- Skin Conditions -

 

 

Granuloma Annulare

 

granuloma annulare Lorenzo Kunze

Overview

Granuloma annulare is a long-term (chronic) skin disease consisting of a rash with reddish bumps arranged in a circle or ring.

Causes

Granuloma annulare most often affects children and young adults. It is slightly more common in girls.

The condition is usually seen in otherwise healthy people. Occasionally, it may be associated with diabetes or thyroid disease. Its cause is unknown.

Symptoms

Granuloma annulare usually causes no other symptoms, but the rash may be slightly itchy.

Patients usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands, or feet. Occasionally, multiple rings may be found.

Rarely, granuloma annulare may appear as a firm nodule under the skin of the arms or legs.

Tests & diagnosis

Your physician may consider the diagnosis of fungal infection when looking at your skin. A skin scraping and KOH test can be used to tell the difference between granuloma annulare and a fungal infection.

A skin biopsy may also be necessary to confirm the diagnosis of granuloma annulare.

Treatment

Because granuloma annulare is usually asymptomatic (causes no symptoms), treatment may not be necessary except for cosmetic reasons. Using the Thermo-Lo may help reduce the development of granuloma annulare. However, the symptoms may come back after the procedure.

Very strong topical steroid creams or ointments are sometimes used to speed the disappearance of the lesions.

In severe cases, ultraviolet light therapy (PUVA) or oral medications may be needed.

Prognosis

Most lesions of granuloma annulare disappear with no treatment within two years. Sometimes, however, the rings can remain for many years. The appearance of new rings years later is not uncommon.

When to contact a doctor

Call your physician if you notice a ring anywhere on your skin that does not go away within a few weeks.

References

Morelli JG. Diseases of the dermis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap. 658.

 

 

Dermatofibroma

 

 

dermatofibroma - Lorenzo Kunzedermatofibroma - Lorenzo Kunzedermatofibroma - Lorenzo Kunzedermatofibroma - Lorenzo Kunze

 

Overview

Dermatofibroma is a skin condition in which

Alternative Names

Skin growths - fatty;

Causes

X are common, particular... They may appear anywhere on the body, but are most often seen on the elbows, joints, tendons, knees, hands, feet, or buttocks.

X a common type of ... that appears on the eyelids and may occur without any underlying medical condition, is not necessarily associated with elevated cholesterol or lipids.

Symptoms

X looks like a sore or bump under the skin. It's usually flat, soft to the touch, and yellow in color. It has sharp, distinct edges.

Treatment

Using the Thermo-Lo may help reduce the development of .... However, X may come back after the procedure.

Prognosis

The growth is non-cancerous and painless, but may be a sign of another medical condition.

Complications

The growth may cause a change in how you look. This is called cosmetic disfiguring.

References

Erro

 

Xanthoma / Xanthelasma

 

Xanthelasma - Lorenzo Kunze Xanthelasma - Lorenzo Kunze

 

Overview

Xanthoma is a skin condition in which fat builds up under the surface of the skin.

Alternative Names

Skin growths - fatty; Xanthelasma

Causes

Xanthomas are common, particularly among older adults and people with high blood lipids. Xanthomas vary in size. Some are very small, while others are bigger than 3 inches in diameter. They may appear anywhere on the body, but are most often seen on the elbows, joints, tendons, knees, hands, feet, or buttocks.

Xanthelasma palpebra, a common type of xanthoma that appears on the eyelids and may occur without any underlying medical condition, is not necessarily associated with elevated cholesterol or lipids.

Symptoms

A xanthoma looks like a sore or bump under the skin. It's usually flat, soft to the touch, and yellow in color. It has sharp, distinct edges.

Treatment

Using the Thermo-Lo may help reduce the development of xanthomas. However, xanthomas may come back after the procedure.

Prognosis

The growth is non-cancerous and painless, but may be a sign of another medical condition.

Complications

The growth may cause a change in how you look. This is called cosmetic disfiguring.

References

Errors in Metabolism. James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 26.

