Indeterminate cell histiocytosis that presented clinically as benign cephalic histiocytosis.
We describe a 12-month-old boy with a four-month history of asymptomatic, small, pink-tan papules on his face. Histopathologic evaluation showed a superficial, dermal infiltrate of histiocytes that was positive for S100, CD1a, CD68, and Factor XIIIa. To our knowledge, this represents the first report of the clinical presentation of benign cephalic histiocytosis with immunohistochemical findings of ICH. We review the classification of histiocytic disorders and the clinical and immunohistochemical features of both ICH and benign cephalic histiocytosis. PMID: 25526330 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Haimovic A, Chernoff K, Hale CS, Meehan SA, Schaffer JV Tags: Dermatol Online J Source Type: research

New world cutaneous leishmaniasis.
Abstract A 24-year-old Bangladeshi man presented with a 12-week history of a pruritic papule on his left elbow that had enlarged and ulcerated. He was without any constitutional or systemic symptoms. He reported a history of extensive travel in the two years prior to presentation that included Bangladesh, South and Central America, and Mexico. Histopathologic features were consistent with leishmaniasis. Speciation by the Centers for Disease Control showed L. brasiliensis. PMID: 25526331 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Trufant JW, Lewin JM, Hale CS, Meehan SA, Pomeranz MK Tags: Dermatol Online J Source Type: research

Plate-like osteoma cutis.
Abstract Osteoma cutis is the aberrant development of bone within the skin. The bone formation may be de novo (primary) or result from an injury to the skin (secondary). Here we present a healthy 53-year-old man with no known abnormalities in calcium or phosphate metabolism with plate-like osteoma cutis of the scalp. Plate- or plaque-like osteoma cutis was initially described as a congenital condition but has now been reported several times in the literature as an idiopathic process that occurs in adults. Treatment options are limited and are only required if the lesion is bothersome to the patient. PMID: 255...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Orme CM, Hale CS, Meehan SA, Long W Tags: Dermatol Online J Source Type: research

Exogenous ochronosis.
We present a case of exogenous ochronosis in a 53-year-old woman with skin type IV, who used a topical hydroquinone preparation of an unknown concentration for several years. Traditionally, exogenous ochronosis was thought to occur exclusively in patients with darker skin types who use high concentrations of hydroquinone cream. Reports now document cases in patients of all skin types and in patients even using low concentrations of hydroquinone cream for short periods of time. Although the incidence of exogenous ochronosis in the United States is unclear, it may be more common than many clinicians believe. It is important ...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Nagler A, Hale CS, Meehan SA, Leger M Tags: Dermatol Online J Source Type: research

White fibrous papulosis of the neck.
We present a 76-year old woman with a five-year history of asymptomatic, white papules that were grouped on the lateral and posterior aspects of the neck, inferior axillae, and central mid-back. The histopathologic findings showed thickened collagen bundles. A diagnosis of white fibrous papulosis of the neck was made, which is believed to be a manifestation of intrinsic aging. There are no treatments for white fibrous papulosis of the neck. One hypothesized approach is the application of a topical anti-oxidant to reduce free-radical induced aging. PMID: 25526334 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Schaffer PR, Tran K, Kaplan J, Patel R, Kamino H, Ramachandran S, Franks AG Tags: Dermatol Online J Source Type: research

Netherton syndrome with ichthyosis linearis circumflexa and trichorrhexis invaginatum.
Abstract Netherton syndrome is a rare, autosomal recessive disorder that is characterized by congenital ichthyosis, trichorrhexis invaginata, and atopic diathesis. Ichthyosis presents at birth with erythroderma and subsequently evolves into ichthyosis linearis circumflexa; hair shaft abnormalities tend to present later. The disorder is caused by loss-of-function mutations in the SPINK5 (serine protease inhibitor Kazal-type 5) gene that encodes LEKTI (lympho-epithelial Kazal-type related inhibitor), which is a protease inhibitor that counteracts epidermal proteases involved in desquamation. Use of topical medicatio...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Ng E, Hale CS, Meehan SA, Cohen DE Tags: Dermatol Online J Source Type: research

