Cutaneous metastases from prostatic carcinoma.

A case of prostatic adenocarcinoma associated with extensive cutaneous metastases and malignant acanthosis nigricans is reported. Pertinent literature is reviewed. The pathogenesis of the possible mechanism of the development of cutaneous metastases in this as well as other related cases is discussed.

Congenital unilateral benign papillomatosis of the mouth.

A 29-year old man had an unusual unilateral lesion of the mucous membranes of the mouth, including the lips, buccal mucosa, hard and soft palate, and uvula. The lesion was a conglomerate of tiny papillomas and had been present since birth. At the age of 8 years, a mass extending from the uvula into the pharynx was surgically excised. The histopathological findings showed acanthosis, papillomatosis, and an inflammatory infiltrate. The findings represent a rare case and perhaps a unique one, to my knowledge.

Green autofluorescence in human epidermal cells.

A characteristic and natural autofluorescence that appears brilliant green in frozen sections of untreated skin when viewed under the fluorescent microscope is demonstrated. Study with various barrier filters and exciter filters indicates that the optimum absorption for visualization of this is 300 to 330 nm, and the optimum fluorescence is between 500 and 530 nm under the conditions used. Clinical study of skin from 52 patients including black, white, Puerto Rican, and Chinese indicates a relationship between skin color and intensity of autofluorescence. In addition, the cellular localization of autofluorescence corresponds to sites of melanin. Cells in the basal layer are involved most conspicuously and nuclei are spared.

Pigmented basal cell cancer masquerading as superficial spreading malignant melanoma.

A 49-year-old woman of Spanish descent had a pigmented lesion on the thigh present for many years, which enlarged recently. The lesion showed notching and black, brown, and blue colors that led to the initial diagnosis of superficial spreading malignant melanoma. Results of skin biopsy disclosed the lesion was a basal cell epithelioma with large amounts of melanin in the dermis. This report illustrates the importance of considering pigmented basal cell epithelioma in the differential diagnosis of superficial spreading malignant melanoma.

Occurrence of bullous pemphigoid after furosemide therapy.

A 78-year-old woman with Parkinson disease developed tense bullous lesions on the chest, arms, and in the groin that were diagnosed as bullous pemphigoid. Histologic examination, as well as immunofluorescence tests, confirmed this diagnosis. The possibility of a drug-induced disease was considered because she was taking seven different medications. Furosemide (Lasix) was suspected primarily. Complete clearing occurred with prednisone therapy, but readministration of furosemide resulted in bulla formation.

Multiple keratoacanthomas associated with steatocystoma multiplex and rheumatoid arthritis. A case report.

Keratoacanthomas have been associated with multiple carcinomas, discoid lupus erythematosus, and multiple sebaceous gland tumors with colonic and gastric carcinoma. Steatocystoma multiplex has been associated with ichthyosis and koilonychia, pachyonychia congenita, multiple hairs and acrokeratosis verruciformis of Hopf, hypertrophic lichen planus, hypohidrosis, hypothyroidism, hidradenitis suppurativa, and hypotrichosis. We report a case of multiple keratoacanthoma associated with steatocystoma multiplex and rheumatoid arthritis.

Successful use of cyclophosphamide and prednisone for initial treatment of pemphigus vulgaris.

Previous reports showed that cyclophosphamide used late in the treatment of patients with pemphigus vulgaris reduced the complications due to steroids. In this study, cyclophosphamide was used in the initial treatment of five patients with pemphigus vulgaris in combination with prednisone to avoid side-effects of prednisone. Two patients had no prior treatment with steroids for pemphigus. Results indicate that initial combined program may be a highly effective treatment method for pemphigus vulgaris. Followup from one to four years after treatment shows all five patients in remission; four require no medication.

Current therapy of pemphigus vulgaris.

Pemphigus vulgaris (PV) is a potentially fatal autoimmune blistering disease of the skin and mucous membranes, characterized by flaccid bullae that rupture and leave erosions. Its treatment is challenging. Although the use of systemic corticosteroids remains the cornerstone of effective therapeutic regimens for PV, their prolonged administration may lead to serious side effects. It is therefore necessary, for many patients, to add immunosuppressive agents or use immunomodulatory procedures to achieve remission. This paper will summarize the treatments available for PV, while focusing on the most recently available therapeutic options.