Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
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Classic variants of cutaneous borreliosis are erythema chronicum migrans (ECM), lymphadenosis benigna cutis (LBC) and acrodermatitis chronica atrophicans (ACA). Other dermatoses have been reported in the literature as possibly linked to borreliosis. ⋯ Borrelia burgdorferi infection was serologically confirmed by the presence of anti-IgM and anti-IgG antibodies. The clinical spectrum of late cutaneous borreliosis should be enlarged to include livedo racemosa.
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A 29-year-old female patient with an autoimmune subepidermal blistering disease had linear deposits of both IgA and IgG at the basement membrane zone. Clinically, the patient presented with tense blisters on the face, trunk, extremities and oral mucosa. Histologically, we found a subepidermal blister formation and a predominantly neutrophilic infiltrate. ⋯ Indirect immunofluorescence demonstrated circulating IgA and IgG autoantibodies. This case extends previous reports on a subgroup of patients with subepidermal blistering diseases characterized by the presence of both IgA and IgG anti-basement membrane antibodies. These patients reveal clinical, histological and immunopathological features of linear IgA disease and bullous pemphigoid.
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Infections with herpes simplex virus (HSV) type I and type II and varicella/zoster-virus (VZV) are lifelong. The life cycle of the virus - primary infection-latency-endogenous reactivation - determines the clinical features of the diseases, i. e. primary infection and recurrences. During pregnancy, infections with HSV and VZV may induce severe maternal illness that occasionally runs a lethal course. ⋯ Maternal varicella and genital herpes simplex within the perinatal period represent a tremendous risk for the newborn to be infected during delivery; such infection may cause life threatening diseases that have a lethal outcome in more than 50% of affected children. We describe the life cycle of HSV/VZV in infected individuals and the peculiar clinical features of maternal infections during pregnancy. The epidemiological and clinical characteristics of the infected fetus and newborn are highlighted and prophylactic and therapeutic possibilities are discussed.
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Embolia cutis medicamentosa (Nicolau Syndrome) is a very rare complication of intramuscular injections which presents with extensive necrosis of the injected skin area. Intra-arteria and/or para-arterial injections after prior perforation of certain vessels are discussed as possible pathogenetic mechanisms. We describe the occurrence of embolia cutis medicamentosa after intra-articular injections into the knee.
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Case Reports
[Persistent erythema and edema of the face associated with rosacea and lymph vessel dysplasia].
A 24-year-old woman with lymph vessel dysplasia had experienced a progressive edema of her legs since her second year of life and progressive facial edema for the past year. She also had telangiectasias and papules on the background of a diffuse erythema as well as marked seborrhea on her face. Histopathological examination of a representative facial lesion revealed a granulomatous dermatitis with periadnexal distribution mainly consisting of lymphocytes and histiocytes. ⋯ By duplex ultrasound, a diagnosis of a massive edema of the legs without evidence for chronic venous insufficiency was made. The clinical and histopathological findings were consistent with solid persistent erythema and edema of the face associated with rosacea and lymph vessel dysplasia. The chronic course, absence of serological abnormalities and nonspecific histopathological features as well as resistance to therapy are the most important diagnostic criteria of this disease also known as Morbihan's disease.