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Alhammad NS, Alshehri S, Alawadi TM, Ragaban A, Alyahya FS, Alharbi A. Telangiectasia Macularis Eruptiva Perstans in a 55-Year-Old Female With Type 2 Diabetes Mellitus. Cureus 2024; 16:e57333. [PMID: 38690480 PMCID: PMC11060500 DOI: 10.7759/cureus.57333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
The authors would like to report a rare case of telangiectasia macularis eruptiva perstans (TMEP), a form of cutaneous mastocytosis, in a 55-year-old female patient with a recent diagnosis of type 2 diabetes mellitus on empagliflozin. The patient presented with a two-month history of rash and itching on her lower extremities, unresponsive to topical treatment. A dermoscopic evaluation and a skin biopsy confirmed the diagnosis of TMEP. The patient demonstrated significant improvement with antihistamine and topical steroid treatment.
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Affiliation(s)
- Norah S Alhammad
- Department of Dermatology, King Fahad Armed Forces Hospital, Jeddah, SAU
| | - Sumayah Alshehri
- Department of Dermatology, King Fahad Armed Forces Hospital, Jeddah, SAU
| | - Toleen M Alawadi
- Department of Dermatology, King Fahad Armed Forces Hospital, Jeddah, SAU
| | - Ali Ragaban
- Department of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Ahmad Alharbi
- Department of Dermatology, Taibah University, Madinah, SAU
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Hida T, Okura M, Kamiya T, Yamamoto M, Hori T, Uhara H. A case of childhood-onset cutaneous mastocytosis with loss of wild-type KIT allele. J Eur Acad Dermatol Venereol 2019; 33:e235-e237. [PMID: 30773694 DOI: 10.1111/jdv.15501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T Hida
- Department of Dermatology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - M Okura
- Department of Dermatology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - T Kamiya
- Department of Dermatology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - M Yamamoto
- Department of Pediatrics, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - T Hori
- Department of Pediatrics, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - H Uhara
- Department of Dermatology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
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Kim GW, Shin K, Kim TW, You HS, Jin HJ, Shim WH, Kim HS, Ko HC, Kim BS, Kim MB. The importance of dermoscopy for the diagnosis of acquired bilateral telangiectatic macules: the angioid streak pattern reveals underlying chronic liver disease. J Eur Acad Dermatol Venereol 2017; 32:1597-1601. [PMID: 29114961 DOI: 10.1111/jdv.14669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/18/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acquired bilateral telangiectatic macules (ABTM) are a newly recognized disease entity, which manifest as multiple telangiectatic pigmented macules confined mostly to the upper arms. OBJECTIVES To evaluate clinical and dermoscopic features in a group of 50 patients with ABTM and to determine the diagnostic usefulness of dermoscopy in ABTM. METHODS Patients were selected from two tertiary teaching hospitals in Korea [Pusan National University Hospitals (Busan and Yangsan)]. Fifty patients (41 males and 9 females; mean age 48.1 years; range 26-78 years) with ABTM were included in the study. The dermoscopic findings were graded using a 4-point scale: none (0), mild (1), moderate (2) and severe (3). In addition, the results of 23 patients with and 27 patients without chronic liver disease (CLD) were compared to determine whether the presence of CLD affects dermoscopic findings. RESULTS Three distinct dermoscopic patterns were observed; brown pigmentations, telangiectasia (linear-irregular vessels) and an angioid streak pattern. Brown pigmentation in the group without CLD had higher severity score than those in CLD group (mean score: 2.00 vs. 1.48, P = 0.033). However, mean telangiectasia severity score was higher in the CLD group (2.14 vs. 1.39, P < 0.001). The angioid streak pattern was more severe and more common in patients with CLD than in those without [1.37 vs. 0.35 (P < 0.001) and 63.0% vs. 26.1%, respectively]. CONCLUSIONS Detailed observations with dermoscopy can provide first clues of the presence of ABTM and underlying chronic liver disease.
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Affiliation(s)
- G-W Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - K Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - T-W Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-S You
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-J Jin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - W-H Shim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H-C Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - B-S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - M-B Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Pascual JC, Bañuls J, Albares MP, Vergara G, Belinchón I, Silvestre JF, Betlloch I. Presentation of Telangiectasia Macularis Eruptiva Perstans as a Long-Standing Solitary Plaque Associated with Renal Carcinoma. J Cutan Med Surg 2016. [DOI: 10.1177/120347540300700507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Mastocytosis is a rare disease characterized by a primary pathological increase in mast cells in different tissues. The skin is the most frequently affected organ. Cutaneous mastocytosis, including urticaria pigmentosa, solitary mastocytoma, diffuse cutaneous mastocytosis, and telangiectasia macularis eruptiva perstans (TMEP), is usually distinguished from systemic mastocytosis. TMEP is characterized mainly by telangiectatic macules. Objective and Methods: We report a case of TMEP with an unusual clinical presentation as a solitary plaque of telangiectatic macules. A renal clear cell carcinoma was detected in a workup for systemic mastocytosis. We discuss the clinical and histological findings and treatment of TMEP. Conclusions: TMEP is a rare form of mastocytosis, which occurs mainly in adults, generally has a good prognosis, and little tendency to urticate or show constitutional symptoms. Clinicians should consider this disorder when confronted with a progressive atypical telangiectatic lesion. However, the malignant neoplasm also found in this patient is of uncertain significance.
