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Dorsal Hands (dorsal + hand)

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Medical Sciences100%

Selected Abstracts

A case of erythema elevatum diutinum associated with breast carcinoma

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2005
Fikriye Yilmaz MD
A 53-year-old woman diagnosed with invasive ductal-type breast carcinoma was referred to our clinic with red,purple lesions on the hands and legs. She had neither pruritus nor pain. The first lesion developed on the dorsal hand. In the following days, new lesions appeared on the extensor surface of the legs. The patient had been treated with modified radical mastectomy and three courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy. Dermatologic examination revealed reddish-violaceous papules and plaques ranging from a few millimeters to 2 cm in diameter, bilaterally located on the dorsal hands, especially over the metacarpophalangeal and interphalangeal joints (Fig. 1). Multiple red,purple, circumscribed papules and plaques of various diameters were observed bilaterally over the shins (Fig. 2). The largest of these plaques showed an annular configuration. The nails showed distal subungual keratosis and yellow discoloration. The rest of the physical examination was normal. Figure 1. Violaceous papules and plaques on the dorsal hands Figure 2. Red,purple, circumscribed, papules and plaques over the shins A biopsy taken from the medial side of the shin revealed a predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (Fig. 3). Figure 3. Predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (hematoxylin and eosin stain, ×100) Complete blood count, routine biochemical tests and fasting lipids, serologic tests of bacterial and viral agents, serum electrophoresis, and serologic profiles for autoimmune connective tissue diseases revealed normal results. Mycologic examination of nail clippings did not show any evidence of fungal infection. In the light of our clinical and histopathologic findings, a diagnosis of erythema elevatum diutinum was made, and the patient was given topical clobetasol propionate therapy. Complete clearance was achieved in 3 weeks (Fig. 4). After six courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy, and radiotherapy, no recurrence of erythema elevatum diutinum lesions was observed. Figure 4. Healed lesion 3 weeks after high-potency topical glucocorticoids [source]

Diversity of human papillomavirus types in periungual squamous cell carcinoma

BRITISH JOURNAL OF DERMATOLOGY, Issue 6 2009
A. Kreuter
Summary Background, There is accumulating evidence that infections with certain high-risk ,-human papillomaviruses (HPVs) are involved in the pathogenesis of digital squamous cell carcinomas (SCCs) and their precursor lesions (SCCs in situ). Objectives, This study was initiated to search for ,- and ,-HPV infections in a collective of SCC and SCC in situ located on the hands. Methods, HPV typing for 36 high-risk and low-risk ,-HPV types and 25 ,-HPV types was performed in SCCs located at different sites of the hands. Additionally, immunohistochemical staining for p16INK4a and Ki67 was performed in 15 samples. Results, In total, 25 SCCs/SCCs in situ (six periungual lesions, eight lesions from the proximal or lateral part of the finger, and 11 lesions from the dorsal part of the hand) were analysed for the presence of ,- and ,-HPV types. Only one lesion (an SCC in situ positive for HPV11 and HPV31) of the dorsal hand and none of the proximal or lateral part finger lesions were ,-HPV positive. In contrast, all six periungual lesions were ,-HPV positive, and the majority (83%) of them carried HPV types other than HPV16 (HPV26, HPV33, HPV51, HPV56 and HPV73). ,-HPV types were found in only two biopsies. p16INK4a and Ki67 expression was significantly higher in HPV-positive lesions as compared with HPV-negative tumours, and both markers significantly correlated with each other. Conclusions, In contrast to other locations of the hands, periungual SCCs are frequently associated with ,-HPV infections. Several high-risk HPV types other than HPV16 can induce periungual SCCs. Given the high recurrence rate and high proliferative activity of HPV-associated periungual SCCs, aggressive treatment and close follow-up of these tumours is mandatory. [source]

Correspondence: Neutrophilic dermatosis of the dorsal hands: a case showing HLA B54, the marker of Sweet's syndrome

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2010
Hideto Takahama MD
No abstract is available for this article. [source]

