Clinics in Dermatology

Clowns have long delighted circus crowds and are celebrated not only in popular culture but also in the dermatology literature as medical eponyms. This contribution discusses four such eponyms: 1) clown nose-like lesion, 2) clown eczema (perioral dermatitis) 3) clown alopecia pattern in frontal fibrosing alopecia and 4) clown's face of Brachman de Lange syndrome (Cornelia de Lange syndrome). This contribution also highlights the role of medical clowning in patient care by paying tribute to Cobo the Clown, also known as Barbara Joyce Cohen, who has served as a dedicated caring clown for over thirty years...

Human trafficking is a global human rights violation affecting millions of individuals across diverse demographics with severe health consequences. Despite the frequent interactions that exploited individuals have with healthcare systems, many remain unrecognized, positioning healthcare providers, including dermatologists, as critical first responders. In the first part of this three-paper series, we discuss the current landscape of human trafficking from a healthcare perspective, emphasizing the role of dermatologists in recognizing and responding to this issue...

Patients experiencing or having experienced trafficking frequently interact with the healthcare system, highlighting the need for healthcare providers to be equipped with the appropriate tools to serve these patients effectively. The third part of this series focuses on navigating encounters with trafficked persons within the dermatology clinic, emphasizing the importance of trauma-informed, patient-centered care. We review the barriers trafficked patients face and mechanisms to overcome these, the importance of comprehensive needs assessments, and the implementation of effective healthcare protocols...

Dermatology is beginning to investigate the uses of virtual reality (VR) and augmented reality (AR) to enhance residency education and to provide patients with comprehensive and interactive experiences. Although the applications of VR and AR to improve patient clinical care are exciting, these technologic advances may have implications about regulatory considerations, patient safety, informed consent, and privacy. We review how using artificial intelligence, VR, and AR can enhance patient care and deliberate the complex issues surrounding these potential innovations...

Human trafficking is a pervasive global health and human rights issue. The skin often bears the early and most visible signs of abuse and exploitation. Despite the visible nature of their trauma, affected patients frequently go unrecognized within healthcare settings due to a lack of standardized guidelines for identifying the dermatological manifestations of trafficking. Herein, we address these challenges by equipping dermatologists and healthcare teams with the necessary tools to recognize, treat, and report the skin signs of human trafficking...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

The presence of congenital melanocytic nevi (CMN) is determined in utero. The location, size, and number of CMN may be of cosmetic concern with significant psychosocial implications. They may also be associated with symptoms such as pruritus, eczema/xerosis, and skin fragilit; however, the most medically concerning issue is the association of CMN with the risk of developing cutaneous melanoma, extracutaneous melanoma, and neurocutaneous melanocytosis (NCM). Patients with CMN are currently risk-stratified based on the projected adult maximum diameter of the largest CMN and the number of CMN (satellites) present...

Melanoma incidence has risen rapidly, at least until recently, while mortality has changed only a little, a phenomenon suggestive of overdiagnosis, which can be defined as the diagnosis as "melanoma" of a lesion that would not have had the competence to cause death or symptoms even if it had not been excised. Overdiagnosis has been attributed to efforts at early diagnosis ("overdetection"), and to changes in criteria resulting in diagnosis as melanoma of lesions previously termed nevi ("overdefinition"). In terms of overdefinition, there is evidence that criteria for the histopathologic diagnosis of melanoma has changed over a period of approximately two decades...

Nail psoriasis affects 20 to 30% of psoriasis patients and is an early predictor of psoriatic arthropathy (PsA). We have evaluated the prevalence, clinical characteristics, and impact on quality of life of patients with nail psoriasis. We conducted a multicenter retrospective cohort study was of patients registered with The Malaysian Psoriasis Registry (MPR) from 1 January 1, 2007 through 31 December 31, 2020. Of the 24147 patients, 13081 (54.2%) had nail psoriasis. Patients with nail psoriasis had la ater onset of psoriasis (34...

BACKGROUND: Diseases reflective of multiorgan vascular injury of diverse etiology, peripheral nerve disease, dysautonomia syndromes and intravascular lymphoma malignancies may potentially exhibit abnormalities on a normal skin biopsy that may be instrumental in establishing a diagnosis. MATERIALS AND METHODS: A retrospective review of our data base was conducted to uncover cases where a normal skin biopsy was performed to rule in or out certain systemic diseases such as complement driven thrombotic microvascular disease including atypical hemolytic uremic syndrome, post transplant thrombotic microangiopathy, and severe/critical COVID-19, systemic capillary leak syndrome, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) intravascular B cell lymphoma, dysautonomia syndromes and mast cell activation syndrome...

