DOCSLIB.ORG

Perforating Dermatoses

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Perforating Dermatoses مـصـر Egypt 3 Dr. Shoukry A. Sakr •Consultant of Dermatology & Cosmetology. •Consultant of Andrology & Marital Relations. •Cairo university , Cairo , Egypt مـصـر Egypt 5 6 OBAGI MEDICAL CENTER KUWAIT 2006-2009 9 Dr. SHOUKRY SAKR ENCYCLOPEDIA WWW.SHOUKRYSAKRDERMAPEDIA.COM SKIN STRUCTURE SKIN STRUCTURE SKIN STRUCTURE Epidermis Vein Dermis Artery Sweat gland Hair follicle Nerve receptor Sebaceous gland 12 Hypodermis EPIDERMAL CELLS 13 EPIDERMAL CELLS 14 EPIDERMAL CELLS 15 THE DERMIS THE DERMIS THE DERMIS THE DERMIS Shaft Sebaceous gland Papilla Sheath Follicle THE DERMIS FUNCTIONS OF THE SKIN 1. The skin is the largest body organ about 6 square meters 2. Body temperature regulation i.e. thermoregulatory function 3. Prevents loss of important body fluids e.g. plasma. 4. Preventing toxic materials to enter into within the tissues. 5. Protects the body from harmful influences of factors like UVR and radiations by (melanocytes) that produce melanin which gives skin , nail and hair color. 6. Works as excretory organ : toxic substances expelled through sweat. 7. Supports and maintains the internal organs of the body. 8. Immune & infection control function. 9. Sensory organ for the pain, heat , cold , touch & pressure. 10. Manufacturer of vitamin "D" under the influence of UVR . 11. Skin is a mirror which reflects expressions as fear or joy . The internal diseases may appear to have cutaneous manifestations. 12. Skin22 texture , color and smell has a very important role in the sexual relations. PERFORATING DERMATOSES 23 PERFORATING DERMATOSES By Dr. Shoukry Sakr 24 PERFORATING DERMATOSES PERFORATING DERMATOSES 25 PERFORATING DERMATOSES - Definition : Its is a group of disorders in which altered components of skin are eliminated via the epidermis by TRANSEPIDERMAL ELIMINATION (TEE) in which a material from the dermis is extruded through the epidermis to the exterior with little or no disruption of the surrounding structures -Types : (I) Acquired reactive perforating dermatoses : Primary Perforating Disorders when occuring in a diabetic patient or a patient with chronic renal failure undergoing hemodialysis 1- Kyrle disease 2- Reactive perforating collagenosis 3- Elastosis perforans serpiginosa 26 4 - Perforating folliculitis PERFORATING DERMATOSES (II) Disorders sometimes associated with TEE : 1- Granuloma annulare 2- NBLD 3- Rheumatoid nodule 4- Sarcoidosis 5- Lichen nitidus 6- Infectious granulomas : leprosy & T.B. 7- Pseudoxanthoma elasticum 8- Solar elastosis 27 PERFORATING DERMATOSES 9- Chondrodermatitis nodularis 10- Porokeratosis of Mibelli 11- Intralesional steroid 12- Calcinosis cutis 13- Osteoma cutis 14- Myxoid cyst 15- Alopecia mucinosis 16- Papular mucinosis 17- Cutaneous amyloidosis 28 PERFORATING DERMATOSES (I) PRIMARY PERFORATING DISORDERES 29 PERFORATING DERMATOSES 30 PERFORATING DERMATOSES Perforating dermatoses : 1ry 1. Reactive perforating collagenosis(RPC) 2. Elastosis perforans serpiginosa(EPS) 3. Perforating folliculitis(PF) 4. Kyrle's disease(KD) 5. Acquired Perforating Dermatosis (APD) : Occur in renal failure&/or diabetes mellitus 2ry 1. Perforating GA 2. PXE 3. Necrobiosis lipoidica 4. Chromomycosis 5. Exogenous agents: 1. ID Cs 2. Ca in drilling mud 31 PERFORATING DERMATOSES 1- Kyrle disease 2- Perforating folliculitis 3- Elastosis perforans serpiginosa 4- Reactive perforating collagenosis 5- Acquired perforating dermatosis 32 PERFORATING DERMATOSES 33 PERFORATING DERMATOSES 1- KYRLE’S DISEASE 34 PERFORATING DERMATOSES - It may be associated with : D.M. , renal failure , hepatic insufficiency , congestive heart failure , hypothyroidism & hyperlipoproteinemia 35 PERFORATING DERMATOSES • The primary lesion is a small papule with silvery scale. • This eventually enlarges to form a redbrown papule or nodule with a central keratin plug. Some, but not all, of the lesions appear to be follicular. These may coalesce to form larger keratotic plaques. Koebnerization is not ordinarily described as such, but a striking linearity of lesions sometimes is noted. • Site: legs, arms , head and neck . Involvement of palms and soles is rare. • Ocular changes, including keratotic lesions of conjunctiva and cornea, have been described in a single case report. 