Lichen planus of the nails with giant cells: lichen nitidus?
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Biomedical subjects
Publications and source records attributed to R Morelli.
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A 68-year-old man had had for 3 years a severe onychodystrophy involving all fingers and toes which clinically mimicked nail lichen planus. The nail biopsy showed amyloid deposits in the superficial dermis of the nail matrix. Physical, pathological and laboratory examinations confirmed the diagnosis of primary systemic amyloidosis. At the time of the diagnosis the patient did not present any other cutaneous sign of systemic amyloidosis.
Two patients showed hypertrophic lichen planus at the sites of previous surgical procedures in their lower extremities after granulomatous reactions. Knots of implanted sutures too close to the epidermis may have caused the inflammatory reaction. Although granulomatous reactions occurring after surgical procedures are fairly common, no cases of lichenoid lesions have been reported previously.
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737 patients with suspected cosmetic- or medicament-related contact dermatitis were patch tested with 6 emulsifier agents: triethanolamine, cetyl stearyl alcohol, sorbitan sesquioleate, polyoxyethylene sorbitan monopalmitate, polyoxyethylene sorbitan monooleate, and Amerchol L 101. 39 patients (5.3%) gave 1 or more positive patch tests to emulsifiers. A total of 54 positive reactions were found, 23 of which were clinically relevant, triethanolamine being the most frequent sensitizer. Patients with emulsifier sensitivity generally give a high prevalence of positive patch tests to other common ingredients of topical preparations, such as preservatives or active ingredients. Cosmetics and topical medicaments were detected as the source of sensitization in an equal number of patients. Patch tests with patients' own causative preparations were frequently negative. To avoid overlooking emulsifier sensitivity, it is advisable to test these compounds in patients with contact dermatitis that is possibly due to topical preparations, regardless of whether they have other clinically relevant positive reactions or whether patch tests with their own products are negative.
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A 2 1/2-year old Italian boy affected by Iso and Kikuchi syndrome is reported. The clinical examination showed hemi-onychogryphosis of both index fingers. Roentgenograms of the affected fingers showed bifurcation of the distal phalanges in the lateral view.
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