Mucosal melanomas are rare malignant tumors arising from the epithelia lining the inner mucosal surfaces of the body. Unlike cutaneous melanoma, we have a limited understanding of mucosal melanomas is currently limited. Mucosal melanomas are characterized by genetic alterations quite distinct from cutaneous melanomas; however, their causative and promoting factors are unknown. These melanomas are characteristically diagnosed at a later stage due to their occult locations, leading to a worse prognosis. Dedicated staging systems for mucosal melanomas exist only for sinonasal and conjunctival melanomas...

Blue nevus-like lesions constitute a category of melanocytic lesions clinically identified by their blue coloration. Histologically, they exhibit two primary features: a dermal location and intense pigmentation. The latest World Health Organization (WHO) classification categorizes blue melanocytic lesions into benign entities (dermal melanocytoses, blue nevus, and deep penetrating nevus), melanocytic tumors with low to intermediate malignant potential (pigmented epithelioid melanocytoma, PEM), and malignant lesions (blue nevus-like melanoma and melanoma arising in blue nevus)...

The Tiber Island in Rome has a rich history as a center of worship and healthcare. Its origins date back to ancient times, with the establishment of the Temple of Asclepius marking its role in healing practices. Over centuries, it evolved into a hub for medical innovation and refuge during epidemics and conflicts. During World War II, the Fatebenefratelli Hospital on the Tiber Island played a pivotal role in sheltering Jews from Nazi persecution. Using a fictitious disease termed "K syndrome," doctors helped endangered Jewish patients to evade capture and deportation to concentration camps by exploiting Nazi fears of contagion...

Hidradenitis Suppurativa (HS) poses diagnostic challenges due to its clinical overlap with various skin conditions and neoplasms, potentially leading to misdiagnoses. The absence of a definitive diagnostic test and infrequent use of histopathology contribute to diagnostic complexities, exacerbated by the recent increased focus on HS. Three cases initially diagnosed and treated as HS underwent through clinical work-up and skin biopsies to resolve diagnostic complexities. Initially labelled as HS, the cases revealed a breast carcinomaon axillary ectopic tissue, a cutaneous gamma-delta T-cell lymphoma, and an infiltrating squamous cell carcinoma...

No abstract text is available yet for this article.

It has long been recognized that the histopathologic differential diagnosis between Spitz nevus and melanoma is sometimes extraordinarily difficult. Both can be composed of large oval to spindled melanocytes with abundant cytoplasm and large nuclei. Genomic studies over the last decade have clarified that Spitz tumors have diverse genetic initiating events, and that for each of these, there are benign, intermediate grade, and malignant lesions. Another discovery is that some melanomas can morphologically resemble Spitz tumors but have conventional initiating mutations (e...

Desmoplastic melanoma is a rare fibrosing variant of melanoma. It typically affects elderly patients but can occasionally affect young or middle-aged individuals. Desmoplastic melanoma is relevant as a diagnostic pitfall for pure tumor variants' distinct histopathologic and clinical features. The latter includes a lower regional lymph node involvement frequency and a more favorable prognosis among thick melanomas. Classic cases of desmoplastic melanoma tend to carry a high mutation burden. Patients with metastases from those tumors tend to respond favorably to novel immunotherapies...

The period of National Socialism (1933-1945), including the Holocaust and World War II, has had a profound impact on dermatology. We have identified Jewish women dermatologists who escaped the perils of National Socialism, document their struggles, and describe their contribution to medicine and dermatology. Medical, history, and media databases were searched. Relevant contributions in languages other than English were translated into English. Fourteen dermatologists were identified, and for seven, there was sufficient information to describe their lives in more detail: Helen Ollendorff-Curth (née Ollendorff) (1899-1982), Bertha Ottenstein (1891-1956), Sidonie Fürst (1891-1973), Marianne Bauer (née Jokl) (1885-1980), Hedwig Fischer (née Hoffmann) (1888-1983), Vera Shukhman (1900-1987) and Lili Farkas (1899-1992)...

Malignant blue melanomas (MBMs) arise from blue nevi and all related intradermal melanocytic proliferations. They harbor specific, mutually exclusive mutations in the G-coupled protein pathway, mainly involving GNAQ or GNA11. Other rare genetic drivers include CYSLTR2 or PCLB4 mutations. PKC and GRM1-gene fusions have been recently added to this list. MBMs have a predilection for the scalp area, presenting as rapidly growing nodules within a pre-existing lesion. Histopathologically, these tumors are located in the dermis and subcutaneous fat and consist of large nodules or expanding dense sheets...