Disseminated cutaneous myxomas in an adult.
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Biomedical subjects
Publications and source records attributed to W Szaniawski.
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BACKGROUND: Cryptococcosis is an opportunistic infection caused by the encapsulated yeast Cryptococcus neoformans. This ubiquitous organism has emerged as a frequent finding in immunosuppressed patients, especially those with underlying malignancies, organ transplants, and the acquired immune deficiency syndrome (AIDS). Cutaneous manifestations of cryptococcosis occur in 10 to 15% of patients having systemic involvement. These skin lesions may simulate a variety of different disease entities. METHODS: A case of crytococcosis mimicking a basal cell carcinoma is the subject of a case report presentation. RESULTS: A case of cutaneous cryptococcosis mimicking basal cell carcinoma occurred in a patient with AIDS, who did not appear to have dissemination, but was treated aggressively to stem possible occult systemic disease. CONCLUSION: Cutaneous crytococcosis may mimic other dermatologic disorders.
Cutaneous protothecosis is an uncommon algal infection with a varied clinical presentation that occurs mainly in immunocompromised patients. We describe a 33-year-old Hispanic woman with AIDS who had a verrucous plaque on the dorsum of her hand. A biopsy specimen revealed organisms suggestive of Prototheca. Culture confirmed the organism to be Prototheca wickerhamii. To our knowledge, this is the first case of cutaneous protothecosis reported in a patient with AIDS.
Giant cell lichenoid dermatitis is a recently described dermatosis thought to be an unusual lichenoid drug eruption. It is characterized by a generalized, pruritic, papulosquamous eruption sparing palms, soles, face and mucous membranes. Histopathologic findings include areas of epidermal hyperplasia and atrophy with focal vacuolar alteration of the basal layer, exocytosis and cytoid body formation. The dermis contains a band-like, mononuclear cell infiltrate at the dermoepidermal junction with admixed eosinophils, plasma cells and large multinucleate cells. The histologic differential diagnosis includes infectious processes, sarcoidosis, lichen nitidus, lupus erythematosus and lichen planus. We report 3 patients with giant cell lichenoid dermatitis, one of whom was subsequently diagnosed as having sarcoidosis. Because giant cell lichenoid dermatitis may resemble sarcoidosis both clinically and histologically, and because cutaneous sarcoid is often associated with systemic involvement, the diagnosis of sarcoid should be strongly considered in patients with giant cell lichenoid dermatitis.
BACKGROUND: Pseudoverrucous papules and nodules were originally described as a reaction to irritation in association with urostomies. These changes have not been described as occurring on the perianal skin or around colostomies. OBSERVATIONS: Five children had remarkably similar-appearing papules and nodules of the perianal and suprapubic skin. The rash consisted of more than a dozen 2- to 8-mm shiny, smooth, red, moist, flat-topped, round lesions. This peculiar and striking reaction appears to be the result of encopresis or urinary incontinence. Biopsy specimens reveal reactive acanthosis or psoriasiform spongiotic dermatitis. The lesions regress when the irritating factor is removed. CONCLUSIONS: Recognition of this entity is important because pseudoverrucous papules and nodules may mimic more serious dermatoses and unnecessary workup may be initiated. Although this reaction involving perianal skin has not been reported previously, we believe it is not uncommon.
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Peripheral blood lymphocytes from patients with chronic lymphocytic leukemia (CLL), lymphoplasmacytoid lymphoma, centrocytic lymphoma and hairy cell leukemia were studied by scanning electron microscopy (SEM). In general, SEM revealed rather homogenous cell populations. Most lymphocytes displayed a moderately villous surface architecture, although smooth surfaces predominated in 3 cases with CLL and in 1 case with lymphoplasmacytoid lymphoma. Hairy cells showed surface features of both lymphocytes and monocytes. The results indicate that leukemic B and T lymphocytes cannot be distinguished by SEM alone.
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The histochemical activity of beta-glucuronidase was studied in sections and cultures of human gliomas. The intensity of reaction paralleled the growth pattern of tumours, but not the degree of their differentiation. The highest activity was found in dysplastic gliomas.
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The authors tried to evaluate the surface of T and B cells in scanning microscope. The lymphocytes were isolated from the blood of healthy men and separated into T and B cells on the basis of rosette tests E and EAC. About 80% of T cells in type E rosettes showed marked bulgings of surface corresponding to numerous, densely crowded microvilli. The remaining 20% of lymphocytes T had more smooth surface. Difficulties were observed frequently in finding differences in the appearance of these cells in relation to lymphocytes B in type EAC rosettes whose surface was covered with minute bulgings corresponding to more delicate and less densely arranged microvilli. The differences in the structure of T and B cells after formation of E and EAC rosettes were not so evident that a decisive separation of both these cell populations on morphological basis would be possible.
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