Massengale WT, Nesbitt LT Jr. Xanthomas. In: Bolognia JL, Jorizzo JL, Rapini RP, eds.: Dermatology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2008: chap 91.

Semenkovich CF. Disorders of Lipid Metabolism. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 217

 

 

Overall References

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Kuroda K, Tajima S. Proliferation of HSP47-positive skin fibroblasts in dermatofibroma. J Cutan Pathol. Jan 2008;35(1):21-6. 

Sellheyer K, Smoller BR. Dermatofibroma: upregulation of syndecan-1 expression in mesenchymal tissue. Am J Dermatopathol. Oct 2003;25(5):392-8. 

Skroza N, Rotolo S, Ceccarelli S, et al. Modulation of the expression of the FGFR2-IIIb and FGFR2-IIIc molecules in dermatofibroma. J Dermatol Sci. Jul 2008;51(1):53-7. 

Kubo M, Ihn H, Yamane K, Tamaki K. The expression levels and the differential expression of transforming growth factor-beta receptors in dermatofibroma and dermatofibrosarcoma protuberans. Br J Dermatol. May 2006;154(5):919-25. 

Yamamoto T. Dermatofibroma: a possible model of local fibrosis with epithelial/mesenchymal cell interaction. J Eur Acad Dermatol Venereol. Apr 2009;23(4):371-5. 

Colome-Grimmer MI, Evans HL. Metastasizing cellular dermatofibroma. A report of two cases. Am J Surg Pathol. Nov 1996;20(11):1361-7. 

Kimyai-Asadi A, Goldberg LH, Greenberg C, et al. Cellular, atypical, and indeterminate dermatofibromas: benign or malignant?. Dermatol Surg. Sep 2008;34(9):1264-71; discussion 1271-2.

Gleason BC, Fletcher CD. Deep "benign" fibrous histiocytoma: clinicopathologic analysis of 69 cases of a rare tumor indicating occasional metastatic potential. Am J Surg Pathol. Mar 2008;32(3):354-62. 

Lopez N, Fernandez A, Bosch RJ, Herrera E. Multiple eruptive dermatofibromas in a patient with Graves-Basedow disease. J Eur Acad Dermatol Venereol. Mar 2008;22(3):402-3

Monteagudo B, Suarez-Amor O, Cabanillas M, et al. [Down syndrome: another cause of immunosuppression associated with multiple eruptive dermatofibromas?]. Dermatol Online J. Sep 15 2009;15(9):15. 

Santos-Juanes J, Coto-Segura P, Mallo S, Galache C, Soto J. Multiple eruptive dermatofibromas in a patient receiving efalizumab. Dermatology. 2008;216(4):363. 

De Unamuno P, Carames Y, Fernandez-Lopez E, Hernandez-Martin A, Pena C. Congenital multiple clustered dermatofibroma. Br J Dermatol. May 2000;142(5):1040-3. 

Naversen DN, Trask DM, Watson FH, Burket JM. Painful tumors of the skin: "LEND AN EGG". J Am Acad Dermatol. Feb 1993;28(2 Pt 2):298-300. 

Niemi KM. The benign fibrohistiocytic tumours of the skin. Acta Derm Venereol Suppl (Stockh). 1970;50(63):Suppl 63:1-66. -

Cox NH. Halo asteatotic eczema localized around a dermatofibroma in acute-onset leg oedema. Br J Dermatol. Aug 2008;159(2):496.

Fitzpatrick TB, Gilchrest BA. Dimple sign to differentiate benign from malignant pigmented cutaneous lesions. N Engl J Med. Jun 30 1977;296(26):1518.

Meffert JJ, Peake MF, Wilde JL. 'Dimpling' is not unique to dermatofibromas. Dermatology. 1997;195(4):384-6.

Samlaska C, Bennion S. Eruptive dermatofibromas in a kindred. Cutis. Mar 2002;69(3):187-8, 190.

Zaballos P, Puig S, Llambrich A, Malvehy J. Dermoscopy of dermatofibromas: a prospective morphological study of 412 cases. Arch Dermatol. Jan 2008;144(1):75-83.

