Posted by James
Although drug-induced LABD is uncommon, its incidence has been steadily increasing in frequency in recent years. Several drugs have been implicated as the cause of LABD, vancomycin being the most frequent. LABD can occur anytime from 1 day to 1 month following the initial administration of vancomycin. In addition to the usual vesicul- obullous presentation, vancomycin-induced LABD can also appear as erythematous papules, erosions, urticarial lesions, and eczematous patches. The histological features may be similar to other vesi- culobullous diseases, but direct immunofluorescence microscopy commonly demonstrates a characteristic linear band of IgA along the basement membrane zone. Due to the heterogeneous clinical features, LABD must be differentiated from a number of diseases including pemphigus vulgaris, bullous pemphigoid, dermatitis herpetiformis, and erythema multiforme.
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Posted by James
A 45-year-old woman presented with pruritic, multiple, tense vesicles and confluent erythematous papules and plaques on the trunk, inguinal areas, and upper thighs for 3 days (Fig. 1A-C). She had been diagnosed with stomach cancer (stage T4N0M];) and accompanying carcinomatosis peritonei and had received palliative total gastrectomy with segmental resection of the transverse colon in May 2004. Afterwards, she underwent 4 cycles of taxotere- cisplatin chemotherapy to alleviate some of her symptoms and is currently taking oral 5-fluorouracil as maintenance therapy. Due to the carcinomatosis, both of her ureters were invaded by the cancer cells, which subsequently led to hydronephrosis and persistent urinary tract infection of both kidneys. This was treated by the insertion of double J catheters but the procedure also induced a chronic bacteriuric state.
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Posted by James
INTRODUCTION
Linear IgA bullous dermatosis (LABD) is a rare acquired autoimmune skin disorder that presents as subepidermal blisters. It can be diagnosed by confirming the presence of a linear band of IgA along the basement membrane zone on direct immunofluorescence microscopy. Although LABD is usually idiopathic, it may be induced by drugs, malignancies, or infections. Many drugs, such as acetaminophen, amiodarone, furosemide, and phenytoin, have been implicated as the cause; however, vancomycin has been found to be the one most commonly associated. Read the rest of this entry »
Posted by James
Aside from other differential type of ACC, we made a distinction with drug-induced ACC, Adams- Oliver syndrome, Bart syndrome, and traumatic origin ulceration. As there were no signs of syndactyly or transverse nail dystrophy and no defects in the central nervous system, Adams-Oliver syndrome, an ACC with transverse limb defects, can be excluded. Bart syndrome which was first described by Bart in 1996, has to be considered; it represents the combination of congenital epidermolysis bullosa, congenital localized absence of skin affecting the extremities, and shedding or dystrophy of the nails. It sometimes also involves the oral mucous membrane. Our patient did not have any nail abnormality or mucus membranes involvement.
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Posted by James
The patient was diagnosed with ACC, according to the clinical, histologic features and course of the disease. About 80% of ACC cases involve the scalp. Less often, the affected areas include the forearms, knees, trunk, legs and face. The condition encom¬passes a heterogeneous group of disorders with or without associated abnormal physical findings, malformation patterns, genetic disease, or a combination of these. Frieden and Sybert have proposed the classification of ACC on the basis of its associated abnormalities and inheritance patterns.
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Posted by James
A newborn male presented with a large ulcer on the right leg which had been present since birth. There was no significant antenatal or family history. The mother had no specific disease or drug history prior to or during the pregnancy. He was born through normal vaginal delivery at 39 weeks’ gestation with a weight of 3.4 kg. On physical examination, a large ulcer was found, with a length of about 20 cm on the right leg from the knee area to the medial dorsal foot (Fig. 1). The toenails, teeth and mucosa of the mouth were not affected, and there was no blistering anywhere on the body. Read the rest of this entry »
Posted by James
INTRODUCTION
Aplasia cutis congenital (ACC) is defined as a localized or widespread absence of skin at birth. As it was first described by Cordon in 1967, the lesions usually appear as circular oval, sharply outlined ulcer, which result in scarring after they are healed. Almost 80% of aplasia cutis appears in the scalp regions, and only about 10 ~ 15% of ACC involve other areas of the body. In some cases, the lesions can be a sign of embryonic malformation, chromosomal abnormality, or ectodermal dysplasia. Moreover, association with epidermolysis bullosa, intrauterine infection, or specific teratogens has been described. Defects of the skin limited to the lower limbs are very rare. The defects are usually presented as ul- cerations, membranous lesions, or areas of atrophic scarring.
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