Annular Skin Lesions Research Articles

Establishment of a Mouse Model for Porokeratosis Due to Mevalonate Diphosphate Decarboxylase Deficiency.

Porokeratosis (PK) is an autoinflammatory keratinization disease (AIKD) characterized by circular or annular skin lesions with a hyperkeratotic rim, pathologically shown as the cornoid lamella. Four genes that cause PK are associated with the mevalonate (MV) pathway. In Chinese PK patients, mevalonate diphosphate decarboxylase (MVD) is the most common causative gene. The lack of an animal model has greatly limited research on PK pathogenesis. In this research, we constructed K14-CreERT2-Mvdfl/fl mice using the Cre-LoxP system to create a mouse model for in-depth studies of PK. The Epidermal Mvd gene was knocked out by intraperitoneal injection of Tamoxifen (TAM). Pathology, immunohistochemistry, RNA-seq, and Western Blot analysis were performed. Skin lesions appeared following Mvd deficiency, and pathological examination revealed the characteristic cornoid lamella, as well as cutaneous inflammation. Furthermore, we observed elevated levels of IL-17A and IL-1β, and a decreased Loricrin level in epidermal Mvd-deficient mice. Compared with the wild-type (WT) group, Mvd deficiency activated the expression of lipid metabolism-related proteins. We developed the first mouse model for PK research, enabling further studies on disease development and treatment approaches.

Tumid Lupus Case Report

ABSTRACT Cutaneous lupus erythematosus (CLE) can present with a wide variety of dermatologic manifestations and is broken down into acute, subacute, and chronic subtypes. Tumid lupus, a variant of CLE, is rarely associated with systemic lupus erythematosus. Lesions of CLE and tumid lupus can mimic multiple other dermatologic conditions. We present a case of a patient with tumid lupus who was initially treated for erythema migrans and systemic symptoms suspected to represent Lyme disease. This article is intended for nurse practitioners, nurses, and other clinicians practicing in dermatology, primary care, urgent care, and emergency medicine settings in the care of patients presenting with annular skin lesions.

Annular Skin Lesions in Infancy.

Annular skin lesions have a unique morphology, and the dramatic appearance of these skin eruptions in infants can cause concern to parents and clinicians. Annular lesions appearing during infancy (defined here as birth to one year of age) lend to a broad differential, ranging from benign cutaneous disorders to severe systemic diseases. This review summarizes the pathogenesis, clinical and histopathologic findings, along with management options of possible etiologies for annular skin lesions in infants, including: annular erythema of infancy, neonatal lupus erythematosus, dermatophyte infections, hemorrhagic edema of infancy, and urticaria multiforme.

Annular dermatoses with rheumatologic implications.

A wide variety of cutaneous disorders present with annular (ringlike) skin lesions, and some of them carry rheumatologic implications because they may involve the joints or belong to the spectrum of connective tissue diseases. The diagnosis of an annular rheumatologic skin disease is possible with a correct clinicopathologic correlation, with a correct anamnesis of the patient, with the evaluation of systemic symptoms, laboratory and instrumental investigations, and finally with a cutaneous biopsy.

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Annular skin lesions in infancy.

Annular skin lesions have a unique morphology, and the dramatic appearance of these skin eruptions in infants can cause concern for parents and clinicians. Annular lesions appearing during infancy (defined here as birth to 1 year of age) lend to a broad differential, ranging from benign cutaneous disorders to severe systemic diseases. This review summarizes the pathogenesis, clinical and histopathologic findings, and management options of possible etiologies for annular skin lesions in infants, including annular erythema of infancy, neonatal lupus erythematosus, dermatophyte infections, hemorrhagic edema of infancy, and urticaria multiforme.

