Introduction. The term “ pustular vasculitis of the hands” described by Strutton for an acute eruption of the hands was recently revisited[1]. “ Neutrophilic dermatosis of the hands” has been preferred. We observe...Introduction. The term “ pustular vasculitis of the hands” described by Strutton for an acute eruption of the hands was recently revisited[1]. “ Neutrophilic dermatosis of the hands” has been preferred. We observed 3 new cases. Observations. Two women and a man, without notable past history, consulted for an acute and painful eruption of both handswith fever. Clinical examination showed erythematous papular or nodular or bullous lesions developed on thenar and hypothenar eminences, and on the finger. Histological findings were predominantly neutrophilic infiltration in the dermis, papillary dermal edema, with or without the presence of leukocytoclastic vasculitis. Diagnosis was Sweet s syndrome. No disease was associated. With indometacine (50- 100 mg per day), all the lesions disappeared rapidly without relapse. Discussion. These 3 cases add to 19 other cases (review of literature) which confirm the existence of a homogenous entity that we think it a localized subset of Sweet s Syndrome, with a fast healing. Our observations are specific by the first localization on thenar and hypothenar eminences and by the excellent response to treatment with a non steroidal antiinflammatory agents such indometacine (50- 100 mg per day). This treatment could be proposed as a first line therapy.展开更多
Background. The presence of inorganic foreign bodies in granulomatous cutaneous lesions is not infrequent. In this paper, we describe the first case of cerium-induced cutaneous granulomatous dermatitis. Case report. A...Background. The presence of inorganic foreign bodies in granulomatous cutaneous lesions is not infrequent. In this paper, we describe the first case of cerium-induced cutaneous granulomatous dermatitis. Case report. A 57-year-old woman seriously burned four years ago presented with papulonodular lesions affecting only the burned areas treated with topical cerium nitrate-silver sulfadiazine cream (Flammacé rium ). Biopsies revealed sarcoidal granuloma associated with exogenous particles. Electron probe X-ray microanalysis demonstrated a high cerium content. Screening for systemic sarcoidosis was negative. The patient was treated with hydroxychloroquine. After four months of follow-up, clinical and histological evidence of decreased infiltrate was noted. Discussion. Cerium nitratesilver sulfadiazine cream (Flammacé rium ) is widely used for the topical treatment of burns. The main effect of cerium is to create superficial calcification, which decreases wound colonization and prevents the formation of granulation tissue (no hypertrophic scar formation) in bur-ns. Prior to our case, no cutaneous side-effects of cerium had been encountered. Inoculation of foreign matter may or may not induce granuloma formation or sarcoidosis in different subjects, according to their immunologic status. The favorable outcome in this case could in fact be due to a change in the pattern of cytokinin production (TH1→ TH2) rather than the effects of hydroxychloroquine therapy.展开更多
文摘Introduction. The term “ pustular vasculitis of the hands” described by Strutton for an acute eruption of the hands was recently revisited[1]. “ Neutrophilic dermatosis of the hands” has been preferred. We observed 3 new cases. Observations. Two women and a man, without notable past history, consulted for an acute and painful eruption of both handswith fever. Clinical examination showed erythematous papular or nodular or bullous lesions developed on thenar and hypothenar eminences, and on the finger. Histological findings were predominantly neutrophilic infiltration in the dermis, papillary dermal edema, with or without the presence of leukocytoclastic vasculitis. Diagnosis was Sweet s syndrome. No disease was associated. With indometacine (50- 100 mg per day), all the lesions disappeared rapidly without relapse. Discussion. These 3 cases add to 19 other cases (review of literature) which confirm the existence of a homogenous entity that we think it a localized subset of Sweet s Syndrome, with a fast healing. Our observations are specific by the first localization on thenar and hypothenar eminences and by the excellent response to treatment with a non steroidal antiinflammatory agents such indometacine (50- 100 mg per day). This treatment could be proposed as a first line therapy.
文摘Background. The presence of inorganic foreign bodies in granulomatous cutaneous lesions is not infrequent. In this paper, we describe the first case of cerium-induced cutaneous granulomatous dermatitis. Case report. A 57-year-old woman seriously burned four years ago presented with papulonodular lesions affecting only the burned areas treated with topical cerium nitrate-silver sulfadiazine cream (Flammacé rium ). Biopsies revealed sarcoidal granuloma associated with exogenous particles. Electron probe X-ray microanalysis demonstrated a high cerium content. Screening for systemic sarcoidosis was negative. The patient was treated with hydroxychloroquine. After four months of follow-up, clinical and histological evidence of decreased infiltrate was noted. Discussion. Cerium nitratesilver sulfadiazine cream (Flammacé rium ) is widely used for the topical treatment of burns. The main effect of cerium is to create superficial calcification, which decreases wound colonization and prevents the formation of granulation tissue (no hypertrophic scar formation) in bur-ns. Prior to our case, no cutaneous side-effects of cerium had been encountered. Inoculation of foreign matter may or may not induce granuloma formation or sarcoidosis in different subjects, according to their immunologic status. The favorable outcome in this case could in fact be due to a change in the pattern of cytokinin production (TH1→ TH2) rather than the effects of hydroxychloroquine therapy.
