Survey of resident physician and attending physician feedback perceptions: There is still work to be done.
Abstract Feedback is essential for resident physician (RP) personal and professional growth. The goal of this study was to explore RP and attending physician (AP) perceptions of feedback. Two online surveys (one for RPs and one for APs) were distributed. One hundred twenty two responses were received, of which 67 were RPs and 55 were APs. Although the majority of RP and AP agree that feedback is essential for resident formation, there was a statistical difference between these groups, P=0.04 (RPs 91% versus APs 80%) with residents more likely to agree and strongly agree with this sentiment. Thirty one percent of A...
Source: Dermatol Online J - February 13, 2020 Category: Dermatology Authors: Hajar T, Wanat KA, Fett N Tags: Dermatol Online J Source Type: research

Characteristics of patients hospitalized for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) at a Level 1 trauma center.
Abstract The purpose of this study is to further characterize the population that is hospitalized for a severe cutaneous drug reaction or that developed once during their hospitalization. We conducted a chart review of patients seen by a dermatologist at the University of California Davis Medical Center for the diagnosis of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Between January 2000 and July 2018, 25 cases of DRESS were diagnosed using RegiSCAR criteria. Twenty-two patients recovered, two were deceased, and one was transferred to another hospital. The most commonly implicated drugs in the d...
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Nguyen M, Chen YC, Tartar D Tags: Dermatol Online J Source Type: research

Drug-induced anti-Ro positive subacute cutaneous lupus in a man treated with olmesartan.
Abstract A 66-year-old man presented to the outpatient dermatology clinic with a chief complaint of a pruritic rash on his upper trunk and proximal upper extremities, which had been present for three weeks. Upon examination, he was found to have an erythematous, annular, and polycyclic eruption on the chest, upper back, and proximal extremities. A clinical diagnosis of subacute cutaneous lupus erythematosus (SCLE) was made. The patient was found to have a positive anti-nuclear antibody (ANA) in a speckled pattern and a positive anti-Ro antibody. A biopsy revealed an interface and lichenoid dermatitis with dermal m...
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Gray T, Segars K, Farsi M, Ross R, Miller R Tags: Dermatol Online J Source Type: research

Bullous hemorrhagic lichen sclerosus of the breast: a report of two cases and review of the literature.
We report two cases of bullous hemorrhagic LS of the breast arising in 66-year-old and 77-year-old women. Bullous hemorrhagic LS of the breast is exceedingly rare, with few reported cases, and presents a diagnostic challenge to clinicians. PMID: 32045162 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Ryan MP, Monjazeb S, Ross LS, Kroger KT Tags: Dermatol Online J Source Type: research

Cutaneous angiosarcoma of the leg.
Abstract Angiosarcomas are malignant neoplasms arising from endothelial cells. Cutaneous angiosarcoma is the most common form, typically occurring in the setting of chronic lymphedema or previous radiation. The head and neck are the most common locations for cutaneous angiosarcoma, with rare occurrence on the trunk and extremities. Herein, we present a case of angiosarcoma on the lower extremity in an elderly man. This 71-year-old man presented with a two-year history of red-yellow discoloration of the left lower leg with subsequent development of black nodules over the past several months prior to presentation. H...
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Cooper H, Farsi M, DO DD, DO RM Tags: Dermatol Online J Source Type: research

Elephantiasis nostras verrucosa: an atypical presentation following intrapelvic lymphoma.
We report a 72-year-old man who presented to the dermatology clinic for an 11-year history of edematous legs, occasionally associated with ulcerations. The findings developed within a year of intrapelvic non-Hodgkin lymphoma and progressed gradually over 10 years after lymphoma remission. Physical examination revealed atypical features including compressible cysts and pitting edema extending from the lower legs to the thighs bilaterally. The patient was noncompliant for the recommended compressive devices and the condition progressively worsened over the course of 7 months of follow-up. Early interdisciplinary management u...
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Hadian Y, Link D, Dahle SE, Isseroff RR Tags: Dermatol Online J Source Type: research

Onset of disseminated cutaneous nodules following toe amputation in heart transplant patient.
We report a case of disseminated Alternaria infection in an immunocompromised patient from a primary focus of ungual phaeohyphomycosis. PMID: 32045165 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Margheim A, Malone JC, Owen C Tags: Dermatol Online J Source Type: research

