Dermatology online journal
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A 53-year-old woman presented with an enlarging, tender, ulcerated nodule on her dorsal hand after being scratched by a stray kitten. Histology was consistent with orf parapoxvirus infection. ⋯ Orf is a zoonosis transmitted to humans from sheep and goats by direct contact or by fomites. Transmission by cat scratch has not been previously described in the literature.
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Voriconazole is an extended-spectrum triazole antifungal approved for treatment of invasive fungal infections. The drug has been associated with phototoxicity, presenting as photodistributed eruptions such as macular erythema or pseudoporphyria. We describe a 59-year-old man with acute myeloid leukemia, status-post matched unrelated donor stem cell transplant, who developed fungal pneumonia and was placed on posaconazole. ⋯ Soon after, the patient began working outside and subsequently developed photodistributed, macular erythema of the head, neck, and upper chest. Melanoma and squamous cell carcinoma have developed in patients with chronic treatment with voriconazole. Strict adherence to photoprotective measures can prevent the side effect of phototoxic eruption or prevent recurrence in patients who develop this adverse reaction without having to discontinue voriconazole.
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Dermatol. Online J. · Jan 2011
Letter Case ReportsRetiform purpura in a patient with a history of cocaine use.
There have been rare published cases of retiform purpura related to cocaine use. Levamisole, a common adulterant, has been implicated as the etiologic agent. We describe a female patient, aged 48 years, with cocaine-related retiform purpura involving her face, abdomen, and legs and alert physicians to the dangers of levamisole-contaminated cocaine.
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Primary cutaneous anaplastic large-cell lymphoma (ALCL) is a form of cutaneous T-cell lymphoma that is characterized by solitary or localized nodules or plaques. Histopathologic features include a diffuse, non-epidermotropic infiltrate with cohesive sheets of large anaplastic CD30+ tumor cells. This entity must be distinguished from systemic ALCL with cutaneous involvement and lymphomatoid papulosis. Treatment modalities include clinical monitoring, radiation therapy, and surgical excision, with systemic chemotherapy reserved for disseminated or extracutaneous disease.