MyMedR

Hemorrhagic bullous Henoch- Schonlein purpura: a case report

Nirmala Ponnuthurai, Sabeera Begum, Lee, Bang Rom

Malaysian Journal of Paediatrics and Child Health, 2016;22(101):0-0.

MyJurnal

Henoch – Schonlein purpura (HSP) is a vasculitis of small sized blood vessels. It is the most common acute systemic vasculitis in childhood. It mainly affects skin, gastrointestinal tract, joints and kidney. It results from Immunoglobulin A mediated inflammation. The characteristic skin findings are palpable purpuric lesions over the lower limbs and buttocks. The occurance of haemorrhagic bullae in children with HSP is rarely encountered. This case report describes a 12 year old boy with bullous haemorrhagic HSP treated at Institute Paediatric, Hospital Kuala Lumpur.

Erythema nodosum-like lesions in a renal transplant recipient

Yap FB, Lee BR

Arch Dermatol, 2011 Jun;147(6):735-40.

PMID: 21690541 DOI: 10.1001/archdermatol.2011.128-a

Syringocystadenoma papilliferum in an unusual location beyond the head and neck region: a case report and review of literature

Yap FB, Lee BR, Baba R

Dermatol. Online J., 2010;16(10):4.

PMID: 21062598

A case of syringocystadenoma papilliferum with multiple papulonodules in a linear fashion located in an unusual location of the right lower abdomen is presented. The presence of a large tumor at the inferior pole raised the suspicion of malignant transformation and the presence of discharge from the lesions raised the possibility of necrosis. However, histopathological examination showed the classical features of syringocystadenoma papilliferum without malignant transformation or tumor necrosis. The patient refused to undergo surgical excision of the nodules and subsequently was lost to follow-up. This case illustrates the atypical location of a rare disease and adds to the differential diagnosis of linear verrucous lesions on the abdomen. Review of all the cases with syringocystadenoma papilliferum outside the head and neck region in the English literature showed only one case of syringocystadenoma papilliferum arising on the abdomen; our patient is the second reported case with the unique feature of linear arrangement of lesions.

Nodular hidradenoma arising on the site of a BCG scar

Bhullar A, Lee BR, Shamsudin N

Australas J Dermatol, 2017 Aug;58(3):e135-e137.

PMID: 27523405 DOI: 10.1111/ajd.12544

Hidradenomas are tumours that arise from the adnexal structures, both eccrine and apocrine and are histologically benign. The tumours that arise from eccrine differentiation are known as poroid hidradenomas and when they arise from the apocrine glands they are called nodular hidradenomas. In our centre a 13-year-old boy presented with a slow-growing, painless erythematous fungating nodule on the left upper arm over a period of 18 months at the site of the BCG vaccination. The nodule was surgically excised and sent for histopathological examination, leading to a diagnosis of nodular hidradenoma. This case is presented to highlight its rarity, together with its clinical features that were suggestive of malignancy but proved ultimately to be benign.

Fulltext "Black box warning" rash with entecavir - case report

Cheong XK, Wong Z, Nor NM, Lee BR

BMC Gastroenterol, 2020 Sep 18;20(1):305.

PMID: 32948126 DOI: 10.1186/s12876-020-01452-3

BACKGROUND: Hepatitis B infection is a significant worldwide health issue, predispose to the development of liver cirrhosis and hepatocellular carcinoma. Entecavir is a potent oral antiviral agent of high genetic barrier for the treatment of chronic hepatitis B infection. Cutaneous adverse reaction associated with entecavir has rarely been reported in literature. As our knowledge, this case was the first case reported on entecavir induced lichenoid drug eruption.

CASE PRESENTATION: 55 year old gentlemen presented with generalised pruritic erythematous rash on trunk and extremities. Six weeks prior to his consultation, antiviral agent entecavir was commenced for his chronic hepatitis B infection. Skin biopsy revealed acanthosis and focal lymphocytes with moderate perivascular lymphocyte infiltration. Skin condition recovered completely after caesation of offending drug and short course of oral corticosteroids.

CONCLUSION: This case highlight the awareness of clinicians on the spectrum of cutaneous drug reaction related to entecavir therapy.

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