Cavicchini S, Tourlaki A, Tanzi C, Alessi E. Dermoscopy of solitary yellow lesions in adults. Arch Dermatol. Oct 2008;144(10):1412.

Demir MK, Ozdemir H, Genchallaç H, Altaner S, Kartal O. Dermatofibroma mimicking malignancy on integrated F-18 fluorodeoxyglucose PET-CT. Diagn Interv Radiol. Mar 2009;15(1):61-3.

Kideryova L, Lacina L, Dvorankova B, et al. Phenotypic characterization of human keratinocytes in coculture reveals differential effects of fibroblasts from benign fibrous histiocytoma (dermatofibroma) as compared to cells from its malignant form and to normal fibroblasts. J Dermatol Sci. Jul 2009;55(1):18-26.

Nair V, Weinreb I, MacNeil N, Szollosi Z, Chetty R, Ghazarian D. A unique biphasic variant of cutaneous fibrous histiocytoma with a storiform pattern and intralesional pigmented melanocytes: "storiform melano-fibrous histiocytoma". Eur J Dermatol. May-Jun 2008;18(3):332-6..

Goldblum JR, Tuthill RJ. CD34 and factor-XIIIa immunoreactivity in dermatofibrosarcoma protuberans and dermatofibroma. Am J Dermatopathol. Apr 1997;19(2):147-53. 

Kim HJ, Lee JY, Kim SH, et al. Stromelysin-3 expression in the differential diagnosis of dermatofibroma and dermatofibrosarcoma protuberans: comparison with factor XIIIa and CD34. Br J Dermatol. Aug 2007;157(2):319-24. 

Mori T, Misago N, Yamamoto O, Toda S, Narisawa Y. Expression of nestin in dermatofibrosarcoma protuberans in comparison to dermatofibroma. J Dermatol. Jul 2008;35(7):419-25. -

Bandarchi B, Ma L, Marginean C, Hafezi S, Zubovits J, Rasty G. D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans. Mod Pathol. Mar 2010;23(3):434-8. -

Horenstein MG, Prieto VG, Nuckols JD, Burchette JL, Shea CR. Indeterminate fibrohistiocytic lesions of the skin: is there a spectrum between dermatofibroma and dermatofibrosarcoma protuberans?. Am J Surg Pathol. Jul 2000;24(7):996-1003. -

Wang WL, Patel KU, Coleman NM, et al. COL1A1:PDGFB chimeric transcripts are not present in indeterminate fibrohistiocytic lesions of the skin. Am J Dermatopathol. Apr 2010;32(2):149-53. -

Zelger BG, Zelger B. [Dermatofibroma. A clinico-pathologic classification scheme]. Pathologe. Nov 1998;19(6):412-9. -

Gonzalez-Vela MC, Val-Bernal JF, Martino M, Gonzalez-Lopez MA, Garcia-Alberdi E, Hermana S. Sclerotic fibroma-like dermatofibroma: an uncommon distinctive variant of dermatofibroma. Histol Histopathol. Jul 2005;20(3):801-6. -

de Feraudy S, Mar N, McCalmont TH. Evaluation of CD10 and procollagen 1 expression in atypical fibroxanthoma and dermatofibroma. Am J Surg Pathol. Aug 2008;32(8):1111-22. -

Spaun E, Zelger B. Dermatofibroma with intracytoplasmic eosinophilic globules: an unusual phenomenon. J Cutan Pathol. Jul 2009;36(7):796-8. -

Garrido-Ruiz MC, Carrillo R, Enguita AB, Peralto JL. Signet-ring cell dermatofibroma. Am J Dermatopathol. Feb 2009;31(1):84-7. -

Quigley BC, Ricciuti J, Morgan MB. Amyloid Light Chain Deposition Associated with Dermatofibroma: Serendipity or Association?. Am J Dermatopathol. Jan 23 2010;-

