An Unusual Presentation of a Unilateral Asymptomatic Riehl's
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Melanocytes and Their Diseases
Downloaded from http://perspectivesinmedicine.cshlp.org/ on October 2, 2021 - Published by Cold Spring Harbor Laboratory Press Melanocytes and Their Diseases Yuji Yamaguchi1 and Vincent J. Hearing2 1Medical, AbbVie GK, Mita, Tokyo 108-6302, Japan 2Laboratory of Cell Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892 Correspondence: [email protected] Human melanocytes are distributed not only in the epidermis and in hair follicles but also in mucosa, cochlea (ear), iris (eye), and mesencephalon (brain) among other tissues. Melano- cytes, which are derived from the neural crest, are unique in that they produce eu-/pheo- melanin pigments in unique membrane-bound organelles termed melanosomes, which can be divided into four stages depending on their degree of maturation. Pigmentation production is determined by three distinct elements: enzymes involved in melanin synthesis, proteins required for melanosome structure, and proteins required for their trafficking and distribution. Many genes are involved in regulating pigmentation at various levels, and mutations in many of them cause pigmentary disorders, which can be classified into three types: hyperpigmen- tation (including melasma), hypopigmentation (including oculocutaneous albinism [OCA]), and mixed hyper-/hypopigmentation (including dyschromatosis symmetrica hereditaria). We briefly review vitiligo as a representative of an acquired hypopigmentation disorder. igments that determine human skin colors somes can be divided into four stages depend- Pinclude melanin, hemoglobin (red), hemo- ing on their degree of maturation. Early mela- siderin (brown), carotene (yellow), and bilin nosomes, especially stage I melanosomes, are (yellow). Among those, melanins play key roles similar to lysosomes whereas late melanosomes in determining human skin (and hair) pigmen- contain a structured matrix and highly dense tation. -
Frequency of Different Types of Facial Melanoses Referring to the Department of Dermatology and Venereology, Nepal Medical Colle
Amatya et al. BMC Dermatology (2020) 20:4 https://doi.org/10.1186/s12895-020-00100-3 RESEARCH ARTICLE Open Access Frequency of different types of facial melanoses referring to the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital in 2019, and assessment of their effect on health-related quality of life Bibush Amatya* , Anil Kumar Jha and Shristi Shrestha Abstract Background: Abnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions. Objectives: The objective of this study was to determine the frequency, underlying cause and impact on quality of life of facial pigmentary disorders among patients visiting the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH) over the course of one year. Methods: This was a cross-sectional study conducted at the Department of Dermatology and Venereology, NMCT H. We recruited patients with facial melanoses above 16 years of age who presented to the outpatient department. Clinical and demographic data were collected and all the enrolled participants completed the validated Nepali version of the Dermatology Life Quality Index (DLQI). Results: Between January 5, 2019 to January 4, 2020, a total of 485 patients were recruited in the study. The most common diagnoses were melasma (166 patients) and post acne hyperpigmentation (71 patients). Quality of life impairment was highest in patients having melasma with steroid induced rosacea-like dermatitis (DLQI = 13.54 ± 1.30), while it was lowest in participants with ephelides (2.45 ± 1.23). Conclusion: Facial melanoses are a common presenting complaint and lead to substantial impacts on quality of life. -
Melasma on the Nape of the Neck in a Man
