Alopecia syphilitica, from diagnosis to treatment.

Alopecia syphilitica (AS) is an uncommon manifestation of secondary syphilis, with a prevalence that ranges from 3% to 7%. It is a nonscarring alopecia that can present in a diffuse pattern, a moth-eaten pattern, or a mixed subtype. Due to its low prevalence and similar presentation to other forms of alopecia such as alopecia areata, telogen effluvium, and tinea capitis, dermatologists must maintain a high degree of suspicion for prompt diagnosis. The diagnosis of AS is made by eliciting the patient's history, obtaining serologic tests, and examining histopathologic or dermatoscopic findings. First-line treatment includes benzathine penicillin G injection, which leads to hair regrowth weeks to months after administration. In this article, we present a focused review on the diagnosis of AS and discuss evidence-based therapeutic approaches for the management and treatment of this condition.

Infantile perineal protrusion.

Infantile perineal protrusion, a relatively newly recognized condition, is underreported in both the dermatologic and pediatric literature. The name "infantile perineal protrusion" has evolved based on the typical anatomic location, morphologic features, and prevalence in prepubertal children. It occurs in 3 settings: constitutional (sometimes genetic or familial); functional (after constipation, diarrhea, or other irritant exposure); or associated with lichen sclerosus et atrophicus. Recognition of infantile perineal protrusion by dermatologists and pediatricians has many implications regarding proper diagnosis and management. The condition may be mistaken for condyloma acuminata or as a sign of trauma, leading to an erroneous investigation of sexual abuse. In this article, we report two new cases and make a thorough review of the literature to elucidate the mechanisms, diagnosis, classification, and management to clarify this often misdiagnosed condition.

Scar sarcoidosis: a case report and brief review.

Scar sarcoidosis refers to lesions of cutaneous sarcoidosis that appear in preexisting scars. This condition may be caused by mechanical trauma such as skin cuts or venipuncture, scars caused by infection such as herpes zoster, and tattoos. We present a case of a 34-year-old man who developed scar sarcoidosis following minor trauma to the left calf. We review the epidemiology, clinical presentations, pathophysiology, and treatment options for scar sarcoidosis.

Pemphigus foliaceus: a case report and short review.

Pemphigus foliaceus (PF) is a rare autoimmune blistering disease presenting in endemic and sporadic forms. The typical presentation is recurrent shallow erosions in a seborrheic distribution. We present a case of a 58-year-old woman with PF who was successfully treated with a combination of oral corticosteroids and dapsone. We also provide a concise review of the literature and discuss the etiology, clinical features, diagnosis, and management of PF.

Fully Regressive Melanoma: A Case Without Metastasis.

Fully regressive melanoma is a phenomenon in which the primary cutaneous melanoma becomes completely replaced by fibrotic components as a result of host immune response. Although 10 to 35 percent of cases of cutaneous melanomas may partially regress, fully regressive melanoma is very rare; only 47 cases have been reported in the literature to date. AH of the cases of fully regressive melanoma reported in the literature were diagnosed in conjunction with metastasis on a patient. The authors describe a case of fully regressive melanoma without any metastases at the time of its diagnosis. Characteristic findings on dermoscopy, as well as the absence of melanoma on final biopsy, confirmed the diagnosis.

Assessing malignant melanoma: a case study.

Good history and close physical examination with high index of suspicions allowed us to perform an excisional biopsy which was also adequate for the primary treatment of this superficial malignant melanoma. The diagnosis, management, and followup of melanoma have undergone many changes and updates over the past decade, prompting practitioners to keep abreast of updated techniques on newer guidelines in order to offer excellent quality care.

Recurrent melanocytic nevi and melanomas in dermoscopy: results of a multicenter study of the International Dermoscopy Society.

IMPORTANCE Differentiating recurrent nevi from recurrent melanoma is challenging. OBJECTIVE To determine dermoscopic features to differentiate recurrent nevi from melanomas. DESIGN, SETTING, AND PARTICIPANTS Retrospective observational study of 15 pigmented lesion clinics from 12 countries; 98 recurrent nevi (61.3%) and 62 recurrent melanomas (38.8%) were collected from January to December 2011. MAIN OUTCOMES AND MEASURES Scoring the dermoscopic features, patterns, and colors in correlation with the histopathologic findings. RESULTS In univariate analysis, radial lines, symmetry, and centrifugal growth pattern were significantly more common dermoscopically in recurrent nevi; in contrast, circles, especially if on the head and neck area, eccentric hyperpigmentation at the periphery, a chaotic and noncontinuous growth pattern, and pigmentation beyond the scar's edge were significantly more common in recurrent melanomas. Patients with recurrent melanomas were significantly older than patients with recurrent nevi (mean [SD] age, 63.1 [17.5] years vs 30.2 [12.4] years) (P<.001), and there was a significantly longer time interval between the first procedure and the second treatment (median time interval, 25 vs 8 months) (P<.001). In a multivariate analysis, pigmentation beyond the scar's edge (P=.002), age (P<.001), and anatomic site (P=.002) were significantly and independently associated with the diagnosis of recurrent melanoma in dermoscopy. CONCLUSIONS AND RELEVANCE Dermoscopically, pigmentation beyond the scar's edge is the strongest clue for melanoma. Dermoscopy is helpful in evaluating recurrent lesions, but final interpretation requires taking into account the patient age, anatomic site, time to recurrence, growth pattern, and, if available, the histopathologic findings of the first excision.