Pityriasis rotunda

Abstract

A 50-year-old Angolan woman living in Portugal for 2 years presented to our department with a 1-year history of brownish, scaly round patches on her thighs. Her medical history included type II diabetes mellitus, arterial hypertension and dyslipidaemia for approximately 3 years, active smoking and iron deficiency anaemia due to menstrual losses. She did not have relevant family medical history or any previous skin disease. The lesions appeared 1 month after an episode of inaugural unstable angina that required the introduction of acetylsalicylic acid, ticagrelor, carvedilol and nitroglycerin to her usual medications of atorvastatin, lisinopril and metformin. The patches were asymptomatic, started on one thigh and progressed over months to both thighs and lower back, expanding also in size. Cutaneous examination revealed 15 hyperpigmented well-defined perfectly circular patches 1 to 20 cm in diameter on both thighs, buttocks and also the lower back. These lesions were dry and slightly scaly and had no erythema or induration, and some were coalesced (Fig. 1). There were no other skin, mucosal or adnexal changes. Skin biopsy showed hyperkeratosis, follicular plugging, areas of diminished or absent granular layer, hyperpigmentation of the basal layer and a sparse perivascular infiltrate of lymphocytes in the dermis (Fig. 2). Periodic acid-Schiff stain was negative for fungus. The diagnosis of pityriasis rotunda was made based on the clinical and histopathological features.

Paraneoplastic dermatosis in pediatric and adult patients

“…При ультраструктурном исследо вании биоптатов кожи отмечается наличие внутри эпидермиса липидных вакуолей и кристаллоподобных включений. Зернистый слой редуцирован до одного слоя, также наблюдается большое количество цемен тирующего вещества [81]. Описаны сниженная экс прессия лорикрина и филаггрина в участках поражен ной кожи, полное отсутствие Nконцевого домена профилаггрина и уменьшение экспрессии эпидер мального филаггрина, что также отмечено при вуль гарном ихтиозе, атопическом дерматите и вульгарном псориазе [82].…”