Cutaneous Collagenous Vasculopathy: A Rare Entity Treated With Pulsed Dye Laser.

Cutaneous collagenous vasculopathy (CCV) is a rare idiopathic dermal microangiopathy. Clinically, it presents as diffuse cutaneous telangiectasias that are indistinguishable from other benign vascular entities, thereby posing a diagnostic challenge. We present a case of CCV successfully treated with pulsed dye laser (PDL). A 27-year-old male presented with generalized erythematous macules, diagnosed as CCV via histopathology. After a successful test spot, PDL treatment resulted in significant improvement. The pathogenesis of CCV involves altered dermal microvasculature and veil cell activation. Epidemiologically, it primarily affects Caucasians, most often in the middle-aged adult population. A negative family history of similar lesions can help narrow down the differential diagnosis. Diagnosis requires biopsy, with histopathological examination demonstrating vessel ectasia and collagenous vessel wall thickening. Given its rarity, CCV presents diagnostic and management challenges though PDL emerges as a promising treatment modality for this condition.

Neutrophilic Panniculitides.

Neutrophilic panniculitides are a heterogeneous group of inflammatory disorders encompassing many different entities. This review article focuses on the epidemiology, pathogenesis, clinicopathological features, diagnosis, and treatment of selected diseases. Patients often seek care due to systemic involvement, but the variable presentation of panniculitides can present a diagnostic challenge. Most therapeutic modalities for neutrophilic disorders are anecdotal at best with a notable lack of standardization of the responses to medications. There is an urgent need for a larger multi-institutional collaboration to address the unmet needs of these challenging, yet rare conditions.

Human herpesvirus 6 meningitis in an adult.

Many cases of viral meningitis are idiopathic, but increased utilization of polymerase chain reaction testing has enabled physicians to better recognize rare causes of viral meningitis. This will likely continue to improve the rate of causative agent identification in seemingly idiopathic viral meningitis, including this case of human herpesvirus 6 (HHV-6) meningitis in an immunocompetent adult patient. More common viral etiologies need to be excluded before diagnosing HHV-6 meningitis, as this maximizes pretest probability and therefore increases validity of a positive result. By efficiently diagnosing HHV-6 meningitis, proper treatment protocols can be initiated earlier to reduce morbidity and mortality. Given the rarity of HHV-6 meningitis in immunocompetent adults, there are no established standard treatment guidelines; previous reported cases, as well as this case, suggest that either intravenous ganciclovir or intravenous foscarnet are the most reasonable first-line treatment options.