We characterize the two main blaschkolinear dermatoses BL and LS sensu stricto morphologically and open new insights into the pathogenesis of these diseases. We propose the concept of a wide spectrum of blaschkolinear dermatoses with BL and LS located somewhere within the spectrum. We do not think that it is helpful for clinicians to enlarge the spectrum of blaschkolinear diseases and to create numerous 'new' entities. Rather, our aim was to unify diseases with similar clinical and histopathological features and common genetic pathomechanisms underlying phenotypic variations.
Expression of CD30 is a distinct marker of lymphocytic activation, originally described in Reed-Sternberg cells of Hodgkin's disease. Recently, the first two cases in which CD30 was expressed in tissue samples derived from superficial cutaneous fungal infections have been reported. The objective of this study was to investigate the expression of CD30 in tinea corporis and to discuss the clinical relevance of CD30. Twenty-three skin biopsies from 23 patients with mycotic infections of the skin were analysed retrospectively. The immunophenotypic expression of CD30 was investigated. In the series investigated, some large CD30-positive cells located in the upper dermal infiltrate were noted in two of 23 biopsy specimens (8.7%). The existence of CD30-positive cells was independent of the density and composition of the accompanying inflammatory infiltrate. We showed that the expression of CD30 in dermatophytoses is not a consistent finding. Instead, as a sign of lymphocytic activation, CD30 expression is observed coincidentally in cutaneous fungal infections. Our data confirm the observation that CD30 antigen is expressed in a variety of benign and malignant skin disorders, including cutaneous fungal infections, probably as an epiphenomenon without clinical relevance.
We report the successful treatment of plaque-like sclerodermiform mucinosis using tacrolimus ointment topically. We present a 70-year-old male with a large chronic erythema and hardening of the nuchal skin and shoulder area. Subjective symptoms were a moderate pruritus and a rather disabling stiffness. A biopsy specimen revealed typical features of lichen myxedematosus. In a subsequent clinical examination, no associated illnesses such as hypothyroidism or gammopathy were found. Since no established therapy exists for this condition, and as there was a lack of response to potent topical glucocorticosteroids, tacrolimus 0.03% ointment was used off-label twice daily. Surprisingly, this resulted in a rapid, almost complete clearance of the skin within three weeks of treatment.
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