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Lower legs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Pink, skin-coloured or yellow waxy plaques or nodules are seen on the anterior shins of around 10% of patients with hyperthyroidism. It is associated with diffuse thyroid enlargement, exophthalmos and thyroid acropachy. The surface of the skin has a peau d’orange effect.
Benign tumours, moles, birthmarks and cysts
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
This is an uncommon, benign lesion of childhood and adolescence. Although usually solitary papules or small plaques, the lesions are occasionally multiple (Fig. 14.20). The individual lesions are pink or orange and may have a corrugated or peau d’orange surface. Their name derives from their histological appearance, which may look frighteningly like a melanoma to the uninitiated.
The female reproductive system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Inspection of the breasts should begin with the patient sitting facing the examiner, with her arms at her sides. Look for any colour change in the skin, asymmetry of the breasts and unusual contour (although the normal right and left breasts are not always of equal size). Look in particular for any dimpling or tethering of the skin, and check that the nipples and areolae are healthy. Local oedema in the skin over a breast carcinoma may produce an appearance likened to the skin of an orange (‘peau d’orange’), but this is an unusual finding.
Mycophenolate mofetil and mycophenolic acid for the treatment of eosinophilic fasciitis: report of two cases and literature review
Published in Journal of Dermatological Treatment, 2022
Ilse Andrea Moreno-Arquieta, Jesus Alberto Cardenas-de la Garza, Jorge Antonio Esquivel-Valerio, Janett Riega-Torres, Adrian Cuellar-Barboza, Maira Elizabeth Herz-Ruelas, Jorge Ocampo-Candiani, Dionicio Angel Galarza-Delgado
A 55-year-old woman was evaluated in the Dermatology Department with a 3-month evolution of a rapidly-spreading dermatosis. Lesions started as edema on the arms and legs and progressed to indurated plaques on the thighs and shoulders. During the interview, she referred a 7-kg weight loss. Raynaud’s phenomenon, arthritis, or sclerodactyly were not reported. Physical examination revealed indurated, symmetrical plaques on the legs, arms, abdominal wall, and shoulders (Figures 1 and 2). Flexion of the ankle and shoulder was limited. Peau d’orange skin was noted on the thighs as well. Laboratory findings showed an elevated ESR, eosinophils within normal limits, and negative anti-scleroderma-70, anticentromere, anti-nuclear, and anti-RNA pol III antibodies. Treatment with MTX and PDN was started but due to fast progression over two-weeks, MMF 1 g/day was added. She presented complete remission at 8 months of follow-up with resolution of skin lesions and joint mobility. One-year after the initial EF diagnosis, the patient presented inflammatory polyarthritis for which MTX was reinitiated (Table 1).
Coquille d’oeuf in young patients affected with Pseudoxantoma elasticum
Published in Ophthalmic Genetics, 2019
Vittoria Murro, Dario Pasquale Mucciolo, Dario Giorgio, Andrea Sodi, Federica Boraldi, Daniela Quaglino, Gianni Virgili, Stanislao Rizzo
Peau d’orange appeared as yellowish/white, punctiform dots scattered from the posterior pole to the mid-peripheral retina and prominently visible temporal to the fovea in all patients. These alterations were better displayed at Color and RF imaging, whereas they were not detectable at the FAF examination. (Figure 1). Specifically, temporally and on the nasal side of the optic disc, these yellowish/white dots rearranged developing a confluent opacity extending beyond the vascular arcades and in the midperiphery. Peripherally to the confluent area, the yellowish/white dots appeared less defined and frequent. Choroidal details were clearly visible in the non-confluent-area, whereas they appeared less discernable in the confluent area. The confluent area, already named as coquille d’oeuf, appeared highly hyper-reflective on red-free imaging whereas it was not detectable using FAF, as for the peau d’orange. The confluent area was well-detectable also on Ch imaging as hyper-reflective lesion. More specifically, in patient P1, the youngest patient of our series (13 yrs), the peau d’orange appeared to consist of less confluent dots, which were clearly detectable even in the mid-periphery and along the vascular arcades. (Figure 1). In the area of peau d’orange, OCT scans revealed an increased density of RPE-Bruch’s membrane complex. This peculiar finding was more evident using an inverse OCT pattern, in which more reflective structures are darker (Figure 2).
Clinical and dosimetric evaluation of recurrent breast cancer patients treated with hyperthermia and radiation
Published in International Journal of Hyperthermia, 2019
Sharvari Dharmaiah, Johnathan Zeng, Vinay S. Rao, Ouyang Zi, Tianjun Ma, Kevin Yu, Heeruk Bhatt, Chirag Shah, Andrew Godley, Ping Xia, Jennifer S. Yu
Patient data were reviewed under a Cleveland Clinic approved IRB protocol. Thirty-six patients with recurrent breast cancer underwent concurrent hyperthermia treatment with radiation at the Cleveland Clinic from 2011–2017. Median follow-up of analysis was 11 months (range 1–123 months). Patient characteristics at initial presentation are summarized in Supplemental Table S1 and at time of recurrence are summarized in Table 1. The patients with inflammatory breast cancer had infiltrating ductal carcinoma with clinical presentations of rapid onset of breast erythema, edema or peau d’orange; erythema involving at least 1/3 of the breast or chest wall; and dermis and dermal lymphatic invasion on pathology. Patients were evaluated by medical oncologists, radiation oncologists and surgeons. Patients with locoregional disease progression were seen for palliative hyperthermia and radiation. Recurrences involved the chest wall, supraclavicular fossa and/or axilla. Clinical exam, CT and bone scan imaging were conducted to evaluate the extent of locoregional and distant disease.