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Erythematous Nodule (erythematou + nodule)
Selected AbstractsHistopathology of a granulomatous lobular panniculitis in acute Q fever: a case reportJOURNAL OF CUTANEOUS PATHOLOGY, Issue 8 2010R Soulard Q fever is a zoonotic infection caused by Coxiella burnetii. Two forms of the disease have been described: an acute form with pneumonia, hepatitis or a flu-like syndrome; and a chronic form in which endocarditis is the most frequent clinical expression. We report a 77 year old male with fever and an erythematous nodule on the right leg. Biopsy revealed a granulomatous lobular panniculitis with some granulomas rimmed by an eosinophilic material, giving a "doughnut" or "fibrin-ring" appearance. Q fever serological studies were positive. Cutaneous signs, among them panniculitis, are probably underestimated during the acute phase of the disease, and recognizing different granulomatous patterns may contribute to the diagnosis. Soulard R. Histopathology of a granulomatous lobular panniculitis in acute Q fever: a case report. [source] Primary Cutaneous Ewing's SarcomaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005K.S. Draft A 57-year-old woman presented with a three-week history of an erythematous nodule on her palm. The clinical diagnosis was pyogenic granuloma. Histology revealed a circumscribed dermal nodule of uniform, primitive round cells with numerous mitotic figures and apoptopic cells. The tumor cells showed strong membranous immunoreactivity for CD99 and nuclear immunoreactivity for Fli-1. The tumor cells were negative for S-100 protein, cytokeratin AE1/3, cytokeratin 20, chromogranin, synaptophysin, and actin. The diagnosis of Ewing's sarcoma was made. CT scans showed no evidence of an osseous or deep soft tissue primary tumor or metastatic disease. The tumor was excised with 1 cm margins, and the patient received six courses of adjuvant chemotherapy. One year after diagnosis, the patient is alive without evidence of disease. Extraosseous Ewing's sarcoma (EES) rarely presents as a primary skin tumor and should be considered in the differential diagnosis of small round cell tumors involving the skin. It is important to distinguish primary cutaneous EES from secondary involvement of the skin by ES, as primary cutaneous EES has a more indolent course compared to classic EES or osseous ES. Immunohistochemical stains for CD99 and Fli-1 are useful markers to confirm the diagnosis of cutaneous ES. [source] An erythematous nodule on the eyelidCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2008A. Mitra No abstract is available for this article. [source] Erythema induratum with pulmonary tuberculosis: histopathologic features resembling true vasculitisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2001Yong Suk Lee MD A 22-year-old South Korean woman presented with a 4-month history of several nodules on both legs. She looked healthy, but suffered from tenderness and swelling of the legs. Physical examination showed multiple, nonulcerating, erythematous nodules occurring on the calves, knee joints, and thighs (Fig. 1). A biopsy specimen of the skin revealed necrotizing vasculitis of medium-sized arteries with fibrinoid necrosis at the border between the dermis and the subcutis. Dense cellular infiltrates, including numerous neutrophils and lymphocytes, presented within and around the vessel walls as in polyarteritis nodosa, with some eosinophils (Fig. 2A,B). There were no other generalized symptoms. She was diagnosed with cutaneous polyarteritis nodosa and was initially treated with systemic steroids. She was given an intravenous injection of Solu-Cortef, 60 mg/6 h for 7 days. This was replaced with oral prednisolone for 2 weeks. The skin lesions and symptoms improved. Figure 1. Small, nut-sized, erythematous, brown-colored nodules and patches on the lower extremities, even above the knee joints Figure 2. (A) Dense infiltration within and around artery (× 40). (B) Slightly expanded lobular panniculitis with vasculitis (× 100) Six months later, she complained of general weakness and recurrent skin lesions. Purified protein derivative (PPD) test gave a moderate positive reaction and chest X-ray examination showed the features of pulmonary tuberculosis: radio-opaque infiltrations in the right lower lung field. A repeated biopsy revealed mild vasculitis with more diffuse lobular infiltrations of the subcutaneous tissue compared with the former specimen. Polymerase chain reaction (PCR) and tissue culture for Mycobacterium tuberculosis were performed from a biopsy specimen. DNA was extracted from skin tissue with an AplisystemTM DNA/RNA detection kit using the resin-mediated boiling method (Stargene, Seoul, South Korea). The primers were designed on the basis of the M. tuberculosis gene IS6110 target (sense primer, 5,-CCA GAT GCA CCG TCG AAC GGC TGA T-3, antisense primer, 5,-CGC TCG CTG AAC CGG ATC GAT GTG T-3,). The amplification was performed with uracil- N -glycosylase (UNG), to prevent carry-over contamination, and internal control primers, to correct for false-negative reaction (Kox LF, Rhienthong D, Miranda AM et al. A more reliable PCR for detection of Mycobacterium tuberculosis in clinical samples. J Clin Microbiol 1994; 32: 672,678; Longo MC, Berninger MS, Hartley JL. Use of uracil DNA glycosylase to control carry-over contamination in polymerase chain reactions. Gene 1990; 93: 125,128). According to the manufacturer's instructions, amplification was carried out for 40 cycles with denaturation at 94 °C for 40 s, annealing at 70 °C for 1 min, and extension at 72 °C for 1 min in a thermal cycler (Perkin,Elmer Cetus, Norwalk, CT, USA). The results of PCR and tissue culture for M. tuberculosis using the biopsy specimen were all negative (Fig. 3). Figure 3. Negative result in PCR for M. tuberculosis (negative control is not shown; M, marker; P, positive control; I, internal control; S, specimen) The patient was finally diagnosed with erythema induratum with pulmonary tuberculosis and was started on antituberculosis medication (isoniazid 400 mg, rifampicin 600 mg, ethambutol 800 mg, and pyrazinamide 1500 mg daily). She showed prompt improvement after 2 weeks of medication. After 9 months of antituberculosis therapy, her skin lesions and chest X-ray had cleared. She was followed up for 4 months with no recurrence of skin and pulmonary lesions. [source] Subcutaneous Panniculitis-Like T Cell Lymphoma Developing in a Patient with Chronic B-Cell Lympocytic LeukemiaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005L Shahabi Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is an unusual peripheral lymphoma most typically presenting with a cytotoxic (CD8-positive, TIA-1-positive) immunophenotype. SPTCLs may have an indolent or highly aggressive clinical course. Histologically, SPTCL may be notoriously difficult to diagnosis. Cases of SPTCL with a deceptively benign appearance similar to that of subcutaneous lupus erythematosus have been described. SPTCL associated with a concomitant systemic leukemia/lymphoma has not been documented in the literature. We report a case of SPTCL arising in a 65-year-old female with a well-established history of B-cell lymphocytic leukemia (BCLL). She presented with two months of recurrent fever and painless erythematous nodules on bilateral lower extremities that were clinically felt to be erythema nodosum. Initial biopsies demonstrated a polymorphous lobular infiltrate with neutrophils, karyorrhexis and lipomembranous change. An excisional biopsy demonstrated an atypical lymphoid population that expressed CD8 and TIA1. PCR analysis confirmed T-cell receptor gene arrangement. The patient was treated with systemic chemotherapy with resolution of her symptoms and complete remission. This is the first well documented case of SPTCL occurring in a patient with long standing B-CLL, and highlights the difficulty of establishing an unequivocal diagnosis of SPTCL. [source] Tender erythematous nodules on the lower limbCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2009P. Farrant No abstract is available for this article. [source] | ||||||||||