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Case of Rapid Progression of Hemiatrophy on the Face: A New Clinical Entity?

Nomura H, Egami S, Yokoyama T, Sugiura M - Case Rep Dermatol Med (2015)

Bottom Line: These diseases usually progress slowly and rapid progression of atrophy is extremely rare.Our case did not meet variable differential diagnoses.We discuss the clinical character of the patient against the past of literature and suppose it may be a new clinical entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Shizuoka Municipal Shimizu Hospital, 1231 Miyakami, Shimizu-ku Shizuoka 424-0911, Japan.

ABSTRACT
A lot of diseases, including lupus profundus, morphea, lipodystrophy, and Parry-Romberg syndrome, may manifest progressive hemifacial atrophy. These diseases usually progress slowly and rapid progression of atrophy is extremely rare. We report a case of elderly-onset rapid progression of hemifacial atrophy only in three weeks. Our case did not meet variable differential diagnoses. We discuss the clinical character of the patient against the past of literature and suppose it may be a new clinical entity.

No MeSH data available.


Related in: MedlinePlus

(a) Clinical manifestation at admission. (b) Axial computed tomography images, with soft-tissue settings, showing atrophy of subcutaneous fat on the right side of the face.
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fig1: (a) Clinical manifestation at admission. (b) Axial computed tomography images, with soft-tissue settings, showing atrophy of subcutaneous fat on the right side of the face.

Mentions: A 65-year-old woman was admitted to our department with complaints of facial asymmetry. The patient and her family noted that skin atrophy of the right cheek had progressed three weeks ago. Physical examination revealed soft-tissue atrophy of right cheek without any symptoms (Figure 1(a)). She was otherwise healthy and had not experienced any notable trauma or injection record at the lesion. There was no family history of craniofacial defects. The laboratory examination revealed slightly high levels of rheumatoid factor (RF) (26‚ÄČIU/mL), but other inspection items, including antinuclear antibody and anti-double-strand DNA antibody, were within normal limits. Computed tomography scan revealed subcutaneous tissue atrophy at the right upper jaw (Figure 1(b)). The maxillary bone was not involved. The histopathology of the lesion showed the degeneration of adipocytes without inflammatory cell infiltration in fat layer and almost normal epidermis and connective tissues of dermis. Neurological disorder was not detected by neurological physical examination, electroencephalogram, and magnetic resonance imaging. She did not require any treatment. No progression of atrophy was observed one year later from the first admission at the time of this writing.


Case of Rapid Progression of Hemiatrophy on the Face: A New Clinical Entity?

Nomura H, Egami S, Yokoyama T, Sugiura M - Case Rep Dermatol Med (2015)

(a) Clinical manifestation at admission. (b) Axial computed tomography images, with soft-tissue settings, showing atrophy of subcutaneous fat on the right side of the face.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4561931&req=5

fig1: (a) Clinical manifestation at admission. (b) Axial computed tomography images, with soft-tissue settings, showing atrophy of subcutaneous fat on the right side of the face.
Mentions: A 65-year-old woman was admitted to our department with complaints of facial asymmetry. The patient and her family noted that skin atrophy of the right cheek had progressed three weeks ago. Physical examination revealed soft-tissue atrophy of right cheek without any symptoms (Figure 1(a)). She was otherwise healthy and had not experienced any notable trauma or injection record at the lesion. There was no family history of craniofacial defects. The laboratory examination revealed slightly high levels of rheumatoid factor (RF) (26‚ÄČIU/mL), but other inspection items, including antinuclear antibody and anti-double-strand DNA antibody, were within normal limits. Computed tomography scan revealed subcutaneous tissue atrophy at the right upper jaw (Figure 1(b)). The maxillary bone was not involved. The histopathology of the lesion showed the degeneration of adipocytes without inflammatory cell infiltration in fat layer and almost normal epidermis and connective tissues of dermis. Neurological disorder was not detected by neurological physical examination, electroencephalogram, and magnetic resonance imaging. She did not require any treatment. No progression of atrophy was observed one year later from the first admission at the time of this writing.

Bottom Line: These diseases usually progress slowly and rapid progression of atrophy is extremely rare.Our case did not meet variable differential diagnoses.We discuss the clinical character of the patient against the past of literature and suppose it may be a new clinical entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Shizuoka Municipal Shimizu Hospital, 1231 Miyakami, Shimizu-ku Shizuoka 424-0911, Japan.

ABSTRACT
A lot of diseases, including lupus profundus, morphea, lipodystrophy, and Parry-Romberg syndrome, may manifest progressive hemifacial atrophy. These diseases usually progress slowly and rapid progression of atrophy is extremely rare. We report a case of elderly-onset rapid progression of hemifacial atrophy only in three weeks. Our case did not meet variable differential diagnoses. We discuss the clinical character of the patient against the past of literature and suppose it may be a new clinical entity.

No MeSH data available.


Related in: MedlinePlus