Yellowish Plaques Research Articles

Effectiveness of Zhuang medicine medicated thread moxibustion on human xanthelasma – a case series

Rationale: Xanthelasma, characterized by yellowish plaques around the eyelids due to lipid deposits, is typically treated through invasive methods like laser therapy or surgery, which often leads to scarring and dyspigmentation. This case series investigates the potential of Zhuang medicine medicated thread moxibustion as a less invasive alternative. Patient Concerns: Three female patients, aged 34, 45, and 55, presented with non-tender, soft yellow plaques near the medial canthi of both upper eyelids. The lesions varied in size and had been present for durations ranging from 6 months to 2 years. These patients expressed concerns about the pain and potential adverse reactions associated with conventional treatments, opting instead for an alternative approach. Diagnoses: Each patient was diagnosed with xanthelasma based on clinical evaluation. Standard diagnostic tests returned normal results, confirming the absence of underlying systemic issues. Interventions: The treatment regimen involved Zhuang medicine medicated thread moxibustion applied at 10-day intervals for a total of three sessions. This traditional method was selected due to its minimally invasive nature. Outcomes: After the first session, patients experienced mild edema, which resolved within 24 h. A significant reduction in the size of the plaques was observed after the second session, and by the third session, there was complete resolution of the plaques. Throughout the treatment and follow-up period of 3 months, no adverse reactions or recurrence of the xanthelasma was noted. Lessons: This case series suggests that Zhuang medicine medicated thread moxibustion could be a safe and effective alternative for the treatment of xanthelasma, avoiding the complications associated with more invasive conventional methods. Further research involving larger sample sizes is recommended to validate these preliminary findings and possibly integrate this method into broader clinical practice.

Pseudoxanthoma Elasticum a Rare Genetic Disorder : A Case Report

Pseudoxanthoma elasticum (PXE) is a rare hereditary condition marked by the accumulation of fragmented and calcified elastic fibers in the body's tissues, leading to skin, vascular, and ocular involvement. In clinical practice, the most prevalent and typically earliest indication of PXE is observed through skin manifestations, which include laxity and the presence of yellowish papules and plaques. Here we report a case of a 40-year-old woman from Nepal presenting with yellowish multiple papules and plaque around the neck and axilla for 20 years, slowly increasing in size and number. A skin biopsy revealed fragmented eosinophilic elastic fibers in the dermis, consistent with PXE. Echocardiography, slit lamp, and indirect ophthalmoscopic examination were done.

P18 Giant Periocular Juvenile Xanthogranulomas Treated with Trametinib

Abstract Juvenile Xanthogranuloma (JXG), the commonest type of non-Langerhans cell histiocytosis, is regarded as a benign self-limiting condition of infancy, characterised by asymptomatic yellow brown papulonodular lesions, usually confined to the skin but occasionally affecting the eyes or internal organs. Skin lesions characteristically regress spontaneously within 3-6 years. We describe an unusually aggressive cutaneous presentation requiring input from paediatric oncology. A 6 year old boy presented with extensive soft yellowish papules, plaques and nodules particularly around the eyes but also over the chest and leg. Biopsy confirmed the clinical diagnosis of JXG. The lesions enlarged progressively with new lesions appearing, causing significant distortion of the upper and lower eyelids with reduced ability to open the eyes, discomfort and distress. Treatment was started with topical steroids, progressing to intralesional and systemic steroids, but with minimal effect. In view of the severity, vinblastine and subsequently cytarabine were added, again with limited benefit. The periocular lesions were surgically debulked and he was commenced on Trametinib (a MEK inhibitor) with a good response. Now aged 9 years, and the patient displayed a favourable clinical response after 3 months of being on Trametinib. JXG rarely requires treatment, but there is no recognised therapy for the occasional problematic lesions. In this case trametinib was effective and well-tolerated. The efficacy of trametinib in histiocytosis has been attributed to the presence of activating BRAF and MAP2K1 mutations. Genetic analysis of JXG may guide future therapies.

