53-year-old man who was seen for a general skin
examination. He has Crohn's disease and
has been on 6-MP for the past 8-10 years.
His gastroenterologist said because of this he should have a skin
examination.
O/E: The patient has
type II skin. He has a 6 mm in diameter pink
papule on the calf of the left leg. Dermoscopically,
this lesion has a dotted vascular pattern.
IMPRESSION: Lesion
left calf. Etiology unclear.
Plan: Excisional biopsy was obtained.
Reference:
Inflammatory Bowel Disease Treatment and Non-melanoma Skin Cancer: Jacqueline F De Luca, MD, Yun Sun Lee, MD, and Douglas Johnson, MD, Hawaii J Med Public Health. 2012.7:324–325.
Plan: Excisional biopsy was obtained.
Reference:
Inflammatory Bowel Disease Treatment and Non-melanoma Skin Cancer: Jacqueline F De Luca, MD, Yun Sun Lee, MD, and Douglas Johnson, MD, Hawaii J Med Public Health. 2012.7:324–325.
Abstract:Immunosuppressant medications for Inflammatory
Bowel Disease can help with both symptoms and disease progression. However,
like immunosuppressants used in transplant patients, they are now suspect of
contributing to nonmelenoma skin cancer (NMSC). Presented is a case of a
57-year-old Jewish man with Crohn's Disease who was diagnosed with a total of
84 NMSCs. We hope to elucidate the risk of immunosuppressants, particularly the
thiopurines, on the development of NMSC.
Consider Tufted Angioma; Bacillary angiomatosis
ReplyDeleteref:
Al-Za’abi AM, Ghazarian D, Greenberg GR, Shaw JC. Eruptive tufted angiomas in a patient with Crohn's disease. J Clin Pathol. 2005;58:214–6.
Has somewhat of a "string of pearls" configuration suggestive of a clear cell acanthoma. I haven't seen any correlations with this and Crohn's disease or with immunosuppression, but the age and morphology would be consistent.
ReplyDeleteClear cell acanthoma with string of pearls seems to fit .
ReplyDeletePatrick Kenny
Yoon Cohen wrote: This looks like "clear cell acanthoma" by looking at the dermoscopic image.
ReplyDelete