Category: November 2017 Brief Communication

Pyoderma gangrenosum, acne, hidradenitis suppurativa and arthralgia: PASH or PAPA syndrome?

Auto inflammatory diseases (AIDs) are a group of disorders characterized by the dysregulation of innate immune system and the absence of circulating autoantibodies and autoreactive T-cells.1 The AIDs characterized by neutrophilic dermatoses includes PAPA (pyogenic arthritis, pyoderma gangrenosum (PG) and acne), PASH (PG, acne and hidradenitis suppurativa), PAPASH (pyogenic arthritis, acne, PG and hidradenitis suppurativa) ,PASS (pyoderma gangrenosum, acne and sterile spondyloarthritis), PsAPASH (psoriatic arthritis, PG, acne, and hidradenitis suppurativa) and PAC (PG, acne, and ulcerative colitis).

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Frontal fibrosing alopecia and lichen planus pigmentosus in an African female

A 47 yr old black female of African descent presented with a one-year history of hair loss involving the frontotemporal hairline (Figure 1). This was preceded by a 6-month history of hyperpigmentation of the face and other sun exposed areas such as the arms and v-neck line. There was no history of using chemical hair straighteners, drugs, contact dermatitis, lupus or HIV infection. The family history was also non-contributory. She had no prior medical illness. Examination
of the scalp revealed scarring alopecia in a frontotemporal distribution with perifollicular erythema and plugging. There were no signs of traction alopecia. Brown- grey macules and patches were distributed on the face, neck and upper limbs with sparing of the mucosa and nails. Laboratory investigations
to exclude HIV and connective tissue disease where all negative. Scalp biopsy showed decreased follicles with a perifollicular lichenoid infiltrate and prominent perifollicular scarring. Skin biopsy showed mild epidermal atrophy, vacuolar alteration of the basal cell layer with keratinocyte apoptosis with pigment incontinence.

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Eruptive syringoma presenting clinically as verruca plana in a 51-year-old Filipino female: A case report

Syringoma is a common benign intraepidermal tumor affecting 0.6% of the general population and is more frequent among women at 75-90%.1,2 Lesions appear as multiple, skin colored to slightly yellowish firm papules in a bilateral symmetrical distribution.3 It is commonly located in the lower eyelids, however the scalp, axillae, abdomen, forehead, penis, and vulva can often be affected.4 Syringomas located over the forearms are unusual and rarely reported.

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