Complete Blood Cell Count-Derived Inflammation Biomarkers in Patients with Xanthelasma Palpebrarum.

Xanthelasma palpebrarum (XP) is the most common type of cutaneous xanthoma, characterized by yellowish cutaneous plaques commonly located near the medial canthus of the eyelid. Although dyslipidemia significantly contributes to its development, inflammation is also believed to be another element in the pathogenesis, especially in normolipidemic patients. Recently, cell counts derived from complete blood counts have been identified as indicators of systemic inflammatory conditions and have also been under discussion concerning their relevance to ocular diseases. This study aimed to assess inflammation indices derived from complete blood cell counts (CBC) in XP patients with normal lipid levels. Patients who had been referred to the oculoplasty department with the diagnosis of XP between January 2020 and January 2023 and age-matched control subjects were retrospectively reviewed. Patients who had abnormal lipid profiles and systemic diseases such as diabetes mellitus, hypertension, malignancy, cardiovascular diseases, systemic infections, and inflammatory diseases were not included in the study. CBC parameters were analyzed and compared between the groups. The study comprised 27 normolipidemic patients with XP and 27 age-matched healthy individuals as the control group. There were no statistically significant differences between the two groups in terms of age (p=0.143). The mean hemoglobin, neutrophil, monocyte, lymphocyte, platelet, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, and aggregate index of systemic inflammation values were higher in the patient group, but the differences were not statistically significant (p>0.05). The mean red cell distribution width and platelet-to-lymphocyte ratio appeared to be lower in the patient group compared to the control group; however, no significant differences were observed between the two groups (p=0.272, p=0.387, respectively). This study might offer insights into the pathogenesis of XP, yet numerous questions remain unanswered, awaiting further investigation in future studies.

Case Report: Leathery black plaque on the temple and scalp

Background Epidermal nevus sebaceous, commonly known as the nevus sebaceous of Jadassohn, is a congenital sebaceous hamartoma. It typically manifests as a single yellowish plaque across the head and neck and is composed of sebaceous glands. It commonly occurs during infancy and grows during puberty. Usually, it follows a benign course; however, in a few cases, it can be malignant. This is the case of a 13-year-old child with verrucous plaques on the temple and scalp. Case report We report the case of a 13-year-old boy with a steadily developing hyperpigmented verrucous plaque on the scalp and ipsilateral side of his face. A dermoscopic examination revealed ridges and fissures in a cerebriform pattern with yellowish-gray globules and a papillary appearance. Physical examination and laboratory tests revealed no abnormalities. Biopsies were taken from the scalp and temple area, and the findings were consistent with the diagnosis of nevus sebaceous. The patient was referred to a plastic surgeon for a staged excision. Conclusions We describe a unique example of a sebaceous nevus that affected the scalp and ipsilateral side of the face. As this hamartomatous growth carries the risk of cancer development, a dermatologist must identify the condition and begin treatment before malignant transformation occurs. This example of multiple verrucous plaques is an exception.

Seborrheic dermatitis - pathogenesis, epidemiology and effective treatment - literature review

Introduction: Seborrheic dermatitis (SD) is common inflammatory dermatology disease. It’s affect up to 3-8% of the population. SD is characterized by erythema yellowish plaques and different level of itching and scaling. The last two symptoms are important factors that affect the quality of life of patients. This condition is usually a reaction to growth of Malassezia spp and commonly develop in regions of strong sebaceous glands such as the scalp, facial area, chest, back. Other factors include increased activity of sebaceous glands, immunosuppression, and stress.
 Aim of the study: A review of current stage of knowledge on the pathophysiology, epidemiology of Seborrheic Dermatitis. Recommended management with newest guidelines of this disease. The impact of the Covid-19 pandemic and the use of masks on the incidence of Seborrheic Dermatitis.
 Material and methods: This review was based on available data searched in the PubMed and Google Scholar by using key words: Seborrheic dermatitis, pathophysiology, epidemiology, diagnosis, treatment, clinical presentation, scalp, infant. 
 Conclusion: The Pathogenesis of Seborrheic dermatitis is not fully understood, the exact molecular process needs to be examined. SD is chronic disease with episode of remission and relapse of symptoms. Patients should be informed that ongoing maintenance treatment will be required. Treatment include topical antifungal (ketoconazole, Ciclopirox olamine, zinc pyrithione) and topical anti-inflammatory drugs like mild or mid-strength corticosteroids or calcineurin inhibitors (off-label use). In severe or resistance cases systematic therapy could be necessary. In this situation antifungal drugs (terbinafine, itraconazole) or low dose of isotretinoin are available options. Also new synergic treatments were introduce like cannabinoids or vitamin D which could make therapy more efficiency.