Cranial fasciitis.
Abstract A 26-year-old man presented with an 18-month history of a subcutaneous mass on his forehead that occurred shortly after being struck by a blunt object. Histopathologic examination showed a proliferation of bland spindle cells and a collagenous stroma that was consistent with cranial fasciitis. Cranial fasciitis, which is a variant of nodular fasciitis, is a benign fibroblastic neoplasm that overlies the skull and often is associated with trauma. Although its rapid onset may give the clinical impression of a malignant condition, cranial fasciitis typically is cured by simple excision without further sequel...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Ginsberg B, Ng E, Hu SW, Meehan SA Tags: Dermatol Online J Source Type: research

Nevus lipomatosus superficialis.
We describe a 15-year-old boy with a three-year history of the classic type of nevus lipomatosus superficialis, which presented as linear arrays of soft, cerebriform papulonodules and plaques in the right inguinal fold. Investigation for chromosomal aberrations and dysregulation of Wnt signaling may provide insights into the pathogenesis of this hamartoma. Treatment is usually with surgical excision although successful use of other modalities has been described. PMID: 25526337 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Kim RH, Stevenson ML, Hale CS, Meehan SA, Chernoff K, Schaffer JV Tags: Dermatol Online J Source Type: research

Candida parapsilosis of the nail-bed without onychomycosis.
We present a unique case of C. parapsilosis infection of the nail bed without infection of the nail plate and with twenty-nail melanonychia. PMID: 25526338 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Rieder E, Hu SW, Meehan SA, Adigun C Tags: Dermatol Online J Source Type: research

Vegetative pyoderma gangrenosum.
We present a case of multiple vegetative pyoderma gangrenosum lesions arising in prior surgical sites in a patient found to have IgA monoclonal gammopathy and abnormal urinary protein electrophoresis. PMID: 25526339 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Kim RH, Lewin J, Hale CS, Meehan SA, Stein J, Ramachandran S Tags: Dermatol Online J Source Type: research

Nail lichen planus in a patient with alopecia totalis.
Abstract A 67-year-old man with a three-year history of non-scarring alopecia that progressed to alopecia totalis despite intralesional glucocorticoid injections is presented. He developed 20-nail dystrophy that was recalcitrant to antifungal and anti-inflammatory treatments. Biopsy of the nail matrix showed histopathologic features of lichen planus. Alopecia totalis and isolated lichen planus of the nails are uncommon subtypes of common dermatologic disorders. Rarely reported concurrently, we provide a review of the literature of their association, which is most likely attributed to their autoimmune pathogeneses....
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Ginsberg BA, Yost JM, Lewin J, Hale CS, Meehan SA, Carucci JA, Ramachandran S Tags: Dermatol Online J Source Type: research

Palmoplantar lichen planus.
We present a case of PPLP that improved with methotrexate after failing treatment with acitretin. PMID: 25526341 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Rieder E, Hale CS, Meehan SA, Leger M Tags: Dermatol Online J Source Type: research

Dermatitis herpetiformis.
Abstract Dermatitis herpetiformis (DH) is an autoimmune bullous disease, which represents the cutaneous manifestation of gluten sensitivity, in the setting of celiac disease. Although classical DH is characterized clinically by grouped, vesicles on an erythematous base, primary lesions often are absent owing to the intense, associated pruritus. Instead, many cases present only with erythematous erosions with numerous overlying excoriations. As in celiac disease, the core pathogenic mechanisms of DH are likely mediated by immunoglobulin A class autoantibodies against one of several transglutaminase enzymes. As the ...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Yost JM, Hale CS, Meehan SA, McLellan BN Tags: Dermatol Online J Source Type: research

Pemphigus foliaceus.
Abstract A 55-year-old woman presented after a four-year history of impetiginized eczema that was distributed over her face, scalp, chest, and back and a recent diagnosis of breast cancer. A skin biopsy specimen for direct immunofluorescence demonstrated intercellular IgG4. Anti-desmoglein 1 and 3 antibodies were present. Indirect immunofluorescence testing was positive on monkey but not rat esophagus. These findings were consistent with a diagnosis of pemphigus foliaceus in association with a malignant condition. After many years of the use of topical glucocorticoids and oral antibiotics, the patient's disease wa...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Orne CM, Hale CS, Meehan SA, Leger M Tags: Dermatol Online J Source Type: research

