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Three cases of papular elastorrhexis
P811
P813
Accessory scrotum presenting as a perineal skin tag: A case report and review of embryologic significance J. B. Foshee, MD, University of Oklahoma, Oklahoma City, OK, United States; Igor Shendrik, MD, University of Oklahoma, Oklahoma City, OK, United States; Paul McQuillen, MD, Jane Phillips Medical Center, Bartlesville, OK, United States; A. Neil Crowson, MD, University of Oklahoma, Oklahoma City, OK, United States
Three cases of papular elastorrhexis Jung Min Bae, MD, Department of Dermatology, Kangnam St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Young Min Park, MD, PhD, Department of Dermatology, Kangnam St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Hyung Ok Kim, MD, PhD, Department of Dermatology, Kangnam St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea Papular elastorrhexis is a connective tissue nevus that occurs in the second decade of life presenting as asymptomatic, small, white-creamy papules. The lesions are usually isolated and scattered over the trunk and extremities. There is typically no history of antecedent trauma, local inflammation, or acne. We report three patients with asymptomatic white, nonfollicular, firm papules scattered over the trunk and face. Histologically, the papules demonstrate focal areas of collagen homogenization with decreased and fragmented elastic fibers. The clinical differential diagnosis includes papular acne scars, dermatofibrosis lenticularis disseminate, cutaneous collagenoma, and nevus anelasticus, but histology clearly separates papular elastorrhexis from the other entities. Papular elastorrhexis is not a well recognized condition, and its exact origin is still unknown. Since 1987, there have been reports of only 14 cases of papular elastorrhexis in the English literature. However, we found 8 cases in the Korean literature, and have recently experienced 3 additional cases over the course of 1 year. Although papular elastorrhexis has been rarely described in the English literature, it is likely that it is not an uncommon condition but has been misdiagnosed as other skin disorders.
Accessory scrotum is defined as scrotal tissue seen in an aberrant location without the presence of testicular tissue. It is a rare congenital malformation that can occur in isolation or in association with other anomalies. Appropriate clinical and histologic evaluation of polypoid lesions in the perineum is necessary in order to differentiate this lesion and assess for anogenital developmental abnormalities. A case of accessory scrotum presenting as a perineal skin tag in a 3-day-old male is reported, along with a discussion of its embryologic significance. Commercial support: None identified.
Commercial support: None identified.
P812 Cutaneous lymphangiectasia associated with photoaging and topical corticosteroid application Young Joon Seo, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea; Sung Ju Baek, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea; Young Lee, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea; Kyung Moon Lee, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea Acquired lymphangioma or lymphangiectasia appears with no evidence of true tumor formation. It has been often associated with the treatment of malignancies of the breast and cervix, surgery, irradiation, keloid, and infection. We report the case of a 69-year-old male with a 1-month history of multiple erythematous bullae on both forearms. For at least 16 years, he had been irregularly applying topical corticosteroids to most of his skin for pruritic rash diagnosed as lichen simplex chronicus or seborrheic dermatitis on clinical grounds, and he had spent more than 40 years of his life as a taxi driver and outdoor worker without protection from sun. A biopsy revealed lymphangiectases with solar elastosis and diminished collagen in dermis, which is not expected in chronic sun damage alone. Topical corticosteroids are known to inhibit the synthesis of collagen by dermal fibroblasts in vitro and in vivo. Usually severe chronic actinic damage in concert with prolonged use of topical corticosteroid may explain the nearly complete replacement of collagen by elastotic tissue in this case. We suggest that this patient’s lymphangiectases resulted from abnormal structure and function of the dermis related to photoaging and steroid application.
P814
Commercial support: None identified.
Commercial support: None identified.
FEBRUARY 2008
A rare case of a porokeratotic eccrine duct and hair follicle nevus Kathryn Quinlan, MD, Henry Ford Hospital, Detroit, MI, United States; Snehal Desai, MD, Henry Ford Hospital, Detroit, MI, United States; Anjeli Laungani, MD, Henry Ford Hospital, Detroit, MI, United States Porokeratotic eccrine duct and hair follicle nevus (PEHFN) is a rare entity characterized by porokeratosis in both the eccrine and hair follicles. We report a case of a 32-year-old healthy male who presented with an intermittently tender growth on the scalp of 1-year’s duration. Exam revealed a flesh-colored depressed plaque with a central keratotic plug. The lesion was excised, and histopathologic evaluation revealed extensive parakeratotic columns with dilated eccrine glandular structures and adjacent hair follicles with cornoid lamellae. Only two previous cases of PEHFN have been reported. Both lesions were congenital. Our case is unique in that the PEHFN arose as a solitary, nonlinear scalp lesion during adulthood, expanding the clinical spectrum of this rare disorder.
