Hereditary progressive mucinous histiocytosis (HPMH) is an extremely rare progressive non-Langerhans cell histiocytic disorder presenting with only cutaneous manifestations. Patients typically ...present with multiple asymptomatic dome-shaped erythematous papules, usually involving the face and upper extremities. Twenty-six cases have been reported worldwide, with no spontaneous regression. Treatment with thalidomide stopped the progression of the disease in two cases. We report a case of progressive mucinous histiocytosis in a 31-year-old female patient with a history of tuberculosis who presented papular lesions on the face that later extended to the hands. She was treated with isoniazid for tuberculosis and isotretinoin for the skin lesions; the improvement was minimal during the next two months, with new lesions appearing on both hands. Thalidomide stopped the progression of the disease. The cause and pathogenesis of HPMH are undetermined. The pathogenesis of HPMH may be similar to that of lysosomal storage disease, considering the intra-cytoplasmic phospholipid deposition in both diseases, in addition to the likelihood of a role of macrophages in triggering the disease. In our patient, tuberculosis may have contributed.
Key Clinical Message
As dermatologists, we must be aware that even limited localized lesions may signal a life‐threatening condition, for which early diagnosis and treatment can improve the ...prognosis.
Bullous pemphigoid is an autoimmune disorder characterized by blister formation. Hypereosinophilic syndrome is a myeloproliferative disorder featuring papules, nodules, urticarial lesions, and blisters. The coexistence of these disorders may highlight the involvement of common molecular and cellular factors. Here, we describe a 16‐year‐old patient with hypereosinophilic syndrome and bullous pemphigoid.
Leukemia cutis is a cutaneous manifestation of leukemia. Herein, we present a rare cutaneous manifestation of leukemia cutis in a patient with myeloid leukemia m5, characterized by hyperpigmented ...red‐to‐brown patches on face and upper trunk. To our knowledge, hyperpigmented patches secondary to leukemia cutis is rarely described in the literature.
Leukemia cutis is a cutaneous manifestation of leukemia. Herein, we present a rare cutaneous manifestation of leukemia cutis in a patient with myeloid leukemia m5, characterized by hyperpigmented red‐to‐brown patches on face and upper trunk. To our knowledge, hyperpigmented patches secondary to leukemia cutis is rarely described in the literature.
COVID‐19 should be considered as a new triggering factor for autoimmune disorders like DM‐lupus overlap syndrome. We recommend that patients presenting with dermatomyositis during this pandemic be ...screened for COVID‐19.
COVID‐19 should be considered as a new triggering factor for autoimmune disorders like DM‐lupus overlap syndrome. We recommend that patients presenting with dermatomyositis during this pandemic be screened for COVID‐19.
Most viral infections can be self-limited, with no requirement for medical intervention. However, the same viruses can cause severe diseases in patients with compromised immunity due to single-gene ...diseases, acquired immune deficiency syndrome, or hematologic malignancies or those receiving immunosuppressive drugs. Occasionally, these immunocompromised patients harbor >1 infectious agent, requiring several concomitant diagnostic tests. We have developed, to our knowledge, a previously unreported whole-transcriptome sequencing–based pipeline that allows virome profiling, quantitation, and expression pattern analysis of 926 distinct viruses by sequencing of RNA isolated from a single lesional skin biopsy. This pipeline can also explore host genetics if there is a Mendelian predisposition to infection. We applied this pipeline to 6 Iranian patients with viral-induced skin lesions associated with immune deficiency secondary to HIV, human T-lymphotropic virus 1, chronic lymphocytic leukemia, and post transplant immunosuppression. In 5 cases, definitive human papillomavirus infections were identified, some caused by multiple viral types. In addition to human papillomavirus, coinfection with other viruses (Merkle cell polyomavirus, cytomegalovirus, and human herpesvirus 4) was detected in some lesions. In 1 case, whole-transcriptome sequencing validated the clinical diagnosis of adult T-cell leukemia/lymphoma in a patient with an initial diagnosis of mycosis fungoides/Sézary syndrome. These findings attest to the power of whole-transcriptome sequencing in profiling the cutaneous virome in the context of compromised immunity.
During the COVID‐19 pandemic, physicians must maintain a high index of suspicion for COVID‐19 in cases of urticarial vasculitis or other forms of urticaria. This is particularly important for acute ...presentations in otherwise asymptomatic individuals and pregnant women, where a prompt approach to the patient can prevent undesirable complications.
During the COVID‐19 pandemic, physicians must maintain a high index of suspicion for COVID‐19 in cases of urticarial vasculitis or other forms of urticaria. This is particularly important for acute presentations in otherwise asymptomatic individuals and pregnant women, where a prompt approach to the patient can prevent undesirable complications.
A 34‐year‐old female patient presented with recurrent bilateral hypopigmented macules on the labia majora. The lesions were treated with topical steroids, which led to mild improvement, but erosive ...plaques developed after discontinuing the treatment. Histopathological findings were compatible with extramammary Paget disease (EMPD), which was treated with radical vulvectomy with no recurrence in the next months of follow‐up.
Non‐specific features of EMPD like hypopigmented macules may lead to misdiagnosis. Awareness, concern, and a high index of suspicion are essential to accomplish early diagnosis and start appropriate treatment, resulting in a better prognosis.
We report two cases of lichen planus following COVID‐19 vaccination in two middle‐aged women, where the first patient presented with lichenplanopilaris (LPP) relapse and development of lichen planus ...14 days after the second dose of AstraZeneca vaccine, and the other patient who had a previous scattered lesion of LP which extended and increased in severity after the first and second dose of Sinopharm. The suggested cause could be due to immune dysregulation and up regulation of T cell lymphocytes which was triggered after COVID‐19 vaccination. What supports our hypothesis that LP had occurred due to COVID‐19 vaccination, is that one of the patients responded successfully to Metronidazole. This means that the infection process after vaccination could be the cause in aggravating LP. To add, one of the suggested mechanisms for the appearance of LP or reactivation of a dormant LPP can be cytotoxic CD8 T‐lymphocytes which increase the secretion of IFN‐γ and IL‐5 cytokines and may also result in basal keratinocytes' apoptosis leading to cutaneous manifestations. This was supported by the efficacy of Tofacitinib that was used in the other patient who presented with reactivation of LPP in addition to LP. Tofacitinib decrease the number of T cell infiltration and adjust IFN expression.
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