Cutis
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Review Case Reports
Cutaneous hyperpigmentation and polyglandular autoimmune syndrome type II.
Primary adrenal insufficiency (Addison's disease) may initially present with cutaneous hyperpigmentation. Addison's disease, when associated with autoimmune thyroid disease and/or insulin-dependent diabetes mellitus, is referred to as polyglandular autoimmune syndrome type II. We present the case of a patient who initially was diagnosed as having Grave's disease and eventually Addison's disease due to persistent cutaneous hyperpigmentation, fatigue, weight loss, hypotension, hyponatremia, peripheral eosinophilia, and positive results of a synthetic corticotropin stimulation test. Addison's disease, polyglandular autoimmune syndrome type II, and cutaneous hyperpigmentation are reviewed.
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The cutaneous histiocytoses are best divided in the Langerhans' cell histiocytoses and non-Langerhans' cell histiocytoses. In the former group, the cells react with S100 and CD1a antibodies, while in the latter group they express a variety of macrophage markers. ⋯ Xanthogranulomas contain a mixture of several different types of histiocytes that also appear in more pure forms as both solitary tumors and disseminated processes. The varying histiocyte morphology provides a unifying concept for non-Langerhans' cell histiocytoses.
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Squamous cell carcinoma of the nail bed is a rare disorder. Metastasis is extremely unusual. ⋯ The tumor was successfully treated by amputation of the involved finger, block dissection of the regional lymph nodes, postoperative irradiation of the involved axilla, and systemic chemotherapy. Early diagnosis by biopsy, especially in patients with recurrent and persistent disease of the nail bed, is recommended, so that treatment can be instituted early while the tumor is confined to its primary site.
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Piezogenic pedal papules are small, occasionally painful, fat herniations that become apparent when weight is placed on the heel. Although the cause is unknown, hereditary factors may play a role. This is the second report of two family members with this condition.
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Self-induced factitial dermatitis, or dermatitis artefacta, is a rare and difficult condition to treat. We present an unusual case of factitious dermatitis with its subsequent severe complications. The clinical features, radiographic findings, histopathologic features, and treatment options are reviewed.