Thai Journal of Dermatology

Non-targetoid Hobnail Hemangioma: Two Case Reports and Literature Review

Pattamon Lertpichitkul — 2024-11-27

Hobnail hemangioma (HH) or targetoid hemosiderotic hemangioma is a benign vascular tumor with classic presentation of pale and ecchymotic halo. However, there are diversity in clinical and dermoscopic manifestations of HH, which can make diagnosis challenging in cases where the characteristic targetoid appearance is absent. This report discussed two cases of non-targetoid HH. A 15-year-old Thai female presented with erythematous plaque on her left knee, where dermoscopic findings include red and dark lacunae with white structures and a reddish homogeneous area, which are indicative of HH. The second case involves a 67-year-old Caucasian male presented with an ulcerated crusted nodule on his upper back. In this case, histopathological examination was necessary to rule out skin cancer and confirm the diagnosis of HH. This study provides an overview of HH and the challenges posed by non-targetoid presentations, emphasizing the importance of clinical and dermoscopic evaluation, as well as histopathological examination in uncertain cases.

Eosinophilic Annular Erythema with Benign Prognosis: A Case Report and Literature Review

Chalermkwan Apinuntham — 2024-11-27

Eosinophilic annular erythema (EAE) is a rare eosinophilic dermatosis with a chronic recurrent course of disease. EAE might be a disease spectrum of Wells syndrome or a distinctive entity¹. We reported an EAE case with typical clinical morphology and histological findings but a rather benign clinical course. The investigations showed relatively high blood eosinophils. While most articles mentioned EAE with clinical chronicity and recurrence, there are a few reports of spontaneous resolution. Our case supports the evidence of a benign clinical course, suggesting that clinicians consider initiating less aggressive treatment in similar cases.

Linear Atrophoderma of Moulin: A Case Report

Yanisorn Nanchaipruek — 2024-11-27

Linear Atrophoderma of Moulin (LAM) is an uncommon acquired, hyperpigmented, and atrophic resembling band lesions along the Blaschko's lines in the absence of antecedent inflammation or sclerotic appearance. The disease is benign, with no related complications, despite the lack of a successful treatment. The precise etiology and optimal course of treatment are still up for debate. In the present study, a 19-year-old female patient was diagnosed with LAM. Her condition, which highlighted the typical clinical and histological characteristics, improved with topical calcipotriol treatment.

Childhood-Onset Epidermolysis Bullosa Acquisita Successfully Treated with Colchicine and a Super-potent Topical Corticosteroid: A Case Report

Chudapa Sereeaphinan — 2024-11-27

Epidermolysis bullosa acquisita (EBA) is an uncommon autoimmune disorder that results in subepidermal blister formation. The clinical manifestations vary depending on subtype. In the classical form, tense bullae or erosions present on non-inflamed skin, accompanied by scars and milia in trauma-prone areas. In the non-classical form, blisters can appear on both non-inflamed and inflamed skin, resembling other autoimmune blistering diseases. The diagnosis relies on histology, immunofluorescence, and serological testing demonstrating autoantibody targeting type-VII collagen which is an element of anchoring fibrils located at sublamina densa of the basement membrane in skin and mucosal tissues. The treatment is challenging since the data on the efficacy of therapeutic options is still scarce. Herein, we reported a rare childhood-onset EBA case successfully treated with colchicine and a super-potent topical corticosteroid.

A Rheumatoid Arthritis-Like Presentation in Multibacillary Leprosy with Concurrent Erythema Nodosum Leprosum

Savita Sittisaksomjai — 2024-11-27

Leprosy is a chronic infectious disease caused by a Mycobacterium leprae (M.leprae), continues to be a diagnostic challenges because of its rarity and diverse clinical manifestations. Classic erythema nodosum leprosum (ENL) typically presents in patients with preexisting borderline lepromatous or lepromatous leprosy. This case report discusses the atypical presentation of ENL in a 69-year-old woman who experienced intermittent crops of red nodules with fever, accompanied by glove and stocking anesthesia, joint deformities without clinical evidence of classic multiple symmetrical papulonodular lesions of lepromatous leprosy. The initial diagnosis of rheumatoid arthritis, followed by treatment with Disease-modifying antirheumatic drugs, failed to provide symptom relief, leading to further investigation. Biopsy results and slit skin smears confirmed multibacillary leprosy with necrotizing suppurative vasculitis, and special stains confirmed the presence of M. leprae. Multidrug therapy was initiated, resulting in an initial improvement in symptoms. This case report emphasizes the importance of considering leprosy with erythema nodosum leprosum in the differential diagnosis for patients presenting with rheumatoid arthritis-like symptoms, particularly in atypical clinical manifestations and when there is no response to standard treatments.