36 PERFORATING DERMATOSES 37 PERFORATING DERMATOSES 38 PERFORATING DERMATOSES 39 PERFORATING DERMATOSES • A partially parakeratotic plug, which fills epidermal depression. It may or may not involve a hair follicle. • Marked acanthosis of surrounding epithelium . Within plug there is admixed basophilic debris. Keratinous material extends focally to basilar layer and may contact dermis. At this point, necrotic cellular material and degenerated connective tissue are noted to undergo transepidermal elimination. • A surrounding mixed infiltrate usually is present, including neutrophils, lymphocytes, and epithelioid histiocytes (macrophages). 40 PERFORATING DERMATOSES 2- PERFORATING FOLLICULITIS 41 PERFORATING DERMATOSES 42 PERFORATING DERMATOSES 43 PERFORATING DERMATOSES 3- ELASTOSIS PERFORANS SERPIGINOSA (PERFORATING SERPIGINOSA ELASTOSIS) 44 PERFORATING DERMATOSES • rare skin disorder in which abnormal elastic tissue fibre passes from dermis to epidermis (TEE). • Three forms: 1. Idiopathic EPS: unknown origin, possibly genetic 2. Reactive EPS: associated e’Down syndrome, Ehlers-Danlos syndrome, Marfan syndrome, osteogenesis imperfecta, scleroderma, acrogeria, perforating granuloma annulare, pseudoxanthoma elasticum. Perforating diseases that may occur in conjunction with EPS. 3. Drug-induced EPS: affects 1% of people treated with Dpenicillamine45 PERFORATING DERMATOSES • D-penicillamine induced dermatoses: 1. cutis laxa 2. anetoderma 3. pseudoxanthoma elasticum (PXE), 4. elastosis perforans serpiginosa (EPS), 5. Ecchymoses 6. lymphangiectasis. 7. Bullous diseases: Pemphigus,pemphigoid,EBA 8. CTD:SLE,dermatomyocitis 46 PERFORATING DERMATOSES EPS most commonly appears during early adulthood (20-30 years) but may been seen in early childhood or late in life. • more common in males than females (ratio 4:1). • C/P: – cluster of small reddish papules 2-5 mm – often grouped in linear, circular or serpiginous (snake-like) patterns. – Each lesion may have a central pit, which is sometimes filled by a crusty or scaly plug. – asymptomatic but can be pruritic. • Sites : back of neck (70%), arms (20%), face (11%), legs (6%) and trunk (3%). 47 PERFORATING DERMATOSES • DD: – Dermatophytosis – Perforating collagenosis – Perforating granuloma annulare • Treatment: spontaneously resolves without complications after a few years. – no cure for EPS. – topical tazarotene(effective in 2pt). – Imiquimod:effective treatment after 10 weeks of therapy. 48 PERFORATING DERMATOSES 49 PERFORATING DERMATOSES 50 PERFORATING DERMATOSES 51 PERFORATING DERMATOSES 4- REACTIVE PERFORATING COLLAGENOSIS 52 PERFORATING DERMATOSES 1- Familial (AR) more in infancy 2- Acquired in association with D.M. & renal failure 53 PERFORATING DERMATOSES 54 PERFORATING DERMATOSES 55 PERFORATING DERMATOSES 5- ACQUIRED PERFORATING DERMATOSIS 56 PERFORATING DERMATOSES 57 PERFORATING DERMATOSES 58 PERFORATING DERMATOSES • irregular, epidermal hyperplasia with hypergranulosis. Centrally, there is a thick, hyperkeratotic and parakeratotic plug containing basophilic material that is embedded in an epidermal invagination59 . PERFORATING DERMATOSES Dilated follicular infundibulum filled with keratinous and necrotic debris . The follicular epithelium is disrupted in one point, and degenerated, basophilic dermal collagen is seen entering the perforation 60 PERFORATING DERMATOSES • Connective tissue fibers and cellular debris are extruded through the epidermis via a spiraling path. 61 PERFORATING DERMATOSES acid orcein- Giemsa stain: Elastic fibers are black. 