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Affiliation(s)
| | - José Bañuls
- Department of Dermatology, Hospital General de Alicante, Alicante, Spain
| | - Ma Pilar Albares
- Department of Dermatology, Hospital General de Alicante, Alicante, Spain
| | - Gloria Vergara
- Department of Dermatology, Hospital General de Alicante, Alicante, Spain
| | - Isabel Belinchón
- Department of Dermatology, Hospital General de Alicante, Alicante, Spain
| | | | - Isabel Betlloch
- Department of Dermatology, Hospital General de Alicante, Alicante, Spain
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Effect of propolis on mast cells in wound healing. Inflammopharmacology 2011; 20:289-94. [PMID: 22179947 DOI: 10.1007/s10787-011-0105-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 11/29/2011] [Indexed: 01/28/2023]
Abstract
Wound healing is divided into three phases: inflammatory, proliferative and remodeling. Mast cells participate in all these phases. The aim of the present study was to determine the effects of propolis on the population of mast cells in oral surgical wounds in comparison to the results obtained with dexamethasone. This study was prospective, in vivo, randomized, semiexperimental, quantitative and comparative animal. A circular surgical wound was made on the dorsum of the tongue of 90 hamsters divided into three experimental groups: topical application of 30% propolis alcoholic extract (Group 1); 0.1% dexamethasone in orabase cream (Group 2); and orabase cream alone (Group 3). Applications were performed every 12 h throughout the experiment. The postoperative times for killing of the animals were 1, 3, 7, 14 and 28 days. The Student's t test for independent samples was employed in the statistical analysis. In the inflammatory phase of healing, propolis caused a greater reduction in the number of mast cells on the edge and in the central region of the surgical wound in comparison to dexamethasone. Moreover, the number of mast cells on day 1 was lower in the central region of the wounds treated with the orabase cream alone in comparison to dexamethasone. In conclusion, the anti-inflammatory action of propolis mediated by mast cells was more effective than dexamethasone in the inflammatory phase of healing.
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Nodularity of the small intestine in a child with systemic mastocytosis associated with hyperimmunoglobulin M syndrome. J Pediatr Gastroenterol Nutr 2011; 53:245. [PMID: 21865968 DOI: 10.1097/mpg.0b013e31820ea688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
Cutaneous mastocytosis can be divided into 4 different clinical variants--urticaria pigmentosa, solitary mastocytoma, diffuse cutaneous mastocytosis, and telangiectasia macularis eruptiva perstans. Skin findings are often accompanied by symptoms secondary to mast cell release of mediators. These symptoms can be both localized to the skin lesion and systemic because of the release of mediators into the bloodstream. The majority of pediatric cases of cutaneous mastocytosis show a good prognosis with gradual resolution of both symptoms and skin lesions. This article will review each of the 4 clinical presentations focusing on pediatric-onset of disease while reviewing the literature.
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Affiliation(s)
- Laura D Briley
- PGY3- Department of Dermatology, Brody School of Medicine at East Carolina University, Greenville, North Carolina 27834, USA.
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Gobello T, Mazzanti C, Sordi D, Annessi G, Abeni D, Chinni LM, Girolomoni G. Medium- versus high-dose ultraviolet A1 therapy for urticaria pigmentosa: a pilot study. J Am Acad Dermatol 2003; 49:679-84. [PMID: 14512916 DOI: 10.1067/s0190-9622(03)01483-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND There is currently no definitive cure for urticaria pigmentosa (UP). Psoralen plus ultraviolet A therapy is efficacious in alleviating symptoms and reducing cutaneous lesions. OBJECTIVE The purpose of this study was to assess the effect of ultraviolet A1 (UVA1) in adult patients with UP and to compare the effectiveness of high-dose (130 J/cm(2)/day for 10 days) and medium-dose (60 J/cm(2)/day for 15 days) UVA1 radiation. METHODS Ten and 12 adult patients with UP were treated with high-dose or medium-dose UVA1, respectively. The number of skin lesions and dermal mast cells, the presence of Darier's sign, the intensity of pruritus, and quality of life measures were evaluated before, at the end of treatment, and 2 and 6 months later. RESULTS Baseline characteristics were similar among the 2 groups of patients. In the majority of patients, the number of lesions was not significantly reduced. However, the number of mast cells in lesional skin decreased markedly in most patients by the end of treatment, and it remained low for the whole study period. Pruritus and quality of life improved considerably by the end of treatment, and the improvement was maintained during the 6-month follow up. No significant differences were observed between patients receiving high- or medium-dose UVA1. CONCLUSIONS UVA1 phototherapy ameliorates both objective and subjective symptoms of adult patients with UP and induces long-term remission in most cases. Medium-dose UVA1 appears at least as effective as high-dose UVA1.
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Affiliation(s)
- Mona Almahroos
- Department of Dermatology, Boston University School of Medicine, Massachusetts, USA
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