RESUMEN
We describe a bacillus Calmette-Guérin (BCG) granuloma that occurred during the course of Kawasaki disease. A 12-month-old male infant with Kawasaki disease had an erythematous indurated plaque with prominent necrotic ulceration at the BCG vaccination site on the left upper arm. Histologic study showed a granulomatous reaction consisting of epithelioid histiocytes, lymphoid cells, and Langhans-type giant cells. No evidence of mycobacterial infection was obtained. The lesion healed completely within 2 weeks without administration of antituberculous agents. We believe that the granulomatous reaction occurred as a result of hypersensitivity to proteins in the BCG vaccine, which appeared after the onset of Kawasaki disease.
Asunto(s)
Adyuvantes Inmunológicos/efectos adversos , Vacuna BCG/efectos adversos , Granuloma/inducido químicamente , Síndrome Mucocutáneo Linfonodular/complicaciones , Úlcera Cutánea/inducido químicamente , Brazo , Biopsia , Granuloma/patología , Humanos , Lactante , Masculino , Síndrome Mucocutáneo Linfonodular/patología , Necrosis , Piel/patología , Úlcera Cutánea/patologíaRESUMEN
A 50-year-old Japanese man had a blue-black patch on the dorsum of his right wrist. Light and electron microscopic study of the lesion revealed dermal melanocytes containing mature melanosomes, predominantly in the upper dermis. This case was diagnosed as acquired dermal melanocytosis confined to the right wrist.
Asunto(s)
Hiperpigmentación/patología , Melanocitos/patología , Muñeca , Células Dendríticas/patología , Epidermis/patología , Humanos , Masculino , Melaninas/análisis , Persona de Mediana EdadRESUMEN
We described a 39-year-old woman with systemic lupus erythematosus who developed 20 dermatofibromas accompanied by more than 30 eruptive benign keratoses while she was receiving systemic corticosteroid therapy. We are not aware of a previous case of multiple dermatofibromas accompanying multiply eruptive keratoses. The autoimmune disease or altered immunity, or both, may have played a role in the pathogenesis of these conditions.
Asunto(s)
Histiocitoma Fibroso Benigno/complicaciones , Queratosis/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Neoplasias Cutáneas/complicaciones , Corticoesteroides/uso terapéutico , Adulto , Diagnóstico Diferencial , Femenino , Histiocitoma Fibroso Benigno/patología , Humanos , Queratosis/patología , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Sistémico/patología , Neoplasias Cutáneas/patologíaRESUMEN
We describe a case of urticarial vasculitis accompanied by erythematous wheals, palpable pupura, and subsequent necrotic ulcerated papular lesions in a patient with type C chronic hepatitis and type II cryoglobulinemia (IgM-kappa and polyclonal IgG). A 56-year-old man developed recurrent urticarial lesions on his lower extremities and trunk. The histology revealed leukocytoclastic vasculitis with perivascular immunoglobulin deposits. Subsequently, multiple reddish papular lesions with necrotic ulcerations appeared on the extensor aspect of his extremities and buttocks. Histology of these lesions showed cryoglobulinemic vasculitis with prominent fibrinoid necrosis of the vascular walls and cryoprecipitate within the vasculature as well as increased hyalinized collagen bundles. These papular lesions have not previously been described as cutaneous necrotizing venulitis to the best of our knowledge. It is suggested that the immune response to hepatitis C virus infection and cryoglobulins may be responsible for severe necrotizing venulitis, resulting in unusual cutaneous lesions.
Asunto(s)
Crioglobulinemia/complicaciones , Hepatitis C/complicaciones , Enfermedades Cutáneas Papuloescamosas/etiología , Urticaria/etiología , Vasculitis/etiología , Enfermedad Crónica , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A 41-year-old woman developed laxity and wrinkling of the skin. This process spread slowly to involve the skin of almost the entire body, without any previous inflammatory skin disorder. The skin of her face, neck, and trunk hung in loose folds, leading to a prematurely aged appearance. One year later she noticed edema on her face and legs. Laboratory studies disclosed low C3 and CH50 serum levels and proteinuria. Skin biopsy specimens revealed extensive loss and fragmentation of dermal elastic fibers. A renal biopsy specimen showed membranoproliferative glomerulonephritis (type 2), and an immunofluorescent study disclosed C3 and IgG deposition in the mesangial matrix and along the glomerular basement membrane. We propose that, in this case, cutis laxa may be related to an abnormal immune response.