RESUMEN
The original article was published on February 15, 2024 and corrected on April 15, 2024.The revised version of the article corrects Figure 2. The changes appear in the revised online PDF copy of this article.
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Hallux , Lipoma , Humanos , Lipoma/patología , Lipoma/diagnóstico , Hallux/patología , Femenino , Masculino , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnósticoRESUMEN
Spindle cell lipomas are a rare type of lipoma usually presenting in middle-aged to older men, often located on the posterior neck or shoulder; presentation on the foot is exceptionally uncommon. We report a 24-year-old man with spindle cell lipomas on the hallux of his left foot. He experienced an uneventful recovery after excision of the mass. We discuss clinical, radiologic, and histopathologic features of spindle cell lipomas and we review the differential diagnosis at this anatomic site.
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Hallux , Lipoma , Humanos , Lipoma/patología , Lipoma/diagnóstico , Lipoma/cirugía , Masculino , Hallux/patología , Adulto Joven , Diagnóstico Diferencial , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/cirugíaRESUMEN
Wolf isotopic response describes the onset of a new dermatosis at the site of a previous, healed dermatosis, which is usually a herpes zoster infection. Fibroelastolytic papulosis is a poorly understood elastolytic condition defined by a loss of elastic fibers specific to the papillary dermis. The present report describes a case of fibroelastolytic papulosis with onset following herpes zoster infection. This association provides new evidence for an immunopathogenic origin for fibroelastolytic papulosis and further supports current theories of the pathogenesis of Wolf isotopic response.
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Herpes Zóster , Enfermedades de la Piel , Lobos , Animales , Tejido ElásticoRESUMEN
Acral amelanotic melanoma can be difficult to diagnose and is often clinically aggressive. The present report describes a case of an acral amelanotic melanoma presenting as a non-healing wound after mimicking a plantar wart for two years. The decision to biopsy a borderline-suspicious lesion on the lower extremity in an elderly individual must be weighed carefully, as lower extremity biopsy carries a risk of poor wound healing and other complications. We discuss clinical and epidemiologic features that can assist in deciding when to perform a biopsy in this setting and can improve the early detection of acral amelanotic melanoma.
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We report a patient with new-onset ulcerated granuloma annulare with concomitant involvement of B-cell leukemia. A granuloma annulare-like eruption with concomitant B cell chronic lymphocytic leukemia involvement in the skin is extremely rare, as only three cases have been previously reported in the literature to our knowledge. Given the rarity of ulceration in conventional granuloma annulare, it is possible this finding may serve as a diagnostic clue for underlying malignancy.
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Granuloma Anular/patología , Leucemia Linfocítica Crónica de Células B/patología , Anciano , Progresión de la Enfermedad , Granuloma Anular/etiología , Humanos , Leucemia Linfocítica Crónica de Células B/complicaciones , MasculinoRESUMEN
Therapeutic applications of light emitting diode-red light (LED-RL) are expanding, yet data on its clinical effects are lacking. Our goal was to evaluate the safety of high fluence LED-RL (≥160 J/cm2 ). In two phase I, single-blind, dose escalation, randomized controlled trials, healthy subjects received LED-RL or mock irradiation to the forearm thrice weekly for 3 weeks at fluences of 160-640 J/cm2 for all skin types (STARS 1, n = 60) and at 480-640 J/cm2 for non-Hispanic Caucasians (STARS 2, n = 55). The primary outcome was the incidence of adverse events (AEs). The maximum tolerated dose was the highest fluence that did not elicit predefined AEs. Dose-limiting AEs, including blistering and prolonged erythema, occurred at 480 J/cm2 in STARS 1 (n = 1) and 640 J/cm2 in STARS 2 (n = 2). AEs of transient erythema and hyperpigmentation were mild. No serious AEs occurred. We determined that LED-RL is safe up to 320 J/cm2 for skin of color and 480 J/cm2 for non-Hispanic Caucasian individuals. LED-RL may exert differential cutaneous effects depending on race and ethnicity, with darker skin being more photosensitive. These findings may guide future studies to evaluate the efficacy of LED-RL for the treatment of various diseases.
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Terapia por Luz de Baja Intensidad , Piel , Humanos , Luz , Método Simple Ciego , Piel/efectos de la radiaciónRESUMEN
The indolent character of squamous cell carcinoma of the foot can be misleading and might result in unwarranted excisions or delayed treatment.
