Pachydermodactyly is a rare digital fibromatosis that can be misdiagnosed with inflammatory rheumatic diseases. So far in the literature only about 150 cases of PDD have been reported. A prompt clinical diagnosis of the disease would prevent inappropriate treatment and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Gold standard therapy for pachydermodactyly is not established yet.A rare case of a 25 years-old male patient with pachydermodactyly is reported. He complained swelling and thhickening around joints in both hands since 7 months ago. He denied having any pain or morning stiffness of the joints and was also free other symptomatic symptomps. Family history was not significant. Dermatological state showed skin colouredhyperkeratotic patches. Laboratory showed no abnormalities. Radiology results shows no bone and joint abnormalities. Dermoscopy examination on lesion shows whitish scaling and cobblestone appearance. Diagnosis of pachydermodactyly is based on anamnesis, physical examination, laboratory findings, and plain radiograph. Early and correct diagnosis is important to prevent unnececessary, expensive, and invasive diagnostic procedure
In human body, the skin is the largest organ that has the function of mediating contact with the outside world and providing our body first line of defense against all kinds of pathogens, poisons and dangerous environments. The role of skin which are physical and immunological, supported by the microbial community that inhabits the skin. Skin microbiota contributes to barrier function by competing with pathogens and dealing with immune cells in the skin, to modulate local and systemic immune responses. Skin microbiota and immune mediators, for example complement system, have two-way interactions, and this shows that commensal microbes must be considered an important part of healthy skin. Many evidence shows that the composition of microbiota, especially in the intestines and also on the skin, can have a major influence on an individual's health. The influence of gut microbiota and its influence on the immune response has been widely studied, but the link of skin microbiota, immune response and certain skin diseases has not been widely discussed in the literature. Skin microbiota is expected to be affected in certain dermatological conditions, such as in psoriasis and in atopic dermatitis, which further shows the importance of the skin microbial community for human health. Understanding of skin microbiota role in pathogenesis of atopic dermatitis is still needed.
Background: Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis disease of childhood. But due to rarity of non Langerhans cell hystiosis itself, the exact prevalence of juvenile xanthogranuloma remain unknown with only a few epidemiological journal ever published. Juvenile xanthogranuloma usually wihout lipid abnormality and systemic involvement. But association between JXG and lipid abnormalities is still not well understood. We describe a patient with multiple cutaneous JXG who also developed hyperlipidemia. Case: A case of a 8 months-old baby patient with juvenile xanthogranuloma is reported. Patient parents noticed yellowish dots on child’s face since six months ago, and it was gradually increase in size and number, and spread to trunks, upper and lower limb since 2 months ago. Patients got formula milk since 7 months ago. Patients father has uncontrolled hypercholesterolemia, and grandparents had controlled dyslipidemia. Dermatological state showed yellowish plaque and papule on the face, trunk, lower limb, and upper limb. Dermoscopy show yellowish papule with sun setting appearance and branched and linear vessel on orange yellow background. Laboratory finding showed elevated lipid serum. Foam cell and Touton giant cell is found on histopathology examination. Discussion: The presented case demonstrates that skin lesions in patients with diagnosed JXG may have a variable clinical presentation, ranging from single to diffuse skin lesions, also present from the birth to childhood. The diagnosis requires histopathological confirmation to avoid misdiagnosis of malignant disease. Association between JXG and lipid abnormalities remain unknown, with most of the patient show normal lipid serum. Majority of patients presenting lesions limited to the skin requires only a strict dermatological observation.
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