Multiple skin neoplasms at one site (MUSK IN A NEST): collision tumor consisting of epidermal (macular seborrheic keratosis) and dermal (lichen amyloidosis) components
This report describes a 42-year-old woman who presented with a pruritic skin condition on her arms and legs of 13 years' duration. Skin biopsy results showed epidermal hyperplasia with hyperkeratosis, hyperpigmentation of the basal layer with mild acanthosis, and evidence of amyloid deposition in the papillary dermis. Based on the clinical presentation and pathology findings, a concurrent diagnosis of macular seborrheic keratosis and lichen amyloidosis was established. A MUSK IN A NEST consisting of a macular seborrheic... (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 20, 2022 Category: Dermatology Source Type: research

Questions raised by a case of adult-onset linear nodular scleroderma
We present an otherwise healthy young woman with unilateral, linear, nodular scleroderma and review the somewhat confounding earlier literature in this area. To date, this young woman's skin changes have proven refractory to oral hydroxychloroquine and ultraviolet A1 phototherapy. Several aspects of this case including the patient's family history of Raynaud disease, her nodular sclerodermatous skin lesions, and the presence of U1RNP autoantibodies raised concern about her management with respect to future risk of developing systemic sclerosis. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Treating linear porokeratosis with topical lovastatin/cholesterol cream
Linear porokeratosis is a rare variant of porokeratosis that is characterized by unilateral lesions along the lines of Blaschko. Like all variants of porokeratosis, linear porokeratosis is characterized by the histopathologic finding of cornoid lamellae bracketing the lesion. The underlying pathophysiology involves a two-hit post-zygotic knockdown of genes involved in mevalonate biosynthesis in embryonic keratinocytes. Although there is currently no standard or effective treatment, therapies targeted to rescue this pathway and restore keratinocyte cholesterol availability are promising. Presented here is a patient with a r...
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Telangiectasias of the breasts showing diffuse dermal angiomatosis in a patient with diffuse livedo reticularis
We report herein a woman with DDA of the breasts presenting as diffuse livedo reticularis and acrocyanosis, both long-standing and considered idiopathic following extensive investigations. Since a biopsy of the livedo did not document DDA features in our case, we suggest that our patient's livedo reticularis and telangiectasias could constitute a vascular predisposition for DDA, as its pathogenesis frequently involves an underlying disease involving ischemia, hypoxia, or hypercoagulability. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

A rare case of lues maligna in an HIV-negative woman
We describe an HIV-negative 43-year-old woman presenting with a diffuse ulceronodular eruption and positive serological tests for syphilis consistent with lues maligna. Lues maligna is a severe and rare variant of secondary syphilis characterized by prodromal constitutional symptoms followed by the formation of multiple well-circumscribed nodules with ulceration and crust. This case depicts a particularly rare presentation as lues maligna usually involves HIV-positive men. The clinical presentation of lues maligna can pose a diagnostic challenge, with infections, sarcoidosis, and cutaneous lymphoma as just a few entities i...
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

A virtual dermatology elective for underrepresented in medicine medical students
(Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Leukocytoclastic vasculitis with features of flagellate purpura: a comparison with flagellate erythema
Leukocytoclastic vasculitis is a histopathologic term describing a type of small-vessel vasculitis characterized by a predominantly neutrophilic inflammatory infiltrate and nuclear debris. Skin involvement is common and can have a heterogeneous clinical presentation. Herein, we describe a 76-year-old woman with no history of chemotherapy or recent mushroom ingestion that presented with focal areas of flagellate purpura secondary to bacteremia. Histopathology revealed leukocytoclastic vasculitis and her rash resolved after antibiotic treatment. It is important to distinguish flagellate purpura from a similar condition, flag...
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Cutaneous leukocytoclastic vasculitis after second dose of mRNA COVID-19 vaccine
Numerous cutaneous reactions following COVID-19 vaccination have already been described. Vasculitis, however, is a rare adverse event, occurring mainly after the first COVID-19 vaccination. Herein, we report a patient with IgA-positive cutaneous leukocytoclastic vasculitis, unresponsive to a moderate dose of systemic corticosteroid that erupted after the second dose of the Pfizer/BioNTech vaccine. Since booster vaccinations are being administered, we intend to raise awareness among clinicians and to highlight this potential reaction and its therapeutic approach. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Small lymphocytic lymphoma presenting as chronic diffuse lip swelling
Although rare, small lymphocytic lymphoma can present as chronic lip swelling and papules, thus mimicking the features of orofacial granulomatosis, a chronic inflammatory disorder characterized by subepithelial noncaseating granulomas, or papular mucinosis, characterized by localized dermal mucin deposition of mucin. When assessing lip swelling, one must carefully consider the clinical clues and have a low threshold to perform a diagnostic tissue biopsy, preventing delays in treatment or progression of the lymphoma. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Herpes manuum: a new name for non-digit herpetic whitlow
We present two cases of non-digit HSV infection of the hand that were misdiagnosed as bacterial infections. As our cases and others demonstrate, the lack of knowledge that HSV infections can occur on the hand leads to confusion and delayed diagnosis among a myriad of providers. Therefore, we seek to introduce the term "herpes manuum" to increase awareness that HSV can appear on the hand in locations aside from the digits and... (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Lichen planus related to COVID-19 vaccine: report of two cases.
(Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Whole exome sequencing in a sample of Peruvian patients diagnosed with epidermolysis bullosa
Background: Epidermolysis bullosa (EB) is a complex and heterogeneous dermatological disease. Four main types of EB have been described, each of them with distinct characteristics: EB simplex (EBS), dystrophic EB (DEB), junctional EB (JEB) and Kindler EB (KEB). Each main type varies in its manifestations, severity, and genetic abnormality. Methods: We sought mutations in 19 genes known to cause EB and 10 genes associated with other dermatologic diseases in 35 Peruvian pediatric patients of a rich Amerindian genetic background. Whole exome sequencing and bioinformatics analysis was performed. Results: Thirty-four of 35 fami...
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Efficacy of gabapentinoids for acute herpes zoster in preventing postherpetic neuralgia: a systematic review of randomized controlled trials
Gabapentinoids (e.g., gabapentin and pregabalin) have been established as a treatment for postherpetic neuralgia (PHN), but their effects on the prevention of PHN are unclear. This systematic review aimed to evaluate the efficacy of gabapentinoids for acute herpes zoster (HZ) in preventing PHN. PubMed, EMBASE, CENTRAL, and Web of Science were queried December 2020 to collect data on relevant randomized controlled trials (RCTs). A total of four RCTs (including 265 subjects) were retrieved. Overall, the incidence of PHN was lower, but not statistically significant in the gabapentinoid-treated group compared to the control gr...
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Pathological complete response to preoperative avelumab treatment in a patient with advanced Merkel cell carcinoma
(Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research

Epidermolytic ichthyosis complicated by staphylococcal scalded skin syndrome in the newborn
We present a neonate with epidermolytic ichthyosis who had a subtle change in clinical findings while hospitalized, including increased fussiness, erythema, and a change in her skin odor, which represented superimposed staphylococcal scalded skin syndrome. This case highlights the unique challenge of recognizing cutaneous infections in neonates with blistering skin disorders and emphasizes the importance of having a high suspicion for superinfection in this population. (Source: Dermatology Online Journal)
Source: Dermatology Online Journal - October 19, 2022 Category: Dermatology Source Type: research