Introduction Pseudolymphoma is a rare complication of tattooing, presenting with infiltrated areas often at the site of a red tattoo and postulated to be an allergic reaction to mercury salt. When present, it may be mistaken for the more commonly occurring tattoo-associated granuloma. Case summary We describe a 47-year old female who developed nodular areas on her tattoo four months after placement by a professional tattoo artist. The nodules were restricted to the red regions and spared the blue-black areas of tattoed skin. Initial differentials included a foreign body or sarcoidal granuloma and contact dermatitis to the red dye. Histology revealed a top-heavy lymphocytic infiltrate spanning most of the dermis, with numerous eosinophils. Dark red, non-polarisable exogenous pigment was scattered throughout the dermis, in association with the inflammatory infiltrate. The epidermis showed intense spongiosis and eosinophilic exocytosis. A final diagnosis of tattoo-induced pseudolymphoma was made. Pseudolymphoma, foreign body and sarcoidal granulomatous reaction patterns from tattoos occur more commonly in red tattoos. Biopsy with histology is required to differentiate these three disorders with divergent management. We review the literature on tattoo-induced pseudolymphoma and highlight the pitfalls associated with the diagnosis.

Administration, Topical ; Aged ; Child ; Cyclopropanes ; administration & dosage ; adverse effects ; Female ; Haptens ; administration & dosage ; adverse effects ; Humans ; Male ; Middle Aged ; Vitiligo ; chemically induced

Cutaneous pseudolymphoma refers to a heterogenous group of benign T-cell or B-cell lymphoproliferative processes that mimic cutaneous lymphoma clinically and sometimes histologically. The causes of cutaneous pseudolymphoma are diverse, including lymphomatoid drug eruptions, lymphomatoid contact dermatitis, arthropod-bite reactions, chronic actinic dermatitis (CAD). Here we describe a case of pseudolymphoma due to hair dye on background of CAD.

The Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (QS 1064-nm Nd:YAG) laser is increasingly used for nonablative skin rejuvenation or "laser toning" for melasma. Multiple and frequent low-fluence, large-spot-size treatments are used to achieve laser toning, and these treatments are associated with the development of macular hypopigmentation as a complication. We present a case series of three patients who developed guttate hypomelanotic macules on the face after receiving laser toning treatment with QS 1064-nm Nd:YAG.
Aluminum ; Humans ; Hypopigmentation* ; Melanosis ; Rejuvenation ; Skin ; Yttrium

Introduction: Lichen planus pemphigoides (LPP) is a rare acquired autoimmune disease characterised by the evolution of subepidermal blisters on normal and lichen planus affected skin. Case summary: We describe a case of lichen planus pemphigoides in a 54-year-old Chinese woman. The patient presented initially with scaly psoriasiform plaques and was diagnosed to have guttate psoriasis. She was treated with narrowband ultraviolet (NBUVB) therapy twice weekly. Within a month of starting phototherapy, she experienced a flare up of her skin lesions with a generalised eruption of violaceous papules, tense bullae over the lower limbs as well as Wickham’s striae over the buccal mucosa. Histology of the violaceous papule over abdomen revealed interface dermatitis, while the specimen from a blister showed subepidermal bulla with linear deposition of IgG and C3 along the basement membrane zone. A diagnosis of LPP was made on clinicopathological grounds. The patient subsequently responded well to oral prednisolone at a dose of 0.5 mg/kg/day. Conclusion: This is the first case report of NBUVB alone unmasking LPP. In the presentation, we will describe the pathological mechanism of NBUVB in the development of LPP and the key features distinguishing LPP from bullous lichen planus (BLP), psoriasis and bullous pemphigoid (BP).

Actinomycosis ; complications ; drug therapy ; pathology ; Aged, 80 and over ; Amoxicillin-Potassium Clavulanate Combination ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Cephalexin ; therapeutic use ; Ciprofloxacin ; therapeutic use ; Clindamycin ; therapeutic use ; Coinfection ; drug therapy ; Drug Resistance, Bacterial ; Escherichia coli Infections ; complications ; drug therapy ; Humans ; Male ; Pseudomonas Infections ; complications ; drug therapy ; Skin Diseases, Bacterial ; complications ; drug therapy ; pathology ; Staphylococcal Skin Infections ; complications ; drug therapy ; Thigh ; Trimethoprim, Sulfamethoxazole Drug Combination ; therapeutic use

Acute Disease ; Aged ; Amylases ; blood ; Humans ; Lipase ; blood ; Magnetic Resonance Imaging ; Male ; Pancreatitis ; complications ; diagnosis ; diagnostic imaging ; Pancreatitis, Chronic ; complications ; diagnosis ; Panniculitis ; diagnosis ; diagnostic imaging ; etiology ; pathology

Adult ; Erythema ; etiology ; Female ; Humans ; Leprosy ; complications ; diagnosis

Purpose: To determine psychometric properties of the Caring Behaviors Inventory-24 (CBI-24) among Korean clinical nurses. Methods: A methodological design was used. Data were collected from 408 clinical nurses. Construct validity analysis was performed, including factorial, convergent, and discriminant validity. Internal consistency was tested by Cronbach’s ⍺ coefficients, inter-item correlation, and corrected item-total correlation. Results: Exploratory factor analysis produced three factors: ‘empathy and supporting’, ‘knowledge and skills’, and ‘providing comfort’. In confirmatory factor analysis results, model fit indices were acceptable (x2/df=3.50, RMR=.05, RMSEA=.08, CFI=.90). The values obtained for the AVE ranged from .53 to .68, and for the CR ranged from .53 to .68. Convergent validity coefficients were noticeably greater in magnitude than discriminant validity coefficients: .53 (AVE1 value) and .68 (AVE2 value)≥.45 (r122 value) and .68 (AVE2 value) and .63 (AVE3 value)≥.61 (r232 value). Internal consistency (Cronbach’s ⍺) of CBI-K was .95. Conclusion The CBI-K was shown to have acceptable construct validity and good internal consistency. Study findings imply that CBI-K could be a useful instrument for clinical administrators and nursing researchers to assess caring behaviors among Korean clinical nurses. Utilization of CBI-K might contribute to the building of empirical knowledge and the understanding of caring behaviors from nurses’ perspectives.