Cutaneous Münchausen syndrome with presentation simulating pyoderma gangrenosum

Parent, Dominique; T, Krafft; Noël, Jean Christophe; Askenasi, Robert; Goldschmidt, Denis; Heenen, Michel; Linkowski, Paul

doi:10.1016/s0190-9622(09)80093-5

Cited by 29 publications

(15 citation statements)

References 6 publications

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“…The geometrical localized character of the necrosis associated with the good general condition of the patient led to consideration of dermatitis artefacta as a possible diagnosis (6). However, the history of the disease, the psychiatric opinion, the inaccessibility of some lesions and the relative hand infirmity due to rheumatoid arthritis resulted in the rejection of this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous necrotizing vasculitis after low dose methotrexate therapy for rheumatoid arthritis: A possible manifestation of methotrexate hypersensitivity

et al. 1997

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Large haemorrhagic and necrotic cutaneous lesions developed after two low dose (5 mg) methotrexate injections in a patient suffering from long standing rheumatoid arthritis. Differential clinical diagnosis included factitia dermatitis, infectious processes, pyoderma gangrenosum, rheumatoid neutrophilic dermatitis, necrotizing arteritis and vasculitis. Histological and direct immunofluorescent examinations of skin biopsies supported the diagnosis of leucocytoclastic vasculitis. We discuss the respective roles of methotrexate and rheumatoid arthritis in the outbreak of leucocytoclastic vasculitis. Hypersensitivity is strongly suspected.

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Section: Discussionmentioning

confidence: 99%

Cutaneous necrotizing vasculitis after low dose methotrexate therapy for rheumatoid arthritis: A possible manifestation of methotrexate hypersensitivity

et al. 1997

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“…Ulceration and necrosis may sometimes occur and mimic pyoderma gangrenosum. 34 Lesions caused by repeated blunt trauma are typically accompanied by ecchymosis. 35 The histopathology of factitial panniculitis is highly variable depending on the type of injury and the injected substance.…”

Section: Neutrophilic (Pustular) Panniculitis Associated With Rheumatmentioning

confidence: 99%

“…35 The histopathology of factitial panniculitis is highly variable depending on the type of injury and the injected substance. Early injected lesions usually show a brisk neutrophilic lobular panniculitis with fat necrosis ( Figure 6, A), 34,36,37 which in some cases may be indistinguishable from infective panniculitis. Indeed, secondary infection is not uncommon and needs to be excluded.…”

Section: Neutrophilic (Pustular) Panniculitis Associated With Rheumatmentioning

confidence: 99%

“…33 Some cases demonstrate significant involvement of the dermis and ulceration of the epidermis. 34,37 Membranous fat necrosis and hemorrhage typical of traumatic panniculitis may be found. 34,35 A careful search for foreign materials under regular and polarized light is strongly recommended for all cases showing neutrophilic panniculitis, and is absolutely essential when foreign body giant cells or granulomas are present (Figure 6, B).…”

Section: Neutrophilic (Pustular) Panniculitis Associated With Rheumatmentioning

confidence: 99%

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Neutrophilic Panniculitis: Algorithmic Approach to a Heterogeneous Group of Disorders

Chan

2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Neutrophilic panniculitis encompasses an etiologically and morphologically heterogeneous group of disorders. Correct histopathologic diagnosis is important in identifying certain systemic diseases and guiding appropriate treatment. Objective.—To review the clinical and histopathologic features of different types of neutrophilic panniculitis, and to provide a diagnostic algorithm for these disorders. Data Sources.—A review of the literature with emphasis on the distinguishing features of different entities was performed. Conclusions.—Evaluation for neutrophilic panniculitis entails paying close attention to the pattern of inflammation, the type of fat necrosis present, any evidence of vascular damage, and other relevant histopathologic features. An algorithmic approach integrating all histopathologic, clinical, and laboratory findings is required for correct diagnosis.

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“…Such patients are often employed in a medical setting 2 . Women seem to be more prone than men 3 . We report a case of cutaneous Munchausen's syndrome, in which the foreign materials observed in the dermis histopathologically aid in the diagnosis of this condition.…”

mentioning

confidence: 93%

Cutaneous Munchausen's syndrome caused by self‐injections of fermented beans

Tochigi¹,

Hara

Goshima

et al. 2008

Acad Dermatol Venereol

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References1 Snow JL, Su SP. Lipomembranous (membranocystic) fat necrosis. Clinicopathologic correlation of 38 cases. Am J Dermatopathol 1996; 18: 151-155. 2 Przyjemski CJ, Schuster SR. Nodular-cystic fat necrosis. J Pediatr 1977; 91: 605-607. 3 Hurt MA, Santa Cruz DJ. Nodular-cystic fat necrosis. A reevaluation of the so-called mobile encapsulated lipoma. J Am Acad Dermatol 1989; 21: 493-498. 4 Sahl WJ Jr. Mobile encapsulated lipomas. Formerly called encapsulated angiolipomas. Arch Dermatol 1978; 114: 1684-1686. 5 Kikuchi I. Encapsulated necrosis on the legs showing a changing number of nodules-a pecial type of encapsulated adiponecrosis? J Dermatol 1984; 11: 413 -416. 6 Toritsugi M, Yamamoto T, Nishioka K. Nodular cystic fat necrosis with systemic sclerosis.

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Cutaneous Münchausen syndrome with presentation simulating pyoderma gangrenosum

Cited by 29 publications

References 6 publications

Cutaneous necrotizing vasculitis after low dose methotrexate therapy for rheumatoid arthritis: A possible manifestation of methotrexate hypersensitivity

Cutaneous necrotizing vasculitis after low dose methotrexate therapy for rheumatoid arthritis: A possible manifestation of methotrexate hypersensitivity

Neutrophilic Panniculitis: Algorithmic Approach to a Heterogeneous Group of Disorders

Cutaneous Munchausen's syndrome caused by self‐injections of fermented beans

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