62 PERFORATING DERMATOSES HYPERKERATOSIS LENTICULARIS PERSTANS (FLEGEL’S DISEASE) 63 PERFORATING DERMATOSES 64 PERFORATING DERMATOSES 65 PERFORATING DERMATOSES COLLOID MILIUM 66 PERFORATING DERMATOSES 67 PERFORATING DERMATOSES 68 PERFORATING DERMATOSES AINHUM (CONGENITAL CONSTRICTION) 69 PERFORATING DERMATOSES 70 PERFORATING DERMATOSES 71 PERFORATING DERMATOSES 72 PERFORATING DERMATOSES PSEUDOINHUM (AUTOAMPUTATION) 73 PERFORATING DERMATOSES 74 PERFORATING DERMATOSES 75 PERFORATING DERMATOSES 76 PERFORATING DERMATOSES PERFORATING NECROBIOSIS LIPODICA 77 PERFORATING DERMATOSES • oval violaceous patch that expands slowly. The advancing border is red and central area turns yellow-brown. The central area atrophies and has a waxy surface; telangiectasias become prominent • HP : degeneration of collagen, granulomatous inflammation of subcutaneous tissues and of blood vessels, capillary basement membrane thickening, and obliteration of vessel lumina. • TEE of degenerated collagen through hair follicle in necrobiosis lipoidica is rare, clinically manifesting as multiple hyperkeratotic plugs on surface of NL lesion . • The most commonly affected site in NL is leg( 85%). Other locations, however, may include hands, fingers, forearms, face, and scalp. The presence of multiple lesions is very rare 78 PERFORATING DERMATOSES Degenerated collagen 79 PERFORATING DERMATOSES Infiltrate of inflammatory cells with foamy cells encircling the altered connective tissue 80 PERFORATING DERMATOSES Transfollicular elimination of necrotic material (Trichromestain) 81 PERFORATING DERMATOSES 82 PERFORATING DERMATOSES 83 OTHER DERMATOSES PERFORATING GRANULOMA ANNULARE 84 OTHER DERMATOSES • Rare • young adults and is more common in women • C/P:lesions pass through four stages: i) erythematous or skin colored papules
Load more

Recommended publications
  • Oral Lichen Planus: a Case Report and Review of Literature
    Journal of the American Osteopathic College of Dermatology Volume 10, Number 1 SPONSORS: ',/"!,0!4(/,/'9,!"/2!4/29s-%$)#)3 March 2008 34)%&%,,!"/2!4/2)%3s#/,,!'%.%8 www.aocd.org Journal of the American Osteopathic College of Dermatology 2007-2008 Officers President: Jay Gottlieb, DO President Elect: Donald Tillman, DO Journal of the First Vice President: Marc Epstein, DO Second Vice President: Leslie Kramer, DO Third Vice President: Bradley Glick, DO American Secretary-Treasurer: Jere Mammino, DO (2007-2010) Immediate Past President: Bill Way, DO Trustees: James Towry, DO (2006-2008) Osteopathic Mark Kuriata, DO (2007-2010) Karen Neubauer, DO (2006-2008) College of David Grice, DO (2007-2010) Dermatology Sponsors: Global Pathology Laboratory Stiefel Laboratories Editors +BZ4(PUUMJFC %0 '0$00 Medicis 4UBOMFZ&4LPQJU %0 '"0$% CollaGenex +BNFT2%FM3PTTP %0 '"0$% Editorial Review Board 3POBME.JMMFS %0 JAOCD &VHFOF$POUF %0 Founding Sponsor &WBOHFMPT1PVMPT .% A0$%t&*MMJOPJTt,JSLTWJMMF .0 4UFQIFO1VSDFMM %0 t'"9 %BSSFM3JHFM .% wwwBPDEPSg 3PCFSU4DIXBS[F %0 COPYRIGHT AND PERMISSION: written permission must "OESFX)BOMZ .% be obtained from the Journal of the American Osteopathic College of Dermatology for copying or reprinting text of .JDIBFM4DPUU %0 more than half page, tables or figurFT Permissions are $JOEZ)PGGNBO %0 normally granted contingent upon similar permission from $IBSMFT)VHIFT %0 the author(s), inclusion of acknowledgement of the original source, and a payment of per page, table or figure of #JMM8BZ %0 reproduced matFSJBMPermission fees
    [Show full text]
  • Dermatology Eponyms – Sign –Lexicon (P)