Verrucous venous malformation.
We describe a 53-year-old man who presented with a large hyperkeratotic plaque of the left dorsal and plantar foot. Biopsy revealed verrucous acanthosis of the epidermis and a proliferation of thin-walled vessels in the dermis. We provide a brief review of the clinical and histopathologic presentation, differential diagnosis, and management of this rare entity. PMID: 32045166 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Leavens J, Worswick S, Kim GH Tags: Dermatol Online J Source Type: research

Angiolymphoid hyperplasia with eosinophilia treated with Mohs micrographic surgery.
Abstract A 60-year-old healthy man presented with several enlarging, tender, spontaneously bleeding, and episodically pruritic nodules on his ear. Five agminated pink-red papulonodules of the superior postauricular sulcus were noted on examination. Pathological examination revealed a lobular dermal vascular proliferation with plump endothelial cells protruding into the lumen in a hobnail pattern, along with a dense perivascular inflammatory infiltrate composed of plasma cells, lymphocytes, and numerous eosinophils. The diagnosis of angiolymphoid hyperplasia with eosinophilia was confirmed. After discussing treatme...
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Trivedi A, Norris I, DeWitt CM, Goldman GD Tags: Dermatol Online J Source Type: research

Erythroderma with circulating atypical T-cells, likely S ézary syndrome.
Erythroderma with circulating atypical T-cells, likely Sézary syndrome. Dermatol Online J. 2019 Dec 15;25(12): Authors: Ugonabo N, Kim R, Chen L, Meehan S, Weed J Abstract The erythrodermic patient is often challenging and requires careful evaluation. Work-up should include an extensive and careful medication history, histological and laboratory testing, and if necessary, molecular studies for the evaluation of underlying malignancy. Herein, we present an erythrodermic patient with repeated biopsies demonstrating a spongiotic process who was found to have circulating atypical T-cells concerning...
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Ugonabo N, Kim R, Chen L, Meehan S, Weed J Tags: Dermatol Online J Source Type: research

A case of porphyria cutanea tarda in the setting of hepatitis C infection and tobacco usage.
We report a case of PCT in the setting of cigarette usage and untreated hepatitis C infection. PMID: 32045169 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Lederhandler M, Chen L, Meehan SA, Brinster NK, Neimann A Tags: Dermatol Online J Source Type: research

Vitiligo-like lesions located over In-transit metastases of malignant melanoma as a clinical marker of complete response to pembrolizumab.
Sánchez-Salas MP Abstract Anti-programmed cell death (PD)-1 therapies in metastatic tumors have a high incidence of immune adverse events, including cutaneous manifestations such as vitiligo-like lesions. This side effect is associated with increased survival and it is a clinical marker of response to treatment. This case report is a graphic representation of the appearance of vitiligo-like lesions over in-transit metastases of malignant melanoma linked to a complete response to treatment with pembrolizumab. PMID: 32045170 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Gracia-Cazaña T, Padgett E, Hernández-García A, Sánchez-Salas MP Tags: Dermatol Online J Source Type: research

Unbearable wearables.
Abstract As wearable devices play an increasing role in the management of health and disease, adverse skin reactions to wearables have become more common. However, the management of allergic contact dermatitis is challenging and new treatment options more compatible with wearable devices are needed. In a 40-year-old woman with contact dermatitis to a continuous glucose monitoring device, topical clobetasol propionate 0.05% spray proved to be an effective treatment that was compatible with the application of adhesive wearables. This case demonstrates that spray formulations of topical steroids are a good option for...
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Wei JJ, Hayward EM, Leung TH, Rosenbach M Tags: Dermatol Online J Source Type: research

The tangential punch biopsy.
Abstract Dermatologists around the world widely utilize skin biopsies, which can be performed using shave, punch, incisional, or excisional techniques [1]. The punch biopsy allows a dermatologist to obtain a full-thickness skin sample. The post-biopsy wound heals by primary closure or second intention [2]. Some suspicious lesions may be located at the body parts that are difficult to access. PMID: 32045172 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Breslavets M, Lapa T Tags: Dermatol Online J Source Type: research