J AM ACAD DERMATOL
AB61
P813
Accessory scrotum presenting as a perineal skin tag: A case report and review of embryologic significance J. B. Foshee, MD, University of Oklahoma, Oklahoma City, OK, United States; Igor Shendrik, MD, University of Oklahoma, Oklahoma City, OK, United States; Paul McQuillen, MD, Jane Phillips Medical Center, Bartlesville, OK, United States; A. Neil Crowson, MD, University of Oklahoma, Oklahoma City, OK, United States
Three cases of papular elastorrhexis Jung Min Bae, MD, Department of Dermatology, Kangnam St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Young Min Park, MD, PhD, Department of Dermatology, Kangnam St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Hyung Ok Kim, MD, PhD, Department of Dermatology, Kangnam St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea Papular elastorrhexis is a connective tissue nevus that occurs in the second decade of life presenting as asymptomatic, small, white-creamy papules. The lesions are usually isolated and scattered over the trunk and extremities. There is typically no history of antecedent trauma, local inflammation, or acne. We report three patients with asymptomatic white, nonfollicular, firm papules scattered over the trunk and face. Histologically, the papules demonstrate focal areas of collagen homogenization with decreased and fragmented elastic fibers. The clinical differential diagnosis includes papular acne scars, dermatofibrosis lenticularis disseminate, cutaneous collagenoma, and nevus anelasticus, but histology clearly separates papular elastorrhexis from the other entities. Papular elastorrhexis is not a well recognized condition, and its exact origin is still unknown. Since 1987, there have been reports of only 14 cases of papular elastorrhexis in the English literature. However, we found 8 cases in the Korean literature, and have recently experienced 3 additional cases over the course of 1 year. Although papular elastorrhexis has been rarely described in the English literature, it is likely that it is not an uncommon condition but has been misdiagnosed as other skin disorders.
Accessory scrotum is defined as scrotal tissue seen in an aberrant location without the presence of testicular tissue. It is a rare congenital malformation that can occur in isolation or in association with other anomalies. Appropriate clinical and histologic evaluation of polypoid lesions in the perineum is necessary in order to differentiate this lesion and assess for anogenital developmental abnormalities. A case of accessory scrotum presenting as a perineal skin tag in a 3-day-old male is reported, along with a discussion of its embryologic significance. Commercial support: None identified.
Commercial support: None identified.
P812 Cutaneous lymphangiectasia associated with photoaging and topical corticosteroid application Young Joon Seo, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea; Sung Ju Baek, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea; Young Lee, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea; Kyung Moon Lee, Department of Dermatology, College of Medicine, Chungnam National University, Daejon, South Korea Acquired lymphangioma or lymphangiectasia appears with no evidence of true tumor formation. It has been often associated with the treatment of malignancies of the breast and cervix, surgery, irradiation, keloid, and infection. We report the case of a 69-year-old male with a 1-month history of multiple erythematous bullae on both forearms. For at least 16 years, he had been irregularly applying topical corticosteroids to most of his skin for pruritic rash diagnosed as lichen simplex chronicus or seborrheic dermatitis on clinical grounds, and he had spent more than 40 years of his life as a taxi driver and outdoor worker without protection from sun. A biopsy revealed lymphangiectases with solar elastosis and diminished collagen in dermis, which is not expected in chronic sun damage alone. Topical corticosteroids are known to inhibit the synthesis of collagen by dermal fibroblasts in vitro and in vivo. Usually severe chronic actinic damage in concert with prolonged use of topical corticosteroid may explain the nearly complete replacement of collagen by elastotic tissue in this case. We suggest that this patient’s lymphangiectases resulted from abnormal structure and function of the dermis related to photoaging and steroid application.
P814
Commercial support: None identified.
Commercial support: None identified.
FEBRUARY 2008
A rare case of a porokeratotic eccrine duct and hair follicle nevus Kathryn Quinlan, MD, Henry Ford Hospital, Detroit, MI, United States; Snehal Desai, MD, Henry Ford Hospital, Detroit, MI, United States; Anjeli Laungani, MD, Henry Ford Hospital, Detroit, MI, United States Porokeratotic eccrine duct and hair follicle nevus (PEHFN) is a rare entity characterized by porokeratosis in both the eccrine and hair follicles. We report a case of a 32-year-old healthy male who presented with an intermittently tender growth on the scalp of 1-year’s duration. Exam revealed a flesh-colored depressed plaque with a central keratotic plug. The lesion was excised, and histopathologic evaluation revealed extensive parakeratotic columns with dilated eccrine glandular structures and adjacent hair follicles with cornoid lamellae. Only two previous cases of PEHFN have been reported. Both lesions were congenital. Our case is unique in that the PEHFN arose as a solitary, nonlinear scalp lesion during adulthood, expanding the clinical spectrum of this rare disorder.
J AM ACAD DERMATOL
AB61