Upper Trunk (upper + trunk)

Distribution by Scientific Domains

Selected Abstracts

A unique variant of Darier's disease

Christopher M. Peterson MD
A 45-year-old black woman presented with a chief complaint of an increasing number of ,,light spots'' on her face, upper trunk, and legs. She had a 4-year history of a pruritic eruption on the dorsum of her hands. The eruption was particularly pruritic in the summer months. Other family members, including her sister and her daughters, reportedly had a similar dermatologic problem. The patient had been previously evaluated and biopsied by another dermatologist. The earlier biopsy was nondiagnostic, however, and she presented for further evaluation of this problem. On physical examination, the patient had hypopigmented macules along her jawline (Fig. 1), lateral neck, and upper chest. She had similar hypopigmented macules on her thighs. She had hyperkeratosis of the palmoplantar surface of her hands and feet. The dorsum of her hands had numerous coalescing, shiny, flat-topped, hypopigmented papules (Fig. 2), and several of her fingernails had distal, V-shaped notching. Figure 1. Hypopigmented macules on the cheek and along the jawline Figure 2. Coalescing, hypopigmented papules on the dorsal aspect of the fingers and hand, with distal notching of the fingernails A punch biopsy from a papule on the dorsum of her hand was obtained. The epidermis had corps ronds present with focal areas of acantholysis above the basal layer (Fig. 3). The dermis had sparse, superficial, perivascular infiltrates composed of lymphocytes and histiocytes. These changes were consistent with our clinical diagnosis of Darier's disease (keratosis follicularis). Figure 3. Corps ronds (large arrow) and focal acantholysis with suprabasal clefts (small arrow) are present in the epidermis (hematoxylin and eosin; original magnification, ×,40) [source]

An Unusual Case of Congenital Linear Eccrine Spiradenoma

Marina Rodríguez-Martín M.D., Ph.D.
Typically, it presents as a painful, slow growing and solitary nodule on the head or upper trunk in adult patients. We report a child with linear ES which presented with asymptomatic papulonodular lesions in a blaschkoid distribution on the face. Cases reported in the literature of multiple spiradenomas are very rare and multiple linear lesions are even rarer. To date, 21 cases of linear/multiple ES have been reported. Of these, eight were in children or adolescents. We report an additional case of this rare clinical presentation and review the literature. [source]

Photosensitive rash due to the epidermal growth factor receptor inhibitor erlotinib

Minnelly Luu
A papulopustular rash occurs in 45,100% of patients undergoing anti-cancer treatment with epidermal growth factor (EGFR) inhibitors. Although the majority of cases involve the face and upper trunk, ultraviolet radiation has not yet been documented to play a major role in inducing or exacerbating symptoms. We describe a 75-year-old man who was being treated with the EGFR inhibitor erlotinib and developed the characteristic rash on unprotected areas of the trunk after photoexposure, while the protected areas (face and neck) remained uninvolved. This case underscores the importance of sun protection in patients treated with EGFR inhibitors and supports in vitro data showing that EGFR blockade results in altered keratinocyte survival and proliferation in response to ultraviolet radiation. [source]

Clinical and histological spectrum of elastotic changes induced by penicillamine

Eric Poon
SUMMARY A 79-year-old-man with cystinuria requiring long-term penicillamine therapy presented with a 6-month history of itchy annular lesions in both axillae. Clinical examination revealed lesions consisting of crusted keratotic papules coalescing in an annular distribution. Associated findings included generalized skin laxity accentuated on the upper trunk and arms, as well as small yellowish papules on the neck. Histological evaluation revealed short, thick, eosinophilic elastic fibres with nodular protrusions. Transepidermal elimination of abnormal elastic fibres was also evident. We discuss the histological and clinical spectrum of penicillamine-induced elastotic changes and compare these changes to those seen in primary elastotic disorders. [source]