Giant Tumor of the perineal regionKey clinical message: Giant condyloma acuminatum, also known as, Buschke-Lowenstein tumour is a very rare, sexually transmitted disease. It is a slow-growing, destructive lesion that affects the anogenital region. The HPV has been identified as an important contributory factor in the development of this tumor.Key words: Dermatology, oncology, Giant condyloma acuminatum , HPV.A 48-year old man presented with a giant lesion of the perineal region which appeared 10 years before and gradually increased in size. Clinical examination revealed a lobulated, exophytic, non-painful, non-bleeding, cauliflower-shaped lesion on the penis and the scrotum, measuring approximately 8 x 7 cm suggestive of a giant condyloma acuminatum (Figure 1). There were no enlarged inguinal nodes. Magnetic resonance imaging of the pelvis and the abdomen revealed no regional lymph node involvement or evidence of distant metastasis. A skin biopsy confirmed the diagnosis of papillary condyloma acuminatum secondary to human papillomavirus (HPV). Radical excision of the entire lesion showed no signs of invasion. Blood tests for detecting Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV) and syphilis were negative. Giant condyloma acuminatum, also known as, Buschke-Lowenstein tumour is a very rare, sexually transmitted disease.1,2 It is a slow-growing, expansive, cauliflower-like, destructive lesion that affects the anogenital region.1,2 The HPV has been identified as an important contributory factor in the development of this tumor.1,2
Hordeum murinum induced pustular irritant contact dermatitisKey clinical message: Plant induced contact dermatitis is very rare. We describe the case oftwo siblings with Hordeum murinum induced pustular irritant contact dermatitis.Key words: allergology, Hordeum murinum, contact dermatitis, patch test.We describe the cases of two siblings, aged 8 and 10 years, who consulted with multiple yellowish pustules and well-demarcated erythema on the face (Figure 1). The eruption started a few hours after accidental exposure to a plant, named Hordeum murinum , while they were playing in the garden (Figure 2). The mother mentioned that this had been their first exposure to this plant. There were no other lesions either on the skin or on mucosae. Laboratory findings were without abnormalities. There was no bacterial growth in a culture of a pustular specimen. The patients were treated with a short course of topical corticosteroids. A resolution of the skin lesions was achieved within a few days. Five weeks after the resolution of dermatitis, the patients were patch tested with wetted and pounded leaves and petals of H.murinum.1 Readings were performed on the day (D)2, D4, and D7 and showed negative results.1 So, we diagnosed the patients with H. murinum -induced pustular irritant contact dermatitis.
Unusual tumor of the toeKey clinical message: Giant Cell Tumor is a soft-tissue tumor that has a very low potential for malignant change. Involvement of the phalanges of foot is very rare and only a few cases have been reported.Key words: Dermatology, oncology, Giant cell tumor, bone tumors.A 39-year-old woman presented with complaints of pain and swelling of the left second toe for four months. The mass had been slowly increasing in size over the previous 3 years. On examination, there was diffuse swelling of the left second toe with erythematous and shiny overlying skin (Figure 1). The X-ray showed an osteolytic expansive lesion with cortical destruction in the region of the distal phalanx of the second toe. No calcification or periosteal reaction was observed. Magnetic resonance (MR) images showed a mass measuring 1×1.5 cm that was heterogeneously hypo intense on both T1- and T2-weighted MR images. This mass showed a marked, diffuse and heterogeneous enhancement on the contrast T1- weighted image. Surgical excision of the tumor was performed. Histopathological examination confirmed the diagnosis of Giant Cell Tumor (GCT) (Figure 2). The patient’s postoperative course was uneventful, and no recurrence or metastasis was observed. GCTs are soft-tissue tumors that have a very low potential for malignant change. It account for approximately 6% of all bone tumors.1,2 It typically involves the long bones in young adults. 1,2 Involvement of the phalanges of foot is very rare and only a few cases have been reported.1,2