We describe a case if a 4 year-old girl who consulted our institution because of multiple tense vesicles and bullae on the perioral area, trunk, elbows, knees and dorsum of hands and feet. Biopsy of the lesion revealed subepidermal cleft with few ill-defined acantholytic cells and patchy areas of vacuolar degeneration showing infiltration with numerous neutophils and occasional eosinorphils. There was linear deposition of C3, IgG and IgA on basement membrane zone. The diagnosis was epidemolysis bullosa acquisita, IgA bullous dermatosis-like presentation. The patient was treated with topical corticosteroid for 1 1/2 months with complete resolution of lesions and appearance of milia on the perioral area and dorsum of hands and feet. Patient remained in remission.

Human ; Female ; Child Preschool ; Adrenal Cortex Hormones ; Biopsy ; Blister ; Elbow Joint ; Immunoglobulin A ; Immunoglobulin G ; Skin Diseases, Vesiculobullous ; Histiocytosis

Mastocytosis is an uncommon, sporadic, heterogenous illness resulting from hyperplasia of mast cells. Diffuse cutaneous mastocytosis is the rarest subtype of mastocytosis affecting children, with bullous mastocytosis being its least common variety. Systemic manifestations like nausea, vomiting, bone pain, diarrhea, and central nervous system abnormalities are less common in children than adults. We report a four-month old male who presented with a two-month history of generalized yellowish to tan macules, papules and plaques with peau d'orange texture, with some blisters and erosions on the back, abdomen and scalp. Darier's sign was positive. Baseline laboratory workup were negative for systemic involvement. CD117 and Giemsa staining were positive for mast cells. Based on the clinical findings and histopathologic results, a diagnosis of bullous mastocytosis was made. Treatment included ketotifen drops, mupirocin cream and cetirizine drops, which resulted in flattening of most lesions and resolution of blisters and erosions.

Human ; Male ; Infant ; Blister ; Cetirizine ; Diarrhea ; Hyperplasia ; Ketotifen ; Mast Cells ; Mastocytosis ; Mastocytosis, Cutaneous ; Mupirocin ; Nausea ; Vomiting

BACKGROUND: Mosquito bite is a common dermatological complaint with various treatments but with no gold standard treatment regimen. OBJECTIVE: To compare the safety and efficacy of 0.025% capsaicin cream against 1% hydrocortisone cream and placebo as anti-inflammatory and anti-pruritic preparation for mosquito bites. METHODS: Seventy-five volunteers were enrolled in the placebo-controlled trial and randomized into three treatment groups. They were exposed to laboratory-reared mosquitoes to incur bites and to apply the designated cream. Anti-inflammatory and anti-pruritic effects were determined by mean lesion size, physician's global assessment, pruritus intensity score and 100mm visual analog scale. RESULTS: The mean lesion size and physician's global assessment, pruritus intensity score and visual analog scale showed no significant difference between 0.025% capsaicin and 1% hydrocortisone and they were both found to be superior to placebo (p-value< 0.001 using repeated measures of ANOVA; Kruskal-Wallis test). CONCLUSION: 0.025% capsaicin is comparable to 1% hydrocortisone as an anti-inflammatory and anti-pruritic preparation for mosquito bites.

Human ; Animal ; Male ; Female ; Analysis Of Variance ; Capsaicin ; Cortisone ; Culicidae ; Hydrocortisone ; Insect Bites And Stings ; Pruritus ; Visual Analog Scale ; Volunteers

Introduction: Granuloma annulare(GA) is a benign, inflammatory skin condition characterized by asymptomatic, flesh colored or erythematous papules. The disseminated variant of granuloma annulare is uncommon, usually affecting women older than 40 years. Case Summary: We report a case of a 52-year-old female, who presented with a 4-year history of skin colored to erythematous papules and annular plaques covering the entire skin surface. Correlation of the clinical presentation, histopathology and dermoscopy findings established the diagnosis of disseminated granuloma annulare. The patient was treated with 25 sessions of narrowband ultraviolet-B (NB-UVB) phototherapy and acitretin 20mg/day for 5 months. Conclusion Both histopathology and dermoscopy were noted to be valuable tools in the diagnosis of disseminated GA, as well as in monitoring response to the combined therapy.
Granuloma Annulare ; Dermoscopy ; Acitretin