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Antineoplásicos Inmunológicos/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Cetuximab/uso terapéutico , Neoplasias Cutáneas/tratamiento farmacológico , Anciano , Carcinoma de Células Escamosas/patología , Femenino , Humanos , Inmunohistoquímica , Masculino , Estudios Retrospectivos , Neoplasias Cutáneas/patología , Resultado del TratamientoAsunto(s)
Alquitrán/efectos adversos , Dermatitis Seborreica/patología , Queratosis/patología , Psoriasis/terapia , Terapia Ultravioleta/efectos adversos , Anciano , Alquitrán/administración & dosificación , Terapia Combinada , Dermatitis Seborreica/etiología , Diagnóstico Diferencial , Femenino , Humanos , Queratosis/etiología , Masculino , Persona de Mediana Edad , Psoriasis/diagnóstico , Remisión Espontánea , Medición de Riesgo , Muestreo , Índice de Severidad de la Enfermedad , Terapia Ultravioleta/métodosRESUMEN
Cutaneous lichen planus is classically characterized by violaceous, pruritic, planar papules and plaques, most commonly affecting the extremities. Lichen planus following radiation therapy is extremely rare and lichen planus following radiation therapy for prostate carcinoma has not been previously reported in the literature. We report a 66-year-old man who presented to the dermatology clinic with a symmetric pruritic eruption affecting the pelvic and gluteal region within two months of radiation therapy targeting the prostate and pelvic lymph nodes for prostate adenocarcinoma. The patient did not have a prior history of lichen planus. Physical examination demonstrated well demarcated, violaceous papules and plaques in a circumferential band-like distribution on the bilateral gluteal, lumbosacral, and pelvic region. In addition, he had a few discrete lesions on the calves and dorsal feet. Punch biopsy revealed an acanthotic epidermis with "saw-tooth" rete ridges and a lichenoid inflammatory infiltrate. A diagnosis of hypertrophic lichen planus was made, reinforcing the importance for clinicians to recognize radiation therapy as a risk factor for developing lichen planus despite no prior history of lichen planus.
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Liquen Plano/etiología , Radioterapia/efectos adversos , Adenocarcinoma/radioterapia , Anciano , Humanos , Liquen Plano/patología , Masculino , Neoplasias de la Próstata/radioterapia , Traumatismos por Radiación/patología , Piel/patología , Piel/efectos de la radiaciónRESUMEN
BACKGROUND: Injectable dermal fillers are becoming increasingly popular for soft tissue augmentation and rejuvenation. Most contemporary biodegradable products are derived from hyaluronic acid, calcium hydroxylapatite, or poly-L-lactic acid. Achievement of desired cosmetic outcomes is largely dependent on selection of the optimal injectable product based on the chemical composition, the physiologic interactions with surrounding tissue, product longevity, and a thorough understanding of potential adverse reactions. OBJECTIVE: To review and describe the biochemistry, physiology, and tissue interactions of the most commonly used contemporary biodegradable dermal fillers. METHODS: A thorough review of the literature was performed with additional review of pertinent clinical cases and corresponding histopathology. RESULTS: This article provides a comprehensive review of the biochemistry, physiology, and potential tissue interactions of the most commonly used biodegradable dermal fillers. The underlying biochemical properties of each product and how they contribute to specific physiologic and adverse tissue reactions is described. CONCLUSION: Understanding of the innate differences in the physical properties, and physiologic responses to soft tissue fillers allows clinicians to achieve desired aesthetic outcomes with fewer adverse events.
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Fenómenos Bioquímicos , Rellenos Dérmicos/metabolismo , Rellenos Dérmicos/farmacología , Ácido Hialurónico/farmacología , Ácido Hialurónico/fisiología , Rellenos Dérmicos/efectos adversos , Rellenos Dérmicos/química , Durapatita/química , Durapatita/metabolismo , Durapatita/farmacología , Humanos , Ácido Hialurónico/efectos adversos , Ácido Hialurónico/química , Poliésteres/química , Poliésteres/farmacologíaRESUMEN
A 50-year-old African-American woman presented to the dermatology clinic with a pruritic eruption of 3 years' duration. On clinical examination, the patient had well-demarcated, pink, atrophic plaques and superficial erosions over the inframammary folds and mid-chest. She also had well-demarcated, hyperpigmented, hyperkeratotic scaly plaques over the abdomen, suprapubic region, elbows, knees, and back with sporadic small superficial blisters. A punch biopsy of the right abdomen was performed and revealed psoriasiform epidermal hyperplasia, focal parakeratosis, and acantholysis throughout the superficial spinous and granular layers. Only a sparse inflammatory infiltrate was present in the underlying dermis. Clinical and histological findings supported the diagnosis of pemphigus foliaceus (PF), but psoriasis was included in the differential diagnosis due to the presence of discrete plaques with an erythematous border. We hypothesize that patients with psoriasiform presentations of PF may be misdiagnosed with plaque psoriasis. It is important to distinguish between PF and psoriasis as there is evidence that ultraviolet light, a common treatment for psoriasis, may exacerbate PF. We document and highlight this atypical psoriasiform presentation of PF in a patient with skin of color to raise awareness and improve diagnosis and outcomes.