A fluorescing spot on the temple: a helpful reminder for a detailed history and physical exam.
Abstract We discuss a woman with a history of non-melanoma skin cancer who presented with a new erythematous macule on her right temple. On examination with Wood lamp the well-demarcated macule fluoresced pink making neoplasm unlikely. Further history and physical examination suggested an inadvertent ink stain and the patient was spared a biopsy highlighting the importance of eliciting a good history and performing a detailed physical examination with additional tools such as a Wood lamp when necessary. PMID: 32045173 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 15, 2019 Category: Dermatology Authors: Tshudy M, Neiner D, Riley C, Neiner J Tags: Dermatol Online J Source Type: research

Systemic 5-fluorouracil induced lupus erythematosus: a review of the literature.
Abstract Drug-induced subacute cutaneous lupus erythematosus (SCLE) is the most common subtype of drug-induced systemic lupus erythematosus and has been associated with more than 100 drugs. It presents weeks to months after initiation of the culprit medication. The eruption is typically in a photodistribution and it is marked by positive serology to anti-Ro (SSA) antibody. Systemic 5-fluorouracil (5-FU) is a less-common culprit of drug-induced SCLE and its occurrence is likely dependent on exposure to ultraviolet light. Herein, we present a review of drug-induced lupus induced by the pyrimidine analog, 5-FU, and i...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Shakhbazova A, Marsch AF Tags: Dermatol Online J Source Type: research

Melanoma in individuals with neurofibromatosis type 1: a retrospective study.
CONCLUSIONS: We did not find statistical evidence for an increased melanoma risk in adults with NF1. However, additional large studies are warranted to clarify whether melanoma risk is increased in NF1 patients. PMID: 32045143 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Zhang M, Bhat T, Gutmann DH, Johnson KJ Tags: Dermatol Online J Source Type: research

Implementation of a patient-assisted teledermatology model in the Veteran Health Administration.
Abstract Owing to the inherently visual nature of the field of dermatology, advances in imaging and communication technology have resulted in wide-spread application of teledermatology since its introduction in the mid-1990s. In the last 20 years, studies have repetitively shown that teledermatology provides effective and efficient quality care for patients. It also increases access to underserved patients and reduces traveling costs, wait times, and unnecessary referrals. In this letter the authors seek to analyze implementation of a direct patient to dermatologist model in a Veteran Health Administration (VHA) p...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Fortugno AP, Dellavalle RP Tags: Dermatol Online J Source Type: research

Diagnosis of cutaneous T-cell lymphoma by insurance type before and after the Affordable Care Act: a national database study.
Abstract The Affordable Care Act (ACT) was implemented to increase health care access and reduce the uninsured in the age group between pediatric and Medicare populations (18-64). The association of the ACA with insurance type upon diagnosis (uninsured, Medicaid, non-Medicaid) has been investigated for otolaryngologic, gynecologic, and the top five non-skin malignancies. Such studies for cutaneous malignancies are lacking. We conducted a retrospective analysis of the prospective National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) cancer database to assess the impact of the ACA on new dia...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Ramachandran V, Park KE, Shah JR, Duvic M Tags: Dermatol Online J Source Type: research

Pleomorphic dermal sarcoma in a man with HIV: report with next-generation sequencing analysis and review of the atypical fibroxanthoma/pleomorphic dermal sarcoma spectrum.
Abstract Atypical fibroxanthoma (AFX) is a rare cutaneous fibrohistiocytic tumor that typically arises on chronically sun-damaged skin, such as the head and neck, as a nondescript ulcerated papule, nodule, or tumor. The clinical prognosis is usually favorable and metastasis is rare. Pleomorphic dermal sarcoma (PDS), or undifferentiated pleomorphic sarcoma, is a recently introduced diagnostic moniker for AFX-like tumors with more aggressive clinical and histologic features such as necrosis and vascular invasion. The exact relationship between AFX and PDS has been debated. Diagnosis of these tumors is generally base...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Chen SX, Eichenfield DZ, Orme C, Hinds B Tags: Dermatol Online J Source Type: research

