When a travel bug gets you down: severe, hypotensive African tick bite fever and response to therapy
We present a United States traveler with African tick bite fever 5 days after she returned from a mission trip to Zimbabwe. The patient exhibited symptomatic hypotension in addition to more typical findings, including fever, fatigue, and a necrotic eschar. The diagnosis was supported by histopathological findings and the patient's symptoms rapidly resolved with oral doxycycline therapy. We believe this case represents the first African tick bite fever diagnosis associated with symptomatic hypotension. This case additionally serves as a reminder of the importance of evaluating patient travel history.PMID:38478662 | DOI:10.5...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Sarthak Singh Saxena Sofia Zeidan Summer Meyer Maxwell A Fung Danielle M Tartar Source Type: research

Disseminated blastomycosis with cutaneous involvement in a 57-year-old woman: a case report and review of management
We present a 57-year-old woman with pulmonary blastomycosis and secondary cutaneous involvement. Her diagnosis was facilitated by dermatology consultation after approximately one year of delay. In endemic areas including Canada and the USA, individuals are at risk for blastomycosis when non-motile fungal spores are inhaled, thus producing pulmonary disease. The organism may disseminate over time, affecting a variety of extrapulmonary organ systems including the skin. In endemic regions of blastomycosis, this important cutaneous manifestation of disease should be considered with a high index of suspicion as to avoid delayed...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Jeremy Strain Camille Hamm Anastasia Shamsuyarova David Gamble Source Type: research

Cutaneous type IV hypersensitivity reaction following tebentafusp treatment for uveal melanoma
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329662993.ABSTRACTTebentafusp is a bispecific protein that recently underwent FDA approval for the treatment of metastatic uveal melanoma that functions by redirecting cytotoxic T cells to glycoprotein-100, a protein highly expressed in melanoma. Although clinical trials have demonstrated that rashes are common in the first few days of treatment, little is known about skin reactions that develop later in the treatment course. Herein, we describe a type IV hypersensitivity reaction and vitiligo-like depigmentation that developed six weeks into treatment and discuss the pos...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Lauren M Fahmy Celine M Schreidah Diana E McDonnell Richard D Carvajal Cynthia M Magro Larisa J Geskin Source Type: research

Pediatric cutaneous mucormicosis
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329662994.ABSTRACTA 9-year-old boy diagnosed with acute myeloblastic leukemia and undergoing chemotherapy, was admitted with febrile neutropenia. During his admission, several violaceous plaques appeared on the upper extremities and anterior left hemithorax, which worsened and acquired a necrotic center. We performed a biopsy and histology showed a cutaneous infarction at the dermoepidermal and subcutaneous level. We observed abundant wide hyphae with right-angled branching and a culture isolated Rhizopus oryzae. A plastic surgery consultant performed a surgical debrideme...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Mariana Claudia Matei Sandra Castejon Ramirez Sara Sanz Sanz Tamara Gracia Cazana Concepcion Lopez Gomez Neus Martinez Arnau Matilde Bustillo Alonso Isabel Bernad Alonso Source Type: research

Linear IgA bullous dermatosis associated with immunotherapy
We present the case of a 67-year-old woman with metastatic ovarian cancer receiving anti-PD1 and anti-CTLA4 with new onset pruritic tense bullae to the trunk, hands, elbows (in annular distribution) that occurred after immunotherapy. Skin biopsy showed subepidermal blister with abundant neutrophils on H&E histology, and linear IgA staining at the basement membrane on direct immunofluorescence consistent with the diagnosis of LABD. The condition did not improve on initial prednisone taper, but blisters rapidly resolved a few days after initiation of dapsone therapy. We favor that our patient's LABD is secondary to h...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Bahar Momin Tue F Nguyen Daniel Glade Alison Messer Source Type: research

Letterer-Siwe disease presenting with gastrointestinal and cutaneous manifestations
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329662996.ABSTRACTHistiocytosis is a set of distinct proliferative illnesses defined by the proliferation and infiltration of varied numbers of dendritic cells, macrophages, and monocytes in the afflicted tissues. The skin and other organs may be impacted by the inflammatory infiltration. It can occur at any age. The severity of the symptoms can range from mild to severe, depending on the degree and type of organ involvement. Although certain forms of histiocytosis can be fatal, others can be treated successfully without sequelae. Langerhans cell histiocytosis manifests i...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Antonina Sergeevna Stadnikova Walaa Fadhil Abbas Olga Borisovna Tamrazova Ekaterina Andreevna Pristanskova Irina Nikolaevna Zakharova Irina Vladimirovna Berezhnaya Dmitry Alexandrovich Skobeev Lyudmila Viktorovna Goncharova Source Type: research

Lupus erythematosus-specific bullous lesions
Dermatol Online J. 2026 Dec 15;29(6). doi: 10.5070/D329662997.ABSTRACTLupus erythematosus (LE)-specific bullous lesions are often difficult to distinguish from other bullous diseases presenting in patients with systemic lupus erythematosus. Herein, we describe a 49-year-old woman with systemic lupus erythematosus with recurrent tense bullae on the forearms. Clinical, histopathologic, and serologic findings led to the diagnosis of LE-specific bullous lesions. We also summarize the diagnostic clues for distinguishing LE-specific bullous lesions, bullous systemic lupus erythematosus, and erythema multiforme-like lesions in LE...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Kristin N Smith Austin J Maddy Kiran Motaparthi Source Type: research

