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Dermatology Online Journal

Alanoud Adas, Ali Dadban, Jean-Philippe Arnault, Guillaume Chaby, Catherine Lok
Acrodermatitis continua of Hallopeau, first described in 1890, is an uncommon variant of pustular psoriasis. It presents as a sterile pustular eruption of the tips of fingers and toes. The condition has a chronic, relapsing course and is often resistant to many anti-psoriatic therapies. In the following case, we present our experience of etanercept use in a 61-year-old man. Although initial therapy with high-dose etanercept achieved a rapid, sustained response and remission, the lesions relapsed a few months into a lower, maintenance dosage...
February 15, 2019: Dermatology Online Journal
Erisa Alia, Eric J Feit, Jacob Oren Levitt
Pretibial myxedema or thyroid dermopathy constitutes dermal deposition of mucin, primarily hyaluronic acid and chondroitin sulfate. It is a manifestation of autoimmune thyroiditis, seen more in Graves disease than in Hashimoto thyroiditis. The time delay from treatment of hyperthyroidism to appearance of localized myxedema varies from one month to 16 years (mean 5.13 years). Despite a variety of therapeutic options, failure and relapse rates are high. Therapeutic options reported in the literature include compression, topical and intralesional corticosteroids, oral pentoxifylline, octreotide, rituximab, plasmapheresis, and high-dose intravenous immunoglobulin...
February 15, 2019: Dermatology Online Journal
Akruti Desai, Dilip Kumar Mishra, Mohammad Javed Ali
Eccrine hidrocystoma is a benign cystic tumor. Such benign cystic lesions may be a cosmetic concern, or when large, can cause eyelid malpositions. We report a patient with a peri-punctal hidrocystoma of the eyelid.
February 15, 2019: Dermatology Online Journal
Patrick T Tran, Allison K Truong, William Munday, Serge Alexanian, Paul Levins
Seborrheic keratosis is a benign condition that can mimic many different non-melanoma and melanoma neoplasms. There have been several case reports of underlying squamous cell carcinomas or intraepidermal carcinomas appearing within lesions that look analogous to seborrheic keratoses. We present a patient with a verrucous melanoma that could be mistaken for a benign skin tumor like an inflamed seborrheic keratosis. In our patient's case, her verrucous plaque was initially clinically suggestive of a benign seborrheic keratosis...
February 15, 2019: Dermatology Online Journal
Claire Alexanian, Stephanie Le, Chelsea Ma, Maxwell Fung, Danielle Tartar
Condyloma lata, a cutaneous manifestation of secondary syphilis, usually appear as verrucous papules and plaques in the anogenital area. Involvement of the umbilicus is very uncommon. Thus, awareness of this presentation, along with appropriate history, physical exam, and laboratory testing may aid clinicians in prompt and accurate diagnosis. We describe a patient with an unusual presentation of condyloma lata on the umbilicus.
February 15, 2019: Dermatology Online Journal
Ashlee L Culver, Amanda Hernandez, So Yeon Paek
Clinicians have a tendency to dismiss patients with psychiatric illness like skin picking disorder without assessing completely for organic disease. Patients with psychocutaneous disease have the potential to develop true dermatopathology and should always be examined thoroughly. We describe a case of skin picking disorder with underlying pilomatricoma. The patient met criteria for skin picking disorder and had been prescribed numerous topical treatments without efficacy by countless physicians over 18 years...
February 15, 2019: Dermatology Online Journal
R Bouceiro-Mendes, A Ortins-Pina, A Fraga, T Marques, M Viveiros, D Machado, L Soares-de-Almeida, J P Freitas, P Filipe
Mycobacterium marinum is a nontuberculous mycobacteria with worldwide distribution that lives in fresh or salt water and is responsible for infections in fish, and sometimes in humans. Human disease consists mainly of cutaneous nodules, but deep structure involvement may also occur. Diagnosis of M. marinum infection remains a challenge, with a considerable time delay between onset of symptoms and diagnosis. We present a 33-year-old man with no immunosuppressive history who was seen in our department with skin nodules over his hand and forearm, distributed in a sporotrichoid pattern...
