Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Feb 2002
Case ReportsGabapentin treatment of multiple piloleiomyoma-related pain.
Familial leiomyomatosis cutis et uteri may present with numerous cutaneous leiomyomas, or piloleiomyomas, which can be painful. Pharmacologic agents have had limited efficacy in mitigating leiomyoma-associated discomfort. We describe a case of familial piloleiomyomas in which intermittent pain at the site of the lesions was substantially reduced by the administration of oral gabapentin. The unusual unilateral distribution of leiomyomas in this case is discussed.
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J. Am. Acad. Dermatol. · Feb 2002
Case ReportsPrimary hyperoxaluria: report of a patient with livedo reticularis and digital infarcts.
Primary hyperoxaluria encompasses 3 rare genetic disorders of glyoxylate metabolism characterized by excessive urinary excretion of oxalic acid, resulting in oxalosis. Patients typically have recurrent calcium oxalate nephrolithiasis and nephrocalcinosis, leading to chronic renal failure and death from uremia. ⋯ We report a patient who presented with acute renal failure and later experienced livedo reticularis and peripheral gangrene before the diagnosis of primary hyperoxaluria was established. A skin biopsy specimen demonstrated numerous characteristic elongate to diamond-shaped, radially oriented, pale yellow translucent oxalate crystals within the vessels, and vessel walls of the subcutaneous fat that were strongly birefringent under polarized light.
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J. Am. Acad. Dermatol. · Jan 2002
Case ReportsAcral localized acquired cutis laxa associated with rheumatoid arthritis.
We report the first case of the acral localization of the acquired form of cutis laxa associated with severe rheumatoid arthritis. The skin laxity was preceded by episodes of itching and swelling of the hands and feet. Histopathology showed that the elastic fibers were lost in the areas of cutis laxa and decreased in adjacent skin. The pathogenetic relationship with rheumatoid arthritis or the intake of related drugs is discussed.
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Acrocyanosis is an uncommon condition characterized by symmetric coolness and violaceous discoloration of the hands and feet. The nose, ears, lips, and nipples are also often affected. ⋯ We present a very interesting case of a 44-year-old woman with almost lifelong idiopathic acrocyanosis. Differential diagnoses are discussed in this article.
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We present a 64-year-old patient with a 9-cm firm, irregular penile mass associated with phimosis, erectile dysfunction, and voiding difficulty. After he reluctantly admitted to multiple penile mineral oil self-injections for enlargement, surgical excision was performed. Pathologic examination was consistent with mineral oil granuloma (paraffinoma). ⋯ Fortunately, most of these fads have been abandoned by medical professionals, but the complicating lesions have been documented as having lag times as long as 30 years. Complete surgical excision remains the treatment of choice to prevent recurrence. Increased public awareness is needed for the prevention of this physically and psychologically debilitating problem.