Erythema Elevatum Diutinum: A Rare Dermatosis with an atypical Presentation

EED is a form of chronic cutaneous vasculitis of unknown underlying etiology [1]. EED was named by Henry RadcliffCrocker and Williams in 1894 but discovered earlier in 1878 by Hutchinson. It presents clinically as asymptomatic, firm, erythematous to yellowish papules, nodules, or plaques involving the extensor surface of extremities often over joints [1]. Antigeninduced small vessel vasculitis is believed to be the cause. Various infections and systemic disorders like streptococcal throat infection, tuberculosis, HIV 1, HIV 2, Hepatitis B, Rheumatoid arthritis, ankylosing spondylitis, Sarcoidosis, Crohn’s disease, Ulcerative colitis, Pyoderma gangrenosum, Paraproteinemia, Myelodysplasia, Kaposi’s sarcoma have been reported to be associated [1]. The clinical presentation of EED varies as the lesions progress leading to diagnostic difficulties [1].

Yellowish papules and plaques in the periocular area.

We report a case of a 63-year-old man with concomitant periocular yellowish papules and plaques with symmetric weakness and paraesthesia of the distal limbs.

Myalgia in a Patient with Adult-Onset Asthma with Periocular Xanthogranuloma (AAPOX) due to Myotonic Dystrophy type 2 (P6-8.013)

<h3>Objective:</h3> To report a patient with myotonic dystrophy type 2 (DM2) and an adult-onset asthma with periocular xanthogranuloma (AAPOX). <h3>Background:</h3> AAPOX is a rare systemic non-Langerhans histiocytosis, clinically characterized by periocular yellowish plaques, adult-onset asthma, and lymphadenopathy, and pathologically characterized by non-caseating granulomas consisting of foamy histiocytes and Touton giant cells. The etiology of AAPOX is unknown, but recent studies suggested a possible link to IgG4-related disease. Autoimmune diseases occur in up to 30% of myotonic dystrophy type 2 (DM2) patients but concomitant AAPOX and DM2 have never been reported. <h3>Design/Methods:</h3> Case report. <h3>Results:</h3> A 38-year-old man with hyperlipidemia presented with 1.5-year history of progressive bilateral periorbital swelling and periocular yellowish plaques, 1-year history of asthma and exercise intolerance, and 4-month history of rosuvastatin-associated myalgias and difficulty climbing stairs. Periorbital soft tissue biopsy revealed characteristic pathological features of AAPOX. Neurologic examination revealed neither weakness nor clinical myotonia. Family history was significant for bradyarrhythmia requiring pacemaker in his mother and maternal grandfather. The patient’s creatine kinase was elevated at 606 U/L (normal &lt; 308 U/L). HMGCR-IgG was negative. IgG4 level was normal. Electromyography revealed diffuse myotonic discharges and a mild proximal myopathy without fibrillation potentials. A triceps brachii biopsy showed a marked increase of fibers harboring internal nuclei, scattered pyknotic nuclear clumps, and type 1 fiber smallness without granulomas. Genetic testing revealed a heterozygous CCTG repeat expansion &gt; 15,600 base pairs in intron 1 of <i>CNBP</i>, consistent with a diagnosis of DM2. His cardiac evaluation was unrevealing. The patient was treated with prednisone and methotrexate with improvement of his periocular disease. Myalgias persisted despite discontinuation of rosuvastati <h3>Conclusions:</h3> We first report the cooccurrence of AAPOX and DM2. Our finding supports the increased risk of autoimmune diseases in DM2 patients. <b>Disclosure:</b> Dr. Skolka has nothing to disclose. The institution of Shreyasee Amin has received research support from NIH. Dr. Liewluck has nothing to disclose.

