Incidental rhabdomyomatous mesenchymal hamartoma.

Rhabdomyomatous mesenchymal hamartoma (RMH) is a rare congenital tumor of the dermal and subcutaneous tissues, often presenting as a papule or a pedunculated or sessile mass at the midline on the head and neck. Although RMH is benign, some cases have reported associations with other congenital and syndromic anomalies. Thus, an accurate diagnosis is important, as an internal or systemic evaluation of the patient may be warranted. We report a case of a solitary RMH on the midline upper chest in a healthy 15-year-old girl.

Subcutaneous sarcoidosis in a melanoma scar.

Cutaneous sarcoidosis often has been referred to. as the great imitator because skin lesions can present with various morphologies. Skin lesions may be the only site of involvement or may accompany systemic disease. Occasionally, sarcoidosis also may infiltrate scars from prior trauma, tattoos, or surgery. We report a case of subcutaneous sarcoidosis limited to a melanoma scar without any other cutaneous or systemic involvement. Familiarity with and proper diagnosis of cutaneous sarcoidosis can allow for appropriate systemic screening and timely management of the disease.

Development of systemic lupus erythematosus in a patient with rheumatoid arthritis following treatment conversion of infliximab to adalimumab.

Systemic lupus erythematosus (SLE)-like syndromes and the development of lupus-related autoantibodies are known to occur during treatment with certain medications. Here a case of complete SLE conversion in a patient with rheumatoid arthritis following sequential treatment with infliximab and adalimumab is reported. Potential mechanisms for development of SLE with this treatment regimen are discussed, as well as the need for further exploration into autoimmune phenomenon with the use of immunobiologic agents.

Irradiated polyglactin 910 for mucosal defects.

The prolonged presence of superficial mucosal sutures or perineal sutures may cause irritation or discomfort and increase the risk of bacterial infections. Although absorbable sutures are commonly used in mucosal areas, many sutures have a prolonged half-life and might still require removal when used superficially. We highlight the use of irradiated polyglactin 910 (IRPG) for closure of mucosal defects and areas where short-term wound support is required. We used IRPG in 50 patients for closure of defects on the lips, oral mucosa, and penis. In all cases, IRPG sutures provided appropriate tensile strength with minimal inflammation, suppuration, or irritation. IRPG resulted in low inflammatory response, rapid degeneration, soft feel, and easy workabil-ity, making it an ideal suture option for closure of mucosal defects and areas where short-term wound support is desired.

Immune protection, natural products, and skin cancer: is there anything new under the sun?

Non-melanoma skin cancers such as squamous cell carcinoma and basal cell carcinoma are the most common types of human neoplasms, representing one third of all new malignancies diagnosed in the US. The number of new cases diagnosed per year in the US alone is approaching one million and continues to rise. Ultraviolet (UV) radiation from the sun is a major cause of non-melanoma skin cancer in humans. Aside from the mutagenic effects of UV radiation, there are suggestions from clinical studies and evidence in animal models that the immune system plays an important role in preventing skin cancer development and progression, and is suppressed by cutaneous exposure to UV radiation. In this article, we review the research on new and existing agents that are being developed to protect the skin immune response from suppression by UV radiation. We also discuss the current state of knowledge regarding their mechanism of action in humans as well as animal models of photosuppression, and their efficacy in cancer prevention.

Molecular diagnosis of cutaneous diseases.

OBJECTIVES: To provide an update on the molecular procedures used increasingly in the study and diagnosis of a variety of dermatologic malignancies and inflammatory disorders and to explore the potential use of these techniques in clinical dermatology. Herein, we review assays such as G-banding, fluorescence in situ hybridization, comparative genomic hybridization, and spectral karyotyping in conjunction with the polymerase chain reaction and DNA microarrays. DATA SOURCES: PubMed was searched for published articles on molecular diagnosis and dermatologic diseases. STUDY SELECTION: All English-language studies were selected if they provided useful methodologic information or highlighted the usefulness of molecular techniques. DATA EXTRACTION: Only methodologic and qualitative information was extracted. DATA SYNTHESIS: The information was synthesized into 2 sections: one describing the principles of different molecular diagnostic techniques, and the other highlighting the contributions of molecular diagnostic techniques to the understanding and diagnosis of several dermatologic diseases. CONCLUSIONS: A basic understanding of the principles of molecular diagnostic techniques is crucial for the practicing dermatologist to benefit from the increasing number of molecular diagnostic articles appearing in the literature and potentially to apply these methods in clinical practice.