Molluscum contagiosum infection with features of primary cutaneous anaplastic large cell lymphoma.
We report this case to demonstrate that reactive CD30+ infiltrate associated with molluscum contagiosum can be mistaken for T-cell lymphomas and patients should be reassured in these cases. PMID: 32045148 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Shalabi D, Ringe J, Lee JB, Nikbakht N Tags: Dermatol Online J Source Type: research

Gorlin syndrome in a patient with skin type VI.
Abstract Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a rare autosomal dominant disorder that is characterized by multiple basal cell carcinomas developing at a young age, keratocystic odontogenic tumors of the jaw, palmar or plantar pits, calcification of the falx cerebri, and skeletal abnormalities. Nevoid basal cell carcinoma syndrome is caused by mutations in the PTCH1 or SUFU genes. Our patient with Fitzpatrick skin type VI was diagnosed with Gorlin syndrome based on the presentation of multiple major diagnostic characteristics. Although he is 33 years old, he has not developed any ...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Poladian K, Difato TC, Anderson KL, Taylor SL Tags: Dermatol Online J Source Type: research

Unilateral hyperhidrosis secondary to brainstem meningioma producing mass effect.
In this report, we describe a 61-year-old man with isolated sweating on the left side of his entire body. A right-sided brainstem meningioma producing mass effect is suspected as the underlying etiology. PMID: 32045150 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Margheim A, Schadt CR Tags: Dermatol Online J Source Type: research

Neonatal sucking blister.
We report a female neonate with a sucking blister on the distal dorsal aspect of her left forearm. These benign bullae should be differentiated from other diseases of the newborn through their presentation, characteristic morphology, and self-limiting course. PMID: 32045151 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Afsar FS, Cun S, Seremet S Tags: Dermatol Online J Source Type: research

Eccrine poromatosis following chemotherapy and radiation therapy.
We present two cases of eccrine poromatosis in patients who had undergone chemotherapy, radiation therapy, and stem cell transplant. This case report serves to raise awareness of this condition and highlight its association with malignancies and their treatment. PMID: 32045152 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Nguyen K, Kim G, Chiu M Tags: Dermatol Online J Source Type: research

Dupilumab for bullous pemphigoid with intractable pruritus.
We report here a case of an elderly patient with refractory BP whose symptoms of pruritus and blistering became well-controlled with the addition of dupilumab to the treatment regimen. PMID: 32045153 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Seidman JS, Eichenfield DZ, Orme CM Tags: Dermatol Online J Source Type: research

Topical timolol for treatment of persistent granulation tissue in the setting of severe hidradenitis suppurativa.
Abstract Hidradenitis suppurativa (HS) is a potentially debilitating dermatological disease that negatively impacts patients' quality of life. Severe cases can be further complicated by persistent granulation tissue at the ostia of sinus tracts, which may prove recalcitrant to standard interventions. Herein we report such a case in which a patient experienced significant improvement from severe HS but was left with persistent granulation tissue that complicated his course of recovery. When standard interventions failed, we elected to begin treatment with topical timolol. After three months, the majority of the gra...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Chen X, Guffey DJ Tags: Dermatol Online J Source Type: research

Bilateral keratoprostheses in a patient with ocular mucous membrane pemphigoid.
We present a 64-year-old man with recalcitrant ocular MMP and consequently advanced corneal involvement that received bilateral keratoprostheses. This case highlights an aggressive but successful placement of bilateral keratoprostheses in recalcitrant ocular MMP, which restored his vision and ultimately his quality of life. PMID: 32045155 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: DeGrazia T, Bromley J, Feldman R Tags: Dermatol Online J Source Type: research

Multidermatomal herpes zoster: a pain in the neck?
Abstract Herpes zoster classically presents as a vesicular eruption along a single dermatome that correlates with the dorsal root ganglion in which varicella zoster virus (VZV) reactivates. Such cases most commonly involve a single thoracic dermatome, but other rare presentations of herpes zoster have been reported including multidermatomal herpes zoster. This letter reports a case of multidermatomal herpes zoster affecting cervical dermatomes C2-C5 and presents all previously published cases of multidermatomal herpes zoster in which involved dermatomes were reported to determine if this condition has a predilecti...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Beuerlein KG, Strowd LC Tags: Dermatol Online J Source Type: research