Cutaneous and ocular persistent yellowish plaques: aclinicopathological challenge.

A 65-year-old woman presented with a 2-year history of an erythematous plaque on the right cheek, the patient was also found to have hyperaemia of the nasal bulbar conjunctiva of the right eye. The usefulness of cutaneous and eye dermoscopy in diagnosis when clinical presentation is challenging is discussed.

An evaluation of quality of life (OHIP-14) in facial adenocarcinoma patient with adjuvant therapy: case report

Adenocarcinoma is a type of carcinoma that begins from the glands. Impovement in management of head and neck cancer have resulted in decreased mortality, increased survival rates and patient’s quality of life. The World Health Organization defines quality of life are include three things, physical function, mentalstatus and ability to socially interact. It is reported a 19-year-old male with a history of right infraorbital adenocarcinoma who had undergone hemimaxillectomy,chemotherapy and radiotherapy. The patient complains painful swallowing and soreness in the oral cavity. Extraoral examination face and eyes was asymmetrical,there was keloid tissue in the right infraorbital and dry lips. Intraoral examination found white plaque on the upper labial mucosa, the left buccal mucosa had severalerythematous lesions and brownish macules. Yellowish white plaque on the anterior two-third of the tongue’s dorsum and there are fissures. Necrotic area on ​​right hard palate with yellowish margin. The teeth at first region are edentulous, whereas regions 2, 3 and 4 most of them are radix. The patient’s quality of life was assessed using the oral health impact profile (OHIP-14). Based on the assessment, the patient's quality of life at the first visit was poor with score 45, the next visit showed improvement with score 39, reduced in pain, improved physical and psychological abilities. It s concluded that oral and dental health is an important thing that can improve the quality of life of patients with infraorbital adenocarcinoma which is supported by good communication between doctors and patients.

PSAT186 Iatrogenic Calcinosis Cutis in a Patient With Postsurgical Hypoparathyroidism

Abstract Clinical Case A 44-year old woman, diagnosed with post-surgical hypoparathyroidism after total thyroidectomy for papillary thyroid carcinoma, was admitted for symptomatic hypocalcemia. On admission, she had positive Trousseau's and Chvostek's signs, carpopedal spasm and prolonged QT interval on ECG. She had an initial serum ionized calcium of 0.70 mmol/L (RI: 1.09- 1.30). Serum phosphorus was also elevated at 5.8 mg/dL (RI: 2.6-4.7). She was given 2 grams of calcium gluconate via slow IV push and was hooked to calcium gluconate drip, 4 grams in 250 cc D5W to run for 8 hours In less than 24 hours, she developed thrombophlebitis on her right hand, hence the drip was shifted to the left hand. The new IV site also developed phlebitis, necessitating transfer to the right antecubital area. The areas of phlebitis were managed with cold compress, pain relievers, topical antibiotics overlapped with oral antibiotics. She continued receiving calcium gluconate IV drips overlapped with calcium and calcitriol tablets until her serum calcium level normalized. She was discharged stable and improved after 4 days but still with erythema over her previous IV sites. However, 3 weeks after discharge, she developed yellowish erythematous plaques and nodules over her previous IV sites. She consulted with a dermatologist who did a skin punch biopsy showing a granulomatous dermatitis, foreign body type, which confirmed the diagnosis of iatrogenic calcinosis cutis. She was treated with pulse dye laser and intra-lesional triamcinolone, oral antibiotics and pain medications. At present, she still has pain, tenderness, with limitation of movement on both hands. She was referred to a plastic surgeon where she was advised to undergo a total of 3 surgeries over a span of 3-6 months. These would involve the placement of tissue expanders, harvesting of flaps, removal of lesions and reconstruction of scars plus hand rehabilitation after the surgeries. Conclusion Iatrogenic calcinosis cutis is a rare complication from extravasation of calcium-containing solutions during intravenous calcium correction. It appears 2-3 weeks after extravasation and has no definitive treatment. In other case reports, it can be managed conservatively but some may require reconstructive surgery. Prevention of extravasation is the only way to avoid this rare and debilitating condition.Reference: Jiménez-Gallo D, Ossorio-García L, Linares-Barrios M. Calcinosis Cutis and Calciphylaxis. Actas Dermosifiliogr. 2015 Dec;106(10): 785-94. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Primary amyloidosis of conjunctiva.

