Sunday 29 May 2011

Filiform Porokeratotic Palmoplantar Keratoderma

Filiform Porokeratotic Palmoplantar Keratoderma Facts:
  • Relatively sudden onset of multiple filiform spines on palms & soles.
  • May be an acquired marker of internal malignancy.
Tags: Filiform Porokeratotic Palmoplantar Keratoderma - Keratoderma - Malignancy
Posted by Medicalchemy
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Ichthyosis Hystrix Lambert

Ichthyosis Hystrix Lambert Facts:
  • Famous ichthyosis disorder, which is now extinct as a pedigree.
  • Named after the family of Lamberts who were known as the porcupine men.
  • The Lamberts were famous at English side shows in the 18th century.
  • The spines covered the entire body except the face, palms, soles & genitalia.
Tags: Ichthyosis - Ichthyosis Hystrix Lambert - Lambert - Porcupine Men -
Posted by Medicalchemy
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Sporotrichoid Skin Lesions

Sporotrichoid Skin Lesions Differential Diagnosis:
  • Anthrax
  • Atypical mycobacterial infection
  • Cat Scratch Disease
  • Nocardiosis
  • Sporotrichosis
  • Tuberculosis
  • Tularemia
Tags: Anthrax - Cat Scratch Disease - Nocardiosis - Sporotrichoid Skin Lesions - Sporotrichosis - TB - Tularemia
Posted by Medicalchemy
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Plantar Fibromatosis

Plantar Fibromatosis Facts:
  • Synon - Ledderhose Disease, Fibromatosis Plantans
  • Similar to Dupuyten's contracture but involves the plantar regions.
  • May be associated with joint motion contractures, esp the big toe.
  • Treatment is similar to that with Dupuytren's contracture, ie surgical excision is the best option.

Tags: Dupuytren's Contracture - Plantar Fibromatosis -
Posted by Medicalchemy
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Acneiform Drug Reactions

Acneiform Drug Reactions:
  • Most common sites are - face, chest & back.
  • Monomorphous exanthem which arises rapidly.
  • Relatively few comedones are present.
Drugs associated:
  • Androgens
  • Barbiturates
  • Corticosteroids (common)
  • Cyclosporin
  • Disulfiram
  • Ethionamide
  • Halides
  • Isoniazid
  • Lithium (common)
  • Oral contraceptives
  • Phenytoin (common)
  • PUVA
  • Rifampicin
  • Tetracyclines
  • Vitamin B2
  • Vitamin B6
  • Vitamin B12
Differential Diagnosis:
  • Bacterial folliculitis
  • Eosinophilic pustulosis (immunosuppressed)
  • Pityrosporum folliculitis

Tags: Acneiform Drug Reaction - Bacterial folliculitis - Eosinophilic pustulosis - Pityrosporum folliculitis
Posted by Medicalchemy
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Lichen Spinulosis

Lichen Spinulosis Features:
  • Also known as Spinulosismus.
  • Unclear nature of the condition.
  • Some define as a spiny variant of keratosis pilaris.
  • Others describe it as patches (round or oval) of grouped follicular plugs.
  • Associated with HIV/ AIDS - possible overlap with pityriasis rubra pilaris.

Differential Diagnosis:
  • Follicular Hyperkeratotic Spicules
  • Hyperkeratosis Follicularis et Parafollicularis in Cutem Penetrans
  • Lichen scrofulosorum
  • Lichenoid fungal id reaction (lichen trichophyticus)
  • Punctate porokeratosis

Tags: Lichen Spinulosis - Keratosis - Pityriasis Rubra Pilaris
Posted by Medicalchemy
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Tuesday 24 May 2011

Subcutaneous Granuloma Annulare

Subcutaneous Granuloma Annulare Features:
  • Other names - Deep granuloma annulare & Pseudorheumatoid nodule.
  • Aetiology - Unknown cause,
  • Epidemiology - Mostly affects children; boys ~2x more than girls.
  • Associations - Classic lesions of granuloma annulare.
  • Skin location - Deep dermal nodules, often over joints.
  • Clinical features - Hard consistency.
  • Anatomical sites - Most often found on the lower extremities, hands or scalp.
  • Pathogenesis - Repeated trauma may be a triggering factor for the lesions localizing over bony prominences.
  • Pathology - Histologically similar to rheumatoid nodules, though the necrobiosis in rheumatoid nodules has a more homogenous eosinophilic appearance, compared with the mucinous oedematous appearance in subcutaneous granuloma annulare.
  • Genetics - Some cases have been reported as familial.
  • Prognosis - May occur as an early-stage dermatologic manifestation of diabetes in a subset of children; recurrence is common.
  • Medical history - First clearly described by Ziegler in 1941.

References:
  • Chung S, Frush DP, Prose NS, Shea CR, Laor T, Bisset GS (1999). Subcutaneous Granuloma Annulare: MR Imaging Features in Six Children and Literature Review. March 1999 Radiology 1999; 210, March, 845-849
  • Felner EI, Steinberg JB, Weinberg AG (1997). Subcutaneous granuloma annulare: a review of 47 cases. Pediatrics 1997 Dec;100(6):965-7.
  • Karen L. Grogg, Antonio G. Nascimento (2001). Subcutaneous Granuloma Annulare in Childhood: Clinicopathologic Features in 34 Cases. Pediatrics 107(3) March 1, pp. e42 (doi: 10.1542/peds.107.3.e42
  • Grogg KL, Nascimento AG (2001). Subcutaneous granuloma annulare in childhood: clinicopathologic features in 34 cases. Pediatrics. 2001 Mar;107(3):E42.
  • Isdale AH, Helliwell PS (1992). An infiltrating rheumatoid nodule ? Ann Rheum Dis 1992; 51 : 688-89
  • Robin M, Lynch FW (1966). Subcutaneous granuloma annulare. Arch Dermatol 1966; 93: 416-20.
  • Sabuncuoğlu H, Oge K, Söylemezoğlu F, Sağlam A (2007). Subcutaneous granuloma annulare of the scalp in childhood: a case report and review of the literature. Turk Neurosurg. 2007;17(1):19-22.
  • Sandipan Dhar, Asim Das, Kaur (1993). Subcutaneous granuloma annulare. Indian J Dermatol Venereol Leprol 1993; 59(3):146-148
  • Stillians AW (1919). An unusual case of granuloma annulare. J Cutan Dis. 1919; 37:580.
  • Ziegler E (1941). Rheumatismus nodosus als einzige Manifestation der rheumatischen Krankheit. Arch Kinderh 122:1–6
Tags: Diabetes Mellitus - Granuloma Annulare - Rheumatoid Nodule
Posted by Medicalchemy
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