Letters to the Editor 181 Melasma on the Nape of the Neck in a Man Ann A. Lonsdale-Eccles and J. A. A. Langtry Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK. E-mail: [email protected] Accepted July 19, 2004. Sir, sunlight and photosensitizing agents may be more We report a 47-year-old man with light brown macular relevant. pigmentation on the nape of his neck (Fig. 1). It was The differential diagnosis for pigmentation at this site asymptomatic and had developed gradually over 2 years. includes Riehl’s melanosis, Berloque dermatitis and He worked outdoors as a pipe fitter on an oilrig module; poikiloderma of Civatte. Riehl’s melanosis typically however, he denied exposure at this site because he involves the face with a brownish-grey pigmentation; always wore a shirt with a collar that covered the biopsy might be expected to show interface change and affected area. However, on further questioning it liquefaction basal cell degeneration with a moderate transpired that he spent most of the day with his head lymphohistiocytic infiltrate, melanophages and pigmen- bent forward. This reproducibly exposed the area of tary incontinence in the upper dermis. It is usually pigmentation with a sharp cut off inferiorly at the level associated with cosmetic use and may be considered of his collar. He used various shampoos, aftershaves and synonymous with pigmented allergic contact dermatitis shower gels, but none was applied directly to that area. of the face (6, 7). Berloque dermatitis is considered to be His skin was otherwise normal and there was no family caused by a photoirritant reaction to bergapentin; it history of abnormal pigmentation. -
Poikiloderma of Civatte, Slapped Neck Solar Melanosis, Basal Melanin Stores
American Journal of Dermatology and Venereology 2019, 8(1): 8-13 DOI: 10.5923/j.ajdv.20190801.03 Slapped Neck Solar Melanosis: Is It a New Entity or a Variant of Poikiloderma of Civatte?? (Clinical and Histopathological Study) Khalifa E. Sharquie1,*, Adil A. Noaimi2, Ansam B. Kaftan3 1Department of Dermatology, College of Medicine, University of Baghdad 2Iraqi and Arab Board for Dermatology and Venereology, Dermatology Center, Medical City, Baghdad, Iraq 3Dermatology Center, Medical City, Baghdad, Iraq Abstract Background: Poikiloderma of Civatte although is a common complaint among population, especially European, still it was not reported in dark skin people as in Iraqi population. Objectives: To study all the clinical and histopathological features of Poikiloderma of Civatte in Iraqi population. Patients and Methods: This study is descriptive, clinical and histopathological study. It was carried out at the Dermatology Center, Medical City, Baghdad, Iraq, from September 2017 to October 2018. Thirty-one patients with Poikiloderma of Civatte were included and evaluated by history, physical examination, Wood’s light examination. Lesional skin biopsies were obtained from 9 patients, with histological examination of the sections stained with Hematoxylin and Eosin (H&E) and Fontana-Masson stain. Results: Thirty-one patients were included in this study, with mean age +/- SD was 53.32+/-10 years, and all patients were males. Twenty-six patients (84%) were with skin phenotype III&IV, The pigmentation was either mainly erythematous (22.5%), mainly dark brown pigmentation (29%), and mixed type of pigmentation (48.5%). These lesions were distributed on the sides of the neck and the face and the V shaped area of the chest. -
Hyperpigmentation on the Head and Neck
PHOTO CHALLENGE Hyperpigmentation on the Head and Neck Blake E. Vest, MD; Spyros M. Siscos, MD; Anand Rajpara, MD A 78-year-old Asian woman presented to the dermatology clinic with progressively worsening dark spots on the forehead and neck of 3 months’ duration. She noted mild pruritis and hair loss involving the eyebrows and anterior scalp. Her medical history was notable for type 2 diabetes mellitus. She deniedcopy any new medical condi- tions or medications and had no prior history of similar symptoms. Physical examination showed hyperpigmented brown macules and patches on the forehead (top) and anterior neck (bottom) withnot sparing of the posterior neck and lower face. Alopecia with areas of perifollicular erythema and hyperpigmentation with reduced follicular open- ings were present on the eyebrows and anterior Doforehead. Two punch biopsies of head and neck lesions were performed. WHAT’S YOUR DIAGNOSIS? a. ashy dermatosis b. frontal fibrosing alopecia overlapping with lichen planus pigmentosus c. keratosis follicularis spinulosa decalvans d. postinflammatory hyperpigmentation CUTIS e. pseudopelade of Brocq PLEASE TURN TO PAGE E3 FOR THE DIAGNOSIS Dr. Vest is from Southern Illinois University School of Medicine, Springfield. Drs. Siscos and Rajpara are from the Division of Dermatology, University of Kansas School of Medicine, Kansas City. The authors report no conflict of interest. Correspondence: Blake E. Vest, MD ([email protected]). doi:10.12788/cutis.0226 E2 I CUTIS® WWW.MDEDGE.COM/DERMATOLOGY Copyright Cutis 2021. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. PHOTO CHALLENGE DISCUSSION THE DIAGNOSIS: Frontal Fibrosing Alopecia Overlapping With Lichen Planus Pigmentosus icroscopic examination revealed focal dermal of the skin have been reported, including the entire pigmentation, papillary fibrosis, and epidermal scalp, eyebrows, and eyelashes. -