A 64-year old male presented in ophthalmology OPD for follow up for refractive errors. He had been wearing bifocal lenses from last 1 year. On local examination, medial canthus of left eye showed a pale yellowish plaque. The rest of the ocular examination and contralateral eye were normal. Slit lamp examination showed a confluent fusiform papule (Figure 1A,B). Computed tomography (CT) scan of the orbit showed no abnormality. Surgical excision was done and tissue sent for histopathological examination showed deposition of a pink homogeneous material in the fibrocollagenous tissue beneath the conjunctival epithelium (Figure 1,C). Congo red stain followed by polarizing microscopy confirmed the pink material to be amyloid with apple green birefringence (Figure 1D,E). Immunohistochemistry (IHC) showed lambda light chain restriction. A diagnosis of conjunctival amyloidosis was made. The patient was then evaluated to rule out systemic amyloidosis or plasma cell dyscrasia. The patient was asymptomatic with no history of trauma, systemic illness, and family history was non-contributory. General and systemic examinations were unremarkable. Complete hemogram, urea, creatinine, liver function test, erythrocyte sedimentation rate, blood glucose, and serum calcium were within normal limits. No abnormality was detected on skeletal survey, electrocardiography, 2D-echocardiography, and ultrasonography of abdomen. Serum protein electrophoresis, serum immunofixation electrophoresis, serum free light chain assay, 24-h urine protein, and urine protein electrophoresis were non-contributory. Bone marrow showed mildly increased plasma cells without light chain restriction on immunohistochemistry. Finally, a diagnosis of primary conjunctival amyloidosis was made and the patient was asked to follow up. Conjunctival amyloidosis occurs secondary to local inflammation and primary form of the disease is very rare. In a previous series published on ocular amyloidosis, only two of 26 ocular cases collected over 30 years had conjunctival involvement. Identification of the disease is a daunting task owing to protean manifestations. Differentiating it from conjunctival inflammation and malignancies is essential. Evaluation for systemic causes is important as the treatment modalities are completely different. While localized form might just need observation or surgical debulking, systemic AL amyloidosis or myeloma would necessitate administration of specific chemotherapy. A long-term follow up is also necessary as recurrence is a known phenomenon and evolution into systemic disease is also a possibility. Concepts design, definition of intellectual content, Literature search, data analysis, manuscript preparation, and manuscript editing: Karuna Jha. Concepts design, definition of intellectual content, manuscript editing: Maitreyee Bhattacharyya. Dr Bhaskar Mitra, Consultant Pathologist, Tribedi and Roy Lab, Kolkata. The authors declare they have no conflicts of interest. The authors received no specific funding for this work. No research on human was performed on this study. Informed consent was taken from the patient. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Species composition and identification of pathogens of real powdery mildew of pumpkin crops

