Annular Plaques Research Articles

Annular plaque over the scalp with patchy alopecia.

Annular plaque over the scalp with patchy alopecia.

A CASE OF NEAR-FATAL ASTHMA EXACERBATION

A CASE OF NEAR-FATAL ASTHMA EXACERBATION

Artificial pearl-induced penile annular lichen planus

Sir, Annular lichen planus is an uncommonly reported variant of lichen planus, especially on the penis [1]. Herein, we report a case of penile annular lichen planus induced by artificial pearls. A 42-year-old, circumcised male presented to our hospital with asymptomatic, annular lesions of the glans penis. Around one month prior to presentation, he reported a history of inserting artificial pearls inside his penis by stainless steel. He denied a history of drug intake or a personal history of hepatitis C. A physical examination revealed multiple, reddish-purple, annular plaques with central atrophy on the glans penis (Fig. 1a). Inguinal lymph nodes and other mucocutaneous lesions were absent.

Localized Annular Plaques on the Penis and Scrotum

Localized Annular Plaques on the Penis and Scrotum

A Rare Case Presentation of Erythema Annulare Centrifugum-Like Acute Psoriasis

We report a case of erythema annulare centrifugum-like psoriasis occurring in a 44-year-old female. The patient presented with annular erythematous plaques with trailing collarette scales affecting the elbows and antecubital fossae, which are consistent with a clinical diagnosis of erythema annulare centrifugum (EAC). Given the presence of classical clinical features of EAC, this case was notable due to biopsy findings, which revealed classic histologic changes of psoriasis. This finding supports the diagnosis of erythema annulare centrifugum-like psoriasis and represents a rare presentation of acute psoriasis. Treatment with topical mometasone led to rapid and sustained long-term remission.

Misdiagnosis of neutrophilic erythema of infancy as leukocytoclastic vasculitis: A potential diagnostic pitfall in an infantile inflammatory dermatosis.

The authors declare no conflict of interest. The data that support the findings of this study are openly available in NFEI at https://pubmed.ncbi.nlm.nih.gov/. F IGURE 1 Annular erythematous plaques in an infant. Erythematous annular plaque on the right thigh (A) and progression after 3 weeks (B) F IGURE 2 Histopathology of annular erythematous plaque. Punch biopsy specimen from the right leg shows perivascular and interstitial dermal inflammatory infiltrate (A, ×100) primarily composed of neutrophils (B, ×400). Perivascular and interstitial inflammatory infiltrate with primarily neutrophilic inflammation with occasional admixed eosinophils (C, ×400). Leukocytoclasis is present (D, ×400) and definitive vessel wall damage is not observed (A–D)

A Unique Case of Squamous Cell Carcinoma Presenting Within a Lesion of Granuloma Annulare

Granuloma annulare (GA) is a common benign granulomatous inflammatory disorder of the dermis or subcutis with classic morphologic and histologic presentation. Common clinical subtypes of granuloma annulare include localized, generalized, subcutaneous, perforating, and patch types. A biopsy is critical in cases of granuloma annulare with atypical features. We present a case of a 58-year-old male who presented with an annular scaly erythematous plaque on the right dorsal hand. Shave biopsy demonstrated irregular nests of mildly atypical squamous epithelium present within the superficial dermis, with abundant histiocytes and multinucleated giant cells arranged in palisades peripherally. These findings were consistent with invasive well-differentiated squamous cell carcinoma (SCC) with surrounding granuloma annulare. This case highlights a unique presentation in which clinicopathologic correlation is critical prior to arriving at a correct diagnosis.

Relationship between annular calcification of plaques in the carotid sinus and perioperative hemodynamic disorder in carotid angioplasty and stenting

Objective: To investigate the correlation between annular plaque calcification in the carotid sinus and perioperative hemodynamic disorder (HD) in carotid angioplasty and stenting (CAS). MethodsThe clinical data of 49 patients undergoing CAS due to narrowing of the carotid sinus were retrospectively analyzed. All patients had preoperative carotid computed tomography angiography (CTA) and were divided into HD and non-HD groups based on the occurrence of HD in the perioperative period of CAS. HD was defined as persistent bradycardia (heart rate < 60 beats per min) or persistent hypotension (systolic blood pressure < 90 mmHg) in the perioperative period and lasting for at least 1 h. The baseline data, including the degree of carotid artery stenosis, plaque length, plaque thickness, calcified plaque morphologies (i.e., plaque circumferential angle: < 90° defined as dotted calcification; 90°–180° defined as arcuate calcification; > 180° defined as annular calcification), contralateral carotid artery conditions, balloon diameter, and stent types, were compared between the two groups. Binary logistic regression was used to analyze the risk factors for the occurrence of HD. ResultsAmong the 49 patients undergoing CAS, 14 (28.57%) developed perioperative HD, and 35 did not. Annular calcification was more common in the patients in the HD group than in the non-HD group. No significant differences in the probabilities of dotted and arcuate calcifications were found between the two groups (p > 0.05). The duration of continuous dopamine consumption in the HD group was 9–71 h. The average hospital stay of the HD group (10.14 ± 4.17 days) was significantly longer than that of the non-HD group (6.57 ± 1.9 days; p < 0.001). Patients in the HD group had significantly more pronounced lumen stenosis (p = 0.033) and longer plaque length (p = 0.034) than those in the non-HD group. After adjusting for age and sex, multivariate regression analysis showed that the presence of annular plaque calcification was an independent predictor of HD (odds ratio: 7.68, 95% confidence interval: 1.46–40.37, p = 0.016). ConclusionsThe occurrence of annular plaque calcification in the carotid sinus was an independent risk factor for perioperative HD in CAS. Preoperative carotid CTA assists with the early identification of high-risk patients who may develop HD.

