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Punch Biopsy Specimen (punch + biopsy_specimen)

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Medical Sciences100%

Selected Abstracts

Axillary intertriginous granular parakeratosis responsive to topical calcipotriene and ammonium lactate

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2003
Michael E. Contreras MD
A 70-year-old white man presented to our clinic with a 6,8-month history of a pruritic, occasionally burning eruption in both axillae. He had been using the same deodorant for more than 1 year and denied any changes in laundry detergent, soaps, or shampoos. He also denied application of other topical products. On physical examination, there were slightly erythematous, lichenified plaques in both axillae, with more extensive involvement of the left side (Fig. 1). Histologic examination of a punch biopsy specimen from a left axillary plaque revealed hyperkeratosis with retention of nuclei and keratohyaline granules in the stratum corneum (Fig. 2). The stratum granulosum was slightly thickened, and the epidermis was mildly acanthotic. Patch tests of the patient's deodorant and shampoo were negative. The patient was advised to discontinue use of his deodorant. His right axilla was treated with topical calcipotriene, applied twice daily, and his left axilla was treated with topical 12% ammonium lactate, applied twice daily. One month later, the lesions in the right axilla had completely resolved. The left axilla was slightly improved, but still exhibited dusky erythematous plaques. After one additional month of treatment with ammonium lactate, the left axillary lesions completely resolved. A follow-up examination 9 months later revealed no recurrence of the lesions in either axilla. Figure 1. Erythematous, lichenified plaques in the axilla Figure 2. Photomicrograph of biopsy specimen showing keratohyaline granules in the stratum corneum (hematoxylin and eosin, × 200) [source]

Follicular porokeratosis: distinct clinical entity or histologic variant?

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 11 2009
M. Pongpudpunth
Various clinical subtypes of porokeratosis, clinically characterized by annular plaques with a normal or atrophic center and a distinctive keratotic ridge, are described based on the age of onset, size, number and distribution of the lesions. Follicular involvement, identified by follicular localization of cornoid lamellae, is uncommon and has only been reported in association with other subtypes such as disseminated superficial actinic porokeratosis and porokeratosis of Mibelli. We present a case of follicular porokeratosis in a 40-year-old male who presented initially with scaly red "papules" in a follicular distribution on the upper extremity. Microscopic examination of a punch biopsy specimen revealed parakeratosis confined to the follicle and mild interface change. A repeat biopsy performed in 2008 revealed identical histologic features. In terms of etiopathogenesis, a clone of cells at the base of the follicle demonstrating abnormal keratinization is not a novel concept and has been demonstrated in other porokeratotic dermatoses. However, the presence of lesions that are solely follicular based, in terms of clinical presentation and histologic findings, and static over a 3-year period favors the concept that follicular porokeratosis is a distinct clinical entity and not merely a histologic variant of the porokeratotic dermatoses described in the literature thus far. [source]

Familial Atrophia Maculosa Varioliformis Cutis: An Ultrastructural Study

PEDIATRIC DERMATOLOGY, Issue 3 2001
Federica Dall'Oglio M.D.
We describe two brothers, ages 14 and 16 years, with spontaneously appearing, asymptomatic, varioliform and linear atrophic lesions. Their past medical history was positive for varicella occurring in childhood without residual facial scarring. Routine laboratory investigations and screening for circulating autoantibodies were negative. Both patients were concordant for HLA A2 and DQ4.1. Routine and ultrastructural histologic examination of a punch biopsy specimen showed the presence of scarce, small, fragmented elastic fibers and compact collagen bundles associated with hypertrophic fibroblasts in the dermis. Our patients remained clinically stable, untreated, over a 2-year follow-up period. No long-term follow-up data have previously been reported. [source]

A case of generalized argyria after ingestion of colloidal silver solution

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009
Yangho Kim
Abstract A 58-year-old woman was referred to our hospital due to progressive skin darkening, which began 5 months previously. The patient had strikingly diffuse blue-gray discoloration of the skin, most prominent in sun-exposed areas, especially her face and hands. The oral mucosa, tongue, gums, eye conjunctiva, ears, nail beds, and trunk were also involved. Bluish-gray discoloration of all nails was aggravated by cold weather. She had ingested 1 L of colloidal silver solution daily for approximately 16 months as a traditional remedy. Her serum silver concentration was 381 ng/ml which was a very high (reference level: <15 ng/ml). Light microscopic examination of a punch biopsy specimen from her nose revealed fine, minute, round, and brown-black granules deposited in the basement membrane of hair follicular epithelium. Scanning electron microscopic examination showed electron-dense granules deposited in the intercellular space of sweat glands. Energy disperse X-ray spectrometry analysis demonstrated peaks for silver and sulfur in the dense black deposits. The ingestion of colloidal silver appears to be an increasing practice among patients using alternative health practices. All silver-containing products including colloidal silver should be labeled with a clear warning to prevent argyria, especially in alternative health practices. Am. J. Ind. Med. 52:246,250, 2009. © 2008 Wiley-Liss, Inc. [source]

Angiolymphoid Hyperplasia with Eosinophilia Successfully Treated with a Long-Pulsed Tunable Dye Laser

DERMATOLOGIC SURGERY, Issue 3 2000
Thomas E. Rohrer MD
Background. To date, both surgical excision and laser treatments for angiolymphoid hyperplasia with eosinophilia (ALHE) have resulted in scarring. Objective. Based on the principle of selective photothermolysis, we considered employing the newer long-pulsed tunable dye laser in the treatment of ALHE, as less scarring would be expected and deeper blood vessels could be ablated. Methods. After punch biopsy specimens confirmed the diagnosis, the patient was treated on two separate occasions, 2 months apart with a long-pulsed tunable dye laser. Results. The lesions flattened after the initial treatment and resolved after a second treatment. No scarring was detectable and no recurrence was noted in follow-up after 1 year. Conclusion. We conclude that the long-pulsed tunable dye laser can be employed successfully to treat superficial lesions of ALHE, particularly in cosmetically sensitive areas. [source]

Erythema Toxicum Neonatorum: An Immunohistochemical Analysis

PEDIATRIC DERMATOLOGY, Issue 3 2001
Giovanna Marchini M.D., Ph.D.
The recruitment of leukocytes to tissues implicates the involvement of adhesion molecules, cytokines, and chemokines. We therefore performed immunohistochemistry on punch biopsy specimens from cutaneous lesions of ten 1-day-old infants with erythema toxicum using specific monoclonal antibodies directed against a variety of adhesion molecules, cytokines, chemokines, and cell type-specific membrane markers. Biopsy specimens of noninflamed skin from four matched newborns and four adults served as controls. The immunohistologic features of erythema toxicum in all 10 infants included a strong staining of the adhesion molecule E-selectin in the vessel wall and the presence of numerous inflammatory cells that were identified as dendritic cells (CD1a, CD83, HLA-DR, CD40, and ICAM-1 positive), eosinophils (EG2 positive), neutrophils (CD15 positive), macrophages (CD14, CD68, and Mac387 positive), and E-selectin-expressing cells. Furthermore, the lesions showed a high incidence of the proinflammatory cytokines interleukin (IL)-1, and IL-1, and of the chemokines IL-8 and eotaxin. This immunologic activity was reduced or absent in noninflamed skin from newborn controls and adults. We conclude that there is an accumulation and activation of immune cells in the lesions of erythema toxicum, also present in noninflamed skin of 1-day-old infants, but to a lower level. The physiologic significance of the rash remains to be elucidated. [source]