Presence of arthralgia exacerbates decreased quality of life in hidradenitis suppurativa patients.
In this study, we distributed a survey consisting of the Short Form 12 Health Survey, used for assessing health outcomes, along with additional questions about joint pain to an online hidradenitis suppurativa support group in order to understand the effect of comorbid arthralgia on quality of life in this disease. The respondents in this study had significantly reduced physical health composite scores-12 (PCS-12), (35.8 versus 50, P<0.001) and mental health composite scores-12 (MCS-12), (33.7 versus 50, P<0.001) scores compared to the general population. Additionally, patients reporting severe arthralgia had ...
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Kremer M, Chang TC, Murina A Tags: Dermatol Online J Source Type: research

Corrigendum: Systemic contact dermatitis related to alcoholic beverage consumption.
Abstract The original article was published on September 15, 2019 and corrected on November 15, 2019.The revised version of the article adds a missing author. This change appears in the revised online PDF copy of this article. PMID: 32045158 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - November 15, 2019 Category: Dermatology Authors: Ramachandran V, Cline A, Summey BT, Feldman SR Tags: Dermatol Online J Source Type: research

Radiation induced lichen planus - an uncommon side effect.
We report a 66-year-old man who presented to the dermatology clinic with a symmetric pruritic eruption affecting the pelvic and gluteal region within two months of radiation therapy targeting the prostate and pelvic lymph nodes for prostate adenocarcinoma. The patient did not have a prior history of lichen planus. Physical examination demonstrated well demarcated, violaceous papules and plaques in a circumferential band-like distribution on the bilateral gluteal, lumbosacral, and pelvic region. In addition, he had a few discrete lesions on the calves and dorsal feet. Punch biopsy revealed an acanthotic epidermis with "...
Source: Dermatol Online J - November 11, 2019 Category: Dermatology Authors: Hadian Y, Chen YC, Eastham DV, Schulman JM, Sood A Tags: Dermatol Online J Source Type: research

Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies.
Abstract Melasma is an acquired hyperpigmentation disorder most commonly affecting females with darker skin types. It is triggered by several factors including sun exposure, genetic influences, and female sex hormones. The pathology of melasma extends beyond melanocytes and recent literature points to interactions between keratinocytes, mast cells, gene regulation abnormalities, neovascularization, and disruption of basement membrane. This complex pathogenesis makes melasma difficult to target and likely to recur post treatment. A better understanding of the latest pathological findings is key to developing novel ...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Rajanala S, Maymone MBC, Vashi NA Tags: Dermatol Online J Source Type: research

Critical analysis of features and quality of applications for clinical management of acne.
CONCLUSIONS: Mobile acne apps can be effective in the self-management and collaborative management of acne. The current acne apps are of variable quality and none contained all 10 features crucial for effective clinical management. The shortcomings identified in this paper can guide future acne app development. PMID: 31735002 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Sambhi RD, Kalaichandran R, Md JT Tags: Dermatol Online J Source Type: research

A new somatic-type delusional disorder subtype: delusion inversus.
Abstract The interplay between psychiatric and dermatologic conditions has been recognized for decades as evidenced by the widely accepted classification system of psychocutaneous disorders: (1) primary dermatologic disorder with psychiatric sequelae, (2) primary dermatologic disorder exacerbated by stress, (3) primary psychiatric disorder with dermatologic sequelae, and (4) miscellaneous. However, there is minimal literature regarding dermatologic patients who demonstrate a preoccupation with a more severe cutaneous disorder despite evidence confirming a diagnosis of a minor, treatable skin condition. These patie...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: De Souza B, McMichael A Tags: Dermatol Online J Source Type: research

Impact of medical scribes on dermatology trainee and attending experience.
CONCLUSIONS: The positive impact of scribes on dermatology education is consistent with results in other disciplines. Although hospitals typically invest in scribes to increase physician efficiency, this study suggests that scribes can also improve the educational experience. PMID: 31735004 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Zhong CS, Mostaghimi A, Nambudiri VE Tags: Dermatol Online J Source Type: research

The rise in subscription skin care services.
Abstract Subscription skin care services are a rising niche of direct-to-consumer telehealth models. The explosion of such services may be a reflection of the increasing demand by patients to have accessible, affordable dermatological care. These models come with both benefits and risks to patients. A thorough understanding of how subscription skin care services work may benefit dermatologists in addressing patients' questions regarding alternative care options. PMID: 31735005 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Visconti MJ, Haidari W, Feldman SR, Taylor SL Tags: Dermatol Online J Source Type: research

