Verruca plana as a complication of CO2 laser treatment: a case report.

Carbon dioxide (CO2) laser treatment is a common therapeutic modality for many dermatologic conditions. It uses a high energy, infrared beam of light, which selectively targets water-containing tissue resulting in controlled ablative resurfacing. This modality, however, can manifest significant cosmetic side effects. Here we report a case of verruca plana manifesting as a response to CO2 laser treatment. A 74-year-old female with recent Mohs surgery for a basal cell carcinoma, presented for full-face-fractionated CO2 treatment to address her surgical scars in addition to treating her mild diffuse actinic damage. Six weeks post treatment, the patient developed erythematous thin plaques over the areas that had been treated. Histology was consistent with verruca plana. Lesions showed mild improvement with topical tretinoin. Verruca plana are benign and typically self-limited; however, they can present a significant cosmetic burden to patients and are an important complication to consider when performing elective cosmetic procedures.

Localized erythema multiforme-like contact dermatitis from a knee brace.

A 47-year-old woman developed allergic contact dermatitis (ACD) to a knee brace after anterior cruciate ligament repair, manifesting as numerous erythema multiforme-like lesions. No previous cases of ACD to this Townsend Rebel knee brace, which is commonly worn postoperatively, have been reported. The patient was treated with triamcinolone ointment, cetirizine, and diphenhydramine. On follow-up, the lesions had resolved. We share this case to increase knowledge of this reaction pattern and encourage further similar reports to clarify the nature of the reaction.

Bupropion-Associated Delayed Onset Urticaria.

Bupropion is an oral antidepressant that is commonly used to treat various mood disorders. Its therapeutic mechanism of action results from inhibiting the reuptake of norepinephrine and dopamine. Bupropion is generally well-tolerated and patients usually experience no side effects or mild adverse events. Rarely, hypersensitivity reactions to bupropion, such as urticaria, have been observed. However, the prevalence of delayed onset bupropion-associated urticaria may not be properly reflected in the literature due to misdiagnosis of the condition caused by its atypical presentation. We report a 20-year-old man with delayed onset bupropion-associated urticaria; he had been on bupropion for three weeks and subsequently developed new severely pruritic, erythematous wheals on his abdomen, bilateral flanks, and upper extremities. The clinical features of this rare adverse reaction to bupropion are also summarized.

Hidradenitis Suppurativa in the Military.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting the apocrine glands that is painful and often debilitating. Clinical manifestations include painful subcutaneous nodules that may lead to purulent secretions, abscesses, and fistula formation. The disease can be disfiguring and can worsen with friction and smoking. Treatment of HS in military servicemembers (SMs) often requires physical duty restrictions, which can result in removal from active service. We report the case of an active-duty marine with a flare of groin HS.

Lesions Arising in a Tattoo of an Active Duty US Marine Corps Woman.

Tattoos are ubiquitous in modern society; however, they do not come without risk of medical complications. When complications arise in the military community, a particularly thorough differential diagnosis should be considered based on the increased exposures service members have during deployment and throughout their military career. We present a case of a 38-year-old active duty US Marine Corps woman with worsening skin lesions arising within a tattoo 6 weeks after acquiring the tattoo on her right chest. Given environmental exposures from a recent deployment to the Middle East, a wide differential was considered. Ultimately, a skin biopsy revealed early hypertrophic scar formation responsive to therapy with intralesional triamcinolone acetonide (Kenalog® [ILK]). However, given the Marine had recently deployed and is part of the active duty population, consideration of alternative, albeit rare, etiologies was imperative.