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Potentially Toxic Metals in Cucumber Cucumis sativus Collected from Peninsular Malaysia: A Human Health Risk Assessment
Chee Kong Yap, Rosimah Nulit, Aziran Yaacob, Zaieka Shamsudin, Meng Chuan Ong, Wan Mohd Syazwan, Hideo Okamura, Yoshifumi Horie, Chee Seng Leow, Ahmad Dwi Setyawan, Krishnan Kumar, Wan Hee Cheng and Kennedy Aaron Aguol
Abstract

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Medicine Group Research Article 記事ID: igmin201

EB Naevi-like Lesion in Infant Bullous Pemphigoid

Dermatology PaediatricsInternal Medicine Affiliation

Affiliation

    Division of Pediatric Dermatology, Mackenzie Evangelical University Hospital, Curitiba, Paraná, Brazil | Division of Pediatric Dermatology, Hospital of Sanitary Dermatology of Paraná, Curitiba, Paraná, Brazil

    Division of Dermatology, Pedro Ernesto University Hospital of State University of Rio de Janeiro, Brazil

    Division of Dermatology, Pedro Ernesto University Hospital of State University of Rio de Janeiro, Brazil

    Division of Dermatology, Pedro Ernesto University Hospital of State University of Rio de Janeiro, Brazil

    Division of Dermatology, Pedro Ernesto University Hospital of State University of Rio de Janeiro, Brazil

    Division of Dermatology, Pedro Ernesto University Hospital of State University of Rio de Janeiro, Brazil

    Division of Dermatology, Pedro Ernesto University Hospital of State University of Rio de Janeiro, Brazil | Division of Pediatric Dermatology, Fernandes Figueira Institute - FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil

    Division of Dermatology, Pedro Ernesto University Hospital of State University of Rio de Janeiro, Brazil | Division of Pediatric Dermatology, Fernandes Figueira Institute - FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil

要約

Epidermolysis Bullosa Naevi (EBN) is a subset of melanocytic nevi with atypical features arising at sites of blistering in patients with congenital EB. It may be clinically misdiagnosed as melanoma and may represent a challenge for the dermatologist. Bullous Pemphigoid (BP) consists of an autoimmune condition presenting with subepidermal blisters, usually affecting the elderly and rarely observed in children The case is reported of an infant who presented with pruritic erythematous bullous lesions, initially appearing over the trunk and legs with progression to arms and face. Clinical and immunopathological features were consistent with the diagnosis of infant BP. In the course of the disease, he developed a pigmented heterogeneous macule with irregular contour and satellite-dotted lesions, located on the right flank. Dermoscopy revealed a regular pigmented network distributed in an agminated manner interspersed with areas of healthy skin. Due to its similarity to EBN, an expectant approach was carried out. The lesion regressed during the 24-month follow-up. To our knowledge, there is only one literature case report of a child who presented with EBN-like in a previous BP lesion. Our case reinforces the presence of atypical melanocytic nevi in bullous diseases. Knowing this type of lesion clinically and dermatoscopically in patients with bullous dermatoses may prevent unnecessary surgical procedures in children.

数字

参考文献

    1. Reis-Filho EG, Silva Tde A, Aguirre LH, Reis CM. Bullous pemphigoid in a 3-month-old infant: case report and literature review of this dermatosis in childhood. An Bras Dermatol. 2013 Nov-Dec; 88(6):961-5. doi: 10.1590/abd1806-4841.20132378. Erratum in: An Bras Dermatol. 2014 Sep-Oct; 89(5):854. Dosage error in article text. PMID: 24474106; PMCID: PMC3900348.
    2. Sousa ACM, Silva AP. Penfigoide bolhoso - Relato de caso. Resid Pediatr. 2017 Oct; 8(2):82-84. doi: 10.25060/residpediatr-2018.v8n2-03.
    3. Schwieger-Briel A, Moellmann C, Mattulat B, Schauer F, Kiritsi D, Schmidt E, Sitaru C, Ott H, Kern JS. Bullous pemphigoid in infants: characteristics, diagnosis and treatment. Orphanet J Rare Dis. 2014 Dec 10; 9:185. doi: 10.1186/s13023-014-0185-6. PMID: 25491396; PMCID: PMC4302581.
    4. Bauer JW, Schaeppi H, Kaserer C, Hantich B, Hintner H. Large melanocytic nevi in hereditary epidermolysis bullosa. J Am Acad Dermatol. 2001 Apr; 44(4):577-84. doi: 10.1067/mjd.2001.112217. PMID: 11260529.
    5. Almeida JrLH. Molecular Genetics of Epidermolysis Bullosa. Anais Brasileiros de Dermatologia. 2002 Jan; 77(5), 519-532. doi:10.1590/S0365-05962002000500002.
    6. Melo JN, Teruya PY, Machado MC, Valente NS, Sotto MN, Oliveira ZN. Epidermolysis bullosa nevi: clinical, dermatoscopical and histological features in a case of recessive dystrofic form. An Bras Dermatol. 2011 Jul-Aug; 86(4):743-6. English, Portuguese. doi: 10.1590/s0365-05962011000400017. PMID: 21987141.
    7. Kopf AW, Grupper C, Baer RL, Mitchell JC. Eruptive nevocytic nevi after severe bullous disease. Arch Dermatol. 1977 Aug; 113(8):1080-4. PMID: 329772.
    8. Lebeau S, Braun RP, Masouyé I, Perrinaud A, Harms M, Borradori L. Acquired melanocytic naevus in childhood vulval pemphigoid. Dermatology. 2006; 213(2):159-62. doi: 10.1159/000093859. PMID: 16902297.
    9. Noor O, Elston D, Flamm A, Hall LD, Cha J. A recurrent melanocytic nevus phenomenon in the setting of Hailey-Hailey disease. J Cutan Pathol. 2015 Aug; 42(8):574-7. doi: 10.1111/cup.12511. Epub 2015 May 26. PMID: 25950447.
    10. Mollet T, Henderson FW, Groben PA, Burkhart CN, Morrell DS. Epidermolysis bullosa nevus-like lesions in a pediatric patient with pyoderma gangrenosum. Pediatr Dermatol. 2011 Jan-Feb; 28(1):32-4. doi: 10.1111/j.1525-1470.2010.01353.x. PMID: 21276050.
    11. Lanschuetzer CM, Emberger M, Hametner R, Klausegger A, Pohla-Gubo G, Hintner H, Bauer JW. Pathogenic mechanisms in epidermolysis bullosa naevi. Acta Derm Venereol. 2003; 83(5):332-7. doi: 10.1080/00015550310012674. PMID: 14609098.
    12. Cotrim CP, Simone FT, Lima RB, Barcaui CB, Sousa MA, Lowy G. Epidermolysis bullosa nevus: case report and literature review. An Bras Dermatol. 2011 Jul-Aug; 86(4):767-71. English, Portuguese. doi: 10.1590/s0365-05962011000400023. PMID: 21987147.

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