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Non-erythematous lesions
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
A pyogenic granuloma is round in shape, bright red or purple in colour, and the surrounding skin will be quite normal. It is neither pyogenic (infected) nor a granuloma. It is due to a localised overgrowth of blood vessels in response to trauma, often a graze or a prick. There is very rapid growth over a few weeks, and usually a history of the lesion having bled spontaneously at some stage. In contrast, an amelanotic malignant melanoma is usually irregular in shape, has some surrounding pigmentation and grows over a period of months rather than days or weeks.
How to prevent and treat chemotherapy-induced nail abnormalities
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Nevertheless, the standard of care for pyogenic granuloma is surgery when necessary. Under local digital block anesthesia, a curettage of granulation tissue and partial removal of the nail plate were completed with partial matricectomy confined to the lateral horns, achieved with chemical cauterization with 88% phenol (phenolization).
Chemotherapeutic-Induced Nail Reactions
Published in Gabriella Fabbrocini, Mario E. Lacouture, Antonella Tosti, Dermatologic Reactions to Cancer Therapies, 2019
Eric Wong, Maria Carmela Annunziata, Antonella Tosti
Pyogenic granulomas present as small, round, red, shiny nodules that have a tendency to bleed (1). Pyogenic granulomas have been described in patients on taxanes, tyrosine kinase inhibitors (Figure 9.7), MEK inhibitors, and EGFR inhibitors such as cetuximab, and typically involve the proximal and lateral nail folds of one or more nails (4,8,33,34,37,39). Typically, discontinuing medications can improve symptoms, but sometimes topical corticosteroids and/or mupirocin ointment may help improve symptoms and prevent infection (11,12). Other treatments that can be considered include topical alitretinoin (9-cis-retinoic acid), cauterization of the granuloma with 8% phenol solution, topical application of liquid nitrogen, topical steroids, or weekly 10% aqueous silver nitrate. Surgical excision is possible but lesions may recur (8,11,46–48). In the authors’ experience, photodynamic therapy can also be a useful treatment.
Herpes Simplex Conjunctivitis and Recurrent Chalazia in a Patient DOCK8 Deficiency
Published in Ocular Immunology and Inflammation, 2022
Tinh Le, Basak Can, Faruk Orge
Ophthalmology was consulted for a left lower eyelid mass that had been present for 1 to 2 weeks without associated pain, burning, or changes in vision. The patient reported experiencing a similar lesion on the same eyelid 3 years ago, which resolved over the course of a month with oral antibiotic treatment. On examination, best uncorrected visual acuity was 20/20 in both eyes. Slit-lamp examination revealed normal anterior segment findings of the right eye. In the left eye, a non-erythematous fungating mass of approximately 2 × 1.50 cm in size was seen inside the medial aspect of the lower lid along with moderate meibomian gland dysfunction and conjunctival injection (Figure 1). The rest of the exam was unremarkable. A diagnosis of pyogenic granuloma was made, and conservative management, including warm compresses and lid scrubs along with erythromycin ophthalmic ointment (0.5%, four times a day), was recommended.
Primary orbital polymethylmethacrylate implant following primary enucleation for retinoblastoma: a study of 321 cases
Published in Orbit, 2021
Shikha Taneja, Tariq Aldoais, Swathi Kaliki
Postoperative complications are listed in Table 2. Over a mean follow-up period of 40 months (median, 34 months; range, 4–129 months), implant exposure was seen in five (2%) cases whereas implant extrusion was seen in nine (3%) cases. There were no contributory factors for implant exposure or extrusion. The five cases with implant exposure were not amenable to wound revision and conjunctival suturing. Of these five cases, four patients underwent implant exchange with a smaller size in order to close the conjunctival wound adequately, while one patient had implant extrusion but a stable customized ocular prosthesis (COP) at last follow-up. Implant migration occurred in 28 (9%) cases, of which two cases were due to post-enucleation tumor recurrence. The most common site of implant migration was supero-temporal (n = 17; 5%) whereas temporal migration was seen in 6 (2%) cases, medial migration in 2 (<1%) cases, anterior migration in 1 (<1%) case, inferior migration in 1 (<1%) case, and infero-medial migration in 1 (<1%) case. Socket infection occurred in 1 (<1%) case which was managed conservatively with topical antibiotics. Socket contraction was seen in 4 (1%) patients including grade 1 contracture in 2 (<1%), grade 2 in 1 (<1%), and grade 4 in 1 (<1%) patient. Minor complications included conjunctival pyogenic granuloma in 10 (3%) cases and conjunctival inclusion cyst in 3 (1%) cases. Pyogenic granuloma was managed with tapering dosage of topical steroids over a month in 6 (2%) cases and remaining 4 (1%) cases required excisional biopsy.
Reactive capillary hemangiomas induced by camrelizumab (SHR-1210), an anti-PD-1 agent
Published in Acta Oncologica, 2019
Yan Teng, Ruifeng Guo, Jianfang Sun, Yiqun Jiang, Yi Liu
A female in her 20s with a history of stage IVa Hodgkin's lymphoma was enrolled in a phase I/II trial (NCT03250962) for a humanized anti-PD-1 IgG4 antibody camrelizumab (SHR-1210). One month after the first SHR-1210 injection, she developed several, 2-5 mm in size, dome-shaped, bright red papules on her scalp, face, chest, abdomen, and extremities (Figure 1(A)). SHR-1210 therapy was continued, and the lesions gradually increased in size and in number over the subsequent three months. One lesion on the right temporal scalp rapidly developed into a 20 x 15 mm, red, friable, sessile nodule with associated ulceration and bleeding. Histological examination of the nodular lesion showed numerous vascular spaces lined by endothelial cells, surrounded by fibromyxoid stroma and scattered inflammatory cells (Figure 2). The histology of this lesion combined with its clinical appearance was typical for pyogenic granuloma. The histological manifestation of the papule lesion on the forehead is consistent with cherry angioma, formed by dilated vascular channels filled with erythrocytes. Immunohistochemical studies revealed positive staining for the surface markers factor VIII-related antigen (von Willebrand factor, vWF), CD31, and CD34, negative stains to lymphoid markers and EBV with low Ki67.