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
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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 -
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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 -
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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
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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
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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
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