Linear discoid lupus erythematous simulating en coup de sabre morphea in a female chronic granulomatous disease carrier
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329662998.ABSTRACTDiscoid lupus erythematosus (DLE), a subtype of chronic cutaneous lupus may be observed in a linear pattern. A 21-year-old woman with history of chronic granulomatous disease state presented to our clinic for a chronic six-year skin eruption on her left eyebrow, left cheek, and left forehead. A punch biopsy of involved left forehead skin was performed and revealed perivascular and periadnexal lymphohistiocytic infiltrate without features of morphea or panniculitis, confirming the histopathologic changes of cutaneous lupus erythematous. The patient was di...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Diem-Phuong Dao Dev Ram Sahni Richard D Sontheimer Source Type: research

A case of filgrastim-induced neutrophilic dermatosis of the dorsal hands in a patient with Felty Syndrome
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329662999.ABSTRACTNeutrophilic dermatosis of the dorsal hands (NDDH) is a variant of Sweet syndrome that presents with erythematous bullae, papules/plaques, or pustules on the dorsal hands. It is most commonly associated with hematologic and solid organ malignancies, though cases of NDDH associated with inflammatory bowel disease, rheumatologic disorders, and medication exposure have also been described in the literature. Felty syndrome is a rare complication of long-standing rheumatoid arthritis characterized by neuropathy, splenomegaly, and neutropenia. Granulocyte colo...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Tejas P Joshi Yelena Dokic Gordana Verstovsek Theodore Rosen Source Type: research

Recurrence of non-sexually acquired acute genital ulceration following COVID-19 vaccination
We report a case of non-sexually acquired acute genital ulceration that initially presented in 2008 as Lipschutz labial ulcers associated with acute Epstein-Barr virus infection, with recurrence twelve years later following administration of the second dose of the Pfizer-BioNTech COVID-19 vaccine. This case report and exhaustive literature review challenges widely accepted views regarding the typical age range of patients affected by non-sexually acquired acute genital ulceration, the sexual history of affected populations, the pathophysiology of lesion occurrence, and possibility of lesion recurrence.PMID:38478671 | DOI:1...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Christy L Waterman Iris K Aronson Source Type: research

Cutaneous erythematous lupus with acneiform presentation
We present a 57-year-old woman with cutaneous lupus erythematosus (CLE), initially treated as acne. She noted blemishes, including nodules and facial swelling for nine months associated with discrete itching of the ears. Examination showed multiple malar nodules, comedones, pustules, atrophic scars, and hyperpigmentation. A biopsy was performed and revealed atrophic epidermis, discrete hyperkeratosis, vacuolar degeneration of basal layer, basal membrane zone with upper dermal lymphohistiocytic inflammatory infiltrate and deep perivascular and peri-adenexal lymphocytes, vascular ectasia, and mucin deposits. The acneiform pr...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Gabriela C Caputo Carolina Sh Bartos Carla Pagliari Paulo R Criado Source Type: research

Symptomatic perineural and intraneural invasion of the trigeminal nerve and subsequent abducens Nerve palsy by cutaneous squamous cell carcinoma
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329663002.ABSTRACTA 74-year-old woman who presented initially with trigeminal neuralgia of the left forehead and scalp was later found to have a poorly differentiated squamous cell carcinoma (SCC) with large-nerve perineural and intraneural invasion of the left supraorbital nerve. Negative histopathologic margins were achieved in three stages of permanent fixed tissue en face processing and the final defect was repaired with a large rotation flap. Approximately one month after repair, the patient presented with new-onset diplopia and was found to have a complete left cran...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Frank T Winsett Andrew M Armenta Kristyna L Gleghorn Brandon P Goodwin Brent C Kelly Richard F Wagner Source Type: research

Is orofacial granulomatosis a distinct clinical disorder?
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329663003.ABSTRACTOrofacial granulomatosis is a rare disorder that is heterogeneously defined in the published literature. Herein, we describe a patient with orofacial granulomatosis with clinical and histologic evidence, discuss differential diagnoses, and offer clinical pearls for diagnosing and assessing this disorder. Our case provides support that orofacial granulomatosis is a distinct disorder as opposed to a sequela of other systemic granulomatous diseases. This information will aid dermatologists in decision making and diagnosing the disorder.PMID:38478674 | DOI:1...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Tiaranesha K Jackson Yacine N Sow Christopher Wachuku Tatiana M Barrera Katherine Omueti-Ayoade Emily Chu Susan C Taylor Nicholas Mollanazar Source Type: research

A widespread blistering eruption: diffuse cutaneous mastocytosis
We report a 5-month-old male who presented with a 3-week history of cutaneous bullae and pruritus. On examination, he had erythema of the cheeks bilaterally and diffuse slightly hyperpigmented, indurated skin on his trunk and abdomen. There were tense vesicles, bullae, and erosions linearly arranged on his trunk and extremities. Both the laboratory and imaging workup were normal. Subsequently, a punch biopsy of a vesicle on the abdomen was obtained and findings confirmed a diagnosis of diffuse cutaneous mastocytosis. An EpiPen(r) was prescribed due to the slightly increased anaphylaxis risk compared to other forms of masto...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Adaora Ewulu Michael A Cardis Melody C Carter Kaiane A Habeshian Source Type: research

Painful subcutaneous nodules in an alcoholic: a case of pancreatic panniculitis
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329663005.ABSTRACTPancreatic panniculitis is an uncommon manifestation of pancreatic disease, affecting approximately 2-3% of patients with acute or chronic pancreatitis [1]. Its accurate diagnosis is crucial for effective treatment as skin manifestations usually precede systemic symptoms of pancreatitis. The diagnosis of pancreatic panniculitis requires identifying and confirming pancreatic disease in addition to the typical histopathological findings of lobular panniculitis without vasculitis. Herein, we present a patient with pancreatic panniculitis, underlying acute p...
Source: Dermatol Online J - March 13, 2024 Category: Dermatology Authors: Marianne Cortes Brittany P Smirnov Source Type: research