Pigmented Contact Dermatitis and Chemical Depigmentation
18_319_334* 05.11.2005 10:30 Uhr Seite 319 Chapter 18 Pigmented Contact Dermatitis 18 and Chemical Depigmentation Hideo Nakayama Contents ca, often occurs without showing any positive mani- 18.1 Hyperpigmentation Associated festations of dermatitis such as marked erythema, with Contact Dermatitis . 319 vesiculation, swelling, papules, rough skin or scaling. 18.1.1 Classification . 319 Therefore, patients may complain only of a pigmen- 18.1.2 Pigmented Contact Dermatitis . 320 tary disorder, even though the disease is entirely the 18.1.2.1 History and Causative Agents . 320 result of allergic contact dermatitis. Hyperpigmenta- 18.1.2.2 Differential Diagnosis . 323 tion caused by incontinentia pigmenti histologica 18.1.2.3 Prevention and Treatment . 323 has often been called a lichenoid reaction, since the 18.1.3 Pigmented Cosmetic Dermatitis . 324 presence of basal liquefaction degeneration, the ac- 18.1.3.1 Signs . 324 cumulation of melanin pigment, and the mononucle- 18.1.3.2 Causative Allergens . 325 ar cell infiltrate in the upper dermis are very similar 18.1.3.3 Treatment . 326 to the histopathological manifestations of lichen pla- 18.1.4 Purpuric Dermatitis . 328 nus. However, compared with typical lichen planus, 18.1.5 “Dirty Neck” of Atopic Eczema . 329 hyperkeratosis is usually milder, hypergranulosis 18.2 Depigmentation from Contact and saw-tooth-shape acanthosis are lacking, hyaline with Chemicals . 330 bodies are hardly seen, and the band-like massive in- 18.2.1 Mechanism of Leukoderma filtration with lymphocytes and histiocytes is lack- due to Chemicals . 330 ing. 18.2.2 Contact Leukoderma Caused Mainly by Contact Sensitization . -
Congenital Horner Syndrome with Heterochromia Iridis Associated with Ipsilateral Internal Carotid Artery Hypoplasia
CASE REPORT Print ISSN 1738-6586 / On-line ISSN 2005-5013 J Clin Neurol 2014 Open Access Congenital Horner Syndrome with Heterochromia Iridis Associated with Ipsilateral Internal Carotid Artery Hypoplasia Fabrice C. Deprez,a Julie Coulier,b Denis Rommel,a Antonella Boschib aDepartments of Radiology and bOphthalmology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium BackgroundzzHorner syndrome (HS), also known as Claude-Bernard-Horner syndrome or Received August 5, 2013 oculosympathetic palsy, comprises ipsilateral ptosis, miosis, and facial anhidrosis. Revised April 15, 2014 Accepted April 21, 2014 Case ReportzzWe report herein the case of a 67-year-old man who presented with congenital HS associated with ipsilateral hypoplasia of the internal carotid artery (ICA), as revealed by Correspondence heterochromia iridis and confirmed by computed tomography (CT). Fabrice C. Deprez, MD Department of Radiology, ConclusionszzCT evaluation of the skull base is essential to establish this diagnosis and dis- Cliniques Universitaires Saint-Luc, tinguish aplasia from agenesis/hypoplasia (by the absence or hypoplasia of the carotid canal) or UCL, Avenue Hippocrate 10, from acquired ICA obstruction as demonstrated by angiographic CT. 1200 Woluwe-Saint-Lambert, J Clin Neurol 2014 Belgium Tel +32.472.93.34.80 Key Wordszzcongenital horner syndrome, internal carotid artery agenesis, Fax +32.81.42.35.05 heterochromia iridis, computed tomography. E-mail [email protected] Introduction spindly left ICA, which was misinterpreted as ICA thrombosis (Fig. 1). The left anterior cerebral artery and MCA were sup- Horner syndrome (HS), also known as Claude-Bernard-Horn- plied by a large posterior communicating artery from the bas- er syndrome or oculosympathetic palsy, comprises ipsilateral ilar artery. -
Table I. Genodermatoses with Known Gene Defects 92 Pulkkinen