Bullous dermatoses secondary to anti-PD-L1 agents: a case report and review of the literature.
Abstract Immune checkpoint inhibitors are used to treat numerous malignancies but may be associated with severe adverse events. Bullous dermatoses, chiefly bullous pemphigoid (BP), are potentially progressive adverse events that cause blistering skin lesions and may involve a significant body surface area. Herein, we report an 87-year-old man with urothelial cell carcinoma undergoing atezolizumab treatment who presented with an acute-onset blistering eruption. Biopsy revealed a subepidermal bulla, direct immunofluorescence revealed linear IgG and C3 deposits at the dermal-epidermal junction, and serum studies reve...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Kosche C, Owen JL, Sadowsky LM, Choi JN Tags: Dermatol Online J Source Type: research

A challenging diagnosis of penile sarcomatoid squamous cell carcinoma.
We report a patient with penile sarcomatoid squamous cell carcinoma (SCC) initially misdiagnosed as condyloma acuminatum. Sarcomatoid SCC is a rare, aggressive, biphasic cancer that often presents a diagnostic challenge and carries a poor prognosis, especially after a delay in diagnosis. Although sarcomatoid SCC may exhibit a broad range of clinical features, the expression of p63 and keratin 34?E12 is a common finding. Our case highlights the importance of accurate clinicopathologic correlation to facilitate a timely diagnosis and management of this rare and highly aggressive malignancy. PMID: 31735007 [PubMed - in p...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Zhang S, Khosravi H, Cardis M, Jedrych J, Ho J, Bunimovich Y Tags: Dermatol Online J Source Type: research

Keratoacanthoma-like nodules as first manifestation of metastatic epithelioid trophoblastic tumor.
Abstract Cutaneous metastases are rarely the initial manifestation of a previously undiagnosed malignancy and keratoacanthoma-like lesions are a notoriously unusual presentation pattern of cutaneous dissemination of a primary tumor. Herein, we report a 40-year-old woman presenting to our dermatology department with multiple keratoacanthoma-like scalp nodules. Subsequent investigation determined it to be the first manifestation of a disseminated endometrial epithelioid trophoblastic tumor, eventually causing the patient's death. Epithelioid trophoblastic tumor, a rare form of gestational trophoblastic disease, is a...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Gil F, Elvas L, Raposo S, Carvalho T, Gil J, Cardoso JC, Fernandes B Tags: Dermatol Online J Source Type: research

Hydroxyurea-induced hyperpigmentation with iron deposition.
We report a novel case in which hydroxyurea hyperpigmentation is associated with iron deposition. PMID: 31735009 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Lee KP, Vangipuram RK, Klimas NK, Sanyal S, Koshelev MV Tags: Dermatol Online J Source Type: research

Widespread subacute cutaneous lupus erythematosus in a patient receiving checkpoint inhibitor immunotherapy with ipilimumab and nivolumab.
Abstract Checkpoint inhibitor immunotherapy, including ipilimumab and nivolumab, is associated with numerous immune-related adverse events including dermatitis, pruritus, hepatitis, diarrhea, and hypophysitis. As the number of patients undergoing immunotherapy treatment increases, however, rare and unusual immune-related adverse events are observed. Many of these resemble known autoimmune phenomenon, such as subacute lupus erythematosus and myositis. Herein, we report a patient with metastatic serous ovarian carcinoma undergoing treatment with combination ipilimumab and nivolumab who developed subacute cutaneous l...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Kosche C, Owen JL, Choi JN Tags: Dermatol Online J Source Type: research

Follicular spicules of multiple myeloma.
Abstract Follicular spicules are a very rare but highly characteristic cutaneous manifestation of multiple myeloma. The spicules typically appear as hyperkeratotic horns in the follicular openings of the face, most commonly on or around the nose and forehead. The pathophysiology of this condition has not been fully elucidated and remains an active area of research and debate. Herein we describe a patient who presented with follicular spicules in the context of unintentional weight loss, anemia, and elevated inflammatory markers. We discuss the diagnostic work-up for such a presentation, review the classification o...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Smith MP, Manabat-Hidalgo C Tags: Dermatol Online J Source Type: research