February 15, 2019: Dermatology Online Journal
Samira Oliveira Silveira, Cassia Michelle Almeida Fernandes, Érica Baptista Pinto, Yandra Sherring Einecke, Caroline Da Silva Alves Palheta, Caio Vinicius Botelho Brito, Leônidas Braga Dias Júnior, Francisca Regina Oliveira Carneiro
A blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a cutaneous lymphoma derived from a plasmacytoid dendritic precursor cell that exhibits aggressive clinical behavior. Herein, we report a 46-year-old woman with a complaint of a painless nodule on the back, associated with pruritus. The nodule grew and new growths appeared over six months of evolution. The histopathological examination of one of the left upper limb lesions showed a dense lymphoid cell infiltrate with atypia in the superficial and deep dermis...
February 15, 2019: Dermatology Online Journal
Muge Gore Karaali, Asude Kara Polat, Ayse Esra Koku Aksu, Cem Leblebici, Mehmet Salih Gurel
Angiolipoma, a subtype of lipoma, is a benign adypocytic soft tissue tumor composed of mature adipose tissue and small vascular proliferations. This entity makes up 5-17% of all lipomas. The diagnosis is made by clinical and pathological examination, ultrasonography, and/or magnetic resonance imaging (MRI). It is generally an encapsulated tumor (noninfiltrative), but rarely has an infiltrative form. Angiolipoma mostly occurs on the trunk and extremities with male predominance. The forearm is the most frequent location for angiolipomas...
February 15, 2019: Dermatology Online Journal
Uriel Villela-Segura, Julieta Peralta-Serna, Alejandra Guerrero-Álvarez, Lorena Estrada-Aguilar
Calcific uremic arteriolopathy (CUA) or calciphylaxis is a syndrome characterized by calcification of vessels located in the dermis and adipose tissue. It commonly occurs in patients with diabetes mellitus, hypertension, and end-stage renal disease. Clinical presentation generally begins with severe pain, followed by the presence of liveloid or purpuric plaques. Later the formation necrotic ulcers occur. This condition is associated with a poor prognosis, with a high rate of mortality within months of the diagnosis...
February 15, 2019: Dermatology Online Journal
Sam Wu, Adewole S Adamson
Enfortumab vedotin is an antibody-drug conjugate targeting nectin-4 and is being studied in the treatment of various epithelial carcinomas including urothelial carcinoma; early data suggests efficacy and tolerability. Rash has been described as an adverse event associated with treatment with enfortumab vedotin, but has not been characterized to date. We report a patient with metastatic urothelial carcinoma treated with enfortumab vedotin who developed erythematous, scaly papules and plaques on his torso and extremities with corresponding histologic features of vacuolar interface dermatitis and maturation disarray of keratinocytes...
February 15, 2019: Dermatology Online Journal
Ayan Kusari, David Cotter, Brian Hinds, Taraneh Paravar
Non-uremic calciphylaxis is a rare, life-threatening condition characterized clinically by cutaneous necrosis and histologically by calcium deposition in small vessel walls. The etiology of non-uremic calciphylaxis remains the subject of ongoing speculation and debate. Herein we present a patient with calciphylaxis who had normal kidney function and numerous rheumatologic diseases, namely systemic lupus erythematosus (SLE), Sjogren syndrome (SS), and myasthenia gravis (MG). We review the pathophysiology, possible mechanisms, and management for non-uremic calciphylaxis...
February 15, 2019: Dermatology Online Journal
Emily L Unrue, Abigail Cline, Alexandra Collins, Vu H Nguyen, Michelle T Pelle, Patrick Blake, Steven R Feldman
BACKGROUND: Phototherapy is effective in treating psoriasis and other skin conditions. However, clinic-based phototherapy can be time-consuming, expensive, and inconvenient. Conventional home phototherapy addresses many hurdles, but has other limitations. OBJECTIVE: Assess the treatment efficacy, adherence, and satisfaction of a novel ultraviolet B home phototherapy system. METHODS: Eight patients with stable plaque psoriasis completed a multicenter, prospective, open label, interventional study using a home phototherapy device designed to improve treatment control and adherence...