Collision tumor of eccrine poroma, seborrheic keratosis, and a viral wart.
Abstract A 68-year-old woman presented for evaluation of a large, red-brown plaque on her left buttock with irregular borders and prominent overlying verrucous changes. The plaque had been present since childhood but over a three-year period had been enlarging with increasing nodularity and easy bleeding with trauma. Histopathologic examination demonstrated an enlarged papillated and polypoid heterogeneous lesion. In part of the specimen, there are bulbous aggregates of small squamous cells with foci of eccrine ductal differentiation. There are other areas with horn pseudocysts, hypergranulosis, and compact orthok...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Bloom BS, Kamino H, Hale CS, Pomeranz MK Tags: Dermatol Online J Source Type: research

Adiposis dolorosa.
We report a 46-year-old woman with a nine-year history of obesity; chronic diffuse pain in the adipose tissue of her medial upper arms, lower trunk, and thighs; multiple biopsy-proven lipomas and angiolipomas; and a lipomatous pseudomass of the breast. Her systemic symptoms included generalized weakness, fatigue, memory impairment, and arthralgias. Although some of the lesions were tender, most were only appreciated with palpation. Her clinical history and histopathologic data suggested adiposis dolorosa (Dercum's disease). Owing to the chronic pain, an interdisciplinary approach with the use of analgesics and doxycycline ...
Source: Dermatol Online J - December 24, 2014 Category: Dermatology Authors: Schaffer PR, Hale CS, Meehan SA, Shupack JL, Ramachandran S Tags: Dermatol Online J Source Type: research

[A case of lichenoid sarcoidosis with characteristic clinical and histopathological findings].
We report a patient with a one month history of an eruption of skin colored papules. Some were grouped in a symmetrical distribution on the trunk, inner arms, and lumbar region. Pathologic examination revealed an infiltrate in the papillary dermis showing a band of noncaseating granulomas along with disruption of the basal lamina and lichenoid changes. The clinicopathological correlation confirmed the diagnosis of lichenoid sarcoidosis. We consider our case interesting owing to the clinical presentation and the lichenoid distribution of granulomas. PMID: 24746311 [PubMed - indexed for MEDLINE] (Source: Dermatol Online J)
Source: Dermatol Online J - December 19, 2014 Category: Dermatology Authors: Sanchez-Lopez J, Porriño-Bustamante ML, Aneiros-Fernández J, Naranjo-Sintes R, Fernández-Pugnaire MA Tags: Dermatol Online J Source Type: research

[Malignant acanthosis nigricans: report of a case].
Abstract The authors present a case of a 44-year-old patient with a disseminated dermatosis diagnosed as acanthosis nigricans. The patient was a smoker and investigation of the cause of her skin lesions resulted in discovery of an asymptomatic metastatic carcinoma in the laryngopharanx, probably of pulmonary origin. PMID: 24746313 [PubMed - indexed for MEDLINE] (Source: Dermatol Online J)
Source: Dermatol Online J - December 19, 2014 Category: Dermatology Authors: Lazzarini R, Simone K, Queiroz G, Courral I, Magliari ME, Feder CK, Lellis R Tags: Dermatol Online J Source Type: research

Detailed protocol for administration of intralesional IL-2 for the treatment of Stage IIIc and IV M1a metastatic melanoma based on current NCCN guidelines.
Abstract Melanoma claims approximately 9,000 lives in the United States annually [1]. Patients who present with satellite, in-transit, or distant cutaneous metastases have limited treatment options and the prognosis for patients with metastatic disease remains poor. Surgical excision remains the most common treatment modality for cutaneous metastases, but may not address concurrent subclinical in-transit metastases. Other palliative treatment options include Bacillus Calmette-Guérin (BCG) and isolated limb perfusion (ILP). Although intravenous IL-2 has been used for treatment of metastatic melanoma since 19...
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Patel F, Wilken R, Burrall B, Martinez S, Wells V, King B, Maverakis E Tags: Dermatol Online J Source Type: research

A case of Griscelli syndrome.
We report the case of a 10-year-old child of consanguineous parents. He presented with abdominal pain and fever and was noted to have silvery hair, eyelashes, and eyebrows. Bone marrow studies indicated hemophagocytosis, whilst microscopic examination of the hair showed irregular agglomerations of pigment in hair shafts. The prognosis, treatment, and genetic counseling needs differ considerably among the various forms of Griscelli Syndrome. PMID: 25419745 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Kerketta JA, Lodh M, Mandal K Tags: Dermatol Online J Source Type: research

