Blastomycosis-like pyoderma is a form of pyoderma with variable clinical findings and histopathological features. We present a case series of 39 patients collected over a 35-year period to demonstrate its clinical features and histological findings. The most common clinical presentations found were solitary plaques, solitary nodules, sinuses, crypts, verrucous plaques and discharge, usually on sun-exposed skin. The most common histopathological findings were chronic granulomatous inflammation, suppurative inflammation, sinus and abscess formation, pseudoepitheliomatous hyperplasia, transepidermal elimination and scarring. We discuss its treatment and the recent literature that has focused on its response to acitretin.
A trial of topical timolol solution in a 92-year-old patient with two chronic leg ulcers resulted in rapid healing of the treated ulcer. While this finding needs to be confirmed, topical timolol is a simple, inexpensive therapy that has the potential to help heal refractory wounds. 1 Tang J, Dosal J, Kirsner R. Topical timolol for a refractory wound. J Am Acad Dermatol 2012; 66 (4 Suppl 1): AB12. 2 Tang JC, Dosal J, Kirsner RS. Topical timolol for a refractory wound. Dermatol Surg 2012; 38: 135-138. 3 Drew P, Posnett J, Rusling L. The cost of wound care for a local population in England. Int Wound J 2007; 4: 149-155. 4 Vowden K, Vowden P, Posnett J. The resource costs of wound care in Bradford and Airedale primary care trust in the UK. J Wound Care 2009; 18: 93-94, 96-98, 100 passim.
We present the case of a 43-year-old man with a clinical diagnosis of acute generalised exanthematous pustulosis in the setting of a recent 9-day holiday to Bali, Indonesia, to visit a female partner whom he had visited five times this year for unprotected sexual intercourse and from whom he had contracted a sexually transmitted infection. He also reports having taken some Indonesian cold and flu medications and ibuprofen.
Introduction: Seborrhoeic keratoses are common benign skin lesions often referred for specialist review. Differential diagnosis includes melanocytic lesions and non-melanoma skin cancer. Dermatoscopy is a useful diagnostic tool for identifying seborrhoeic keratosis; however the exclusion of melanoma may still be challenging.Methods: Seborrhoeic keratoses, solar lentigo and lichenoid keratoses seen by a teledermatoscopy service at Waikato Hospital were reviewed. Patients' characteristics and clinical and dermatoscopic features from clinical photographs were recorded.Results: 569 lesions were included: 384 seborrhoeic keratoses, 175 solar lentigo and 10 lichenoid keratoses. These accounted for 20% of all lesions seen during the study period from January 2010 to February 2013. The mean age of the patients was 61 years (range 21-101). Approximately half the lesions were from sun-exposed body parts. Most seborrhoeic keratoses were on the face (147/384, 38%) followed by the chest (14%) and back (13%). The most frequent dermatoscopic findings were cerebriform structures, comedo-like openings and milia-like cysts. Simple reassurance was given for most lesions (515/569, 91%) and cryotherapy was recommended for 5%. Two lesions were biopsied (from face and back) and one excised (face).
Conclusions:Seborrhoeic keratosis are commonly referred for specialist assessment, particularly lesions on the face where the exclusion of malignancy may be difficult. Teledermatoscopy allows for a confident diagnosis in most cases, reducing unnecessary surgical intervention for these benign lesions.A 13-day old presented with multiple crusted, haemorrhagic papules, which were noted at birth, involving his head, neck, arms and legs. He was systemically well. An extensive infection screen was unremarkable. Routine investigations were normal. A skin biopsy from his calf showed features of a Langerhans cell histiocytosis (LCH) with S100 and CD1a positivity. The lesions healed with atrophic scarring within 3 months and the child remains well.Congenital self-healing reticulohistiocytosis is a rare form of LCH. It commonly presents as multiple papules or nodules that are noted at birth or during the neonatal period. The lesions resolve spontaneously. Rarely, skin-only LCH can progress to multisystem disease and therefore long-term clinical follow up and laboratory evaluation is necessary to monitor disease recurrence and progression.
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