    2XU'HUPDWRORJ\2QOLQH Historical Article Dermatology Eponyms – sign –Lexicon (P)� Part 2 Piotr Brzezin´ ski1,2, Masaru Tanaka3, Husein Husein-ElAhmed4, Marco Castori5, Fatou Barro/Traoré6, Satish Kashiram Punshi7, Anca Chiriac8,9 1Department of Dermatology, 6th Military Support Unit, Ustka, Poland, 2Institute of Biology and Environmental Protection, Department of Cosmetology, Pomeranian Academy, Slupsk, Poland, 3Department of Dermatology, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan, 4Department of Dermatology, San Cecilio University Hospital, Granada, Spain, 5Medical Genetics, Department of Experimental Medicine, Sapienza - University of Rome, San Camillo-Forlanini Hospital, Rome, Italy, 6Department of Dermatology-Venerology, Yalgado Ouédraogo Teaching Hospital Center (CHU-YO), Ouagadougou, Burkina Faso, 7Consultant in Skin Dieseases, VD, Leprosy & Leucoderma, Rajkamal Chowk, Amravati – 444 601, India, 8Department of Dermatology, Nicolina Medical Center, Iasi, Romania, 9Department of Dermato-Physiology, Apollonia University Iasi, Strada Muzicii nr 2, Iasi-700399, Romania Corresponding author: Piotr Brzezin′ski, MD PhD, E-mail: [email protected] ABSTRACT Eponyms are used almost daily in the clinical practice of dermatology. And yet, information about the person behind the eponyms is difficult to find. Indeed, who is? What is this person’s nationality? Is this person alive or dead? How can one find the paper in which this person first described the disease? Eponyms are used to describe not only disease, but also clinical signs, surgical procedures, staining techniques, pharmacological formulations, and even pieces of equipment. In this article we present the symptoms starting with (P) and other. The symptoms and their synonyms, and those who have described this symptom or phenomenon. Key words: Eponyms; Skin diseases; Sign; Phenomenon Port-Light Nose sign or tylosis palmoplantaris is widely related with the onset of squamous cell carcinoma of the esophagus.
    [Show full text]
  • A Report of Kyrle's Disease (Hyperkeratosis Penetrans) in a 43
    A Report of Kyrle’s Disease (Hyperkeratosis Penetrans) in a 43-Year-Old Male with End-Stage Renal Disease Ryan Skinner, DO,* Nina Sabzevari, BS,** Daniel Hurd, DO*** *Chief resident, Dermatology Department, LewisGale Hospital Montgomery, Blacksburg, VA **4th-year medical student, Edward Via College of Osteopathic Medicine, Blacksburg, VA ***Program Director, Dermatology Residency Program, LewisGale Hospital Montgomery, Blacksburg, VA Disclosures: None Correspondence: Ryan Skinner, DO; [email protected] Abstract Kyrle’s disease, also known as hyperkeratosis penetrans or hyperkeratosis follicularis et parafollicularis in cutem penetrans, is a rare condition, classified as one of the perforating dermatoses. Clinical presentation is typically numerous red-brown nodules with a scaly crust and central hyperkeratotic plug. Although an identifiable cause has yet to be established, there appears to be a strong relationship with end-stage renal disease and diabetes mellitus. In this report, we present a case of Kyrle’s disease in a 43-year-old male with multiple comorbid medical conditions and provide a review of efficacious treatments. Introduction was first described in 1916 and usually presents The etiology of Kyrle’s disease is unknown, Perforating dermatoses, including Kyrle’s disease as an extensive, painless papular eruption with a and although in some cases it appears to be (or hyperkeratosis follicularis et parafollicularis hyperkeratotic central plug. It most commonly a primary perforating skin disorder, in others involves the lower extremities but can also it occurs secondary to chronic kidney disease, in cutem penetrans), perforating folliculitis, 3 elastosis perforans serpiginosa, and reactive involve the upper extremities and trunk. There liver disease, congestive heart failure or diabetes is no involvement of the acral surfaces or mucous mellitus.4 Treatment is focused on managing perforating collagenosis, are disorders of 3 transepithelial destruction of dermal structures, membranes.
