We report an eight-year-old female who showed a recurrence of multiple dermatofibromas on the left trunk. She was born with no apparent abnormalities, and her parents did not notice any lesions until she was one year old. New lesions have developed repeatedly on the brownish macules that became visible prior to nodule formation. She has undergone surgical excision 4 times. The number of lesions developing after each has varied; the total developed thus far is 17. From these findings, we made the final diagnosis of multiple clustered dermatofibroma (MCDF). We herein describe this case with a review of the literature. In most cases of MCDF, the lesions tend to increase in number as the patient approaches puberty. We should pay close attention to any further development throughout adolescence.
A 70-year-old man presented with edematous erythema on his eyelids and erythematous rashes on his head, ear and neck. He also had paronychial erythema and nailfold bleeding. Histopathological findings from the erythema of his neck showed dermal edema and a lymphocytic infiltration at the dermo-epidermal junction and around the small vessels in the upper dermis. Laboratory blood examination revealed high levels of creatine kinase (CK) and lactate dehydrogenase (LDH). No antinuclear antibody or anti-1 antibody was detected. A manual muscle test showed proximal muscle weakness, but there were no signs of muscle inflammation in an electromyogram and a thigh MRI. No interstitial pneumonia or malignancy was detected. We diagnosed this case as typical dermatomyositis and started prednisolone. His symptoms gradually regressed. Later, anti-TIF1 and anti-SRP antibodies were detected in his serum. The coexistence of these two myositis-specific autoantibodies is considered extremely rare; generally, an affected patient has only one myositis-specific antibody.
A 59-year-old male with brown macules on his trunk and extremities for 9 years was diagnosed with mycosis fungoides (MF) on the basis of skin manifestation and pathological findings. Topical application of corticosteroid and narrow-band UVB irradiation was administered. Two years later, a lesion arose and enlarged rapidly on left temporal skin, progressing to tumor stage. Ordinary treatments including interferon, chemotherapy, and/or radiotherapy could not be administered because of financial problems of the patient. A single-fraction palliative radiotherapy of 8 Gy electron beam was irradiated on the tumor at an outpatient clinic. The tumor vanished after two weeks, and fully epithelized after six weeks. Single fraction radiotherapy can be a useful method to control the tumor of MF when the patient can't undergo ordinary treatments. This is the first case of single-fraction palliative radiotherapy for an MF tumor in Japan.