Talaromycosis clinically and histopathologically mimicking histoplasmosis in an immunocompromised patient
We report an immunocompromised patient with talaromycosis mimicking histoplamosis. A 26-year-old HIV-positive man had suffered from rashes over the face, trunk, and extremities for three months. His physical examination showed centrally necrotic, ulcerated papules and nodules. A biopsied papule revealed granulomas containing numerous oval, yeast-like cells, some displaying central septation. Saboraud agar culture grew mold with diffuse red pigment consistent with T. marneffei. Careful histopathological examination and microbiological culture are important for the accurate diagnosis of fungal infections. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 9, 2020 Category: Dermatology Source Type: research

Linezolid as a treatment option for cutaneous non-tuberculous mycobacterial infections
We describe a 67-year-old immunocompetent woman with cutaneous NTM infection after she recently underwent a root canal procedure. Although the species was not identified and she was unable to tolerate multiple antibiotics, she ultimately responded well to three months of treatment with linezolid. Given that cutaneous NTM infection can present in immunocompetent patients and that the incidence is rising, it is important for clinicians to maintain a high index of clinical suspicion, especially in patients with a recent history of surgery, trauma, or cosmetic procedures. Linezolid has coverage against non-tuberculous mycobact...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Ulcerative IgA vasculitis in the setting of warfarin therapy
We report a patient with HSP who presented with cutaneous ulcerative plaques and proteinuria in the setting of warfarin therapy. We would like to raise the awareness of this potential adverse effect of warfarin for prompt diagnosis. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Upcoming topical TRPV1 anti-pruritic compounds
Transient receptor potential vanilloid type 1 (TRPV1) is found on sensory neurons, keratinocytes, sebocytes, and dendritic cells. Activated TRPV1 channels are believed to help propagate the itch sensation. Therefore, there has been great interest in targeting TRPV1 to treat pruritus. Since oral formulations aimed at TRPV1 have led to adverse effects such as hyperthermia, there has been emphasis on developing novel topical agents. Several companies are investigating topical TRPV1 anti-pruritic compounds and the initial data has been very promising. These drugs have the potential to be important treatment options for the man...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Lepromatous leprosy presenting with type II reaction before and type I reaction after treatment
Lepromatous leprosy is associated with a high bacillary load and poor cellular immune response. Early dermatologic manifestations include erythematous macules, papules, nodules, and plaques with a symmetrical distribution. Leprosy also shows two major reaction states including type I (reversal reaction) and type II (vasculitis). These reactions are usually seen in some patients who are undergoing treatment. Herein, we report an interesting patient with lepromatous leprosy who presented with skin lesions of type II reaction without receiving any anti-leprosy treatment and surprisingly showed a type I reaction eight months a...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Ulcerated cutaneous Richter syndrome
We report a patient with chronic lymphocytic leukemia who presented with a large and rapidly evolving ulcer, revealed to be a high-grade cutaneous lymphoma. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Granuloma inframammary adultorum, a case report
Granuloma inframammary adultorum represents a variant of erosive papulonodular dermatosis; we report a case of a patient with bilateral erosive plaques and nodules predominantly located under the breast. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Advertising techniques increase biologic treatment willingness in patients with psoriasis
Background: Although biologics have revolutionized psoriasis care, some patients may be reluctant to consider implementing biologic therapy. Objective: To determine whether willingness to take a biologic is increased by commonly used advertising techniques. Methods: An online survey was used to assess subjects with a self-reported diagnosis of psoriasis and their willingness to initiate biologic treatment (N=400). Subjects were randomized to receive one of the following surveys: clinical data with positive framing (N=80), bandwagon-based statement (N=80), testimonial-based statement (N=80), comparative advertising (N=80), ...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

An atypical presentation of discrete papular mucinosis in the genitalia mimicking a molluscum contagiosum infection
We report the second case of a papular mucinosis with an exclusive genital involvement. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Bullous fixed drug eruption related to multivitamins
Multivitamins are commonly consumed over-the-counter supplements. Drug reactions related to multivitamins are rare and very few cases have been reported. This is a case of a young woman who developed bullous fixed drug eruption to multivitamins. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

