These data indicate that the enhanced expression of TLR2 by infiltrating macrophages and DCs may contribute to the pathogenesis of inflammatory lesions of acne inversa.
A 56-year-old man with type 2 diabetes mellitus presented with a 2-year history of slowly progressing, painless lesions on his fingertips. Physical examination revealed hyperkeratotic papules that were clinically diagnostic of common warts (Panels A and B). Warts are a manifestation of cutaneous infection with human papillomavirus (HPV). To limit the cost of the medical supplies required for fingerstick capillary blood glucose monitoring, the patient had been reusing the same lancet several times per day. Cycling from finger to finger resulted in the sequential inoculation of each fingertip with HPV. The patient was advised not to reuse the skin-prick lancets. After 6 weeks of topical treatment with fluorouracil and salicylic acid preparations, there was substantial improvement in the appearance of the lesions (Panel C).
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