Thai Journal of Dermatology

Scrotal Verruciform Xanthoma: An Unusual Condyloma-Like Lesion of the Genitalia

2025-09-09T05:52:23+07:00

Verruciform xanthoma (VX) is a rare, benign lesion with histological characteristics of papillary proliferation and foam cell accumulation. Although it predominantly affects the oral mucosa, its occurrence in the genital region is unusual. This report discusses a case of scrotal VX in a 90-year-old male, emphasizing its clinical and histopathological characteristics.

False Positive Infectious Serologies Mimicking Viral Exanthem in a Patient with Angioimmunoblastic T-Cell Lymphoma

2025-10-20T08:36:15+07:00

Angioimmunoblastic T-cell lymphoma (AITL) represents a severe subtype of peripheral T-cell lymphoma and mimics drug reactions, infection, or autoimmune diseases. Due to its nonspecific clinical features, diagnosing AITL can be difficult and is frequently delayed. We report a case of a 70-year-old Thai male who presented with fever and generalized morbilliform eruption. Initial laboratory investigations revealed positive serological tests for Mycoplasma, Measle virus, and Epstein-Barr virus. The patient was treated with appropriate antibiotics, however, there was no clinical improvement. The lack of response to antibiotic therapy prompted reconsideration of the initial diagnosis. Subsequent careful examination revealed enlarged cervical lymph nodes, lymph node biopsy confirmed AITL. In patient with AITL, we hypothesize that positive serological tests for multiple pathogens often result from immune dysregulation or cross-reactivity rather than true infections. Therefore, physicians must interpret these findings cautiously to avoid misdiagnosis.

Facial Granular Parakeratosis: The First Report of Combined Eccrine and Follicular Involvement

2025-10-15T05:49:58+07:00

Granular parakeratosis is a rare cutaneous disorder that typically affects intertriginous areas such as the axillae and groin. Non-intertriginous involvement is uncommon, and facial presentations are particularly rare. We report a case of a 40-year-old Thai woman with a two-year history of recurrent, pruritic, brownish, hyperkeratotic papules involving the face, neck, anterior chest, and upper back, without axillary or other typical flexural involvement. The lesions were aggravated by heat and sweating. Histopathological examination revealed focal compact parakeratosis with retained basophilic keratohyalin granules, extending into both the eccrine ostia and follicular infundibula, confirming the diagnosis of granular parakeratosis. Based on the available literature, this appears to be the first reported case of combined eccrine and follicular involvement. After a one-month follow-up, the patient showed marked improvement with topical corticosteroids and lifestyle modifications to reduce heat exposure.

White fibrous papulosis of the chest and back: A case report

2025-12-01T05:54:49+07:00

White fibrous papulosis (WFP) is a rare, benign dermatologic condition within the spectrum of fibroelastolytic papulosis of the neck (FEPN). It typically presents as asymptomatic, pale to skin-colored, firm, non-follicular papules, most commonly on the neck of elderly individuals. We report a 39-year-old Thai woman with a four-year history of slowly progressive, monomorphic, skin-colored papules on the upper back and chest with few papules on each side of the neck. Histopathology showed thickened collagen bundles with sparse perivascular lymphoid infiltrates in the dermis, and elastin staining revealed a slight reduction of elastic fibers in the upper reticular dermis. Correlating clinical and histological findings, a diagnosis of WFP was established, with the truncal involvement representing an uncommon presentation of this condition.

Bullous Pemphigoid with Milia: An Uncommon Clinical Manifestation

2025-11-26T08:26:22+07:00

Bullous pemphigoid (BP) is the most prevalent autoimmune disorder characterized by subepidermal blistering, primarily affecting older adults. While BP primarily presents with tense bullae on the extremities and trunk, milia formation during recovery is a rare but notable occurrence. We report an 86-year-old Thai male diagnosed with BP who developed milia on the trunk and extremities during the recovery phase. Diagnosis was confirmed by clinical findings, histopathology, and immunological studies, which showed subepidermal blistering, elevated anti-BP180 levels, and epidermal-side IgG deposition. Treatment included prednisolone, doxycycline, nicotinamide, and topical clobetasol, with lesion improvement observed.