Pyoderma gangrenosum following gastric bypass surgery.

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that is a rare complication of surgery. Its diagnosis and treatment often are delayed in the postsurgical setting; by the time a dermatologist is consulted, lesions often are quite large and may be accompanied by systemic symptoms. Prompt treatment of severe PG with systemic therapy is warranted; however, in patients with contraindications to systemic immunosuppressive agents, treatment with superpotent topical corticosteroids may be considered. We present a case of PG following gastric bypass surgery along with a review of the literature on postsurgical PG.

Superficial acral fibromyxoma: an overview.

Superficial acral fibromyxoma is a rare, slow-growing soft tissue tumor, which is commonly located in the periungual and subungual regions of the fingers and toes in adults. To date, fewer than 50 cases have been reported worldwide. Microscopic examination reveals a moderately circumscribed, nonencapsulated tumor situated in the dermis, which may also extend into the subcutis. The neoplasm consists of a moderately cellular proliferation of stellate and spindle-shaped fibroblast-like cells embedded in a myxocollagenous stroma. Mast cells are easily identified throughout this lesion. Multinucleated stromal cells may also be present, but nuclear atypia and mitotic figures are rare. The tumor shows immunoreactivity for CD34, epithelial membrane antigen, CD99, and less frequently, CD10. Superficial acral fibromyxoma has a benign behavior but may persist or recur if inadequately excised. Therefore, complete excision and close follow-up are advised.

Cutaneous disseminated xanthogranuloma in an adult: case report and review of the literature.

Xanthogranuloma (XG) is a rare, non-Langerhans cell histiocytosis (LCH) that most commonly presents in infancy or early childhood. The condition is typified by the formation of reddish to yellow papules and nodules that are usually solitary. Xanthogranuloma rarely occurs in adults with immunohistochemical features similar to those seen in juvenile XG. Lesions in the adult form seen in juvenile XG. Lesions in the adult form also are typically solitary. We describe a 70-year-old white man who presented with widespread flat-topped, reddish to yellow papules and nodules with histologic and immunohistochemical findings consistent with XG. We explore the pathogenesis, differential diagnosis, prognosis, and treatment of this rare eruption. Comparison of adult and juvenile XG will facilitate a better understanding of the disease. Although rare, XG is an important disease to consider in the differential diagnosis of xanthomatous disease in adults.