One person, two bilateral symmetrical giant Becker nevi
Becker nevus, first described by Samuel William Becker in 1949, is a focal epidermal hypermelanotic disorder. It commonly presents as a unilateral hyperpigmented patch that is predominantly distributed on the upper trunk and proximal extremities and frequently associated with hypertrichosis. There have been few reports in the literature of Becker nevus with bilateral involvement; multiple Becker nevi is also unusual. Herein, we report a young man with two bilateral symmetrical giant Becker nevi, one on the trunk with extension to both arms and the second on the abdomen. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Annular erythema as a cutaneous sign of recurrent ductal breast carcinoma, misdiagnosed as erythema chronicum migrans
Annular erythema as a clinical manifestation of locoregional recurrence of breast cancer is extremely rare. Only three papers with the description of five cases have been published in the current literature to our knowledge. Herein, we describe two additional cases of annular erythema as a cutaneous sign of recurrent ductal breast carcinoma; both were misdiagnosed as erythema chronicum migrans. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Physical symptoms and psychosocial problems associated with hidradenitis suppurativa: correlation with Hurley stage
Background: Quality of life (QOL) in hidradenitis suppurativa (HS) patients is negatively impacted by physical and psychosocial problems. The aim of this study was to investigate the frequency and severity of HS-specific symptoms and to correlate these with disease severity. Methods We analyzed medical record data from 145 patients seen in an academic HS specialty clinic between August 2009 to March 2018. Results Hurley stage III patients had significantly higher mean Dermatology Life Quality Index (DLQI) scores (20.2) compared to patients with Hurley stage I (11.3) and II (13.9), (P
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

An unusual case of pigmented plaques on the sole
We present an unusual case of a young patient who presented with asymptomatic non-pruritic flat-topped pigmented plaques on his left sole and no other lesions elsewhere. Histology was consistent with lichen planus. We emphasize a high index of suspicion owing to varied clinical presentation and the necessity of a biopsy for diagnosis (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Anaphylaxis following administration of extracorporeal photopheresis for cutaneous T cell lymphoma
We report a dermatology patient who developed anaphylaxis after receiving extracorporeal photopheresis for the treatment of leukemic mycosis fungoides. We suspect that our patient's anaphylaxis resulted from exposure to an agent used in extracorporeal photopheresis. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Granuloma annulare-like eruption in chronic lymphocytic leukemia
We report a patient with new-onset ulcerated granuloma annulare with concomitant involvement of B-cell leukemia. A granuloma annulare-like eruption with concomitant B cell chronic lymphocytic leukemia involvement in the skin is extremely rare, as only three cases have been previously reported in the literature to our knowledge. Given the rarity of ulceration in conventional granuloma annulare, it is possible this finding may serve as a diagnostic clue for underlying malignancy. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Pseudoepitheliomatous, keratotic, and micaceous balanitis mimicking lichen sclerosus et atrophicus
We present a man in his 70s with a hyperkeratotic whitish plaque over the internal prepuce and glans. The lesion was slowly growing for four years prior to presentation and was resistant to several topical treatments. The histological examination of the lesion revealed marked hyperkeratosis and pseudoepitheliomatous hyperplasia, supporting the diagnosis of pseudoepitheliomatous, keratotic, and micaceous balanitis. It is important to be aware of this uncommon but potentially malignant condition affecting elderly men. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Academic Dermatologist
The University of California, Davis, School of Medicine, Department of Dermatology, is recruiting for two academic dermatologists in the Clinical X series or Health Sciences Clinical Professor (HSCP) series at the Assistant/Associate/Full Professor level based on experience and qualifications. These positions are for general medical dermatologists.Expectations of the Clinical X series is to engage in teaching, research, service and clinical work, while expectations of the faculty in the HSCP series are primarily clinical and include teaching, service and scholarly and/or creative activity. The appointments may be made up t...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Toxic erythema of chemotherapy secondary to gemcitabine and paclitaxel
Toxic erythema of chemotherapy (TEC) is an infrequently reported cutaneous condition, with diagnosis predominately based on clinical presentation, histologic findings, and known reported associations. Therefore, it is important to both recognize common presentations of TEC and be mindful of chemotherapeutic agents associated with this cutaneous side effect to prevent misdiagnosis and prolonged time to treatment. Herein, we present a patient with TEC occurring in intertriginous skin (malignant intertrigo) with classic clinical and histologic findings. In our patient this was associated with a combination neoadjuvant gemcita...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Spiny keratoderma
We report a new case of spiny keratoderma associated with endometrial carcinoma. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Scientist
The University of California, Davis, School of Medicine, Department of Dermatology, is recruiting for a scientist position with skin immunology and microbiome research experience at the rank of Associate or Full Professor/In-Residence series based on experience and qualifications. Expectations of a Clinical X series is to engage in teaching, research, service, and clinical work, while expectations of faculty in the HSCP series are primarily clinical and include teaching, service, and scholarly and/or creative activities. The appointment may be made up to 100% and will report to the Chair of the Department of Dermatology. W...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Programmed cell death protein 1 inhibitor-induced recalcitrant mixed small and medium vessel vasculitis
Pembrolizumab, a programmed cell death protein 1 (PD1) inhibitor, has been known to be associated with several adverse reactions, including immune related adverse events. In less than one percent of patients, PD1 inhibitors have been linked to the development of connective tissue disease. Patients with previously known connective tissue disease are hypothesized to be at increased risk of flares in as many as 40% of cases. A 70-year-old man with a past medical history significant for rheumatoid arthritis in remission and stage IV lung adenocarcinoma presented to the dermatology clinic after one cycle of nivolumab and eight ...
Source: Dermatology Online Journal - October 7, 2020 Category: Dermatology Source Type: research

