The chronic inflammatory disease presenting as painful subcutaneous nodules is:
Hidradenitis suppurativa is a chronic inflammatory disease presenting as painful subcutaneous nodules. Patients experience appreciable physical, psychological, and economical hardship and decreased quality of life when compared with patients who suffer from other chronic dermatologic disease such as psoriasis and alopecia. It is characterized by multiple abscesses, inter-networking sinus tracts, foul-smelling exudate from draining sinuses, inflammation in the dermis, both atrophic and hypertrophic scars, ulceration, and infection, which may extend deep into the fascia. The diagnosis is made clinically without the need for imaging or laboratory tests.
Correct statements about toxic epidermal necrolysis (TEN) include all of the following EXCEPT:
These inflammatory diseases represent a spectrum of an autoimmune reaction to stimuli such as drugs that result in structural defects in the epidermal-dermal junction. The cutaneous manifestations of toxic epidermal necrolysis syndrome (TENS) follow a prodromal period reminiscent of an upper respiratory tract infection. A symmetrical macular eruption follows starting from the face and trunk and spreading to the extremities. Typically, a Nikolsky sign develops in which lateral pressure causes the epidermis to detach from the basal layer. The macular eruption evolves into blisters, causing an extensive superficial partial-thickness skin injury with exposed dermis.
The rare adenocarcinoma of the apocrine gland that often appears as a nonpigmented plaque is:
This rare adenocarcinoma of apocrine glands arises in perianal and axillary regions and in genitalia of men and women. Clinical presentation is that of erythematous or nonpigmented plaques with an eczema-like appearance that often persist after failed treatment from other therapies. An important characteristic and one that the surgeon must be acutely aware of is the high incidence of concomitant other malignancies with this cutaneous disease. Forty percent of cases are associated with primary gastrointestinal and genitourinary malignancies, and a diligent search should be made after a diagnosis of extramammary Paget disease is made. Treatment is surgical resection with negative microscopic margins, and adjuvant radiation may provide additional locoregional control.