    [Show full text]
  • Elastosis Perforans Serpiginosa: a D-Penicillamine Induced Dermatoses in a Patient with Wilson’S Disease
    Article / Clinical Case Report Elastosis Perforans Serpiginosa: a D-penicillamine induced dermatoses in a patient with Wilson’s disease Swagatika Samala , Mukund Sablea How to cite: Samal S, Sable M. Elastosis Perforans Serpiginosa: a D-penicillamine induced dermatoses in a patient with Wilson’s disease. Autops Case Rep [Internet]. 2020 Apr-Jun;10(2):e2020167. https://doi.org/10.4322/acr.2020.167 ABSTRACT Long term use of D-penicillamine for Wilson’s disease can be associated with many adverse reactions and systemic side effects. We report the case of a 28-year-old male patient diagnosed with Wilson’s disease presenting with a serpiginous raised violaceous skin lesion in the anterior aspect of the neck over the last six months and two small papules with central umbilication during the last month. Histopathological examination of skin lesions demonstrated transepidermal perforating channel, and the Verhoeff’s-van Gieson stain showed marked increase number of irregular serrated elastic fibers suggesting the diagnosis of D- penicillamine induced elastosis perforans serpiginosa. Keywords Skin Diseases; Biopsy; Elastic tissue. INTRODUCTION CASE REPORT D-penicillamine (DPA) therapy is the mainstay A 28-year-male diagnosed with WD on oral DPA of chelation therapy for patients of Wilson’s therapy (250 mg thrice daily) for the last 18 years disease (WD). Various systemic adverse effects, presented with serpiginous raised violaceous skin including many dermatological manifestations, lesions in the anterior aspect of neck over the last may be observed with prolonged use of this drug. six months and two small papules with central The dermatological side effects of DPA can be of three umbilication for one month (Figure 1).
    [Show full text]
  • Ceratodermia Mutilante De Vohwinkel: Relato De Três Casos Em Uma Família* Vohwinkel´S Mutilating Keratoderma: Report of Three Familial Cases*
    Cavalcante, Holanda, Almeida & Filho 311 Caso Clínico / Case Report Ceratodermia mutilante de Vohwinkel: relato de três casos em uma família* Vohwinkel´s mutilating keratoderma: report of three familial cases* Lúcia Isabel de Sá Cavalcante1 Érica de Magalhães Holanda1 Thereza Lúcia Prata de Almeida 2 José Wilson Accioly-Filho3 Resumo: A ceratodermia hereditária mutilante ou síndrome de Vohwinkel é afecção dermatológica rara caracterizada pelo espessamento cutâneo das palmas, plantas e dorso de mãos e pés, e por constrições em faixa dos dedos (pseudoainhum). São relatados três casos em uma família, envolvendo duas gerações. Em todos havia, adicionalmente, perda auditiva neurossensorial. Discutem-se o diagnóstico diferencial com ou- tras ceratodermias palmoplantares e o tratamento com retinóides. Trata-se da primeira descrição dessa enti- dade no Brasil. Palavras-chave: ainhum; ceratodermia palmar e plantar Summary: Keratoderma hereditarium mutilans, or Vohwinkel´s syndrome, is a rare cutaneous di- sease characterized by thickening of the palms, soles and dorsa of the hands and feet, and by ainhum- like constriction of the fingers. This paper reports a case of three family members, over a span of two generations, who were affected by this disorder. Sensorineural deafness was also observed in each patient. We discuss differential diagnosis and retinoid treatment of this condition. This is the first case report on this disease to come from Brazil. Key words: ainhum; keratoderma, palmoplantar. INTRODUÇÃO INTRODUCTION As ceratodermias palmoplantares hereditárias repre- Heriditary palmoplantar keratodermas represent a sentam um grupo heterogêneo de doenças que se caracteri- heterogeneous group of diseases characterized by diffuse zam pelo espessamento cutâneo difuso ou focal das palmas e or focused cutaneous thickening of the palms and soles.