Necrolytic acral erythema masquerading as cellulitis.
Abstract Necrolytic acral erythema (NAE) is a rare cutaneous sign of hepatitis C virus infection and has recently been linked to zinc deficiency. It presents as well-demarcated erythematous plaques in a sandal-like distribution on the dorsal feet with psoriasiform epidermal hyperplasia on histology. Our patient reported a 9-month history of progressive bilateral lower extremity erythema, swelling, erosions, and nail dystrophy that failed to improve despite multiple courses of antibiotics for presumed lower extremity cellulitis. Serum studies revealed zinc deficiency. This case supports the association of NAE with ...
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Iyengar S, Chang S, Ho B, Fung M, Konia TH, Prakash N, Sharon VR Tags: Dermatol Online J Source Type: research

Deep dermatofibrosarcoma protuberans in a ninety-year old-woman.
Abstract A 92-year-old woman was referred for the assesment of an asymptomatic subcutaneous tumor that developed after an accidental fall. The mass clinically and radiologically simulated a subcutaneous hematoma. Finally, the histological study was consistent with subcutaneous dermatofibrosarcoma protuberans. PMID: 25419747 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Gracia-Cazana T, Pastushenko I, Concellon M, Grasa M Tags: Dermatol Online J Source Type: research

Hydroxychloroquine-induced fatal toxic epidermal necrolysis complicated by angioinvasive rhizopus.
Abstract The majority of toxic epidermal necrolysis (TEN) cases are provoked by "high risk" medications (e.g. allopurinol, aromatic anticonvulsants, nevirapine, oxicam non-steroidal anti-inflammatory agents, and sulfonamides). TEN usually occurs 1 to 8 weeks after initial administration of the offending agent, but re-administration can evoke TEN within hours to days [1]. Hydroxychloroquine has rarely been associated with TEN, with one case proving fatal [2-4]. Herein, we report a case of hydroxychloroquine-induced fatal TEN complicated by angioinvasive Rhizopus. To our knowledge, this is the first case r...
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Cameron MC, Word AP, Dominguez A Tags: Dermatol Online J Source Type: research

Unusual CD8 positive lymphomatoid papulosis in childhood.
We report a 15-year-old girl with CD8+ T-cells, an unusual phenotype in this disease. The clinical and pathological differential diagnoses are discussed. PMID: 25419749 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Mateo S, Vazquez Osorio I, Jose Seoane M, Manuel Suarez-Penaranda J, Vazquez Veiga H Tags: Dermatol Online J Source Type: research

Unusual case of frontal mucocele presenting with forehead ulcer.
We report an 80-year-old woman presenting with a forehead skin ulcer and painless subcutaneous forehead induration. Histopathologic examination revealed mucin deposition and inflammation. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans showed a mass originating from the frontal sinus with frontal bony defect and frontocutaneous fistula. Surgical excision of the mass confirmed the mucocele diagnosis. In this article, we present a case of frontocutaneous fistula and skin ulcer, which is an unexpected complication of frontal mucocele. We propose that in the case of a localized non-healing ulcerated for...
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Altintas Kaksi S, Kaski M, Balevi A, Ozdemir M, Cakir A Tags: Dermatol Online J Source Type: research

A case report of primary cutaneous histoplasmosis requiring deep tissue sampling for diagnosis.
Abstract Importance: This is a case of primary cutaneous histoplasmosis, without any systemic involvement, that occurred without a history of trauma. Due to its rarity and varied clinical presentation, there is much difficulty in diagnosis of this disease entitiy, especially in differentiating it from pyoderma gangreosum. This patient required deep tissue sampling and a DNA probe for Histoplasma to establish a time-sensitive diagnosis as multiple superficial biopsies are nondiagnositic. PMID: 25419751 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Kollipara R, Hans A, Hall J, Watson K Tags: Dermatol Online J Source Type: research

An eschar and violaceous nodules as the presenting signs of lymphomatoid granulomatosis.
We report a 31-year-old male with LYG who presented with cutaneous symptoms. The skin biopsy was devoid of B-cells and non-reactive for EBV. We present this case to emphasize the role of dermatologists in the diagnosis of LYG and to caution clinicians that cutaneous lesions may lack diagnostic evidence of EBV infection. PMID: 25419752 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Fischer R, Shaath T, Meade C, Fraga GR, Rajpara A Tags: Dermatol Online J Source Type: research