92 Pulkkinen, Ringpfeil, and Uitto JAM ACAD DERMATOL JULY 2002 Table I. Genodermatoses with known gene defects Reference Disease Mutated gene* Affected protein/function No.† Epidermal fragility disorders DEB COL7A1 Type VII collagen 6 Junctional EB LAMA3, LAMB3, ␣3, 3, and ␥2 chains of laminin 5, 6 LAMC2, COL17A1 type XVII collagen EB with pyloric atresia ITGA6, ITGB4 ␣64 Integrin 6 EB with muscular dystrophy PLEC1 Plectin 6 EB simplex KRT5, KRT14 Keratins 5 and 14 46 Ectodermal dysplasia with skin fragility PKP1 Plakophilin 1 47 Hailey-Hailey disease ATP2C1 ATP-dependent calcium transporter 13 Keratinization disorders Epidermolytic hyperkeratosis KRT1, KRT10 Keratins 1 and 10 46 Ichthyosis hystrix KRT1 Keratin 1 48 Epidermolytic PPK KRT9 Keratin 9 46 Nonepidermolytic PPK KRT1, KRT16 Keratins 1 and 16 46 Ichthyosis bullosa of Siemens KRT2e Keratin 2e 46 Pachyonychia congenita, types 1 and 2 KRT6a, KRT6b, KRT16, Keratins 6a, 6b, 16, and 17 46 KRT17 White sponge naevus KRT4, KRT13 Keratins 4 and 13 46 X-linked recessive ichthyosis STS Steroid sulfatase 49 Lamellar ichthyosis TGM1 Transglutaminase 1 50 Mutilating keratoderma with ichthyosis LOR Loricrin 10 Vohwinkel’s syndrome GJB2 Connexin 26 12 PPK with deafness GJB2 Connexin 26 12 Erythrokeratodermia variabilis GJB3, GJB4 Connexins 31 and 30.3 12 Darier disease ATP2A2 ATP-dependent calcium 14 transporter Striate PPK DSP, DSG1 Desmoplakin, desmoglein 1 51, 52 Conradi-Hu¨nermann-Happle syndrome EBP Delta 8-delta 7 sterol isomerase 53 (emopamil binding protein) Mal de Meleda ARS SLURP-1 -
A Clinicoepidemiological Study of Facial Hypermelanosis Among Females of Reproductive Age Group
Our Dermatology Online Original Article A cclinicoepidemiologicallinicoepidemiological sstudytudy ooff ffacialacial hhypermelanosisypermelanosis aamongmong ffemalesemales ooff rreproductiveeproductive aagege ggrouproup Sameer Abrol1, Rohini Sharma2 1M.D. Medicine. GMC Jammu, Jammu and Kashmir, India, 2Assistant professor, Department of Dermatology, GMC Rajouri, Jammu and Kashmir, India Corresponding author: Dr. Rohini Sharma, E-mail: [email protected] ABSTRACT Background: Facial hypermelanosis has great psychological and aesthetic complications attached to it specially in females. A number of factors like genetic, environmental, systemic, work in consortium to give rise to various types of hypermelanosis. Women in the 15-49 years age group, which is the reproductive age group are influenced by various hormonal alterations along with external and systemic agents thus manifesting as various types of hypermelanosis. Aims and objectives: This study was undertaken to assess the clinical and epidemiological aspects of various types of facial hypermelanosis and various factors implicated. Material and methods: A total of 350 women in the age group of 15- 49 years were taken up for the study. A detailed clinical history, thorough examination was done in all patients. Relevant investigations were carried out. All the results were statistically analyzed and inferences were drawn. Results: A total of 350 women were taken up for study. Maximum patients (133,38%) were in the age group of 26 -35 years. Among various hypermelanosis, maximum women(128,36.5%) came with the complaint of melasma, 90(25.7%) women with post inflammatory hypermelanosis, 50(14.3%)females with periorbital hypermelanosis. In our study, melasma, post inflammatory hyperpigmentation due to acne, acanthosis nigricans formed a major share in the 15-49 years age group thus suggesting the role of hormonal alterations and rising PCOS. -
Oral Melanosis
IJHNS 10.5005/jp-journals-10001-1065 CASE REPORT Oral Melanosis Oral Melanosis 1Harvinder Kumar, 2Pankaj Chaturvedi 1Associate Professor, Department of ENT, Maharaja Agrasen Medical College, Hisar, Haryana, India 2Associate Professor, Department of Head and Neck Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India Correspondence: Harvinder Kumar, Associate Professor, Department of ENT, Maharaja Agrasen Medical College, Hisar, Haryana India, e-mail: [email protected] ABSTRACT There is very little information in literature about oral melanosis not associated with racial pigmentation or secondary to other syndromes. Various stimuli that can result in an increased production of melanin at the level of mucosa include trauma, hormones, radiation and medications. Three such cases are reported in which stimulus for genesis of melanosis was mechanical trauma in form of smoking. Keywords: Oral, Melanosis, Smoking. INTRODUCTION In our clinical practice we see many cases of oral pigmentary lesions, the etiology