J Drugs Dermatol. 2018;17(4):471-473.
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Negro o Afroamericano , Pénfigo/diagnóstico , Psoriasis/diagnóstico , Administración Oral , Dapsona/administración & dosificación , Diagnóstico Diferencial , Femenino , Humanos , Leprostáticos/administración & dosificación , Persona de Mediana Edad , Pénfigo/tratamiento farmacológico , Psoriasis/tratamiento farmacológicoAsunto(s)
Histiocitosis de Células no Langerhans/diagnóstico , Enfermedades de la Piel/diagnóstico , Adulto , Diagnóstico Diferencial , Cara , Ingle , Histiocitosis de Células no Langerhans/complicaciones , Histiocitosis de Células no Langerhans/patología , Humanos , Masculino , Enfermedades de la Piel/complicaciones , Enfermedades de la Piel/patologíaRESUMEN
Complications from radiation exposure during fluoroscopic guidance of cardiac catheterization may occur. With repeated procedures, the risk for cutaneous injuries increases. Herein, we describe a 59-year-old man with extensive coronary artery disease, who had undergone multiple revascularization procedures and developed a non-healing ulcer on his left inferior scapula. The patient's medical history, physical exam findings, and histopathology gave clues to a case of radiation-induced dermatitis and necrosis.
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Enfermedad de la Arteria Coronaria/cirugía , Fluoroscopía/efectos adversos , Radiodermatitis/etiología , Piel/patología , Angioplastia Coronaria con Balón/métodos , Dorso , Cateterismo Cardíaco/métodos , Puente de Arteria Coronaria/métodos , Humanos , Masculino , Persona de Mediana Edad , Necrosis , Radiodermatitis/patologíaRESUMEN
BACKGROUND: Metastases to the skin are found with increased frequency at certain sites, such as the scalp, but the biological factors that influence this distribution are not understood. OBJECTIVE: We aimed to compare the proportional frequency of metastases at various cutaneous locations with the immunologic microenvironments at those sites. METHODS: We retrospectively identified all biopsy specimens of cutaneous metastases diagnosed at our institution from 1991 to 2014 (n = 1984) and mapped their anatomic distribution while controlling for regional surface area. Using a separate, mapped cohort of normal-appearing skin samples (n = 140), we measured the density of regulatory T cells, CD4(+) effector T cells, and CD8(+) T cells by flow cytometry. RESULTS: Per unit surface area, cutaneous metastases arise most commonly on the head and neck, followed by the trunk, upper extremities, and lower extremities, respectively. Sites with more frequent metastases tend to contain a greater density of regulatory T cells and a lower proportion of CD8(+) T cells (P < .05). LIMITATIONS: Immunologic factors were only assessed in control tissue and were not measured from patients with metastatic disease in this correlative single-center study. CONCLUSION: The distribution of cutaneous metastases follows the distribution of regulatory and effector T cells in skin. Further studies are required to prove a mechanistic association between local immunologic factors and the development of cutaneous metastases.
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Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/secundario , Microambiente Tumoral/inmunología , Linfocitos T CD8-positivos/inmunología , Humanos , Estudios Retrospectivos , Neoplasias Cutáneas/patología , Subgrupos de Linfocitos T/inmunologíaRESUMEN
IMPORTANCE: Multiple hereditary infundibulocystic basal cell carcinoma syndrome (MHIBCC) is a rare genodermatosis in which numerous indolent, well-differentiated basal cell carcinomas develop primarily on the face and genitals, without other features characteristic of basal cell nevus syndrome. The cause is unknown. The purpose of the study was to identify a genetic basis for the syndrome and a mechanism by which the associated tumors develop. OBSERVATIONS: Whole-exome sequencing of 5 tumors and a normal buccal mucosal sample from a patient with MHIBCC was performed. A conserved splice-site mutation in 1 copy of the suppressor of fused gene (SUFU) was identified in all tumor and normal tissue samples. Additional distinct deletions of the trans SUFU allele were identified in all tumor samples, none of which were present in the normal sample. CONCLUSIONS AND RELEVANCE: A germline SUFU mutation was present in a patient with MHIBCC, and additional acquired SUFU mutations underlie the development of infundibulocystic basal cell carcinomas. The downstream location of the SUFU gene within the sonic hedgehog pathway may explain why its loss is associated with relatively well-differentiated tumors and suggests that MHIBCC will not respond to therapeutic strategies, such as smoothened inhibitors, that target upstream components of this pathway.