    [Show full text]
  • Secondary Pseudoainhum in a Patient with Turner Syndrome Brady S
    CASE REPORT Secondary Pseudoainhum in a Patient With Turner Syndrome Brady S. Davis, OMS IV Scott Harris, DO Mitchell D. Forman, DO Report of Case From the Touro University Secondary pseudoainhum is an autoam- A 44-year-old white woman with Turner syndrome Nevada College of putation that develops in individuals aged (45,X) presented for a routine rheumatologic examina- Osteopathic Medicine in Henderson. approximately 20 to 50 years and is caused tion for episodic oligoarthritis in her right ankle. A complete medical history and physical examination re- Financial Disclosures: by diseases such as keratodermas, trauma, or None reported. congenital factors. The authors report a novel vealed bilateral lower extremity toe lesions. Her left second and third, and her right second, third, and fourth Support: None reported. case of secondary pseudoainhum in a patient toes demonstrated linear bandlike constrictions be- Address correspondence with Turner syndrome (45,X) who presented tween the interphalangeal joints (Figure) consistent to Brady S. Davis, OMS IV, with bandlike constrictions in the toes bilat- 874 American Pacific Dr, with grade I pseudoainhum. The toes were warm, non- erally. To the authors’ knowledge, secondary Henderson, NV 89014-8800 tender, and had good capillary refill. There was no pseudoainhum has not been reported to be E-mail: do14.brady.davis clinical evidence to suggest peripheral vascular disease. associated with Turner syndrome. However, @nv.touro.edu The patient could not recall how long the painless, physicians should be aware of this potential- Submitted asymptomatic lesions had been present. She reported October 18, 2013; ly deforming disease in patients with Turner no trauma to the toes or feet.
    [Show full text]
  • Acute Rheumatism
    Ann. rheum. Dis. (1970), 29, 569 Ann Rheum Dis: first published as 10.1136/ard.29.5.569 on 1 September 1970. Downloaded from Abstracts This section is published in collaboration with Abstracts of World Medicine and Ophthalmic Literature, published by the British Medical Association, and also includes a great many which are specially commissioned for this Journal. They are divided into the following sections: Acute Rheumatism Other Forms of Arthritis Immunology and Serology Rheumatoid Arthritis Bone Diseases Biochemical Studies Still's Disease Non-articular Rheumatism, including Disk Therapy Osteoarthrosis Syndromes, Sciatica, etc. Surgery Spondylitis Pararheumatic (Collagen) Diseases Other General Subjects Gout Connective Tissue Studies At the end of each section is a list of titles of articles noted but not abstracted. Not all sections may be represented in any one issue. Acute rheumatism published in the past, this is the first from Iran, and it emanates from the Pahlavi University School of Medical A Day Hospital for Children with Rheumatic Fever (Paediatric) Cardiology in Shiraz. The prevalence of SPAGNUOLO, M., GAVRIN, J., and RYAN, J. (1970) rheumatic fever over a 10-year period was found to be Pediatrics, 45, 276 1 fig., 11 refs 0 5 per cent., which is higher than that currently reported by copyright. from most Western In the rheumatic disorders of children, as in other ill- countries. In forty episodes observed nesses, the amount of medical supervision needed de- amongst patients of an average age of 10 years, 45 had creases with time, although continued observation re- established carditis (64-5 per cent.), but very few de- mains desirable.