of which ranges from physiologic changes (e.g. racial pigmentation) to manifestations of systemic illnesses (e.g. Addison’s disease) and malignant neoplasms (e.g. melanoma and Kaposi’s sarcoma). There is very little information in literature about oral melanosis not associated with racial pigmentation or secondary to other syndromes. We are reporting three such cases of oral melanosis which presented at different subsites in contrast to sites commonly seen in literature. Here is review of literature of oral melanosis in terms of its etiology, pathophy- siology, clinical presentation and differential diagnosis. Fig. 1: Changes of oral melanosis at ventral CASE REPORT aspect of tongue (case 1) First case was a 38-year-old female who presented with brown pigmentation on ventral aspect of tongue (Fig. -
Cutaneous Events Associated with Immunotherapy of Melanoma: a Review
Journal of Clinical Medicine Review Cutaneous Events Associated with Immunotherapy of Melanoma: A Review Lorenza Burzi 1,†, Aurora Maria Alessandrini 2,3,†, Pietro Quaglino 1, Bianca Maria Piraccini 2,3, Emi Dika 2,3,† and Simone Ribero 1,*,† 1 Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; [email protected] (L.B.); [email protected] (P.Q.) 2 Dermatology, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; [email protected] (A.M.A.); [email protected] (B.M.P.); [email protected] (E.D.) 3 Dermatology, IRCCS Sant’Orsola Hospital, 40138 Bologna, Italy * Correspondence: [email protected] † Equal Contribution. Abstract: Immunotherapy with checkpoint inhibitors significantly improves the outcome for stage III and IV melanoma. Cutaneous adverse events during treatment are often reported. We herein aim to review the principal pigmentation changes induced by immune check-point inhibitors: the appear- ance of vitiligo, the Sutton phenomenon, melanosis and hair and nail toxicities. Keywords: melanoma; immunotherapy; pigmentation disorders; vitiligo; melanosis; halo nevus; alopecia; poliosis Citation: Burzi, L.; Alessandrini, A.M.; Quaglino, P.; Piraccini, B.M.; 1. Introduction Dika, E.; Ribero, S. Cutaneous Events The function of the immune system in melanoma disease course is well established. Associated with Immunotherapy of Immune checkpoint inhibitors have shown promise in enhancing the immune system to Melanoma: A Review. J. Clin. Med. fight against cancer cells and in providing a higher response rates than chemotherapies 2021, 10, 3047. https://doi.org/ used in the past [1,2]. 10.3390/jcm10143047 Tumor cells inactivate the process of immunosurveillance by expressing ligands Academic Editor: Masutaka Furue of immune checkpoint pathways. -
Localized Depigmentation on Genital Melanosis: a Clue for the Understanding of Vitiligo
Correspondence 663 30 years: interestingly, this age group had the highest inci- had reticulated heterogeneous pigmentation of the penis dence rate ratio of all age groups analysed. which had been present since the age of 12 years. The lesion It would appear from the limited data presented that there was unique and had shown minimal enlargement during the may be evidence of comorbid disease, associated with meta- first 4 years. Six years after the onset of the hyperpigmenta- bolic syndrome, detected at an early age in young people with tion, he noticed the appearance of depigmented macules that psoriasis. Clearly more work needs to be done in this area. In were stable for more than 4 years (Fig.1a). An 18-year-old the interim this provides an opportunity to reinforce healthy man presented with testicular hyperpigmentation that progres- lifestyle choices in children in general but particularly those sively increased in size for 6 years. He had developed depig- with psoriasis and raises the question of whether we should mented macules strictly located at the site of the be monitoring for associated features of metabolic syndrome hyperpigmented lesions 3 years previously (Fig. 1b). A 54- in this age group. year-old man had a heterogeneous hyperpigmentation of the penis which had slowly enlarged over 3 years. Depigmented Department of Dermatology, Queen’s C.I. WOOTTON macules located on the previously hyperpigmented area had Medical Centre, Nottingham NG7 2UH, U.K. R. MURPHY developed in the last 8 months and a new hyperpigmented le- E-mail: [email protected] sion was noted from 6 months previously on the base of the penis (Fig.