Background Myiasis is a cutaneous infestation by the larvae of dipterous flies. It can be furuncular/nodular, papular, or pustular. Diagnosis of cutaneous myiasis depends mainly on clinical examination especially for the nodular form. The latter two forms can present diagnostic difficulties. Dermoscopy has been reported to be helpful. This report illustrates some of the dermoscopic features of this condition.Methods The history, clinical findings, and dermoscopic findings of 15 affected individuals were documented.Results Dermoscopy in all patients showed the posterior end of larvae (creamy-white bodies and respiratory spiracles resembling birds' legs with digitated feet). Larval motility and bubbles were noticed in 15 and 10 of patients, respectively. Skin surrounding the larvae showed hypopigmentation in 11 patients and an increase in dilated capillaries in 13.Conclusions Dermoscopy can facilitate the diagnosis of myiasis particularly of the papular and pustular forms.
Background: Acral subcorneal hematoma (ASH) is a dark-colored skin lesion of the palms and/or soles due to bleeding. ASH may be difficult to be clinically differentiated from acral melanocytic lesions, resulting in unnecessary biopsies. Few researches reported the importance of dermoscopy in differentiating ASH from acral melanocytic lesions. Purpose: This study aims at reporting the dermoscopic features in a series of ASH to facilitate precise diagnosis and to avoid performing unnecessary surgical techniques. Methods: Eighteen patients with ASH were studied. Dermoscopic images were obtained using a handheld dermoscope and a dermoscope-adopted phone camera. Paring test was performed on all lesions. Results: The preliminary diagnoses of the lesions were ASH in 55.6%, acral melanocytic nevi in 33.3%, and acral lentiginous melanoma in the remaining 11.1%. Dermoscopically, the lesion colors were red-black in 44.4%, black in 27.8%, and brown in the remaining 27.8%. The pigmentation patterns were homogeneous (structureless) in 55.6%, parallel ridge in 27.8%, and negative pseudonetwork in the remaining 16.6%. Over 44% of the lesions had red and/or brown globular satellites. Peripheral red lines with/without radial extensions were noticed around ASH in 55.6%. Paring led to complete removal of pigmentation in all ASH (100%), with the appearance of post-paring blood-tinged serum in 55.6%. No skin biopsies were performed. Conclusion: Although there is clinical similarity between ASH and acral melanocytic lesions, dermoscopy and paring test can facilitate a precise diagnosis and markedly decrease the need for unnecessary invasive procedures.
Varicella zoster is an omnipresent virus which commonly affects childhood as chicken pox. Although the primary infection is self-limiting and seldom severe, the virus remains dormant in the body. The virus resides in the dorsal root or cranial nerve ganglion and reactivation may occur years later as herpes zoster or "Shingles". Herpes zoster (HZ) can occur at any age but is rare in childhood and adolescents. Old aged and immunosuppressed subjects are at risk for developing the disease. The most common area involved in HZ is the trunk (dermatomes innervated by the thoracic nerves) and rarely presents exclusively in the upper extremity. We report a case of HZ isolated to the radial nerve distribution in a healthy 8 years boy. The reported case reveals the importance of considering zoster infection in young age, or uncommon sites when evaluating the onset of pain in a dermatomal distribution specially if associated with vesiculobullous rash.
<p class="abstract">Polymorphic eruption of pregnancy (PEP), also known as pruritic urticarial papules and plaques of pregnancy [PUPPP] is the most common of all the specific dermatoses of pregnancy. It is a benign, self-resolving, pruritic disorder of pregnancy, usually affecting primigravida during the last trimester of pregnancy or immediately postpartum. Its exact pathogenesis is still unknown, and its clinical presentations are variable. It may mimic many common dermatoses. In PEP, the histological findings are non-contributory and the laboratory results, including direct and indirect immunofluorescence are negative. Diagnosis mainly depends on clinical findings. Significant diagnostic confusion may occur with early lesions of pemphigoid gestationis, which needs to be differentiated from PEP as the former may have a bad fetal outcome. PEP is not associated with any fetal or maternal risk, and symptomatic treatment is all that is usually required. The awareness of this condition helps the physician recognize this entity, reassure the patient, and avoid unnecessary investigations. This review focuses on etiology, various clinical presentations, differential diagnosis, and management of PEP.</p>
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