Erosive pustular dermatosis of the scalp
We present a 60-year-old woman with a four-year history of non-healing scalp erosions, progressive skin atrophy, and scarring alopecia despite intravenous antibiotics and intraoperative debridement who improved with systemic glucocorticoids. Our report emphasizes the importance of early recognition of EPDS when delayed wound healing and erosive disease occur in the setting of iatrogenic injury to the scalp. Timely treatment with systemic anti-inflammatory agents is paramount to prevent cicatricial alopecia and mitigate further scalp insult in EPDS. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 17, 2020 Category: Dermatology Source Type: research

Recurrent angiolymphoid hyperplasia with eosinophilia during several pregnancies
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign vascular tumor. Although its etiology is not clearly known, infection, hormonal factors, and trauma are the suspected reasons. There are few cases considered to be related to pregnancy described in the literature. Granulomas are rarely seen in the histopathology and only four patients with granulomas have been described. Herein, we will present a 28-year-old woman who has been pregnant three times; in every pregnancy, she developed pink nodular lesions on the back of her ear. In the first two pregnancies, the lesions had appeared during the pregnancy and ...
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Intravascular lymphoma presenting with paraneoplastic syndrome
Intravascular lymphomatosis (IVL) is a rare type of B-cell non-Hodgkin lymphoma (BCNHL), which can mimic many other diseases. Fever, neurological symptoms, and skin findings are the most frequent clinical findings. Intravascular lymphomatosis may be associated with genetic factors and infection with human immunodeficiency virus (HIV), human herpesvirus 8 (HHV-8), human T-lymphotropic virus 1 (HTLV1), Epstein-Barr virus (EBV), and hepatitis B virus (HBV). A 50-year-old man was hospitalized with recalcitrant hyponatremia of unknown cause. He had also telangiectatic, indurated, slightly erythematous plaques on his trunk for t...
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Primary cutaneous adenoid cystic carcinoma of the abdomen: a rare entity
We describe a case of primary cutaneous adenoid cystic carcinoma on the abdomen that was successfully treated with wide excision. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Circumscribed palmoplantar hypokeratosis: a case report and review of the literature
We describe an 84-year-old man presenting with a solitary, well-circumscribed, chronic erosion of the sole. Histopathologic examination confirmed diagnosis of circumscribed palmoplantar hypokeratosis. Circumscribed palmoplantar hypokeratosis is a rare and benign condition of unknown etiology presenting as an erosion on the palms or soles. Although lesions are typically asymptomatic, the entity is important for dermatologists and providers in other specialties to recognize, especially considering a differential diagnosis that includes neoplasia. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Secukinumab-associated localized granuloma annulare (SAGA): a case report and review of the literature
We report the third case of secukinumab-associated GA in a 52-year-old woman with a history of diabetes mellitus type II, dyslipidemia, and non-alcoholic steatohepatitis. After four months of therapy with secukinumab, she presented with pink papules coalescing to plaques... (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Hand-foot skin reaction with primarily dorsal involvement in a patient with metastatic renal cell carcinoma on cabozantinib
A 61-year-old man with metastatic renal cell carcinoma on cabozantinib developed hand-foot skin reaction with predominantly dorsal involvement including painful violaceous plaques over the joints and keratotic yellow plaques on the palmar fingers. The medication was discontinued with resolution of the plaques and later reinitiated at a lower dose uneventfully. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Case report and review of solitary cutaneous focal mucinosis: a unique primary cutaneous mucinosis unrelated to mucinosis-associated systemic diseases
Localized deposition of mucin in the upper dermis is referred to as cutaneous focal mucinosis. Patients with this condition either present with a single skin lesion (solitary cutaneous focal mucinosis) or numerous skin lesions (multiple cutaneous focal mucinosis). A man with solitary cutaneous focal mucinosis is described and the features of this condition are reviewed. Solitary cutaneous focal mucinosis has a slight male predominance and typically presents in adults, ranging in age from 29 years to 60 years, as a nodule or papule that is flesh-colored or white and most commonly located on an extremity or the trunk. Micros...
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Dermatomyositis associated with nivolumab therapy for melanoma: a case report and review of the literature
We present a rare case of dermatomyositis associated with nivolumab therapy for melanoma. Nivolumab is an immune checkpoint inhibitor that blocks the programmed death-1 (PD1) receptor and has a number of associated immunotherapy related adverse events. Although most are T-cell mediated, some are antibody mediated mimics of classical autoimmune diseases. We review the characteristics of other cases of anti-PD1 associated dermatomyositis and the recent literature to better understand how to classify and treat this challenging immunotherapy related adverse event. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Giant pilomatrixoma: a distinctive clinical variant: a new case and review of the literature.
We report a 59-year-old man with an exophytic and ulcerated nodule in the left parotid region that was removed with the suspected diagnosis of a cutaneous squamous cell carcinoma. Histopathological analysis showed a proliferation of basaloid cells with areas of transition to ghost cells, under granulation tissue, hemorrhage, and an ulcerated epidermis. Thus, the diagnosis of giant pilomatrixoma was made. We reviewed the literature and found a total of 53 articles that report a total... (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

