A 12-year-old boy showed a slatecolored scaly patch on h; ight face for 2 months. Histopathologic findings showed basal vacuolations and dermal me arphages with only scanty lymphoid cells in the fat tissue layer. Besides the facial lesion, lesions of edematous localized erythema were noted on his right if and left buttock with similar mi rocopical findings. 6 months later the facial lesion was aggravated like a cellulitis, of which thc bevpsy findings were consistent with mycosis fungoides. The patient received chemotherapy aftei the diagonsis for one month before his termination. Because of the rarity of mycosis fungoides in childhood age and its un common cutaneous lesions, the case is reported.
Buttocks ; Cellulitis ; Child ; Dronabinol ; Drug Therapy ; Erythema ; Humans ; Lymphocytes ; Male ; Mycosis Fungoides* ; United Nations

Eosinophilic cellulitis (Wells'syndrome) is an uncommon skin disorder. We report two adult male patients who had recurrent erythematous plaques and a nodular lesion on the abdomen. The histopathologic feature of their skin biopsies similarly indicated a marked infiltrate of eosinophils in the dermis with the fashion of "flame figures". One of the patients demonstrated blood eosinophilia. Given the clinicohistological findings, the patients fulfilled the criteria for the diagnosis of eosinophilic cellulitis. The skin lesions remained refractory to medications such as corticosteroids, sulfones, antihistamines, and minocycline. Considering the beneficial effect of cyclosporine in the treatment of eosinophilia-associated dermatoses, we speculated that eosinophilic cellulitis might respond to cyclosporine therapy. Thus, each of the two patients was given cyclosporine (microemulsion formulation) at a daily dose of 1.25 or 2.5 mg/kg, i.e., 100 or 200 mg, respectively. Complete remission of the skin eruptions was obtained in both patients during a 3- or 4-week period of treatment. No side effects were observed. Neither of the patients experienced relapse of the disease at least over 10 months after the discontinuation of the cyclosporine therapy. We suggest that administration of low-dose cyclosporine be a safe and useful therapeutic option in patients with eosinophilic cellulitis.
Adult ; Case Report ; Cellulitis/*drug therapy ; Cyclosporine/*therapeutic use ; Eosinophilia/*drug therapy ; Human ; Immunosuppressive Agents/*therapeutic use ; Male

Wells' syndrome or eosinophilic cellulitis is an uncommon cutaneous disorder characterized by recurrent erythematous and edematous plaques that often resemble acute cellulitis. The characteristic microscopic findings are diffuse dermal eosinophilia with marked edema, and flame figures consisting of amorphous or granular eosinophilic material around collagen bundles of the dermis. Etiology and pathogenesis are unknown, but the disease has been found to be associated with infections, arthropod bites, drug administration, surgery and hematologic disorders. We report the case of a 55-year-old man with pancreatic carcinoma who was presented with an asymptomatic erythematous to brownish subcutaneous nodule on the left buttock of several days' duration. A biopsy specimen taken from the erythematous to brownish nodule showed many flame figures and diffuse infiltration of eosinophils in the dermis and subcutaneous fat tissue. The rapid resolution of the skin lesion with chemotherapy of the pancreatic carcinoma supports a relationship between the two conditions.
Arthropods ; Biopsy ; Buttocks ; Cellulitis ; Collagen ; Dermis ; Drug Therapy ; Edema ; Eosinophilia ; Eosinophils ; Humans ; Middle Aged ; Skin ; Subcutaneous Fat

