Thai Journal of Dermatology

Dermatofibrosarcoma Protuberans with Fibrosarcomatous Change: A Case Report of Rare Entity

Chinathip Theerawattanawit — 2024-06-05

Dermatofibrosarcoma protuberans (DFSP) is a rare malignancy affecting the skin and underlying soft tissues. Typically characterized by a favorable prognosis with low metastatic and recurrence rates, DFSP can manifest as a subtype with an unfavorable outcome known as DFSP with fibrosarcomatous changes (DFSP-FS). Histologic examination reveals DFSP-FS to exhibit more atypical cellular features and increased mitotic activity compared to the classic DFSP variant. In this report, we detail the case of a 48-year-old Thai female patient presenting with a progressively enlarging mass on the lumbosacral area. Pathological and immunohistochemical analyses confirmed the diagnosis of DFSP-FS. This case presents the rarity of DFSP-FS and emphasizes its distinctive pathological and immunohistochemical characteristics.

Clues in the Diagnosis of Pityriasis Rubra Pilaris: A Case Report and Literature Review Comparing it to Psoriasis

Suvijak Untaaveesup — 2024-06-05

Pityriasis rubra pilaris (PRP) is a rare papulosquamous skin disease characterized by palmoplantar keratoderma, erythroderma, orange plaques amidst normal skin and nail changes. A severe case of PRP can mimic erythrodermic psoriasis; therefore, accurate diagnosis is challenging. Clinical presentation, dermoscopic findings, and skin biopsy play pivotal roles in differentiating PRP from psoriasis. We present a case report and review the literature about the imperative diagnostic clues to distinguish PRP from psoriasis.

Cutaneous Manifestations of Cobalamin Deficiency in Bowel Resection Patient with Thalassemia Trait

Patchareya Mekasuwandit — 2024-06-05

A 32-year-old male patient with a history of ileum dissection due to blunt abdominal injury, a history of bacterial overgrowth, and beta thalassemia traits, presented with hyperpigmentation at palms, gingivae, nails, and premature greying of hair. His hematologic conditions included megaloblastic anemia. Peripheral blood smear revealed hypersegmented neutrophils. The bone marrow biopsy showed neucleocytoplasmic asynchrony. Neurological examination was completed without significant finding of proprioception loss or ataxia. The cobalamin level was confirmed as low level. One mg of B12 was intramuscularly injected daily for a week and 1 mg intramuscular injection weekly. One month following, the hair showed repigmentation.

Adult-onset Still's Disease with a Rare Life-Threatening Complication of Acute Pulmonary Embolism: A Case Report and Literature Review

Thanradee Ngeywijit — 2024-06-05

Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder with unknown etiology that most commonly affects young female adults. The characteristic signs and symptoms of AOSD are high-spiking fever, evanescence salmon-pink rash and arthritis. Atypical cutaneous manifestations of AOSD can present with persistent pruritic papules and plaques, flagellate erythema, linear plaques or vesicular eruptions. Two serious complications which can occur in patients with AOSD are reactive hemophagocytic syndrome and thrombotic thrombocytopenic purpura. Pulmonary embolism is one of the cardiovascular emergencies which are rarely reported as a complication of AOSD. Here in, we report the case of a 35-year-old Burmese woman presented with subacute intermittent high-grade fever with sore throat, polyarthritis, and persistent pruritic rashes with flagellate erythema for 3 weeks. She fulfilled the criteria for the diagnosis of AOSD. During the admission, she developed a sudden onset of dyspnea subsequent investigation revealed an intraluminal filling defect at the lateral and posterior right lower lobes that was most compatible with pulmonary embolism. She was treated with oral naproxen, prednisolone 30 mg/day (0.6 mg/kg/day), cyclosporin A 50 mg/day, topical betamethasone cream 0.1% for AOSD, and received enoxaparin 0.6 mg SC twice daily for 1 week, then oral warfarin 2 mg/day for pulmonary embolism. After 4 weeks of switching treatments, her clinical condition was partially improved.

ประวัติความเป็นมาและพัฒนาการของการอบรมระยะสั้นสำหรับแพทย์เวชปฏิบัติ ของสมาคมแพทย์ผิวหนังแห่งประเทศไทย กับการกำเนิดของสมาคมฯ

Sumanas Bunyaratavej — 2024-06-05