Eosinophilic cellulitis (Wells' syndrome) is an inflammatory dermatosis characterized by marked eosinophilic infiltrates. Drugs and various infections are recognized causes of eosinophilic cellulitis. Eosinophilic cellulitis has been reported in non-hematological malignancies in two patients with squamous cell carcinoma and one with nasopharyngeal carcinoma. We report the association of eosinophilic cellulitis with adenocarcinoma of the colon. Curative hemicolectomy led to a complete remission, suggesting that underlying malignancies can trigger eosinophilic cellulitis.

Adenocarcinoma↗

PubMed2004

[Tender livid papules].

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Adolescent↗

PubMed2003

PET imaging of Rosai-Dorfman disease: correlation with histopathology and ex-vivo beta-imaging.

We report the case of a woman who developed an early relapse of a squamous cell carcinoma (SCC) and was thus restaged twice within a year using [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET). While there was no evidence of metastatic tumor outspread, focally increased FDG uptake was visible in numerous nodes but showed no change during the period between the two PET scans. These nodes, predominantly located at the proximal extremities, ranged in size from about 1 cm to over 6 cm. They were located subcutaneously, showed a red/bluish livid color and were of stout consistency. These nodes occurred first after radiochemotherapy for a non-Hodgkin's lymphoma (NHL) about 6 years earlier and slowly increased in size and number. One node of the right forearm was resected and ex-vivo beta-imaging, directly measuring the positron emission of the intranodal FDG distribution, was done and showed an overall increased glucose utilization with distinct spots of high metabolism. Histopathological work-up of the tumor showed widespread granulomatous tissue with lymphocyte follicles. Immunostaining showed the tumor to be positive for S100, CD68 and vimentin. Rosai-Dorfman disease (RDD) was diagnosed and no evidence of a potential relapse of the previous NHL was detected. RDD is a rare disease that is associated with the multifocal growth of benign tumors. The lesions are metabolically highly active. The correlation of the beta-imaging and histopathological results showed a high metabolism within granulomatous tissue with more intense metabolism within lymphocyte follicles.

Aged↗

PubMed2003

[Pseudomelanoma following laser treatment or laser-treated melanoma?].

BACKGROUND: The increasing use of lasers for the removal of pigmented skin lesions has led to a growing risk of erroneously treated malignant melanocytic tumours. PATIENTS AND METHODS: In two patients, both of whom developed a melanoma, the lesions were initially misdiagnosed clinically as a benign naevus and treated with laser vaporisation. RESULTS: On recurrence of the tumours, the diagnosis of melanoma was finally established by histological examination of the excised tumours in which differentiation from pseudomelanoma remained difficult. CONCLUSIONS: In such cases of initially misdiagnosed melanomas, laser removal not only complicates and delays the correct diagnosis but might also worsen the prognosis after recurrence of an incompletely removed tumour.

Adult↗

PubMed2003

Herpes simplex virus type 2-associated eosinophilic cellulitis (Wells' syndrome).

Eosinophilic cellulitis (Wells' syndrome) is a recurrent inflammatory dermatosis characterized by massive infiltration of eosinophils into the skin. Drugs and pathogens have been recognized causes of eosinophilic cellulitis. We report the repeated association of eosinophilic cellulitis with herpes simplex virus type 2 infections. Antiviral therapy led to a complete remission of eosinophilic cellulitis, indicating that causative treatment of underlying diseases can be effective in controlling eosinophilic cellulitis.

Antiviral Agents↗

PubMed2003

Prurigo pigmentosa: a distinctive inflammatory disease of the skin.