    [Show full text]
  • Acquired Perforating Dermatosis
    Dermatology Online Journal UC Davis Peer Reviewed Title: Acquired perforating dermatosis: a clinical and dermatoscopic correlation Journal Issue: Dermatology Online Journal, 19(7) Author: Ramirez-Fort, Marigdalia K., Tufts Medical Center Khan, Farhan, Center for Clinical Studies Rosendahl, Cliff O., The University of Queensland Mercer, Stephen E., The Mount Sinai School of Medicine Shim-Chang, Helen, The Mount Sinai School of Medicine Levitt, Jacob O., The Mount Sinai School of Medicine Publication Date: 2013 Publication Info: Dermatology Online Journal Permalink: http://escholarship.org/uc/item/7q40n20h Keywords: Dermatosis, Medicine Local Identifier: doj_18958 Abstract: Acquired Perforating Dermatosis (APD) is a perforating disease characterized by transepidermal elimination of dermal material [1,2]. This disease usually develops in adulthood. APD has been reported to occur in association with various diseases, but is most commonly associated with dialysis-dependent chronic renal failure (CRF) or diabetes mellitus (DM) [1,2,3,4]. Morton et al found that APD occurs in up to 10% of patients undergoing hemodialysis [5]. Additionally, Saray et al found that sixteen of twenty-two cases with APD were associated with CRF [3]. Copyright Information: eScholarship provides open access, scholarly publishing services to the University of California and delivers a dynamic research platform to scholars worldwide. Copyright 2013 by the article author(s). This work is made available under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs3.0 license, http:// creativecommons.org/licenses/by-nc-nd/3.0/ eScholarship provides open access, scholarly publishing services to the University of California and delivers a dynamic research platform to scholars worldwide. Volume 19 Number 7 July 2013 Case Report Acquired perforating dermatosis: a clinical and dermatoscopic correlation Marigdalia K.
    [Show full text]
  • Elastosis Perforans Serpiginosa Secondary to D-Penicillamine Therapy with Coexisting Cutis Laxa
    Elastosis Perforans Serpiginosa Secondary to D-Penicillamine Therapy With Coexisting Cutis Laxa Les B. Rosen, MD; Matthew Muellenhoff, DO; Thi T. Tran, DO; Michelle Muhart, MD Elastosis perforans serpiginosa (EPS) is a rare The patient presented to dermatology with a new complication of D-penicillamine therapy. EPS has onset eruption involving the back, axillae, chest, been reported in patients with Wilson disease, upper arms, and legs bilaterally. She stated this erup- cystinuria, and rheumatoid arthritis after many tion was sensitive to touch and contact with cloth- years of high-dose therapy. We report a case of ing. Findings from a physical examination showed D-penicillamine–induced EPS with coexisting loose hyperextensible skin on the trunk and extrem- acquired cutis laxa in a patient with cystinuria. ities with overlying grouped keratotic erythematous Although both EPS and acquired cutis laxa can papules arranged in a serpiginous pattern (Figure 2). be associated with D-penicillamine therapy, few Results of a 3-mm punch biopsy revealed short, cases have been reported with overlapping clin- thick, eosinophilic fibers with transepidermal elimi- ical presentations, and previously only in nation of elastin (Figure 3). The Verhoeff-van patients with Wilson disease. We review the Gieson stain highlighted elastic fibers with nodular characteristic clinical and histologic features of protrusions, giving a “zipperlike” pattern throughout EPS and discuss the potential dermatologic the dermis (Figure 4). Foreign body–type giant cell manifestations of D-penicillamine therapy. reaction to the elastic fiber was present. Cutis. 2005;76:49-53. The patient’s history and clinical and histologic find- ings supported the final diagnosis of elastosis perforans serpiginosa (EPS) secondary to D-penicillamine Case Report therapy with coexisting acquired cutis laxa.