February 15, 2019: Dermatology Online Journal
Philip R Cohen
Platelet-rich plasma, which contains numerous growth factors that promote hair growth, is a nonsurgical treatment available for patients with androgenetic alopecia. However, neither the quantity nor the location and depth of platelet-rich plasma placement in the scalp is uniform; in addition, multiple painful injections are required. Vertical uniform channels from the skin surface into the dermis, created by ablative laser fractional photothermolysis, can be used to enhance the cutaneous delivery of medications...
February 15, 2019: Dermatology Online Journal
Adrian Pona, Wasim Haidari, Sree S Kolli, Steven R Feldman
BACKGROUND: Patients with psoriasis have a growing interest in managing their disease through diet. OBJECTIVE: This review paper aims to analyze dietary interventions for psoriasis and their outcome. METHODS: Terms "psoriasis AND diet" were used to search PubMed database and 63 articles describing dietary changes influencing psoriasis were selected. RESULTS: Low calorie diet (LCD) improves Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in conjunction with topical or systemic therapy, although LCD was unsuccessful in maintaining disease remission when patients discontinued concomitant cyclosporine or methotrexate therapy...
February 15, 2019: Dermatology Online Journal
Deborah N Dorrell, Steven R Feldman
Sun-exposed areas of the body - including the face, neck, and extensor forearms - are chronically exposed to UV light and display signs of photoaging. The skin distal to the proximal interphalangeal (PIP) joint is, however, typically spared owing to the natural rest position of the hand. The inward curvature of the fingers, termed the finger flexion cascade, orients the skin distal to the PIP joint toward the ground as in knuckle-walking primates. The near constant protection of this area of skin from sun may reflect our primate ancestry, the daily activities of which included swinging through trees and knuckle-walking...
January 15, 2019: Dermatology Online Journal
Divya Seth, Sophie Wang, Harib H Ezaldein, Miesha Merati, Jeffrey F Scott
Acne vulgaris affects a large portion of the population and drives many patients to seek over-the-counter (OTC) treatments. Light-emitting diode (LED) therapy has recently emerged as a potential therapeutic option for inflammatory acne. We used the U.S. Food and Drug Administration (FDA) 510(k) premarket submission database to assess the growth in OTC LED therapy devices for treatment of acne. We also used Google Trends data in searches for "acne light therapy mask" to characterize growth in consumer interest in these devices...
January 15, 2019: Dermatology Online Journal
Brett C Neill, William V Stoecker, Ramzi Hassouneh, Anand Rajpara, Daniel J Aires
Cellulitis, a bacterial infection of the skin and subcutaneous tissue, is often misdiagnosed. Cellulitis accounts for a large number of all infectious disease-related hospitalizations in the U.S. Cellulitis can be challenging to diagnose since it lacks pathognomonic findings. We reviewed all articles on cellulitis within the last 20 years that included a statistical analysis, with odds ratios (OR), of specific clinical features of cellulitis. We then constructed a mnemonic encompassing the features with the highest odds ratios...
January 15, 2019: Dermatology Online Journal
Erica B Lee, Kelly A Reynolds, Deeti J Pithadia, Jashin J Wu
Development of lentigines in areas of resolving psoriatic plaques is a rare phenomenon that has been reported following various treatment modalities including phototherapy, topical therapies, and biologics. Although the exact mechanism is unknown, evidence suggests that the cause may be multifactorial, with factors such as skin type, sun exposure, inflammation, and immunologic cytokines all playing a potential role. Herein, we present the first reported case of a patient developing multiple lentigines following treatment of psoriasis with the IL-23 inhibitor guselkumab...
January 15, 2019: Dermatology Online Journal
Sofia Lopes, Ana Nogueira, Irene Gullo, Joana Pardal, J M Lopes, Filomena Azevedo
Systemic immunoglobulin light chain amyloidosis is the most common and severe type of amyloidosis. There is an abnormal fibrillary protein deposition in tissues that leads to progressive and irreversible organ dysfunction. The most commonly affected organs are kidney and heart. Although rare, cutaneous manifestations may be the first clinical sign of the disease and usually present as hemorrhagic lesions, such as purpura, petechiae, and ecchymosis. We present a 71-year-old man that presented to our department because of exuberant purpuric plaques in the anogenital area as the first manifestation of an amyloid light-chain (AL) amyloidosis...
January 15, 2019: Dermatology Online Journal
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