Aggressive meningioma presents as innocuous forehead lesion: a case report.
Abstract Cutaneous meningiomas are very rare neoplasms. In this case report we document a type III (anaplastic meningioma) presenting as a subcutaneous forehead mass. Anaplastic meningiomas arise from the neuraxis. They are biologically aggressive neoplasms that extend into the dermis or subcutaneous tissue via direct extension through the bone. PMID: 25419753 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Joselow A, Raugi G, Knezevich SR Tags: Dermatol Online J Source Type: research

Eccrine poromatosis in a patient with acute myeloid leukemia following chemotherapy.
We report a case of eccrine poromatosis occuring on the palms and soles occuring after chemotherapy in a patient with a history of acute myeloid leukemia. PMID: 25419754 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Garshick M, DeFilippis EM, Harp J, Gaan J Tags: Dermatol Online J Source Type: research

Erythema ab igne: evolving technology, evolving presentation.
We present a case of a 49-year-old woman with erythema ab igne on her posterior thighs owing to 2-4 hours per day of seat heater use in her car. Erythema ab igne is caused by prolonged exposure to a heat source. It used to be caused mainly by wood stoves used to heat homes. Erythema ab igne is now more often related to other heat sources, including heating pads, laptop computers, and car seat heaters, as in our case. As technology changes, so does the presentation of skin conditions that are related to technology. PMID: 25419755 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Kesty K, Feldman SR Tags: Dermatol Online J Source Type: research

Congenital onychodysplasia of the index finger presenting as a congenital bifid nail.
We report a case of a COIF presenting as a congenital bifid nail deformity with underlying bone deformity. PMID: 25419756 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Crowe D, DiSano K Tags: Dermatol Online J Source Type: research

Erythematous nodule of the ear.
Abstract An elderly may with eccrine porocarcinoma of the ear is presented. This rare tumor in an unusual location has the potential for metastasis and local recurrence. PMID: 25419757 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Thompson L, Malone J, Schadt C Tags: Dermatol Online J Source Type: research

Linear, pruritic red to brown papules on the left chest.
Abstract A 28-year-old woman presented with a 12-year history of red to brown papules in a linear distribution on the left lateral chest associated with recent flares of pruritus. She had previously been clinically diagnosed with lichen planus. A punch biopsy was performed, and histopathologic exam revealed Darier-like acantholysis. The patient was diagnosed with type 1 segmental Darier disease and her symptoms improved with topical tretinoin. PMID: 25419758 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Ren V, Champion RW, Boyd AS, Powers JG Tags: Dermatol Online J Source Type: research

Rapidly involuting congenital hemangioma (RICH): a brief case report.
We report a case of an infant with RICH occurring on the scalp, examined at birth and followed for 26 weeks. PMID: 25419759 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Scalise R, Bolton J, Gibbs NF Tags: Dermatol Online J Source Type: research

Unilateral and pruritic papules: segmental Darier-White disease.
Abstract Darier-White disease is an uncommon disorder, which presents in a localized pattern in about 10% of patients, usually without nail, mucosa, or acral involvement. Type-1 is the most common of the segmental Darier-White disease types: papules have unilateral distribution along Blaschko lines. A 36-year-old woman diagnosed with type-1 segmental Darier-White disease is reported herein. PMID: 25419760 [PubMed - as supplied by publisher] (Source: Dermatol Online J)
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Puente N, Nieto O, Tardino JC, Borbujo J Tags: Dermatol Online J Source Type: research

Zosteriform lichen planus after herpes zoster: report of a new case of Wolf's isotopic phenomenon and literature review.
We report a 74-year-old man who presented with a zosteriform eruption consisting of erythematous-scaly, slightly pruritic papules on the right flank some weeks after herpes zoster (HZ) had healed on the same area. Histologic examination showed typical changes of lichen planus, confirming the diagnosis of post-HZ zosteriform lichen planus (ZLP). The lesions regressed with topical steroid treatment. Zosteriform lichen planus (ZLP) is one example of Wolf's isotopic phenomenon appearing after HZ. So far, only 17 cases have been reported in the literature. The precise pathogenesis of ZLP is not well known, although persisting v...
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Lora V, Cota C, Kanitakis J Tags: Dermatol Online J Source Type: research

