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241


Paraneoplastic erythema annulare centrifugum eruption (PEACE)

Mu, Euphemia W; Sanchez, Miguel; Mir, Adnan; Meehan, Shane A; Pomeranz, Miriam Keltz
Erythema annulare centrifugum (EAC) is a reactive erythema with distinct, annular, erythematous plaques with trailing scale. This condition has been associated with various etiologies, which include an associated malignant condition. EAC with cancers or paraneoplastic erythema annulare centrifugum eruptions (PEACE), is more likely to be associated with lymphoproliferative malignancies such as lymphomas and leukemias. Histopathologic features include a superficial and deep, lymphohistiocytic perivascular infiltrate. We present a patient with a history of diffuse large B cell lymphoma in remission for two years, who presented with a one-year history of EAC.
PMID: 26990337
ISSN: 1087-2108
CID: 2051302

Photodistributed granuloma annulare

Gittler, Julia; Mir, Adnan; Meehan, Shane A; Pomeranz, Miriam Keltz
Annular elastolytic giant cell granuloma (AEGCG) is a controversial entity that is considered by many to be a variant of granuloma annulare (GA). The majority of cases of AEGCG occur in Caucasian women (3:2) between the ages of 40 and 70, with the distribution of the mostly annular lesions favoring exposed areas of skin and rarely involving covered skin. The most common systemic association has been with diabetes mellitus. We present a 52-year-old woman with an asymptomatic, annular, erythematous, photodistributed eruption of two-years duration. As part of her evaluation, it was detected that she had a hemoglobin A1C of 10.3% and a diagnosis of diabetes mellitus was made. We review the literature on the clinical and histopathologic features of GA and AEGCG and the overlap between these entities.
PMID: 26990338
ISSN: 1087-2108
CID: 2051312

IgA vasculitis (Henoch-Schonlein purpura)

Farhadian, Joshua A; Castilla, Carmen; Shvartsbeyn, Marianna; Meehan, Shane A; Neimann, Andrea; Pomeranz, Miriam Keltz
We report the first case of direct immunoflourescence-proven immunoglobulin A (IgA) vasculitis associated with influenza infection in an adult patient. IgA vasculitis, which was previously known as Henoch-Schonlein purpura, is the most common systemic vasculitis in children but rarely occurs in adults. Disease onset often occurs after upper respiratory tract infections that are caused by adenovirus or enterovirus. The American College of Rheumatology defines IgA vasculitis by the presence of any two of the following four criteria: age
PMID: 26990342
ISSN: 1087-2108
CID: 2051352

Lupus miliaris disseminatus faciei

Cymerman, Rachel; Rosenstein, Rachel; Shvartsbeyn, Marianna; Meehan, Shane A; Kornreich, Craig
Lupus miliaris disseminatus faciei (LMDF) is a rare, inflammatory condition, which is characterized by red-brown and yellow-brown papules on the face, with characteristic involvement of the eyelids and with histopathologic findings of suppurative and granulomatous folliculitis and dermatitis. The etiology of this disease is not known, but retinoids, anti-inflammatory, immunosuppressive, and antimicrobial medications are utilized to treat the condition with variable results. We present the case of a patient with LMDF that has thus far been refractory to treatment.
PMID: 26990343
ISSN: 1087-2108
CID: 2051362

Nodular amyloidosis

White, Forrest; Shvartsbeyn, Marianna; Meehan, Shane A; Ramachandran, Sarika
Nodular amyloidosis is the rarest form of primary cutaneous amyloidosis. We report the case of a 74-year-old woman with an eight-year history of asymptomatic, hyperpigmented plaques on the pretibial areas. A skin biopsy specimen showed deposits of amorphous eosinophilic material that extended throughout the dermis with apple-green birefringence with a Congo-red stain, which established a diagnosis of nodular amyloidosis. Patients with nodular amyloidosis should be evaluated for systemic disease and followed appropriately due to a small risk of progression to systemic amyloidosis.
PMID: 26990345
ISSN: 1087-2108
CID: 2051372

Primary diffuse macular amyloidosis

Kanchanapoomi, Melissa; Rosenstein, Rachel; Shvartsbeyn, Marianna; Meehan, Shane A; Dolly, Naomi; Femia, Alisa
We present a 53-year-old woman with diffuse macular amyloidosis. We discuss the clinical manifestations, pathophysiologic mechanisms, and associations of cutaneous macular amyloidosis.
PMID: 26990346
ISSN: 1087-2108
CID: 2051382

Linear atrophoderma of Moulin

Ahearn, Ian M; Gittler, Julia; Shvartsbeyn, Marianna; Meehan, Shane A; Pomeranz, Miriam Keltz
We present a 40-year-old woman with asymptomatic, linear, hyperpigmented atrophic plaques in a Blaschkoid distribution on the right back and right upper extremity that is consistent with a diagnosis of linear atrophoderma of Moulin. Clinical lesions developed with a biphasic pattern in late adolescence and in adulthood. The pathogenesis of this acquired, progressive Blaschkolinear dermatosis may hold insight into the pathogenesis of this rare dermatologic condition, as well as other dermotoses, which include those resulting from post-zygotic genetic mosaicism.
PMID: 26990347
ISSN: 1087-2108
CID: 2051392

Generalized granuloma annulare in a folliculocentric distribution

Rothman, Lisa R; Mir, Adnan; Meehan, Shane A
We present a 69-year-old man with type 2 diabetes mellitus and a five-year history of an eruption of follicular pustules, papules, and nodules, which was identified histopathologically as folliculocentric granuloma annulare (GA). Folliculocentric generalized GA is a rarely reported variant of GA, in which the the palisading histiocytes form focal granulomas in a follicular pattern. In this case, the GA may represent an isotopic phenomenon, with lesions developing in hair follicles that were previously affected by a suppurative folliculitis.
PMID: 26990334
ISSN: 1087-2108
CID: 2051272

Benign familial pemphigus ( Hailey-Hailey disease)

White, Forrest; Shvartsbeyn, Marianna; Meehan, Shane A; Urbanek, Richard W
A 56-year-old man presented with a 15-year history of scaly red plaques on the trunk and axillae. Skin biopsy was consistent with Hailey-Hailey disease. His condition was refractory to multiple therapies, which included topical and oral antibiotics and topical, intralesional, and oral glucocorticoids. Treatment with subcutaneous botulinum toxin type A at the axillae and on the back led to a nearly complete resolution of plaques in those areas. Botulinum toxin type A should be considered in patients with extensive Hailey-Hailey disease who are fail traditional therapies.
PMID: 26990332
ISSN: 1087-2108
CID: 2051252

Angiolymphoid hyperplasia with eosinophilia

Farhadian, Joshua A; Shvartsbeyn, Marianna; Meehan, Shane A; Urbanek, Richard W
Angiolymphoid hyperplasia with eosinophilia is a rare, benign, vascular proliferation that presents as dome-shaped, light-pink-to-red-brown papules or subcutaneous masses that lack distinguishing surface changes. The condition typically presents as a single lesion or multiple lesions that involve contiguous areas. The pathogenesis is poorly understood. Angiolymhpoid hyperplasia with eosinophilia has been associated with antecedent trauma, T-cell proliferation, infection, and hormone imbalance. This report details a case of widespread angiolymphoid hyperplasia with eosinophilia that flared while the patient was pregnant.
PMID: 26990330
ISSN: 1087-2108
CID: 2051232