Large hypochromic annular plaques on the trunk

Large hypochromic annular plaques on the trunk

Comparison of Safety, Efficacy, and Cost-Effectiveness of Miconazole 2% Versus Sertaconazole 2% in the Treatment of TineaCorporis: A Randomized Control Trial

Tineacorporis is a dermatophytic infection of the body, which involves the keratin layer of the skin. These lesions are present as an annular plaque with an advancing border along with central clearing. Miconazole, a topical antifungal drug and has good efficacy, in anti dermatophyte. Sertaconazole is a highly selective inhibitor of fungal cytochrome P-450 sterol C-14 α-demethylation via the inhibition of the enzyme cytochrome P450 14α-demethylase.It is claimed to be superior to other old topical imidazoles in tineacorporis. .The present study was aimed to compare the safety, efficacy and cost-effectiveness of topical antifungals, where we have compared Miconazole and Sertaconazole 2% creams in the treatment of fungal infection caused by tineacorporis, by assessing the ADR’s and therapeutic outcomes, using comparative, unicentered, randomized, non-blinded trial with 2 parallel treatment arms of one-month duration. In this study 106 patients were randomly assigned into 2 groups of Miconazole 2% cream and Sertaconazole 2% with 54 and 52 patients in each group respectively. Measurement is carried out at baseline, 1st, 2nd and 3rd follow-up for desired effects like itching, erythema, pain and lesions, physician’s global assessment (PGA), safety and cost-effectiveness. The results showed that sertaconazole 2% cream is efficacious and superior to Miconazole 2% cream in the improvement of clinical parameters and PGA. At the end of the follow-up phase, both groups of drugs are effective and well-tolerated in patients with no recurrence of tineacorporis. Effectiveness of SSertaconazole is early and superior with minor side effects. However, Miconazole is cost effective and safe.&#x0D;

Itchy Vesicular Rash.

A 38-year-old woman presented with a rash of 5 days’ duration that initially appeared on the wrists after playing with her kitten, with subsequent involvement of the chest, back, abdomen, and upper and lower extremities. Physical examination revealed multiple annular plaques with raised erythematous borders, rare peripheral vesicles, and superficial central scaling.

Papular variant of actinic granuloma: a case report

Annular elastolytic giant cell granuloma (AEGCG) is an uncommon granulomatous skin disease characterized by giant cells in the dermis phagocytosing damaged elastin fragments, found mostly in areas that are more commonly exposed to sunlight. Asymptomatic annular plaques is the most common clinical presentation, although rare reports of a papular variant of AEGCG exist [1, 2]. We report a case of annular elastolytic giant cell granuloma papular variant with a history of allergies and intensive photodamage.

Nonoccupational Allergic Contact Dermatitis to 4-Acryloylmorpholine in Smartwatch Screen Protectors Glue.

We recently identified an outbreak of occupational allergic contact dermatitis (ACD) involving workers of a Spanish company selling smartphone protective cases from a glue product. A chemical analysis of one glue sample revealed the presence of 4-acryloylmorpholine among other allergens.The same glue is also used to attach tempered glass protective cases to Apple smartwatches. Our objective was to describe a case series of nonoccupational consumer ACD from the previously mentioned Apple smartwatch protective case glue. We evaluated epidemiological and clinical data, as well as patch tests results. Three women were diagnosed with nonoccupational ACD from the adhesive. An annular vesicular inflammatory plaque involving the dorsal aspect of the wrist was initially observed in all. Two of the 3 patients were patch tested with 4-acryloylmorpholine 0.5% with positive strong reactions. Both also strongly reacted to a sample of the glue semiopen tested in a drop of petrolatum. One of them was also positive for various acrylates. 4-Acryloylmorpholine has been identified in an adhesive used to attach protective cases to smartwatches. Nonoccupational ACD have been described to involve consumers of smartwatches. A UV-curable adhesive used to attach protective cases to smartwatches has been considered to be the culprit.

A Connexin Gene (GJB3) Mutation in a Chinese Family With Erythrokeratodermia Variabilis, Ichthyosis and Nonsyndromic Hearing Loss: Case Report and Mutations Update.