Clinical chemotherapy refractoriness is characterized by resistance to multiple drugs. Multidrug resistance(MDR) is caused by over-reactivity of a unidirectional drug efflux pump, transmembrane glycoprotein(P-glycoprotein), which is encoded by the MDR1 gene. P-glycoprotein leads to increased drug efflux and decreased intracellular drug concentration. Clinical trials that attempt to reverse or modulate MDR have been done. Cyclosporin-A and verapamil are the most extensively studied agents and several trials of cyclosporin-A as a MDR modulator have been reported. We report a case of an 8-year-old girl with acute mixed type leukemia who failed to respond 3 times to remission-induction therapy. It led us to conclude she had multidrug resistance. We tried a fourth induction chemotherapy including cytarabine, idarubicin and 6-thioguanine to which cyclosporin-A was added. Then, she showed signs of severe bone marrow depression and fulminant perianal cellulitis. But she recovered and successfully achieved complete remission. The addition of cyclosporine could be useful in achieving complete remission for cases of acute leukemia that resist to usual chemotherapy. Futher observation including more cases will be needed to assess long-term survival and efficacy of adding cyclosporine.
Bone Marrow ; Cellulitis ; Child ; Cyclosporine ; Cytarabine ; Depression ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Female ; Humans ; Idarubicin ; Induction Chemotherapy ; Leukemia* ; P-Glycoprotein ; Thioguanine ; Verapamil

Ampicillin ; pharmacology ; therapeutic use ; Cellulitis ; drug therapy ; prevention & control ; Comorbidity ; Endocarditis ; drug therapy ; prevention & control ; Female ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Recurrence ; Sepsis ; drug therapy ; prevention & control ; Streptococcal Infections ; drug therapy ; physiopathology ; Streptococcus agalactiae ; pathogenicity

Albendazole ; therapeutic use ; Animals ; Antiparasitic Agents ; therapeutic use ; Cellulitis ; parasitology ; Eyelid Diseases ; diagnosis ; Humans ; Ivermectin ; therapeutic use ; Male ; Middle Aged ; Myiasis ; complications ; diagnosis ; drug therapy ; Wounds and Injuries ; complications

PURPOSE: The outcome of adjuvant systemic chemotherapy, in patients with a locally advanced transitional cell carcinoma of the upper urinary tract, was analyzed. MATERIALS AND METHODS: Between January 1990 and June 2001, a total of 97 patients underwent surgery for a transitional cell carcinoma of the upper urinary tract at our institute. Forty-five had a locally advanced disease (T3, N1, N2, lymphovascular invasion). Of these, 33 patients (chemotherapy group) underwent a median of four courses of cisplatin-based adjuvant systemic chemotherapy (M-VAC in 23, gemcitabine plus cisplatin in seven, CISCA in three), whereas 12 (Observation group) refused chemotherapy. To define possible prognostic factors in these patients, various factors, including age, sex, location, surgical method, pT stage and number of involved lymph nodes, were analyzed using the Cox's regression model. RESULTS: The mean follow-up was 39 months, ranging from 8 to 98 months; the median survival time in the chemotherapy and observation groups were 65 and 31 months, respectively. Five-year disease-specific survival rates in the chemotherapy and control groups were 71.1 and 40.9%, respectively. Of the several factors, adjuvant chemotherapy (p=0.016) and lymph node metastasis (p=0.017) both had prognostic significance. In the chemotherapy group, 21 (63.6%) were given a reduced dose for at least one cycle due to a reduced renal function. However, there was no fatal febrile neutropenia, while cellulitis or grade 3 neutropenia occurred in six patients during the chemotherapy. CONCLUSIONS: Our findings suggest that adjuvant systemic chemotherapy, for a locally advanced transitional cell carcinoma of the upper urinary tract, may lead to a significant prolongation in the survival time.
Carcinoma, Transitional Cell* ; Cellulitis ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Febrile Neutropenia ; Follow-Up Studies ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Neutropenia ; Survival Rate ; Ureteral Neoplasms ; Urinary Tract*