Proposed classification for koebner, wolf isotopic, renbok, koebner nonreaction, isotopic nonreaction and other related phenomen.
This article will review the series of these responses including: Koebner phenomenon, Wolf isotopic response, Renbök response, Koebner nonreaction, isotopic nonreaction, and other related skin reactions. Because most of these reported phenomena have similar morphological features the diagnosis is often made on the basis of differences in the clinical presentation. Note that some of the cutaneous reactions of similar phenomena have been described using varied nomenclature, further adding to the confusion. In view of this, we believe that at present there is a robust need to define each cutaneous reaction accordingly an...
Source: Dermatol Online J - November 25, 2014 Category: Dermatology Authors: Kannangara AP, Yosipovitch G, Fleischer Jr AB Tags: Dermatol Online J Source Type: research

Toxic epidermal necrolysis due to voriconazole: case report and review.
We describe a 67-year-old woman who underwent allogeneic peripheral blood stem cell transplantation as treatment for chronic lymphocytic leukemia. She developed toxic epidermal necrolysis after she was transitioned to voriconazole, which was a component of her post-transplant regimen. The diagnosis of toxic epidermal necrolysis in our patient was made clinically and confirmed histologically. Based on the temporal initiation of voriconazole therapy and the development of her adverse cutaneous reaction, we concluded that voriconazole was the offending agent. There are limited reported cases of voriconazole-induced toxic epid...
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Gomulka J, Wilson BD, Joyce JC Tags: Dermatol Online J Source Type: research

Acitretin for the management of generalized cutaneous lichen planus.
CONCLUSION: Generalized cutaneous lichen planus may pose a therapeutic challenge for the symptomatic relief of skin lesions. Topical and systemic corticosteroids are first-line treatments. In patients who fail corticosteroids, relapse after corticosteroid therapy, or have contraindications to corticosteroids, acitretin may be considered a potential second-line therapy. PMID: 25244164 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Vazirnia A, Cohen PR Tags: Dermatol Online J Source Type: research

Metastatic laryngeal carcinoma mimicking eruptive keratoacanthomas: report of keratoacanthoma-like cutaneous metastases in a radiation port.
We describe cutaneous metastases in a radiation port clinically mimicking eruptive keratoacanthomas. Using the PubMed database, an extensive literature search was performed using the keywords cancer, carcinoma, keratoacanthoma, laryngeal, metastases, metastasis, metastatic, mimicking, port, radiation, radiotherapy, radiation, skin, visceral. We were able to summarize the features of patients with keratoacanthoma-like cutaneous metastases and discuss radiation port cutaneous metastases. Cutaneous metastases can be the initial manifestation of a previously undiagnosed malignancy or can present in a patient with an establishe...
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Ellis DL, Riahi RR, Murina AT, Cohen PR Tags: Dermatol Online J Source Type: research

Oral lichen sclerosus expressing extracellular matrix proteins and IgG4-positive plasma cells.
We report a 47-year-old man with LS that exhibited an asymptomatic white plaque with red patches on the maxillary alveolar mucosa extending to the labial mucosa. He had no other skin disease. Positive immunostaining for tenascin and scarcity of fibronectin suggested extracellular matrix reorganization. Elastin immunostaining indicated a reduction of elastic fibers. Immunoexpression of collagen IV in blood vessels and its absence in the epithelial basement membrane, together with diffuse MMP-9 immunoexpression, suggested altered proteolytic activity. Mast cell staining bordering areas of sclerosis indicated a possible role ...
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: De Aquino Xavier FC, Prates AA, Gurgel CA, De Souza TG, Andrade RG, Goncalves Ramos EA, Pedreira Ramalho LM, Dos Santos JN Tags: Dermatol Online J Source Type: research

Incidental angiofibromas prompt a diagnosis of multiple endocrine neoplasia type-1 (MEN-1).
CONCLUSIONS AND RELEVANCE: This case highlights the importance of vigilance on the part of dermatologists to be aware of subtle skin findings that may be characteristic of rare disorders and may have gone unrecognized by other providers and the patients themselves. In this respect, dermatologists are in a unique position given their specialized training in the recognition of inherited skin disorders. An early diagnosis of an inherited disorder, especially one with increased risk of malignancy, can allow for appropriate surveillance and potentially alter the course of the disease. PMID: 25244167 [PubMed - in process] (...
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Roman JW, Logemann NF, Adams E Tags: Dermatol Online J Source Type: research

Disseminated Herpes Simplex Virus presenting as crusted papules on the palms and soles of an immunosuppressed patient.
We report an interesting case of disseminated HSV in a 77-year-old immunocompromised man, presenting as necrotic papules and pustules with no associated systemic involvement. PMID: 25244168 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Fancher W, Marsch A, Landers J, Scribner J Tags: Dermatol Online J Source Type: research

