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Biomedical subjects

J Miljković

Publications and source records attributed to J Miljković.

3 recordsLinked to original sources

Zosteriform lichen planus-like eruption.

Lichen planus (LP) is a relatively common papulosquamous skin disease of unknown etiology, it is believed to be a T-cell mediated disorder. In addition to the cutaneous eruptions it may also affect mucous membranes, nails or cause scarring alopecia. Lichen planus appears in various clinical variants which are categorized according to the morphology and configuration of lesions. We present a 34-year-old man who developed a papular eruption localized unilaterally on the right side of the body in a linear-zosteriform pattern within the L5-S1 nerve segments. The skin lesions clinically and histologically mimicked LP. Topical treatment with betamethason ointment for one month led to remarkable improvement, but a zosteriform hiperpigmentation persisted. According to the clinical findings in our patient and a review of the literature, we believe that lichenoidzosteriform eruption is a variant of lichen planus or a herpes zoster infection.

Adult↗

Hypereosinophilic dermatitis-like erythema annulare centrifugum in a patient with chronic lymphocytic leukaemia.

A 65-year-old male presented with a history of disseminated erythema annulare centrifugum lesions and a high peripheral blood eosinophilia (55%). Histopathology of a lesion revealed a superficial and deep perivascular and interstitial inflammatory eosinophilic infiltrate. The bone marrow aspirate showed a heavy eosinophilic infiltrate. There was no evidence of any other systemic involvement except for bone marrow eosinophilia. The patient had a 6-year history of chronic lymphocytic leukaemia. The disease is in complete remission for the last 3 years. The clinical and histopathological findings in the reported patient correspond to the diagnosis of hypereosinophilic dermatitis. Topical treatment with corticosteroid creams was successful. The cutaneous lesions gradually resolved in 8 weeks, within 7 months the peripheral blood eosinophilia slowly declined from 55% to 7%.

Aged↗

Necrolytic migratory erythema associated with hyperglucagonemia and neuroendocrine hepatic tumors.

We present a 61-year-old man with a 2-year history of persistent disseminated, psoriasiform annular pruritic lesions, acrodermatitis, weight loss, anemia and diabetes. Histopathology of the affected skin showed nonspecific subacute psoriasiform dermatitis. The computed tomographic scan of the abdomen revealed multiple hepatic tumors. Histopathological examination of ultrasound-guided needle biopsy from a hepatic lesion demonstrated a neuroendocrine tumor. Somatostatin-receptor scintigraphy with radio-labelled octreotide confirmed the likelihood of the neuroendocrine nature of the hepatic tumors and excluded the presence of other such lesions throughout the rest of the body, including the pancreas. The serum glucagon level was markedly increased. The diagnosis of necrolytic migratory erythema associated with hyperglucagonemia and neuroendocrine hepatic tumors was made and therapy with the long-acting somatostatin analogue octreotide was started. The skin changes resolved after the initiation of therapy, but no improvement of other symptoms was observed. Having reached the final stage of the disease, which was further complicated by congestive heart failure, the patient died one year later. As no autopsy was performed, we were unable to establish whether the hepatic tumors represented a metastatic process of previously undetected pancreatic glucagonoma or if they were extra-pancreatic glucagon-secreting tumors. The correct diagnosis of necrolytic migratory erythema is important, since it might be the clue for early detection of glucagonoma or of extra-pancreatic glucagon-secreting tumors.

Antineoplastic Agents, Hormonal↗