Cosmetic filler agents may be detected and identified during routine ultrasound of dermatological lesions; the latter appear to be pathologically related to the cosmetic procedure.
Infantile systemic hyalinosis and juvenile hyaline fibromatosis are presumably autosomal recessive inherited diseases of unknown origin in which accumulation of an amorphous, hyaline material occurs in the skin and other organs. Both disorders may show clinical overlapping, suggesting that they might represent different variants of the same disease spectrum. We describe a 6-year-old boy with such overlap. Salient features included papular skin lesions on his face and neck, gingival hyperplasia, perianal nodules, large subcutaneous tumors on the scalp, hyperpigmented plaques over the metacarpophalangeal joints and malleoli, limited joint movement, diffuse osteopenia, short stature, and persistent diarrhea. Histopathologic and ultrastructural studies confirmed the presence of hyalin material in the dermis. The term systemic hyalinosis involves both conditions and should be preferred until a clear distinction can be made between them.
Sonography is a noninvasive imaging method that can reliably detect common benign tumors and pseudotumors of the nail and provide precise data about their characteristics. This imaging modality can support diagnosis and surgery and can allow a better definition and improvement of the cosmetic outcome of the treatment.
Background: Plantar warts are common and pain is one of the main symptoms. The anatomical alterations associated with the primary lesion are unclear. Moreover, an adequate separation between the lesion and the surrounding tissue abnormalities could help to better manage this pathology and enable the provision of comprehensive information to physicians and patients. Methods: A color Doppler ultrasound examination was performed on 29 recurrent plantar warts and 10 healthy controls. The morphology and extension of the warts and surrounding soft tissue abnormalities are described. The diagnosis of a plantar wart was correlated with a standard histology in all cases. Statistical analysis was performed by the Student t test. Results: On ultrasound, all warts were recognizable, and sonographic signs of soft tissue inflammation were detected that were associated with the warts: in 79% (23/29) of the cases there was an increase in sublesional arterial blood flow in the dermis, 54% (16/29) had a plantar bursitis, and 52% (15/29) had a focal decrease in subcutaneous echogenicity. No signs of inflammation were seen in the unaffected controls. Conclusion: Ultrasound can provide detailed anatomical data on warts and their inflammatory changes in the surrounding tissues. This noninvasive imaging technique may help to manage difficult cases.
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