Porokeratotic eccrine ostial and dermal duct nevus - revisited.
Abstract We hereby report a rare case of a 14-year-old girl presenting with asymptomatic pitted papules over the flexor aspect of her right 4th and 5th digits. This was histopathologically proven to be porokeratotic eccrine ostial and dermal duct nevus (PEODDN). PMID: 25244169 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Bhunia D, Ghosh S, Rudra O, Biswas SK Tags: Dermatol Online J Source Type: research

Alopecia areata with white hair regrowth: case report and review of poliosis.
Abstract Alopecia areata is thought to be a T-cell mediated and cytokine mediated autoimmune disease that results in non-scarring hair loss. Poliosis has been described as a localized depigmentation of hair caused by a deficiency of melanin in hair follicles. A 57-year-old man with a history of alopecia areata developed white hair regrowth in areas of previous hair loss. We retrospectively reviewed the medical literature using PubMed, searching: (1) alopecia areata and (2) poliosis. Poliosis may be associated with autoimmune diseases including alopecia areata, as described in our case. However, it is also reported...
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Jalalat SZ, Kelsoe JR, Cohen PR Tags: Dermatol Online J Source Type: research

Bullous systemic lupus erythematosus in a patient with human immunodeficiency virus infection: a paradox of autoimmunity and immunodeficiency.
We describe a 26-year-old man with an 8-year history of HIV infection who developed bullous SLE. The patient presented with widespread, tense bullae as well as oral ulcerations. Clinical, laboratory, histological, and cutaneous immunofluorescence findings confirmed the diagnosis of bullous SLE. Given the immunological consequence of HIV infection, the co-occurrence of these two diseases would, theoretically, be unusual. Theories pertaining to the interplay of immunologic mechanisms of the seemingly paradoxical occurrence of autoimmunity in the setting of HIV infection are discussed. PMID: 25244171 [PubMed - in process...
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Maley A, Parker S Tags: Dermatol Online J Source Type: research

Dyskeratosis congenita.
CONCLUSIONS AND RELEVANCE: Early recognition and long term care is important in patients with DC because of their propensity to develop malignancy, hematologic abnormalities, and infection. Better understanding of this disease may lead to insights into other disorders associated with abnormal telomere maintenance. PMID: 25244172 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Keeling B, Antia C, Steadmon M, Wesson S, Williams C Tags: Dermatol Online J Source Type: research

Future perspective of probiotics in dermatology: an old wine in new bottle.
Abstract Probiotics are live microbial food supplements that are beneficial to the host health when administered in adequate amounts. Probiotics do have an exciting concept in digestive functions, but these live microbes have wider applicability as evidenced by gut-brain-skin axis theory given 80years back. However, the details regarding use of probiotics for dermatological indications ranging from atopic dermatitis to acne and sexually transmitted infections is dispersed in the literature, herein we have tried to focus all under one heading. Overall, probiotics seem to be promising and safe therapeutic modality, ...
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Kumar S, Mahajan BB, Kamra N Tags: Dermatol Online J Source Type: research

Increasing use of non-traditional vehicles for psoriasis and other inflammatory skin conditions.
CONCLUSION: Although there was increasing use of non-traditional vehicles, the rate of use has remained low. Dermatologists appear to have greater familiarity with the use of these newer vehicle formulations than do physicians in other specialties. PMID: 25244174 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Huang KE, Davis SA, Cantrell J, Feldman SR Tags: Dermatol Online J Source Type: research

Myxoid stroma and delicate vasculature of a superficial angiomyxoma give rise to the red planet sign.
Abstract Superficial angiomyxomas are uncommon benign mesenchymal tumors. They often recur locally if partially removed. This case report demonstrates not only the characteristic pathological findings of a superficial angiomyxoma in a 33- year-old man, but also shows a unique dermatoscopic image, which in our estimation resembles a celestial red planet such as the blood moon seen during a lunar eclipse. We propose to call this the "red planet" sign for a superficial angiomyxoma on dermoscopic examination. PMID: 25244175 [PubMed - in process] (Source: Dermatol Online J)
Source: Dermatol Online J - September 25, 2014 Category: Dermatology Authors: Green M, Logemann N, Sulit DJ Tags: Dermatol Online J Source Type: research