Serratia marcescens is a gram-negative bacillus of enterobacteriaceae family. The organism is known to cause various types of infection including cellulitis, bacteremia, pneumonia, endocarditis, meningitis, peritonitis, osteomyelitis, and septic arthritis. Cellulitis due to gram-negative organisms is uncommon and usually occurs in immunosuppressed hosts. We present a case of S. marcescens cellulitis in a patient with acute lymphocytic leukemia who had been treated with chemotherapy. Microbial studies with pus identified S. marcescens as a causative organism of cellulitis. The lesion healed completely by antibiotic treatment.
Arthritis, Infectious ; Bacillus ; Bacteremia ; Cellulitis* ; Drug Therapy ; Endocarditis ; Enterobacteriaceae ; Humans ; Immunocompromised Host ; Leukemia ; Meningitis ; Osteomyelitis ; Peritonitis ; Pneumonia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Serratia marcescens* ; Serratia* ; Suppuration

We report a case of corneal perforation with preseptal cellulitis in a patient with acute lymphocytic leukemia (ALL). A 17-yr-old female patient who was undergoing combination chemotherapy for ALL was referred due to upper lid swelling and pain in the right eye for 2 days. Visual acuity in the right eye was 20/20. Initial examination showed no abnormal findings, other than swelling of the right upper eyelid. Computed tomography showed a finding of preseptal cellulitis. Microbiologic study of bloody and purulent discharge revealed Serratia marcescens. Corneal melting and perforation with iris prolapse were detected in the right eye on the 16th day. Emergent tectonic keratoplasty was performed. Seven months after surgery, visual acuity in the right eye was 20/300, and the corneal graft was stable.
Adolescent ; Anti-Bacterial Agents/therapeutic use ; Cellulitis/*diagnosis/drug therapy/etiology/microbiology ; Corneal Perforation/*diagnosis/etiology/therapy ; Corneal Transplantation ; Drug Therapy, Combination ; Female ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*drug therapy ; Serratia marcescens/isolation & purification ; Tomography, X-Ray Computed ; Visual Acuity

OBJECTIVETo review the recent diagnosis and treatment experience with deep neck infection and emphasize the importance of radiologic evaluation, microbiology and appropriate treatment selection in these patients.

METHODSA respective review was conducted in 95 cases who were diagnosed as having deep neck from Jan. 2006 to March 2015.

RESULTSThe primary diseases in 95 patients with deep neck infection were acute tonsillitis or acute laryngitis (27 cases), infection of upper respiratory tract (23 cases), odontogenic infection or oral inflammation (16 cases), foreign bodies in esophagus (9 cases), acute cervical lymphadenitis (5 cases) and cause uncertain (15 cases). Computed tomography was performed in all of patients to identify the location, extent, and character (cellulitis in 47 cases or abscesses in 48 cases) of the infections. The locations of abscess were parapharyngeal abscess (25 cases), retropharyngeal abscess (9 cases), submaxillary space abscess (6 cases), pretracheal space abscess (5 cases) and esophageal abscess (3 cases).

COMPLICATIONSmediastinitis (2 cases), pericarditis (1 case), bilateral pneumothorax (2 cases), and upper digestive tract (1 case). Bacterial cultivation performed in 35 patients and positive results were detected in 21. All patients were given intravenous antibiotic therapy. Tracheotomy was performed in 4 cases. Preoperative contrast enhanced CT was performed in 42 patients and indicated the formation of abscess. Three cases with the symptoms of septic shock were transferred to ICU and one was cured. All the patients were cured except two who died of massive hemorrhage of upper digestive tract and septic shock.

CONCLUSIONSThe airway patency in patients with deep neck infections must be ensured. Drainage may be mandatory in selected cases at presentation or in cases who fail to respond to parenteral antibiotics within the first 24-48 hours. Imaging evaluation plays a significant role in the diagnosis and rational therapeutic management in deep neck infection. Bacterial cultivation can help to make the effective treatment and provide reliable evidence for the etiopathogenisis.

Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; drug therapy ; Cellulitis ; pathology ; Drainage ; Esophagus ; pathology ; Foreign Bodies ; pathology ; Humans ; Laryngitis ; microbiology ; pathology ; Neck ; microbiology ; pathology ; Retropharyngeal Abscess ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; Tonsillitis ; microbiology ; pathology ; Treatment Outcome