A case of erythema elevatum diutinum associated with breast carcinoma

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2005
Fikriye Yilmaz MD
A 53-year-old woman diagnosed with invasive ductal-type breast carcinoma was referred to our clinic with red,purple lesions on the hands and legs. She had neither pruritus nor pain. The first lesion developed on the dorsal hand. In the following days, new lesions appeared on the extensor surface of the legs. The patient had been treated with modified radical mastectomy and three courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy. Dermatologic examination revealed reddish-violaceous papules and plaques ranging from a few millimeters to 2 cm in diameter, bilaterally located on the dorsal hands, especially over the metacarpophalangeal and interphalangeal joints (Fig. 1). Multiple red,purple, circumscribed papules and plaques of various diameters were observed bilaterally over the shins (Fig. 2). The largest of these plaques showed an annular configuration. The nails showed distal subungual keratosis and yellow discoloration. The rest of the physical examination was normal. Figure 1. Violaceous papules and plaques on the dorsal hands Figure 2. Red,purple, circumscribed, papules and plaques over the shins A biopsy taken from the medial side of the shin revealed a predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (Fig. 3). Figure 3. Predominantly neutrophilic infiltrate and nuclear dust around the dermal vessels and orthokeratotic stratum corneum (hematoxylin and eosin stain, ×100) Complete blood count, routine biochemical tests and fasting lipids, serologic tests of bacterial and viral agents, serum electrophoresis, and serologic profiles for autoimmune connective tissue diseases revealed normal results. Mycologic examination of nail clippings did not show any evidence of fungal infection. In the light of our clinical and histopathologic findings, a diagnosis of erythema elevatum diutinum was made, and the patient was given topical clobetasol propionate therapy. Complete clearance was achieved in 3 weeks (Fig. 4). After six courses of cyclophosphamide, adriamycin, and fluorouracil chemotherapy, and radiotherapy, no recurrence of erythema elevatum diutinum lesions was observed. Figure 4. Healed lesion 3 weeks after high-potency topical glucocorticoids [source]

Lichenoid photodermatitis associated with nimesulide

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2001
Umit Tursen MD
An 81-year-old-female patient presented with a 2 week history of erythematous to violaceous lichenoid papules and plaques exhibiting a reticulated pattern on the ,,V'' area of the chest and dorsal hands. Fine, whitish reticulated networks were present over the surface of many well developed papules. The lesions were sharply demarcated and moderately pruritic (Fig. 1). Figure 1. ,Violaceous lichenoid papules with reticular pattern located on the ,,V'' area of the chest The result of routine complete blood cell count, urinalysis, erythrocyte sedimentation rate, liver and kidney function tests were within normal limits. Antinuclear and anti-DNA antibodies were negative, and total C3 and C4 complement levels were normal. Hepatitis B surface antigen, anti-Hepatitis B surface antigen, anti-Hepatitis B core IgM antibody were negative, while anti-Hepatitis C virus antibody was positive. A skin biopsy specimen obtained from the neck of our patient revealed an interface lichenoid dermatitis accompanied by individual necrotic epidermal keratinocytes, parakeratosis and eosinophils in the infiltrate (Fig. 2). Figure 2. ,Interface lichenoid dermatitis accompanied by individual necrotic epidermal keratinocytes and parakeratosis (Hematoxylin and eosin; original magnification, × 200) Nimesulide therapy was stopped and the patient was treated with topical corticosteroids and systemic antihistamines. The eruption resolved within 5 days. The rash returned following nimesulide rechallenge. [source]

Neutrophil dermatosis of the dorsal hands

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2005
HK Larsen
Neutrophil dermatosis of the dorsal hands (NDDH) is a recently described skin manifestation regarded as a subset of acute febrile neutrophilic dermatotis (Sweet syndrome). We describe 5 cases with pustular and ulcerative plaques and/or bullae and vesicles of the dorsal hands. Three of the patients also had skin changes at sides other than the hands. Associated conditions were found in two patients, one patient treated with hemo-dialysis for chronic glomerulonephritis, and one patient had suffered from a streptococcal tonsillitis prior to the eruption. Two of the patients had fever, two had neutrophil leucocytosis in peripheral blood and two had elevated sedimentation rates. Histological findings showed signs of vasculitis in biopsies from two of the patients. NDDH is discussed on the basis of prior case reports concerning the subject, and it is concluded that Neutrophil dermatosis of the dorsal hands should be regarded as a localized variety of Sweet syndrome. [source]