A Unique Case of Localized Palmar Erythema Annulare Centrifugum

Figurate erythemas (FE) are a group of diseases defined by the presence of annular or arciform erythematous skin lesions that can occur anywhere on the body. Four different types of figurate erythemas have been described: erythema annulare centrifugum (EAC), erythema gyratum repens (EGR), erythema migrans, and erythema marginatum. While each of these presents with similar morphologies, the clinical and histopathological features are often unique and can aid in the diagnosis. Although the majority of the figurate erythemas are idiopathic, some may be associated with infections, stress, or other diseases. We present a novel case of recurrent figurate erythema in a 27-year-old male that appeared to be exacerbated by hydrochlorothiazide (HCTZ) and social stressors.

Porokeratosis of the vulva: A case report

Porokeratosis is a rare skin disease characterised by annular skin lesions with a thread-like keratotic border, which corresponds to the histological hallmark known as the cornoid lamella. We present an exceptionally rare case involving the vulva of a 47-year-old woman. To the best of our knowledge, there are only two previous case reports of porokeratosis isolated to the vulva. Our histological examination revealed well-developed cornoid lamellae that were each characterised by a thin column of parakeratosis, hypogranulosis and apoptotic keratinocytes in the spinous layer.

Acute hemorrhagic edema: Uncommon features

Acute hemorrhagic edema: Uncommon features

Clinico-etiological analysis of annular skin eruptions: a cross-sectional study from Western Maharashtra

<p class="abstract"><strong>Background:</strong> Annular skin eruptions commonly present in dermatology outpatient department. The most common cause of annular lesions encountered among the adult population in developing nations is dermatophytosis. The aim of the study was to identify risk factors and determine etiology of annular skin lesions after correlation of clinical, pathological, serological and mycological features and to analyze the clinical and laboratory features.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional study was conducted on 103 patients presenting with annular skin eruptions to the Dermatology outpatient/inpatient department of BJ Government Medical College and Sassoon Hospital, Pune during a two year period (2015 to 2017).<strong></strong></p><p class="abstract"><strong>Results:</strong> During a two year period from 2015 to 2017, 103 patients with annular skin eruptions were enrolled. Of these, 67% (65.05%) had superficial dermatophytosis while 16 (15.5%) had Hansens disease. Other groups of sporadic cases found were chronic plaque psoriasis (54.85%), pityriasis rosea (43.9%), pityriasis versicolor (21.9%), secondary syphilis (21.9%), granuloma annulare (21.9%), annular elastolytic giant cell granuloma (11%), Bowens disease (11%), erythema multiforme (11%), porokeratosis (11%) and sarcoidosis (11%). Statistically significant association was found between number, color, site and symptoms in superficial dermatophytosis.</p><p><strong>Conclusions:</strong> This was a novel study that attempted a comprehensive clinico-etiological compilation of annular skin eruptions analyzing a large number of clinical variables and risk factors. Based on the observations, an algorithmic clinical approach has been suggested to facilitate early diagnosis and treatment initiation.</p>

Clonal Expansion of Second-Hit Cells with Somatic Recombinations or C>T Transitions Form Porokeratosis in MVD or MVK Mutant Heterozygotes

Patients with disseminated superficial actinic porokeratosis (DSAP) and linear porokeratosis (LP) exhibit monoallelic germline mutations in genes encoding mevalonate pathway enzymes, such as MVD or MVK. Here, we showed that each skin lesion of DSAP exhibited an individual second hit genetic change in the wild-type allele of the corresponding gene specifically in the epidermis, indicating that a postnatal second hit triggering biallelic deficiency of the gene is required for porokeratosis to develop. Most skin lesions exhibited one of two principal second hits, either somatic homologous recombinations rendering the monoallelic mutation biallelic or C>T transition mutations in the wild-type allele. The second hits differed among DSAP lesions but were identical in those of congenital LP, suggesting that DSAP is attributable to sporadic postnatal second hits and congenital LP to a single second hit in the embryonic period. In the characteristic annular skin lesions of DSAP, the central epidermis featured mostly second hit keratinocytes, and that of the annular ring featured a mixture of such cells and naïve keratinocytes, implying that each lesion reflects the clonal expansion of single second hit keratinocytes. DSAP is therefore a benign intraepidermal neoplasia, which can be included in the genetic tumor disorders explicable by Knudson's two-hit hypothesis.