Gonzalez S. Regarding the case report of Dr Phillip W. Allen on apocrine gland cyst with hemosiderotic dermatofibroma. Adv Anat Pathol. Nov 2008;15(6):376; author reply 376. -

Shuweiter M, Boer A. Spectrum of follicular and sebaceous differentiation induced by dermatofibroma. Am J Dermatopathol. Dec 2009;31(8):778-85. -

King R, Googe PB, Page RN, Mihm MC Jr. Melanocytic lesions associated with dermatofibromas: a spectrum of lesions ranging from junctional nevus to malignant melanoma in situ. Mod Pathol. Aug 2005;18(8):1043-7. -

Kovach BT, Boyd AS. Melanoma associated with a dermatofibroma. J Cutan Pathol. May 2007;34(5):420-2. -

Orrock JM, Abbott JJ, Gibson LE, Folpe AL. INI1 and GLUT-1 expression in epithelioid sarcoma and its cutaneous neoplastic and nonneoplastic mimics. Am J Dermatopathol. Apr 2009;31(2):152-6. -

Weber PJ, Moody BR, Foster JA. Inverted pyramidal biopsy. Dermatol Surg. Jul 2001;27(7):681-4. -

Krupa Shankar DS, Kushalappa AA, Suma KS, Pai SA. Multiple dermatofibromas on face treated with carbon dioxide laser. Indian J Dermatol Venereol Leprol. May-Jun 2007;73(3):194-5. -

Fernandez-Flores A, Manjon JA. Mitosis in dermatofibroma: a worrisome histopathologic sign that does not necessarily equal recurrence. J Cutan Pathol. Sep 2008;35(9):839-42. -

Aiba S, Terui T, Tagami H. Dermatofibroma with diffuse eosinophilic infiltrate. Am J Dermatopathol. Jun 2000;22(3):281-4. -

Alexandrescu DT, Wiernik PH. Multiple eruptive dermatofibromas occurring in a patient with chronic myelogenous leukemia. Arch Dermatol. Mar 2005;141(3):397-8. -

Aydin E, Vardareli OS, Bilezikci B, Ozgirgin ON. [Dermatofibroma accompanied by perforating dermatosis in the auricle: a case report]. Kulak Burun Bogaz Ihtis Derg. 2005;15(3-4):83-6. -

Curco N, Jucgla A, Bordas X, Moreno A. Dermatofibroma with spreading satellitosis. J Am Acad Dermatol. Dec 1992;27(6 Pt 1):1017-9. -

Evans J, Clarke T, Mattacks CA, Pond CM. Dermatofibromas and arthropod bites: is there any evidence to link the two?. Lancet. Jul 1 1989;2(8653):36-7. -

Fuciarelli K, Cohen PR. Sebaceous hyperplasia: a clue to the diagnosis of dermatofibroma. J Am Acad Dermatol. Jan 2001;44(1):94-5. -

Heenan PJ. Tumors of the fibrous tissue involving the skin. In: Elder D, ed. Lever's Histopathology of the Skin. 8th ed. Philadelphia, Pa: Lippincott-Raven; 1997:847-53.

Hong SB, Yang MH, Lee MH, Haw CR. Dermatofibroma-like atypical granular cell tumour. Acta Derm Venereol. 2005;85(2):179-80. -

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Requena L, Farina MC, Fuente C, et al. Giant dermatofibroma. A little-known clinical variant of dermatofibroma. J Am Acad Dermatol. May 1994;30(5 Pt 1):714-8. -

Sanchez RL. The elusive dermatofibromas. Arch Dermatol. Apr 1990;126(4):522-3. -

Sanchez Yus E, Soria L, de Eusebio E, Requena L. Lichenoid, erosive and ulcerated dermatofibromas. Three additional clinico-pathologic variants. J Cutan Pathol. Mar 2000;27(3):112-7. -

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Wick MR, Ritter JH, Lind AC, Swanson PE. The pathological distinction between "deep penetrating" dermatofibroma and dermatofibrosarcoma protuberans. Semin Cutan Med Surg. Mar 1999;18(1):91-8. -

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