Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Aug 1981
Case ReportsChloroquine-induced remission of nodular panniculitis present for 15 years.
A 62-year-old woman experienced a continuous series of subcutaneous masses of the arms, buttocks, and legs which had resisted treatment for over 15 years. On the arms and buttocks the lesions were nonerythematous and asymptomatic, but those on the lower leg were at times tender and erythematous. ⋯ Bacterial hypersensitivity may have played a role in their pathogenesis since fibrin microclot induction tests showed a marked sensitivity to gram-negative bacteria. Although there was never any clinical, serologic or histologic evidence of lupus, the lesions completely disappeared as a result of long-term low-dose chloroquine treatment.
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J. Am. Acad. Dermatol. · Mar 1981
ReviewClinical evaluation of the patient with bruising and bleeding.
Abnormal bleeding or bruising is frequently encountered in the clinical practice of dermatology. A working knowledge of mechanisms of normal hemostasis, a complete history (general, bleeding, familial), a thorough physical examination, and an appropriate laboratory evaluation are the integral steps in the diagnostic process. Cutaneous bruising and/or bleeding may be a manifestation of a previously unrecognized hereditary coagulation deficiency such as mild hemophilia or von Willebrand's disease (vWD), hereditary or acquired qualitative or quantitative platelet disorder, disturbance of the vascular or supporting structure, or it may be due to one of several acquired systemic disorders.
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Skin specimens from five mummies were examined histologically. The specimens ranged in age from 2,000 to 3,200 years. ⋯ The histology of the three remaining skin fragments retained surprising histologic architectural detail. One specimen obtained from the sole of the foot was compatible with a callus.
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J. Am. Acad. Dermatol. · Oct 1980
Case ReportsDiffuse melanosis in metastatic melanoma. Further evidence for disseminated single cell metastases in the skin.
Electron microscopy (EM) and electron microscopic cytochemistry have shown that diffuse melanosis in advanced metastatic melanoma is the result of an unlimited spread of single melanoma cells throughout the dermis; these cells retain their melanogenic capacity and continue to produce melanized melanosomes which eventually are deposited within dermal macrophages and thus impart to the skin a diffuse slate-blue color. These findings are in accordance with previous observations in a similar patient and thus support the concept that single cell metastasis represents a common pathogenic event in these patients.
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A 58-year-old white man had an enlarging lesion on the sole of the right foot mistakenly diagnosed clinically and histologically as verruca vulgaris. Lack of response to therapy led to a repeat biopsy which showed malignant melanoma, acral lentiginous type, level IV. The lesion was surgically removed, and 11 months later there was no evidence of recurrence. In the differential diagnosis of lesions of the palms and soles, one should include acral lentiginous melanoma, especially if the lesion is pigmented.