Annular skin lesions in childhood. Review of the main differential diagnoses

Annular skin lesions in childhood. Review of the main differential diagnoses

Generalised Granuloma Annulare-Uncommon in Clinical Practice

Generalised granuloma annulare is a benign inflammatory dermatosis characterized by dermal papules and annular plaques. It is often clinically confused with other dermatoses particular superficial fungal infection. A man of 50 years came with multiple erythematous, mildly pruritic, firm papules and annular skin lesion over the extremites and back of trunk for the last two years. He was treated with an oral antifungal for several months under diagnosis of tinea corporis without remission. The diagnosis of Generalised Granuloma Annulare was made based on skin biopsy and histopathological examination. Oral Acitretin and topical tacrolimus (0.1%) were administered and after 1 month of follow up period the lesion were started to regress. Complete remission was found after 3 months treatment.
 CBMJ 2016 July: Vol. 05 No. 02 P: 39-42

Dermatophytosis in a Dog Seropositive for Ehrlichia Spp

In this report, we present a case of dermatophytosis in a dog seropositive for Ehrlichia spp.Mild annular skin lesions observed on initial presentation persisted and became worse during the course of antibiotic therapy. Microscopic examination of the fungal culture of skin scrapings revealed infection with Microsporum gypseum. The patient fully recovered following treatment with topical 1% clotrimazole and antifungal shampoo.

Diagnosing rashes, part 9: Annular rashes

Practice NursingVol. 25, No. 5 DermatologyDiagnosing rashes, part 9: Annular rashesJean WatkinsJean WatkinsSearch for more papers by this authorJean WatkinsPublished Online:5 May 2014https://doi.org/10.12968/pnur.2014.25.5.230AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesCyr PR (2006) Diagnosis and management of granuloma annulare. Am Fam Physician 74(10): 1729–34 Google ScholarDermNet NZ (2013a) Pityriasis rosea. http://tinyurl.com/2ueaafj (accessed 4 April 2014) Google ScholarDermNet NZ (2013b) Urticaria. http://tinyurl.com/q8ydjk5 (accessed 7 April 2014) Google ScholarDrago F, Broccolo F, Rebora A (2009) Pityriasis rosea: an update with a critical appraisal of its possible herpesviral etiology. J Am Acad Dermatol 61(2): 303–18. doi: https://doi.org/10.1016/j.jaad.2008.07.045 Crossref, Google ScholarEastham B (2013) Discoid lupus erythematosus. http://tinyurl.com/76d929c (accessed 7 April 2014) Google ScholarHarding M (2014) Chronic urticaria (hives). http://tinyurl.com/q3uj374 (accessed 7 April 2014) Google ScholarHsu S, Le EH, Mohamad R et al. (2001) Differential diagnosis of annular lesions. Am Fam Physician 64(2): 289–97 Google ScholarKnott L (2012) Discoid eczema. http://tinyurl.com/3964fgg (accessed 7 April 2014) Google ScholarLesher JL (2013) Tinea corporis clinical presentation. http://tinyurl.com/pclgm6m (accessed 4 April 2014) Google ScholarLui H (2013) Plaque psoriasis. http://tinyurl.com/76hnby9 (accessed 7 April 2014) Google ScholarMerola JF (2013) Dermatologic manifestations of sarcoidosis. http://tinyurl.com/npmxrj8 (accessed 7 April 2014) Google ScholarNational Institute for Health and Care Excellence (2010) Lyme disease. http://cks.nice.org.uk/lyme-disease (accessed 7 April 2014) Google ScholarNational Institute for Health and Care Excellence (2013) Fungal skin infection—body and groin. http://tinyurl.com/nfgnxfx (accessed 4 April 2014) Google ScholarUnwala R (2014) Approach to the patient with annular skin lesions. http://tinyurl.com/ojdelhg (accessed 4 April 2014) Google ScholarWillard RJ (2012) Erythema annulare centrifugum. http://tinyurl.com/plt3z8k (accessed 7 April 2014) Google Scholar FiguresReferencesRelatedDetails 1 May 2014Volume 25Issue 5ISSN (print): 0964-9271ISSN (online): 2052-2940 Metrics History Received 27 March 2014 Accepted 4 April 2014 Published online 5 May 2014 Published in print 1 May 2014 Information© MA Healthcare LimitedKeywordsAnnular rasheslesionsdifferential diagnosismanagementtreatmentPDF download