When cultivating pumpkin crops in most agricultural regions of the world, one of the most aggressive diseases is real powdery mildew, the damage of plants in which, under optimal soil and climatic conditions for the pathogen, reaches 100%. In the open and protected ground, among the cultivated representatives of the Cucurbitaceae family, the most widespread and harmful are the species Sphaerotheca fuliginea (Schlecht ex Fr.) Poll and Erysiphe cichoracearum f. sp. cucurbitacearum (DC ex Merat). In regions where both phytopathogens are present, mixed infections may occur, making identification difficult, and, accordingly, further plant protection measures. The pathogens of this powdery mildew of pumpkin crops have different requirements for temperature and humidity. During the growing season, there may be a change in species composition when conditions change, for example, when a new season begins. Symptoms of the disease in the form of a white or yellowish powdery plaque in the form of rounded spots (mainly on the leaves) can manifest themselves at all stages of plant development, the susceptibility of which increases by the beginning of fruiting. According to biological characteristics, S. fuliginea and E. cichoracearum are obligate biotrophic pathogens, unable to exist independently without living photosynthetic tissue, except for the wintering (sexual) stage of teleomorphs in the form of globular kleistothecia. At this stage, it is not difficult to differentiate pathogens by the morphology of kleistothecium. When analyzing the plant material of melons with the naked eye, S. fuliginea and E. cichoracearum cause similar symptoms of damage, but by microscopy these organisms can be distinguished by a complex of morphological characteristics. Taxonomically significant features are: the location of the mycelium, the formation of conidia (single or chain), the presence or absence of noticeable fibrosin bodies, the features of the appressoria, the size and shape of the conidia, as well as the position and type of their sprout tubes. The works of Russian and foreign scientists have shown the possibility of determining the types and physiological races of pathogens using an indirect method: reactions to differentiator plants. To date, about 30 physiological races of the pathogen Podosphaera xanthii (Sphaerotheca fuliginea) and 2 races of E. cichoracearum are known. However, this method does not always correlate with the methods of molecular analysis. Determination of the species composition of powdery mildew pathogens is a starting point for the development of a further strategy for the cultivation of pumpkin crops and in breeding work for resistance to this disease.

Bilateral yellow plaques on the upper eyelids

Bilateral yellow plaques on the upper eyelids

KIKUCHI DISEASE-LIKE INFLAMMATORY PATTERN IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENT: A CASE REPORT

Kikuchi-Fujimoto disease (KFD) is a benign and rare disorder that can be a manifestation of the Kikuchi disease-like inflammatory pattern (KLIP) and coexists with systemic lupus erythematosus (SLE). The corresponding treatment of these diseases is difficult. A 66-year-old Thai man with underlying SLE presented with generalized yellowish erythematous papules and plaques throughout his body. No evidence of fever, lymphadenopathy, or hepatosplenomegaly was noted. Antinuclear antibodies (ANA) were positive but anti-dsDNA, anti-Smith, anti-snRNP, and anti-Ro antibodies were negative. The histopathology was consistent with KFD, and the patient was diagnosed with a Kikuchi disease-like inflammatory pattern. Hydroxychloroquine elicited a rapid and favorable response in the patient who remained relapse-free while on low-dose hydroxychloroquine. Here, we report the case of a 66-year-old Thai man with erythematous plaques on his chest and neck.