Pink verrucous plaque in a man with systemic mastocytosis.
We present a 53-year-old man with systemic mastocytosis who presented with a pruritic, verrucous plaque in the gluteal fold that showed multiple cornoid lamellae on histopathologic evaluation, diagnostic of porokeratosis ptychotropica. Various treatments have been reported, including topical corticosteroids, retinoids, vitamin D analogs, calcineurin inhibitors, imiquimod, phototherapy, cryotherapy, or ablative laser therapy, but recurrences are common. PMID: 31735012 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Terrell JR, Urban JR, Fung MA, Tartar DM, Kiuru M Tags: Dermatol Online J Source Type: research

Persistent dermatomal eruption on a leg.
Abstract Unilateral linear capillaritis (ULC) is a rare variant of pigmented purpuric dermatoses (PPD) that is characterized by a linear or pseudo-dermatomal eruption on a single extremity. Although clinically distinct from the other PPD, it shares histopathologic features with this group. Herein, we present a man in his 50s who presented with asymptomatic macules and scaly papules on the left lower extremity in a linear distribution. The eruption persisted despite treatment with topical triamcinolone 0.1% and oral rutocide. PMID: 31735013 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Hoesly PM, Cappel MA, Sluzevich JC Tags: Dermatol Online J Source Type: research

Apocrine hidrocystoma on the nipple: the first report in this unusual location.
We report the first case of this cyst in this unsual location. PMID: 31735014 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Magdaleno-Tapial J, Valenzuela-Oñate C, Martínez-Doménech Á, García-Legaz-Martínez M, Martínez-Aparicio A, Alegre-de Miquel V, Pérez-Ferriols A Tags: Dermatol Online J Source Type: research

Palmoplantar epidermoid cysts: two cases and brief review of the literature.
This article reviews the possible etiology, diagnosis, and prognosis of palmoplantar epidermoid cysts. PMID: 31735015 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Arandes-Marcocci J, Melé-Ninot G, Quintana-Codina M, Iglesias-Sancho M, Salleras Redonnet M Tags: Dermatol Online J Source Type: research

Safety of guselkumab in hepatitis B virus infection.
Abstract Reactivation of hepatitis B virus (HBV) following the use of TNF antagonists has been reported and is a contraindication to use of these medications. Although the risk of reactivation of HBV during use of ustekinumab and secukinumab is low in patients with only HBV core antibody positivity, the risk is substantial in patients with chronic HBV infection. Less information is available regarding the use of pure IL-23 antagonists. Herein we discuss the successful treatment with guselkumab of a patient with HBV core antibody positivity, without evidence of HBV reactivation or other liver complications. PM...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Duncan JR, Orlowski TJ, Elewski BE Tags: Dermatol Online J Source Type: research

Unilateral contact dermatitis of the chest.
We present a case of unilateral dermatitis of the chest developing in a patient with a history of allergy to metal. A name tag attached magnetically to his work uniform was identified as the cause of the eruption. Unilateral eruption of the chest can be a manifestation of allergic contact dermatitis to metal objects in breast pockets or attached to clothing. PMID: 31735017 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Ramani LT, Feldman SR Tags: Dermatol Online J Source Type: research

Secondary organizing pneumonia (bronchiolitis obliterans with organizing pneumonia) associated with adalimumab for treatment of chronic plaque psoriasis.
We report a 68-year-old woman with a longstanding history of chronic plaque psoriasis, treated with the tumor necrosis factor (TNF) inhibitor, adalimumab. After 8 years of treatment, she developed a gradual-onset, non-productive cough with associated generalized fatigue and mild dyspnea. Radiological investigations demonstrated ground-glass opacities in the left lower lobe and bronchoscopy revealed a fibroinflammatory process consistent with organizing pneumonia. Her biologic treatment was ceased and corticosteroid treatment commenced, with resolution of both her symptoms and the radiological findings. Given the increasing...
Source: Dermatol Online J - October 15, 2019 Category: Dermatology Authors: Doolan BJ, Cranwell WC, Nicolopoulos J, Dolianitis C Tags: Dermatol Online J Source Type: research