An evolving presentation of cutaneous tuberculosis
We report a case of CTB which evolved from a lupus vulgaris presentation to the metastatic tuberculous abscess variant. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Revisiting the Rintala advancement flap for nasal tip reconstruction
The approach to nasal reconstruction is based on the nature of the defect and the donor tissue. The Rintala flap, first described by Rintala and Asko-Slejavaara, is a surgical technique used to close midline nasal defects. It is a simple, one-stage procedure and is most effective for defects ranging from 1.5 to 2.5 centimeters. In addition, the Rintala flap is an excellent tissue match and maintains the natural contour of the nose. Other flaps employed in nasal defect closure include the paramedian forehead flap and the Rieger flap. The authors discuss the Rintala flap technique and utility with comparison to alternative f...
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Association between pemphigus and psoriasis: a systematic review and meta-analysis
Pemphigus has been associated with other autoimmune and autoinflammatory disorders. Specifically, some case reports in the literature document coexistence of pemphigus with psoriasis, but this association is lacking larger scale investigation. With this in mind, we conducted a systematic review and meta-analysis to evaluate the association between pemphigus and psoriasis. In doing so, we found an association between the two conditions. Pemphigus was more common in patients with psoriasis than in controls (OR 2.64, 95% CI 1.24-5.59, P=0.01), with heterogeneity (I2=94%). We go on to propose pathophysiologic mechanisms and it...
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