Background: Gap junctions formed by connexins are channels on cytoplasm functioning in ion recycling and homeostasis. Some members of connexin family including connexin 31 are significant components in human skin and cochlea. In clinic, mutations of connexin 31 have been revealed as the cause of a rare hereditary skin disease called erythrokeratodermia variabilis (EKV) and non-syndromic hearing loss (NSHL). Objective: To determine the underlying genetic cause of EKV, ichthyosis and NSHL in three members of a Chinese pedigree and skin histologic characteristics of the EKV patient. Methods: By performing whole exome sequencing (WES), Sanger sequencing and skin biopsy, we demonstrate a Chinese pedigree carrying a mutation of GJB3 with three patients separately diagnosed with EKV, ichthyosis and NSHL. Results: The proband, a 6-year-old Chinese girl, presented with demarcated annular red-brown plaques and hyperkeratotic scaly patches on her trunk and limbs. Her mother has ichthyosis with hyperkeratosis and geographic tongue while her younger brother had NSHL since birth. Mutation analysis revealed all of them carried a heterozygous missense mutation c.293G>A of GJB3. Skin biopsy showed many grain cells with dyskeratosis in the granular layer. Acanthosis, papillomatosis, and a mild superficial perivascular lymphocytic infiltrate were observed. Conclusion: A mutation of GJB3 associated with EKV, ichthyosis and NSHL is reported in this case. The daughter with EKV and the son with NSHL in this Chinese family inherited the mutation from their mother with ichthyosis. The variation of clinical features may involve with genetic, epigenetic and environmental factors.

Annual health care utilization and cost of granuloma annulare in the United States, 2016 to 2019: A cross-sectional study

To the Editor: Granuloma annulare (GA) is a granulomatous skin condition characterized by annular erythematous papules and plaques and/or subcutaneous nodules, which may be localized or generalized. The annual incidence in the United States is approximately 0.04%.1 GA is a heterogeneous disease, with some patients having minimal disease and some having more widespread disease; in case series, generalized GA has been reported in approximately 20% to 25% of all patients.2 Numerous treatment modalities are used; however, there is little consensus on appropriate treatment and even fewer well-controlled studies on treatment efficacy.

Placas anulares en el prepucio y el escroto en el contexto de una sífilis secundaria reinfección

Placas anulares en el prepucio y el escroto en el contexto de una sífilis secundaria reinfección

Reactive granulomatous dermatitis: A useful and encompassing term

Reactive granulomatous dermatitis: A useful and encompassing term

Annular elastolytic giant cell granuloma mimicking cutaneous sarcoidosis.

Annular elastolytic giant cell granuloma (AEGCG) is a benign skin disorder, with, unknown cause. It appears as erythematous papules or annular plaques. Few challenging cases of AEGCG have been reported in the literature. We describe a rare clinical presentation of AEGCG mimicking cutaneous sarcoidosis.

A Retrospective Study of 105 Patients with Elastolytic Giant Cell Granuloma and a Proposal for a New Clinical Classification.

Elastolytic giant cell granuloma, an idiopathic granulomatous dermatosis, is characterized by annular plaques on sun-exposed areas, and has been termed actinic granuloma or annular elastolytic giant cell granuloma. Many atypical clinical manifestations and lesions involving sun-protected areas have been reported. The aims of this retrospective study of 105 patients were to summarize the clinical and histological features of patients with this condition; to provide evidence for the viewpoint that elastolytic giant cell granuloma is a better term to include all clinical morphological types presenting with elastolysis, elastophagocytosis, and an infiltrate of multinucleated giant cells histologically; and to establish a new clinical classification. The varying clinical manifestations were further categorized into annular, papular, giant, mixed and generalized forms. The pathological manifestations were classified into giant cell, necrobiotic, histiocytic, sarcoidal and mixed patterns. Diabetes mellitus or impaired glucose tolerance were the most commonly identified comorbidities. Oral low-dose corticosteroid may be an effective treatment.

Erythema annulare centrifugum associated with insulin therapy: a case report

Abstract A 52‐year‐old man with type 2 diabetes presented with peripherally spreading erythematous annular eruptions around the insulin injection sites on the anterior thighs. These lesions appeared shortly after initiation of subcutaneous premix human insulin injection. On examination, two well‐defined annular erythematous plaques of size around 10cm x 5cm with a rim of trailing scale over the margin were seen over the anterior aspect of bilateral thighs. He underwent assessment for diabetic complications screening and other relevant investigations. Histopathological examination of the lesion revealed uninvolved epidermis along with classical coat sleeve appearance of perivascular lymphocytic infiltration and dermal oedema in the upper dermis, which was suggestive of a diagnosis of erythema annulare centrifugum (EAC). The lesions resolved completely in two weeks after stoppage of insulin.Insulin administration is associated with many cutaneous adverse reactions such as lipohypertrophy, lipoatrophy, oedema and allergic reactions. Allergic reactions to insulin may be localised cutaneous ones or systemic ones necessitating stoppage or change of insulin preparation. EAC is an uncommon inflammatory dermatologic condition whose exact aetiology is unknown and most probably represents delayed type hypersensitivity to various allergens. To the best of our knowledge, the association of insulin therapy induced EAC has not been previously reported in the literature. Copyright © 2022 John Wiley &amp; Sons.