Images in clinical medicine. Paget's disease of the breast.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
Marc E Grossman
Publications and source records attributed to Marc E Grossman.
Nodular tuberculid in a patient with HIV.
Tuberculids (papulonecrotic tuberculid, erythema induratum, and lichen scrofulosorum) are cutaneous hypersensitivity reactions to Mycobacterium tuberculosis . We report the fifth case of a recently described tuberculid, nodular tuberculid. The distinguishing feature was that of a granulomatous vasculitis occurring at the dermohypodermal junction on biopsy specimen of the subcutaneous nodules.
Adult↗
Mycobacterium abscessus cellulitis and multifocal abscesses of the breasts in a transsexual from illicit intramammary injections of silicone.
We report the case of a 29-year-old transsexual who developed Mycobacterium abscessus infection after receiving intramammary liquid silicone injections in the nonphysician office setting. Our patient represents 1 of 14 confirmed and 11 suspected cases in New York City of M abscessus infection after illicit cosmetic procedures. As injectable cosmetic procedures are becoming increasingly popular, dermatologists should be aware of both the common and unusual complications. Furthermore, all physicians should be alerted to the current cluster of M abscessus infections after injections for cosmetic purposes by nonmedical practitioners in New York City.
Abscess↗
An unusual combination: lipedema with myiasis.
Lipedema refers to the abnormal deposition of subcutaneous fat causing a striking enlargement of the lower extremities that is out of proportion to the upper body. Most clinicians are unaware of this disease and thus it is seldom diagnosed correctly. Cutaneous myiasis is the infestation of skin by fly larvae. We describe an unusual case of a woman with lipedema who developed cutaneous myiasis.
Adipose Tissue↗
Pyomyositis.
Four patients were admitted to Columbia Presbyterian Medical Center for evaluation of lower extremity pain and swelling. Three patients were initially misdiagnosed with cellulitis and one patient underwent evaluation for dermatomyositis. After consultation by the dermatologist, a correct diagnosis of pyomyositis was made clinically and confirmed by imaging, surgery, or an interventional procedure. Wound, blood, and urine cultures were positive for methicillin-sensitive Staphylococcus aureus in 100%, 50%, and 25% of patients, respectively. After the appropriate diagnosis and treatment, all patients experienced rapid resolution of symptoms and a favorable outcome.
Adult↗
Management of cutaneous lesions associated with an emerging epidemic: community-acquired methicillin-resistant Staphylococcus aureus skin infections.
Explore the source record for details and available documents.
Anti-Bacterial Agents↗
Bull's-eye cutaneous infarct of zygomycosis: a bedside diagnosis confirmed by touch preparation.
We report an immunocompromised woman with chronic lymphocytic leukemia who developed cutaneous zygomycosis at the site of an arterial line. The initial lesion resembled a bulls-eye. Bull's-eye lesions of zygomycosis have been reported twice before. Recognition of this sign may allow the dermatologist to make a rapid presumptive diagnosis and initiate treatment for this life-threatening infection.
Aged↗
Increased detection of rickettsialpox in a New York City hospital following the anthrax outbreak of 2001: use of immunohistochemistry for the rapid confirmation of cases in an era of bioterrorism.
