Anca Chiriac, Cristian Podoleanu and Simona Stolnicu
Background: Self-induced skin lesions, especially in young children, can create confusion within pediatricians, dermatologists, or other medical care providers, leading to different diagnoses, unnecessary investigations, and delaying the correct therapeutic psychiatric evaluation.
Case report: We report the case of a 4-year-old boy who was referred to Dermatology after being hospitalized in the Allergy Department for a chronic allergic contact dermatitis. He had been previously diagnosed with chronic hand dermatitis, atopic dermatitis, and psoriasis, and treated with no favorable outcome. Scaly erythematous plaques were noticed on the dorsal aspects of both hands and on the lateral folds of the fingers. The skin lesions were distributed in a non-symmetrical way. A diagnosis of self-injurious behavior was presumed, and psychiatric evaluation was asked. The child was transferred to the Psychiatry Department, and a diagnosis of schizophrenia was concluded.
Anca Chiriac, Cristian Podoleanu and Simona Stolnicu
Alopecia areata represents an autoimmune process against an unidentified autoantigen in the follicle of the hair, which affects all ages, from young children (a few months old) to elderly patients. Alopecia areata has an important impact on the quality of life, leading to a predisposition towards anxiety and depression, especially if the patients are treated with corticoid therapy that heightens the risk for such psychiatric disorders. We present the case of a patient with alopecia areata who was diagnosed at the age of 18 months, and had been followed-up until the age of 27 years.
Anca Chiriac, Monica Tarcea, Cristian Podoleanu and Simona Stolnicu
We present a case of “gloves and socks” syndrome associated with Mycoplasma pneumoniae infection in a 6-year-old child hospitalized for febrile syndrome associated with monomorphic purpuric papular eruption localized on the distal part of extremities, in a “gloves and socks” pattern. Clinical diagnosis was confirmed by positivity of specific IgM against Mycoplasma pneumoniae. Favorable outcome was obtained by administration of oral clarithromycin.
Anca Chiriac, Rareș Georgescu, Piotr Brzezinski and Simona Stolnicu
Psoriasis is a systemic chronic immune-mediated disorder, rarely reported in HIV-infected patients, in which the disease is more severe and debilitating. Response to treatment is modest, and skin diseases may profoundly affect the patients’ quality of life. Anti-psoriasis therapies have immunosuppressive effects and must be carefully recommended in HIV-infected patients. Moreover, the compliance of HIV patients diagnosed with psoriasis is low, and monitoring these patients is challenging. Herein we present a rare case of severe HIV-associated psoriasis with large plaques localized on the trunk, abdomen, limbs and plantar area in a non-compliant patient, with impaired renal and hepatic functions, dyslipidemia, and anemia, for whom the therapeutic approach was disappointing.
Anca Chiriac, Cristian Podoleanu, Adrian Năznean and Simona Stolnicu
Hyperkeratotic lesions result from continuous mechanical action on the skin forming a callus or a corn. The accumulation of horny layers will increase pressure, creating a vicious cycle. We present a new approach based on relieving pressure or friction, strictly based on the results of pedography (pedobarography).
Anca Chiriac, Laura Trandafir, Cristian Podoleanu and Simona Stolnicu
Cystic fibrosis (CF) is an autosomal recessive affliction triggered by genetic mutations in the cystic fibrosis transmembrane conductance regulator. The lung and pancreas are the most frequently affected organs in cystic fibrosis, cutaneous involvement is undervalued and underdiag-nosed. Skin lesions observed in patients diagnosed with cystic fibrosis are not well known and can create confusions with other dermatological diseases. The diagnosis of cutaneous lesions as signs of cystic fibrosis by pediatricians or dermatologists, despite their overlapping with different nutritional deficiencies, would allow earlier diagnosis and proper treatment and could improve quality of life and outcomes.
Anca Chiriac, Piotr Brzezinski, Adrian Năznean, Cristian Podoleanu and Simona Stolnicu
The present paper highlights the usefulness of 70% trichloroacetic acid in treating sebaceous hyperplasia in elderly patients. Esthetics are an important issue, and different therapeutic modalities can be used, such as systemic isotretinoin, surgical excision, electrocautery, cryosurgery, topical photodynamic therapy and laser, but all these methods are expansive and invasive procedures that may result in scars, which are more extensive than the original lesions.
Anca Chiriac, Anca Eduard Chiriac, Cristian Podoleanu and Simona Stolnicu
Introduction: Pilomatrixoma or pilomatricoma is a benign appendageal growth, originating from hair cortex cells.
Case presentation: We present an unusual case of a 65-year-old female patient who has been diagnosed and treated for a presumed recurrent furunculosis localized on the abdominal area. Ultrasonography raised the suspicion of pilomatrixoma. A large excision was performed and histopathology confirmed the diagnosis.
Conclusions: Ultrasonography could be a simple and reliable diagnostic tool in daily practice.
Anca Chiriac, Piotr Brzezinski, Cristian Podoleanu and Simona Stolnicu
Background: Anogenital premalignancies and malignancies often affect females and males, and human papillomavirus infection plays a crucial role in their etiopathogenesis. These lesions are very important and represent an immense public health burden.
Case presentation: A 78-year-old Caucasian male presented to the Dermatology Unit for persistent, slowly progressing, well-demarcated, erythematous plaques on the glans penis, observed by the patient 18 months prior to the consultation. Variable topical treatments were applied, with no improvement and with the denial of a punch biopsy. A clinical diagnosis of erythroplasia of Queyrat was established and the test for HPV revealed an association with subtype 16 (which excluded other benign inflammatory conditions). Positive results were obtained after 4 weeks of topical application of 5% imiquimod cream, once daily, 5 times a week.
Conclusion: Erythroplasia of Queyrat should be diagnosed in a non-compliant patient based on the clinical picture and HPV testing even in the absence of a biopsy, and a non-surgical treatment should be initiated immediately.