Clinical and experimental dermatology
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Clin. Exp. Dermatol. · Jul 2009
Case ReportsHypereosinophilic syndrome with various skin lesions and juvenile temporal arteritis.
Hypereosinophilic syndrome (HES) is a multisystem disease with a high mortality rate. It is characterized by peripheral blood eosinophilia and eosinophilic infiltration of the skin and many other organs. The commonest cutaneous features include erythematous pruritic maculopapules and nodules, angio-oedema or urticarial plaques. ⋯ Histologically, the lesion is characterized by a significant intimal thickening with moderate eosinophilic infiltrates, constriction or occlusion of the vascular lumen and absence of giant cells. We report a patient with HES presenting with eosinophilic cellulitis, Raynaud's phenomenon, digital gangrene and JTA. JTA may also be one of the features of HES.
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Clin. Exp. Dermatol. · Jul 2009
Case ReportsSuperficial granulomatous pyoderma treated preoperatively with infliximab.
We report a case of superficial granulomatous pyoderma (SGP) treated successfully with infliximab. A 71-year-old woman developed erythema, erosions and cribriform scarring in the right periorbital area following enucleation of the right eye. ⋯ The patient's disease was unusual in that it failed to respond to a wide variety of immunosuppressants and this condition is rarely reported to affect the face. Eventually she was treated successfully with infliximab, enabling her to undergo extensive surgery despite the fact that her disease was pathergic in onset.
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Clin. Exp. Dermatol. · Jul 2009
Risk factors for severe impetiginized atopic dermatitis in Japan and assessment of its microbiological features.
Patients with atopic dermatitis (AD) are susceptible to cutaneous bacterial infection. When such patients develop infection, some have extensive impetiginized dermatitis with high fever. To clarify the risk factors for severe impetiginized AD and its microbiological features, we reviewed clinical and microbiological data of 14 patients with impetiginized AD who were admitted to our hospital between the years 1999 and 2006. ⋯ Cultures of the lesional skin yielded both Streptococcus pyogenes and Staphylococcus aureus in 12 patients. S. pyogenes alone was isolated in two cases. These observations suggest that poorly controlled AD in adults is a risk factor for severe impetiginized AD and that S. pyogenes might play an important role in the development of severe clinical symptoms.
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Clin. Exp. Dermatol. · Jul 2009
Case ReportsSilicone breast implant rupture presenting as bilateral leg nodules.
Gross migration of silicone gel from ruptured breast implants is a rare event. It is associated with extravasation of gel into the breast parenchyma, and to distant locations such as the abdominal wall and inguinal areas. This silicone deposits present as subcutaneous nodules and cause a local reaction known as siliconoma. ⋯ This is a rare case of gross migration of silicone to the shins, originating from ruptured breast implants. To our knowledge, there is no previous report of silicone migration to such a distant location. We discuss the common presentation of silicone migration and highlight the importance of awareness among dermatologists and plastic surgeons about this unusual occurrence.
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Clin. Exp. Dermatol. · Jul 2009
An investigation into the blood-flow characteristics of telangiectatic skin lesions in systemic sclerosis using dual-wavelength laser Doppler imaging.
Superficial telangiectases associated with systemic sclerosis may be more responsive to treatment than those deeper in the dermis. We investigated whether dual-wavelength laser Doppler imaging (LDI) is sufficiently sensitive to ascertain the distribution of blood flow within telangiectases and whether blood flow relates to telangiectatic diameter. The perfusion and diameter of 20 telangiectases were measured in superficial and deeper layers of the skin using dual-wavelength LDI. ⋯ Clinically apparent diameters correlated with those of the superficial (r = 0.61, P = 0.01), but not with the deeper blood flow images. Hence, the apparent size of telangiectases at the skin surface does not predict blood flow through the microvessel(s) at deeper levels, and thus clinically apparent size is unlikely to predict treatment response. Dual-wavelength LDI may help predict treatment response.