A 6-Week-Old Boy with Annular Skin Lesions

A 6-week-old, otherwise healthy boy presented to the dermatology clinic for evaluation of an eruption involving his scalp, face, and trunk. The truncal lesions had been present for several weeks, and the facial and scalp lesions were noticed 5 days prior to presentation. The eruption was asymptomatic without scratching or discomfort noted by his mother. Past medical history was remarkable for preterm delivery due to maternal hypertension during pregnancy. The infant was thriving and gaining weight appropriately. There was no family history of cutaneous or autoimmune disease. No one in the family had a recent tinea infection. On physical exam, he was a well-appearing, vigorous infant. There were multiple erythematous papules and annular plaques involving his left pre-auricular and post-auricular areas, scalp, upper chest, and right abdominal wall (Figures 1 and 2). No other cutaneous or mucus membrane lesions were noted. His cardiac, lung, and abdominal exams were normal.

Eosinophilic annular erythema is a peculiar subtype in the spectrum of Wells syndrome: a multicentre long‐term follow‐up study

Eosinophilic annular erythema (EAE) was proposed to describe annular skin lesions associated with tissue eosinophilia, however, its relation to Well's syndrome (WS) remains a source of controversy. We studied a series of patients to increase awareness of this entity and to clarify its relation to WS. A multicentre study in which the clinical records, histological findings, laboratory results, therapeutic responses and follow-up of 10 patients were demonstrated. The study included seven women and three men with age ranging from 31 to 54 years. The duration of the disease ranged from 3 to 28 months. All patients showed involvement of trunk and extremities. Early lesions were manifested as erythematous plaques, which progressed to well-developed figurate lesions and ended as large annular lesions with pigmented centre and elevated border. Flame figures were only observed in well-developed and long-standing lesions. Blood eosinophilia was found in all patients with different grades. Associated disorders included chronic gastritis, diabetes mellitus, chronic hepatitis-C virus infection and chronic kidney disease. The disease showed chronic course with high relapse rate and resistance to various therapeutic modalities including systemic steroid alone and in combination with hydroxychloroquine and cyclosporine. We believe that EAE is a peculiar clinical variant in the spectrum of WS, which is characterized by a chronic course, resistance to treatment and high relapse rate. The diagnosis and evaluation of this condition need a close monitoring with repeated clinical, histological and laboratory assessment.

Annular, erythematous skin lesions in a neonate

A 7-day-old premature female infant presented with rapidly progressive, erythematous, annular skin lesions from the 5th day of life. She was diagnosed provisionally as a case of neonatal lupus erythematosus and was investigated accordingly. Histopathological examination of the skin biopsy specimen revealed presence of hyphae of dermatophytes in the stratum corneum, and the diagnosis was changed to tinea corporis. Differential diagnosis of the annular erythema of infancy has been discussed and the importance of scraping a scaly lesion for KOH preparation in the diagnostic work-up of such a patient has been highlighted.

Slowly Progressive Annular Skin Lesions in an Elderly Patient

Slowly Progressive Annular Skin Lesions in an Elderly Patient

Slowly Progressive Annular Skin Lesions in an Elderly Patient

Slowly Progressive Annular Skin Lesions in an Elderly Patient