More than 200 patients with prurigo pigmentosa, a disease described first by Nagashima in 1971, have been reported on in Japan, but only 28 non-Japanese patients have come to notice as of today. In order to establish reliable, repeatable criteria for diagnosis of the disease, we studied 25 patients with prurigo pigmentosa and reviewed the literature pertaining to it as recorded in another 182 patients.Clinically, prurigo pigmentosa presents itself as pruritic urticarial papules, papulovesicles, and vesicles arranged in reticular pattern and distributed symmetrically on the back, neck, and chest. Lesions involute in a matter of days, leaving behind netlike pigmentation. Exacerbations and recurrences are the rule. Histopathologically, prurigo pigmentosa begins with a superficial perivascular infiltrate of neutrophils. Shortly thereafter, neutrophils are scattered in dermal papillae and then sweep rapidly through an epidermis in which spongiosis, ballooning, and necrotic keratocytes are accompaniments. En route, abscesses may form in the surface epithelium. Very soon, eosinophils and lymphocytes come to predominate over neutrophils in a dermal infiltrate that assumes a patchy lichenoid pattern. Intraepidermal vesiculation follows on spongiosis and ballooning and, sometimes, subepidermal vesiculation on vacuolar alteration at the dermo-epidermal junction. As the epidermis becomes hyperplastic, parakeratotic, and slightly hyperpigmented, melanophages begin to appear in the dermis. Studies by immunofluorescence are negative invariably. Dapsone or minocyclin are effective treatments; both of those agents inhibit migration and/or function of neutrophils. The cause and pathogenesis have yet to be determined. Prurigo pigmentosa is unique among inflammatory diseases of the skin and the singularity of it is manifest both clinically and histopathologically.

Adult↗

PubMed2002

Expression of polo-like kinase (PLK1) in thin melanomas: a novel marker of metastatic disease.

BACKGROUND: The maximum thickness of a primary malignant melanoma as measured by Breslow's method is currently the most important prognostic factor. However, some thin melanomas (< or= 0.75 mm), which should have an excellent prognosis according to Breslow, can be lethal due to their ability to metastasize. METHODS: In our study, thin malignant melanomas (< or= 0.75 mm) from 36 patients were analyzed with immunohistochemical techniques using monoclonal antibodies directed against PLK1 and Ki-67. The immunoreactivity of 22 melanomas which developed metastases within 5 years of follow-up was compared with a group of 14 non-metastasized melanomas. Two independent investigators evaluated stained sections. Differences of PLK1 and Ki-67 indices between melanomas with and without metastases were tested statistically using the Mann-Whitney U-test. RESULTS: Malignant melanomas with metastases expressed PLK1 at markedly elevated levels compared to melanomas without metastases (median, 60.00% vs. 37.98%; p = 0.000053). The difference of the Ki-67 index between both groups was not significant (median, 6.35% vs. 4.53%; p = 0.150473). CONCLUSIONS: Our results suggest that PLK1 expression in thin melanomas is a reliable marker to identify patients at high risk for metastases.

Cell Cycle Proteins↗

PubMed2002

Mycosis-fungoides-type cutaneous T cell lymphoma of the hands and soles: a variant causing delay in diagnosis and adequate treatment of patients with palmoplantar eczema.

BACKGROUND: The etiopathology of chronic eczematous lesions of the palms and/or soles remains elusive in a considerable proportion of patients. Accumulating evidence suggests that a rare variant of mycosis fungoides (MF)-type cutaneous T cell lymphoma (CTCL) restricted to the palms and/or soles may mimic common palmoplantar dermatoses. OBJECTIVE: In the present study, we analyzed the clinical and histological characteristics of 3 adult patients with preexisting nonclassified chronic palmoplantar eczema poorly responding to standard therapies. Palmar and/or plantar MF was eventually diagnosed. METHODS: The course of the disease, response to previous therapies and dermatological features are described, results of histochemical and immunohistochemical analyses are reported, including T cell receptor gamma gene rearrangement where obtainable. RESULTS: Onset of cutaneous lesions with broad clinical variation was experienced 2-10 years prior to diagnosis; conventional therapies led to short-time or partial remission only; except for 1 patient, the epidermotropic infiltrate was predominantly composed of CD4-positive cells; topical photochemotherapy seems to result in more durable responses. CONCLUSION: As therapeutic strategies for this disease variant differ from symptomatic standard treatment regimens, awareness of MF-type CTCL as a relevant differential diagnosis of palmoplantar eczema should be expanded to prevent delay in diagnosis and adequate therapy.

Aged↗