Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Jul 2008
Review Case ReportsKikuchi's disease: case report and systematic review of cutaneous and histopathologic presentations.
Kikuchi's disease, also known as histiocytic necrotizing lymphadenitis, is a systemic illness with classic clinical findings of cervical lymphadenopathy and fever. Diagnosis is confirmed by lymph node histology, which reveals paracortical foci of necrosis and a histiocytic infiltrate. Kikuchi's disease has been associated with a number of infections, but no single source has been identified. ⋯ Description of the histopathologic findings of skin lesions is limited to single case reports and one case series. We describe a 24-year-old woman with fevers, lymphadenopathy, hepatic and hematologic abnormalities, and a skin eruption involving the face, neck, trunk, and extremities with characteristic lymph node and cutaneous histopathologic findings. We completed a systematic review of the clinical presentations and histopathology of Kikuchi's disease.
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Reiter's syndrome, also known as reactive arthritis, is the classic triad of conjunctivitis, urethritis, and arthritis occurring after an infection, particularly those in the urogenital or gastrointestinal tract. Dermatologic manifestations are common, including keratoderma blennorrhagicum, circinate balanitis, ulcerative vulvitis, nail changes, and oral lesions. Epidemiologically, the disease is more common in men, although cases have also been reported in children and women. ⋯ Clinical presentation, severity, and prognosis vary widely. Treatment is difficult, especially in HIV-positive patients. Prognosis is variable; 15% to 20% of patients may develop severe chronic sequelae.
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J. Am. Acad. Dermatol. · Jul 2008
Case ReportsSarcoidal alopecia as a mimic of discoid lupus erythematosus.
Cicatricial alopecia presents a diagnostic challenge to clinicians. In particular, lesions of cutaneous sarcoidosis of the scalp may resemble discoid lupus erythematosus (DLE). ⋯ These cases highlight the importance of making the correct diagnosis of sarcoidal alopecia versus DLE so that a patient can receive the correct work-up and definitive treatment. These cases illustrate the fact that there should be a low threshold for biopsy of cicatricial plaques on the scalp.
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J. Am. Acad. Dermatol. · Jul 2008
Case ReportsHydroxyethyl starch-induced pruritus relieved by a combination of menthol and camphor.
Hydroxyethyl starch is a key component of many colloid volume expanders used in hypovolemic shock and otologic disease. Pruritus is a common side effect. ⋯ Although classically refractory to treatment with corticosteroids and antihistamines, some benefit has been achieved with capsaicin, ultraviolet light therapy, and oral naltrexone. We present a case responsive to menthol and camphor and discuss the possible therapeutic mechanism.