A novel CDKN2A in-frame deletion associated with pancreatic cancer-melanoma syndrome
Pancreatic cancer-melanoma syndrome (PCMS) is an inherited condition in which mutation carriers have an increased risk of malignant melanoma and/or pancreatic cancer. About 30% of PCMS cases carry mutations in CDKN2A. This gene encodes several protein isoforms, one of which, known as p16, regulates the cell-cycle by interacting with CDK4/CDK6 kinases and with several non-CDK proteins. Herein, we report on a novel CDKN2A germline in-frame deletion (c.52_57delACGGCC) found in an Italian family with PCMS. By segregation analysis, the c.52_57delACGGCC was proven to segregate in kindred with cutaneous melanoma (CM), in kindred ...
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Kikuchi-Fujimoto disease preceded by lupus erythematosus panniculitis: do these findings together herald the onset of systemic lupus erythematosus?
We present a young adult woman who had a remote history of KFD and later presented with combined features of discoid lupus and lupus erythematosus panniculitis (LEP). On subsequent rheumatologic workup, she fulfilled criteria for SLE. We discuss the differential diagnosis of both KFD and LEP and emphasize how strong communication among dermatologists... (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Giant pigmented apocrine hidrocystoma of the scalp
Hidrocystomas are benign cysts of sweat duct epithelium that can present as single or multiple lesions, with or without pigmentation. The size is typically 1-3mm in diameter. Although hidrocystomas commonly occur in most parts of the head and neck region, occurrence on the scalp is rare. Herein, we present a 29-year-old woman with a giant pigmented apocrine hidrocystoma of the scalp, which, to our knowledge, represents the largest of its kind reported to date. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Toxic epidermal necrolysis occurring with immune checkpoint inhibitors
We report a 67-year-old man with TEN occurring during nivolumab and ipilimumab co-therapy and review published cases to highlight the challenges in recognizing and managing these patients. ICI-induced TEN can present atypically with delayed onset in comorbid, immunosuppressed patients with an associated high mortality rate. Prompt recognition and drug withdrawal are essential to improve outcomes. High dose systemic corticosteroid has also been recommended for the management of ICI-induced TEN, unlike other drug-induced TEN for which optimal immunomodulatory treatment is still debated. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - September 15, 2020 Category: Dermatology Source Type: research

Urgent safety considerations for dermatologic surgeons in the COVID-19 pandemic
Dermatologic surgeons are at increased risk of contracting SARS-COV-2. At time of writing, there is no published standard for the role of pre-operative testing or the use of smoke evacuators, and personal protective equipment (PPE) in dermatologic surgery. Risks and safety measures in otolaryngology, plastic surgery, and ophthalmology are discussed. In Mohs surgery, cases involving nasal or oral mucosa are highest risk for SARS-COV-2 transmission; pre-operative testing and N95 masks should be urgently prioritized for these cases. Other key safety recommendations include strict control of patient droplets and expanded pre-c...
Source: Dermatology Online Journal - September 10, 2020 Category: Dermatology Source Type: research

Dermatology and anatomy laboratory: comparing three formats of integration
We describe and report student satisfaction results of three novel teaching methods for integrating basic dermatology concepts into gross anatomy laboratory. Methods: During the first year of the intervention, 180 students attended an hour-long anatomy laboratory session during which skin lesions were examined. One attending and three resident dermatologists spent time at all tables of students, then circulated to answer questions. During the second year, 189 students participated in the same teaching session preceded by a 30-minute in-class lecture. During the third year, 172 students were given the option to view a suppl...
Source: Dermatology Online Journal - September 10, 2020 Category: Dermatology Source Type: research

Acne related to dietary supplements
Multiple prescription medications may cause or aggravate acne. A number of dietary supplements have also been linked to acne, including those containing vitamins B6/B12, iodine, and whey, as well as "muscle building supplements" that may be contaminated with anabolic-androgenic steroids (AAS). Acne linked to dietary supplements generally resolves following supplement discontinuation. Lesions associated with high-dose vitamin B6 and B12 supplements have been described as monomorphic and although pathogenesis is unknown, a number of hypotheses have been proposed. Iodine-related acne may be related to the use of kel...
Source: Dermatology Online Journal - September 10, 2020 Category: Dermatology Source Type: research

Terbinafine-induced lichenoid drug eruption: case report and review of terbinafine-associated cutaneous adverse events
Terbinafine is an antifungal agent used in the treatment of hair, nail, and skin dermatophyte infections. Skin side effects to terbinafine are not common. Lichenoid drug eruption is a medication-related adverse cutaneous event; the lesion morphology and pathology mimic lichen planus. A woman with onychomycosis developed a lichenoid drug eruption one week after starting terbinafine. The features of her dermatosis and the characteristics of two additional men who also experienced terbinafine-induced lichenoid drug eruption are discussed. They were receiving a daily terbinafine dosage of either 125mg or 250mg to treat onychom...
Source: Dermatology Online Journal - September 5, 2020 Category: Dermatology Source Type: research

