Injectable cutaneous microimplants may occasionally cause either persistent local irritation or late skin reactions in the form of foreign body granulomas at the injected areas. Permanent elimination of the latter is not easily achieved. The skin of a female patient developed nodules along the treated sites on her face a few months following the last session of intracutaneous injections. Intralesional steroids offered temporary and incomplete clearance. Colchicine was administered orally for better results.
Disseminated and recurrent infundibular folliculitis, henceforth referred to as D.R.I.F., is a very rare, puritic, follicular, benign disease of unknown etiology seen mostly in black males. It is often self-limited and usually unresponsive to local or systemic treatment. However, vitamin A, either alone or combined with vitamin E, is occasionally effective. We report a case of a patient with D.R.I.F. treated successfully with isotretinoin.
Connective tissue nevi are benign hamartomas that usually appear as widespread, multiple, papular, skin lesions. They are subdivided into collagen, elastin, proteoglycans and mixed type, depending on their particular histopathologic features, and they often appear as a component of Buschke-Ollendorff Syndrome.
Eosinophilic cellulitis was ¢rst described in 1979 by Wells & Smith (1) as a recurrent granulomatous dermatitis with eosinophilia. It is a rare skin condition usually a¡ecting adults and only a few cases have ever been reported in children. CASE REPORT A 12-year-old girl presented with an erythematous, papular, occasionally pruritic eruption covering both her legs. Her main complaint was aesthetic. The rash consisted of grouped red papules 10^15 mm in size. The patient was afebrile and reported no arthralgia or any other systemic symptoms. She denied any recent arthropod bite, viral or fungal infection, or ingestion of any kind of drug. The eruption had been recurrent since the age of 4 years. Originally only the shins had been a¡ected but gradually, on successive eruptions, the lesions were extending to the thighs. There was no personal or family history of atopy. The physical examination and haematological and biochemical evaluations were normal apart from blood eosinophilia. IgE value and standard RAST tests were normal. The patient had been using topical steroids for nodular prurigo with no bene¢t. Histopathological examination revealed hyperkeratosis in the epidermis and necrosis of the epidermal cells. Marked oedema and focal formation of subepidermal eosinophilic pustules were seen at the papillary dermis. Both normal and basophilic degenerated collagen ¢bres were observed in the dermis covered by eosinophilic granules, i.e. foci consistent with``£ame ¢gures''. In£ammatory in¢ltrate of eosinophils, a few neutrophils, nuclear debris, lymphocytes and histiocytes, the latter forming focal aggregates, was detected among the altered collagen ¢bres. There was also similar perivascular in¢ltrate, although no signs of vasculitis were recognized. PAS stain for fungi was negative. Our patient with a body weight of 49 kg was treated with cetirizine tablets. The initial dose was 10 mg three times daily and 2 weeks later this was reduced to 10 mg once daily for 4 more weeks. The girl felt mild sleepiness only at the beginning of the course. Full recovery was noticed by the end of the fourth week of treatment and some residual hyperpigmentation was the only complaint, which responded quickly to topical treatment with 10% AHA (alpha-hydroxy acids). On follow-up the skin remained clear over a period of 18 months. However, 12 months after discontinuation of the treatment the patient developed insulin-dependent diabetes mellitus type 1.
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