BACKGROUND: Rickettsialpox is a self-limited febrile illness with skin lesions that may be mistaken for signs of potentially more serious diseases, such as cutaneous anthrax or chickenpox. The cluster of cutaneous anthrax cases from bioterrorism in October 2001 likely heightened awareness of and concern for cutaneous eschars. OBJECTIVES: To apply an immunohistochemical technique on paraffin-embedded skin biopsy specimens for diagnosing rickettsialpox, and to compare the reported incidence of rickettsialpox before, during, and after the cluster of cutaneous anthrax cases. DESIGN: Case series. SETTING: Dermatology department in a large tertiary care hospital in New York City. PATIENTS: Eighteen consecutive patients with the clinical diagnosis of rickettsialpox from February 23, 2001, through October 31, 2002. MAIN OUTCOME MEASURES: Results of immunohistochemical testing of skin biopsy specimens and of serological testing. RESULTS: Immunohistochemical testing revealed spotted fever group rickettsiae in all 16 eschars and in 5 of the 9 papulovesicles tested. A 4-fold or greater increase in IgG antibody titers reactive with Rickettsia akari was observed in all 9 patients for whom acute and convalescent phase samples were available; 6 patients had single titers indicative of rickettsialpox infection (> or =1:64). Of the 18 patients, 9 (50%) presented in the 5 months following the bioterrorism attacks. CONCLUSIONS: Rickettsialpox remains endemic in New York City, and the bioterrorism attacks of October 2001 may have led to increased awareness and detection of this disease. Because rickettsialpox may be confused with more serious diseases, such as cutaneous anthrax or chickenpox, clinicians should be familiar with its clinical presentation and diagnostic features. Immunohistochemical staining of skin biopsy specimens, particularly from eschars, is a sensitive technique for confirming the clinical diagnosis.
Adolescent↗
Nephrogenic fibrosing dermopathy (scleromyxedema-like illness of renal disease).
Nephrogenic fibrosing dermopathy or scleromyxedema-like illness of renal disease is a recently reported disorder. It manifests as scleromyxedema-like skin lesions without associated paraproteinemia, occurring in the setting of renal disease. In the majority of cases skin lesions of nephrogenic fibrosing dermopathy develop after hemodialysis or renal transplantation; however, the origin is still unknown. We report 4 new cases of nephrogenic fibrosing dermopathy and review the literature. The clinical and histopathologic features, differential diagnosis, possible etiology, and treatment options are reviewed.
Adult↗
Images in clinical medicine. Finger-pad tophi.
Explore the source record for details and available documents.
Cyclosporine↗
Bullous adult T-cell lymphoma/leukemia and human T-cell lymphotropic virus-1 associated myelopathy in a 60-year-old man.
Here we report a case of vesiculobullous adult T-cell lymphoma/leukemia (ATLL); to our knowledge the first such report of this presentation. We emphasize the difficulty in clinically distinguishing ATLL from cutaneous t-cell lymphoma. The case is further distinguished by the simultaneous presentation of human T-cell lymphotropic virus-1-related myelopathy in this patient, an unusual occurrence.
Antineoplastic Combined Chemotherapy Protocols↗
Amphotericin B-resistant Aspergillus flavus infection successfully treated with caspofungin, a novel antifungal agent.
Invasive aspergillosis is uncommon in immunocompetent hosts but is the second most common opportunistic fungal infection in immunocompromised patients. There has been a dramatic increase in the incidence of life-threatening aspergillosis during the past 2 decades, and the morbidity and mortality of these infections despite antifungal therapy remain unacceptably high. We describe a patient with amphotericin B-resistant Aspergillus flavus successfully treated with caspofungin, an agent belonging to a new class of antifungal drugs. Caspofungin shows great promise in the treatment of invasive aspergillosis.
Aged↗
Acute infectious purpura fulminans associated with asplenism or hyposplenism.
Acute infectious purpura fulminans is a rapidly progressive syndrome of hemorrhagic skin necrosis associated with acute infection and disseminated intravascular coagulation. We report 5 cases of purpura fulminans and briefly review the literature. All cases were associated with encapsulated organisms (Streptococcus pneumoniae or Group A streptococcus), and 4 of the 5 patients had asplenism or functional hyposplenism.
Acute Disease↗
Periungual myxoid neurofibroma.
A 34-year-old woman presented with a slow growing nontender nodule on her left index finger that had been present for 2 years. The tumor was excised and was histologically determined to be a myxoid neurofibroma. We report this case because of the rarity of both the tumor and its periungual location and to provide a review of the literature.
Adult↗
Linear porokeratosis with underlying bony abnormalities.
A 58-year-old woman with linear porokeratosis involving the right hand and arm had distal digital narrowing and nail dystrophy with radiographic changes. Whereas isolated cases of bone resorption and flexion deformities with porokeratosis of Mibelli are known to occur, to our knowledge, bony abnormalities in association with linear porokeratosis have not been reported.
Anti-Inflammatory Agents↗