Accentuation of ichthyosis vulgaris due to associated leprosy

Shah, Anita; Shah, Sonal; Doshi, H. V.

doi:10.1136/pgmj.49.570.282

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Acquired ichthyosiform dermatoses have been described in association with various medical conditions, including malignancy, specifically non‐Hodgkin’s lymphoma, 4 B‐cell lymphoma and Hodgkin’s disease, 5–6 multiple myeloma, 7 mycosis fungoides, 8 leukemia, and breast, ovarian, 9 cervical, and bronchopulmonary carcinomas. 2 Other conditions, such as sarcoidosis, 10–12 chronic abnormal vitamin A metabolism, 13 essential fatty acid deficiency following intestinal resection, 2 pityriasis rotunda, 3–7 hypothyroidism, eosinophilic fasciitis, 14 leprosy, 15 and Down’s syndrome, 16 have also been discussed in the literature. Certain medication, including nicotinic acid, triparanol, butyrophenones, dixyrazine, cimetidine, clofazimine, 17 etretinate, and isotretinoin, 2 have been associated with an acquired ichthyosiform dermatosis.…”

Section: Discussionmentioning

confidence: 99%

Sympathectomy‐induced ichthyosis‐like eruption

2000

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An 80‐year‐old African–American man, with a past medical history of childhood rheumatic fever, hypertension, coronary artery disease, unstable angina, and asbestosis, underwent cardiac catheterization 37 years ago for unstable angina. The postcatheterization course was complicated by a right brachial arterial thrombosis. A venous brachial bypass graft was placed, with vascular supply to the affected arm restored. Postbypass, the patient recovered full use of the arm, but suffered from persistent arm pain. Surgical sympathectomy was performed 1 year later. The patient has been pain‐free since, but noted soon after sympathectomy, unilateral scaly dry skin, unilateral hypohidrosis of the axilla, and increased temperature sensitivity on the affected limb. In the 37 subsequent years, despite application of emollients, he reported no significant improvements or changes in the skin findings. The patient denied that other family members suffered from similar skin problems. He denied ever having atopy or other skin problems prior to the current episode. On physical examination, dry plate‐like scales were seen on the dorsum of the right hand ( Fig. 1A,B), right shoulder, and upper back, extending to the midline ( Fig. 1C), in an area of distribution supplied by the injured nerves. Mild follicular prominence of the affected extensor arm was also seen as compared with the uninvolved arm (not shown). 1 Patient with fish‐like fine scales on the right hand (a) which are absent on the left hand. (b) Close‐up view of the fish‐like scales on the affected hand. (c) Posterior trunk and shoulder demonstrating ichthyosiform change extending to the midline Bilateral 4‐mm skin punch biopsies were obtained from the skin of the dorsum of the affected hand and unaffected control hand, in identical locations between the first and second digits. Tissue specimens were split and each sent in formalin and glutaraldehyde for routine histology and electron microscopic evaluation, respectively. For electron microscopy specimens, samples were fixed in 3% glutaraldehyde solution, postfixed in ferrocyanide osmium tetroxide, and then samples were dehydrated in graded series of ethanol and embedded in epoxy resin. Ultrathin sections were cut with a diamond knife on Sorval MT‐2b ultramicrotome, mounted on copper grids, and examined in a JEOL EM 100 electron microscope. On routine microscopic evaluation, the affected skin demonstrated a thick hyperkeratotic and compact stratum corneum ( Fig. 2), as compared with the loose basketweave appearance of the stratum corneum of the skin of the control hand ( Fig. 3).A thin and hypodense granular layer with more diffuse and small keratohyaline granules was seen in the affected skin as compared with the control. The overall epidermal thickness, however, appeared unchanged. 2 Biopsy from the affected hand showing a thick compact stratum corneum overlying a thin epidermis, with a stratum granulosum of thickness not commensurate with the thickness of the horn (1 cell layer) 3 Biopsy from the unaffected...

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Section: Discussionmentioning

confidence: 99%

Sympathectomy‐induced ichthyosis‐like eruption

2000

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“…Patients with pseudo‐leprosy, or ichthyosis (from the Greek for “fish”), have prominent scales all over their bodies, usually large and centrally adherent, with loose edges . Often associated with atopy, ichthyosis vulgaris is also a manifestation of several syndromes . Leprosy and pseudo‐leprosy can develop in the same person …”

Section: Sherlock Holmes and Cocainementioning

confidence: 99%

“…20 Often associated with atopy, ichthyosis vulgaris is also a manifestation of several syndromes. 20,21 Leprosy and pseudo-leprosy can develop in the same person. 20…”

Section: Brain-fever: Fever Of the Brain?mentioning

confidence: 99%

Medical references and curiosities in the Sherlock Holmes stories

Kampmann

2019

Medical Journal of Australia

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“…Dans une étude indienne concernant les lésions dermatologiques observées au cours de la lèpre, l'IA était trouvée avec un taux d'incidence voisin de 5 % au cours de la lèpre multibacillaire [2,8]. La survenue d'une IA au cours de la lèpre pourrait être concomitante à la maladie et serait donc aggravée par l'hypohidrose au sein des plaques de la lèpre [9], ou expliquée par la malnutrition chez ces malades issues de milieux socioéconomiques défavorisés [10]. Parfois l'IA survient au décours du traitement antilépreux et serait donc une complication de la prise médicamenteuse notamment la clofazimine.…”

Section: Commentairesunclassified