifestations featuring polyneuropathy, organomegaly, endocrinopathy, M protein and constant skin involvement. We have seen a 58-year-old white man presenting with generalized eruptive angiomas as a rare skin manifestation of this syndrome. We review the literature and discuss the pathogenesis of vascular proliferation in this unusual entity.
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2 cases of malignant hidroacanthoma simplex are reported. Prominent ultrastructural findings were sparse tonofilaments and villous-like, interdigitating cytoplasmic processes connected by small desmosomes. Positive intracytoplasmic stain for carcinoembryonic antigen was found in 1 case. Benign and malignant eccrine poromas and hidroacanthoma simplex appear to be related neoplasms on the basis of ultrastructural and immunohistochemical findings.
A 71-year-old man developed multiple subcutaneous nodules during Pseudomonas aeruginosa septicemia. The acute and simultaneous flare of inflammatory nodules in a septic patient appears to be rather specific in Pseudomonas infections. Histological vascular lesions are prominent in the subcutaneous nodules.
Two cases of spreading pigmented actinic keratosis are reported. In case number one, an invasive, pigmented squamous cell carcinoma developed in the lesion. Clinicopathologic features include size greater than normal, lateral spread of the lesion, and presence of melanin in dysplastic epidermal cells, dendritic melanocytes and dermal melanophages. Differential diagnosis to be considered includes lentigo maligna, lentigo maligna melanoma and seborrheic keratosis.
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We describe a typical case of lipodystrophia centrifugalis abdominalis infantilis. This rare disorder is almost exclusively seen in Japanese children. The patient, a 3-year-old girl of Chinese ancestry, had a depressed area of skin in the right groin which gradually spread across the abdomen. The lesion had a distinctive, slightly erythematous, raised border and regional lymphadenopathy was present.