    [Show full text]
  • Global Development Assistance for Adolescent Health from 2003 to 2015
    Supplementary Online Content Li Z, Li M, Patton GC, Lu C. Global development assistance for adolescent health from 2003 to 2015. JAMA Netw Open. 2018;1(4):e181072. doi:10.1001/jamanetworkopen.2018.1072 eTable 1. List of Donor Countries Included in the CRS eTable 2. 132 Recipients in the CRS (According to the World Health Organization Regions) eTable 3. Key Words to Identify the Related Age Group (Adolescence) in the Creditor Reporting System eTable 4. CRS Purpose Name and Respective Fractions Allocated to Adolescent Health eTable 5. Definitions of DAAH on the Leading Causes of DALYs of Adolescent Health eTable 6. Key Words Used to Search for Projects on Skin and Subcutaneous Diseases in the Creditor Reporting System eTable 7. Key Words Used to Search for Road Injury Projects in the Creditor Reporting System eTable 8. Key Words Used to Search for HIV/AIDS Projects in the Creditor Reporting System eTable 9. Key Words Used to Search for Projects on Iron-Deficiency Anemia in the Creditor Reporting System eTable 10. Key Words Used to Search for Self-Harm Projects in the Creditor Reporting System eTable 11. Key Words Used to Search for Projects on Interpersonal Violence in the Creditor Reporting System eTable 12. Key Words Used to Search for Projects on Depressive Disorders in the Creditor Reporting System eTable 13. Key Words Used to Search for Projects on Lower Back and Neck Pain in the Creditor Reporting System eTable 14. Key Words Used to Search for Diarrheal Projects in the Creditor Reporting System eTable 15. Key Words Used to Search for Tuberculosis Projects in the Creditor Reporting System eTable 16.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr
    USOO7359748B1 (12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr. 15, 2008 (54) APPARATUS FOR TOTAL IMMERSION 6,339,216 B1* 1/2002 Wake ..................... 250,214. A PHOTOGRAPHY 6,397,091 B2 * 5/2002 Diab et al. .................. 600,323 6,556,858 B1 * 4/2003 Zeman ............. ... 600,473 (76) Inventor: Rhett Drugge, 50 Glenbrook Rd., Suite 6,597,941 B2. T/2003 Fontenot et al. ............ 600/473 1C, Stamford, NH (US) 06902-2914 7,092,014 B1 8/2006 Li et al. .................. 348.218.1 (*) Notice: Subject to any disclaimer, the term of this k cited. by examiner patent is extended or adjusted under 35 Primary Examiner Daniel Robinson U.S.C. 154(b) by 802 days. (74) Attorney, Agent, or Firm—McCarter & English, LLP (21) Appl. No.: 09/625,712 (57) ABSTRACT (22) Filed: Jul. 26, 2000 Total Immersion Photography (TIP) is disclosed, preferably for the use of screening for various medical and cosmetic (51) Int. Cl. conditions. TIP, in a preferred embodiment, comprises an A6 IB 6/00 (2006.01) enclosed structure that may be sized in accordance with an (52) U.S. Cl. ....................................... 600/476; 600/477 entire person, or individual body parts. Disposed therein are (58) Field of Classification Search ................ 600/476, a plurality of imaging means which may gather a variety of 600/162,407, 477, 478,479, 480; A61 B 6/00 information, e.g., chemical, light, temperature, etc. In a See application file for complete search history. preferred embodiment, a computer and plurality of USB (56) References Cited hubs are used to remotely operate and control digital cam eras.
    [Show full text]
  • Primary Surgery
    811 Make sure the pain is due to the varicose veins (relieved on lying down, worse at the end of a day’s standing), and 35 Vascular surgery not due to (invisible) ischaemia, arthritis of the hip or knee, a prolapsed intervertebral disc, or meralgia paraesthetica (32.17) which can be there at the same time as the (visible) varicose veins. Swelling of the legs may 35.1 Varicose veins co-exist with varicose veins, but is usually due to another cause, e.g. heart failure or lymphoedema. Very occasionally varicose veins are the result of an ANATOMY AND PHYSIOLOGY. arterio-venous fistula: you should be able to hear a bruit There are four categories of leg vein, and they all have valves which stop and feel a thrill over the fistula. The veins may be blood flowing downwards away from the heart. (1) Long and short saphenous veins run superior to the deep fascia, enormous. Occlusion of the fistula by pressure will, and are usually deep to the fibrous layer of the superficial fascia (35-1). however, make them disappear. They have numerous valves, the most important of which is the femoral valve, in the long saphenous vein, just before it penetrates the deep fascia to join the femoral vein. The femoral valve prevents blood from the femoral vein flowing back into the saphenous vein. (2) Superficial collecting veins are tributaries of the saphenous veins. They lie between the skin and the fibrous layer of the superficial fascia. These have valves, but they are poorly supported by connective tissue.
    [Show full text]