CO2 Laser Treatment of Xanthelasma Palpebrarum in skin, Aden, Yemen

Background: Xanthelasma palpebrarum clinically presents as yellowish plaques on the upper and/or lower eyelids. CO2 laser is considered the gold-standard for its treatment. Objectives: To evaluate the effectiveness of CO2 laser in the treatment of patients with xanthelasma palpebrarum. Patients and methods: Fifty eight patients were presented to our clinics in Almansoora and Khormakser in Aden, during the period January 2020 to December 2020 with xanthelasma palpebrarum and treated with CO2 Laser. Results: The study patients were 58 included in the study, the females were (81%) and the males were (19%). The mean age of all patients was 49.2 ± 9.4 years and their age ranged between 32 – 68 years (p ≤0.05). The age group 50 years old and less represent (53.4%). We treated the patients with CO2 laser and the results were excellent among (75.9%) patients and good results among (17.2%) patients. More excellent results were among patients aged ≤ 50 years old, good results were predominant among patients aged more than 50 years old. The difference between values was statistically significant (p = 0.005). We observed the side effect as follows: hypopigmentation in (10.3%) patients, hyperpigmentation in (3.4%) patients and erythema in (5.2%). Three patients (5.2%) developed a recurrence of xanthelasma. In our study cholesterol level was found high in (17.2%) distributed among patients of age group ≤ 50 years old with (5.2%) and among age group &gt; 50 years old with (12.1%) patients. Conclusion: In our study, excellent results were predominant followed by few numbers of good results. Further studies needed for more patients.

Multiple reddish-brown and yellowish indurated plaques with pancytopenia and paraproteinemia.

Multiple reddish-brown and yellowish indurated plaques with pancytopenia and paraproteinemia.

The Effect of Brilliant Blue-Based Plaque-Staining Agents on Aesthetic Orthodontic Appliances.

Orthodontic appliances discolour over treatment time, and a yellowish plaque builds up on the contact area of the brackets, adhesive and teeth. Brilliant Blue-based plaque-staining agents (BBPSAs), which increase tooth brushing efficiency, have the potential to support the maintenance of proper oral hygiene during orthodontic treatment. However, they exhibit strong colouring properties, and their impact on the aesthetics of braces remains unclear. Therefore, the aim of this study was to investigate the influence of commercially available BBPSAs on the colour of aesthetic orthodontic materials. A light-cured, colour-changing orthodontic adhesive and new-generation, monocrystalline, sapphire brackets were chosen for the experiments. The effect of the staining agent on the tested materials was investigated in terms of the reaction temperature and time, as well as the presence of black tea-induced impurities on the materials. The CIELAB (Commission Internationale de L’éclairage L* a* b*) colour system parameters were measured, and the colour differences (ΔE*ab and ΔE00—the Commission Internationale de L’éclairage 2000 colour-difference) were determined for the materials under several experimental conditions. The braces’ green-red colour expression was positively affected by the BBPSA. Under in vitro conditions, the regular use of the BBPSA for 90 days visibly improved the unfavourable colour change caused by the black tea.

A Rare Case of Juvenile Xanthogranuloma in 8 Months Old Baby with Dyslipidemia

Background: Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis disease of childhood. But due to rarity of non Langerhans cell hystiosis itself, the exact prevalence of juvenile xanthogranuloma remain unknown with only a few epidemiological journal ever published. Juvenile xanthogranuloma usually wihout lipid abnormality and systemic involvement. But association between JXG and lipid abnormalities is still not well understood. We describe a patient with multiple cutaneous JXG who also developed hyperlipidemia.&#x0D; Case: A case of a 8 months-old baby patient with juvenile xanthogranuloma is reported. Patient parents noticed yellowish dots on child’s face since six months ago, and it was gradually increase in size and number, and spread to trunks, upper and lower limb since 2 months ago. Patients got formula milk since 7 months ago. Patients father has uncontrolled hypercholesterolemia, and grandparents had controlled dyslipidemia. Dermatological state showed yellowish plaque and papule on the face, trunk, lower limb, and upper limb. Dermoscopy show yellowish papule with sun setting appearance and branched and linear vessel on orange yellow background. Laboratory finding showed elevated lipid serum. Foam cell and Touton giant cell is found on histopathology examination.&#x0D; Discussion: The presented case demonstrates that skin lesions in patients with diagnosed JXG may have a variable clinical presentation, ranging from single to diffuse skin lesions, also present from the birth to childhood. The diagnosis requires histopathological confirmation to avoid misdiagnosis of malignant disease. Association between JXG and lipid abnormalities remain unknown, with most of the patient show normal lipid serum. Majority of patients presenting lesions limited to the skin requires only a strict dermatological observation.