Malignant myopericytoma: Case report and review of the literature.

A 29-year-old male presented with a two-week history of a tender lesion on his right thigh. The lesion was a 1.5 cm erythematous nodule with overlying hemorrhagic crust. Histopathologic examination of a biopsy specimen revealed a highly cellular neoplasm with irregular vesicular nuclei, prominent nucleoli, and scattered mitotic figures. The cells within the lesion were rounded, ovoid and spindle shaped cells with perivascular growth. The architecture and staining pattern of the lesion were most consistent with a diagnosis of malignant myopericytoma, an exceedingly rare malignancy.

Progressive Flat Papules on the Extremities: Epidermodysplasia Verruciformis.

During a US military medical mission to Guatemala, a 32-year-old woman with Fitzpatrick skin type IV presented with a chief complaint of numerous white spots on her arms and legs. She had initially noticed a few white spots 25 years earlier, and stated that they had been continuously increasing in number ever since. The lesions were asymptomatic and had not been previously treated; this encounter was the first time she had ever seen a physician. The patient denied any family history of similar-appearing lesions. She was otherwise healthy and was not taking any medications. On examination, she had numerous 3- to 5-mm, well-circumscribed, hypopigmented macules and flat papules scattered on all four extremities (Figures 1 and 2). A full body skin examination revealed no eruptions or similar-appearing lesions elsewhere.

Diffuse facial rash in a former collegiate wrestler.

The patient described a history of "recurrent impetigo," which led to an uncommon diagnosis.

Linear atrophy and vascular fragility following ultrasoundguided triamcinolone injection for DeQuervain tendonitis.

A 64 year-old woman presented with a one-yearhistory of purpuric, atrophic, linear patches alongthe left lateral forearm. The patient had receivedtwo ultrasound-guided triamcinolone injectionsone year earlier into her left extensor pollicis brevisand abductor pollicis longus tendon sheathsfor DeQuervain tendonitis. In the seven monthsfollowing the second injection, the patient developedatrophy, purpura, and telangiectasias starting at thesite of injection and extending proximally, followingthe course of her left cephalic vein. The patient wastreated initially with amlactin and moisturizing creamcontaining alpha-hydroxy acid cream to aid in dermalrepair. Despite treatment, she continued to haveproximal progression of the atrophy and purpura.A 4mm punch biopsy revealed a normal-appearingepidermis overlying horizontal dermal fibrosis, alongwith atrophic-appearing adipocytes with accentuatedcapillaries in the subcutaneous fat, consistent witha diagnosis of corticosteroid atrophy. These grossand microscopic changes presumably resulted fromlymphatic uptake and spread of the corticosteroidfollowing the injections for tendonitis. Although localatrophy and vascular fragility are well-documentedside effects of corticosteroid injections, linear spreadof these symptoms is rarely reported, and to this pointhas not been demonstrated in the literature followingultrasound-guided steroid injection for DeQuervaintendonitis.