The British journal of dermatology
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We report the case of a woman who had pain in both heels which was exacerbated by long periods of exercise. On examination, there were small flesh-coloured papules which appeared over the medial and lateral aspects of the heels only on weight bearing. Coincidentally, she was noted to have larger flesh-coloured papules over the anterior surface of the shins. ⋯ A good subjective clinical response was achieved which has been maintained by fortnightly treatments. We discuss the prevalence, pathogenesis and treatment of painful piezogenic pedal papules. We believe that our patient is the first to have 'herniations' at both heel and shin sites and the first to have successful sustained pain relief for painful piezogenic pedal papules.
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Basal cell carcinoma (BCC) is a frequent skin cancer with low metastatic potential. Expression of the anchoring filament proteins, native laminin-5 and its individual alpha 3, beta 3 and gamma 2 chains, uncein. and linear IgA antigen was examined by immunostaining in 17 BCC with different histological subtypes. Immunoreactivity of the hemidesmosomal proteins, integrin alpha 6 beta 4, 230-kDa bullous pemphigoid antigen (BP-230 Ag) and plectin/HD-1, and that of dermal-epidermal junction (DEJ) components, integrin alpha 2 beta 1, laminin-1, collagen IV, and collagen VII was also analysed. ⋯ The labelling of integrin alpha 2 beta 1, laminin-1, collagen IV and collagen VII indicated no alteration in the synthesis of these proteins. In peritumoral lacunae, immunoreactivity of hemidesmosome and anchoring filament proteins was absent, except for plectin/HD-1 on the tumour side and sometimes for laminin-5 on the stromal side, while laminin-1, collagen IV and collagen VII were detected on the stromal side. These findings suggest that the components of the hemidesmosome-anchoring filament complex are not synthetized or assembled properly in BCC, and that the alteration of these adhesion structures may be the cause of peritumoral lacunae.
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Case Reports
Successful treatment for acrodermatitis continua of Hallopeau using topical calcipotriol.
We report a 71-year-old woman who had severe inflammatory acrodermatitis continua of Hallopeau. The administration of local remedies, soft X-rays and a number of systemic treatments resulted only in transient and incomplete resolution of the lesions. The pustules, increased skin fragility, tender oedema and erythema were successfully controlled by the local administration of calcipotriol.
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We report a case of acrodermatitis chronica atrophicans in an 11-year-old girl living in an area endemic for Lyme borreliosis. The diagnosis was first made on the basis of clinical, histopathological and serological findings. Moreover, Borrelia burgdorferi-specific DNA was amplified from lesional skin by polymerase chain reaction. ⋯ The skin changes clearly responded to the therapy, and Borrelia burgdorferi-specific gene segments were no longer detectable by polymerase chain reaction. This is the first report of molecular-proven acrodermatitis chronica atrophicans in childhood. The occurrence of this late skin manifestation of Lyme borreliosis in children is reviewed.