Discrepancies by dermatology resident gender in diagnostic confidence and management of female and male genital lichen sclerosus
This study highlights gender discrepancies with dermatology resident confidence and practice habits and may serve to further guide curricula to address these disparities. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - August 20, 2020 Category: Dermatology Source Type: research

Nail-patella syndrome: "nailing" the diagnosis in three generations
Nail-patella syndrome (NPS) is a hereditary disorder characterized by fingernail changes, elbow dysplasia, hypoplastic patellae, and presence of iliac horns. Clinical presentation can be subtle, and the spectrum of presentation often makes NPS a challenging diagnosis. Herein, we describe three family members with nail-patella syndrome who presented with different features and varying severity. The opportunity to recognize this rare syndrome in three linear generations provided a unique insight into NPS, and a moment to appreciate the random and unpredictable clinical presentation. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - August 20, 2020 Category: Dermatology Source Type: research

Hidradenitis suppurativa at the knees
Hidradenitis suppurativa is a poorly understood, destructive disease centered on pilosebaceous units and characterized by inflammatory nodules that progress to abscesses, sinus tracts, and scars. The typical patient is a young woman with involvement of the axillae, breasts, and groin. Presented is a 60-year-old man with poorly controlled diabetes, who initially developed pink-to-yellowish plaques with punched out ulcers on his knees that evolved to scars and draining sinus tracts. Draining sinus tracts were also noted under the left axilla. Histopathology revealed suppurative granulomatous inflammation centered on hair fol...
Source: Dermatology Online Journal - August 20, 2020 Category: Dermatology Source Type: research

Current and emerging treatment options for metastatic melanoma: a focused review
Melanoma is responsible for nearly 9,000 deaths each year in the United States. Until the early 2000s, chemotherapeutic agents were the mainstay of treatment for metastatic disease. Currently approved treatments include therapies that block signal transduction pathways (BRAF inhibition), increase anti-tumor immune responses (CTLA-4 blockade), or stimulate tumor-infiltrating T cells (IL2). In recent years, various new strategies have emerged. Radiation therapy has been widely underutilized, but it can prime tumor cells that are distant from the field of radiation, a phenomenon termed the abscopal effect. Other therapies suc...
Source: Dermatology Online Journal - August 20, 2020 Category: Dermatology Source Type: research

Vulvar and perineal verrucous changes complicating hidradenitis suppurativa after wide excision: a case and literature review
We report a 54-year-old woman with an over 20-year history of HS, who had previously undergone wide perineal excision with secondary intention healing and presented with a painful verrucous vulvar plaque and proximal non-healing perineal wound. The patient had four perineal scouting biopsies performed and excisional biopsy with no evidence of high-grade dysplasia or carcinoma on histology. Chromogenic in situ hybridization was negative for HPV 16 and 18 mRNA; the patient's HIV and HSV PCR were also negative. Our patient was treated with interferon alfa-2b with notable clinical improvement. There is currently no standardize...
Source: Dermatology Online Journal - August 20, 2020 Category: Dermatology Source Type: research

Nicolau syndrome following intramuscular naltrexone injection
We present a patient who had a sudden post-injection inflammatory response consistent with Nicolau syndrome after a 6 month course of repeated intramuscular naltrexone injections. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - August 20, 2020 Category: Dermatology Source Type: research

Eccrine mucinous nevus: clinical and histopathological description in an adult Nevus mucinoso ecrino en el adulto: descripci ón clínicohistológica
Eccrine mucinous nevus is an uncommon hamartoma whose histological diagnosis is simple because of its peculiar morphological features, which include an increase in the number and/or size of the glands and eccrine ducts accompanied by abundant mucin deposits. When it presents with the typical symptom, focal hyperhidrosis, clinical suspicion is possible. El nevus mucinoso ecrino (NME) es un hamartoma escasamente reportado en la literatura cuyo diagn óstico histológico es sencillo debido a sus peculiares rasgos morfológicos, que incluye un aumento del número y/o tamaño de las glá...
Source: Dermatology Online Journal - August 20, 2020 Category: Dermatology Source Type: research