Case report: verapamil-induced subacute cutaneous lupus erythematosus.

Calcium-channel blockers (CCB), including verapamil, nifedipine, and diltiazem, are one of the most widely prescribed class of drugs in the treatment of cardiovascular disease. In the last several years, CCBs have been linked with a distinct cutaneous subset in the lupus spectrum, subacute cutaneous lupus erythematosus (SCLE), and we describe a case induced by verapamil.

Monitoring vital signs during outpatient Mohs and post-Mohs reconstructive surgery performed under local anesthesia.

BACKGROUND: Although dermatologic surgery carries a low risk of serious adverse events, concern over the safety of outpatient surgical procedures in general has led some to question whether intraoperative patient monitoring should be performed during all procedures performed in the clinic setting. OBJECTIVE: To characterize the intraoperative monitoring practices of Mohs surgeons and examine the relationship between changes in vital signs during skin surgery and the incidence of serious adverse events. METHODS: We surveyed a group of Mohs surgeons and prospectively measured blood pressure, pulse, and pulse oximetry of 100 patients undergoing repair of Mohs surgery defects under local anesthesia in the outpatient clinic setting. RESULTS: The majority of survey respondents utilize no intraoperative monitoring, and serious adverse events are rare (0.2 per 1000 procedures performed). Moderate fluctuations in our patients' vital signs occurred (<10% deviation from baseline); however, all measured variables returned to near baseline by procedure end and were not associated with any serious adverse events. CONCLUSIONS: Surgical repair of Mohs defects performed under local anesthesia in the outpatient clinic setting continues to be very safe. Intraoperative vital sign measurements did not appear to be useful in detecting or avoiding potential adverse events in our patient population.

Idiopathic bilateral auricular ossificans: a case report and review of the literature.

Petrification of the auricle results in a rigid and immalleable ear. The etiology of such a finding is usually ectopic calcification. The condition has been associated with injurious processes, such as cold injury, and with various endocrinopathies, including Addison disease. In a significant number of cases, ossification occurs without knowledge of the precipitating cause or event. True auricular ossification is a rare occurrence, with only 12 histologically confirmed cases in the literature. We herein present the clinical and pathologic findings of another case. A 60-year-old man with diet-controlled diabetes presented with a 10-year history of slowly and insidiously stiffened auricles. He denied any precipitating historical events. Routine testing did not demonstrate systemic abnormalities. Radiographic examination revealed opacities consistent with bony structure in the auricles of the ears, with the right more prominent than the left. Histologic sampling demonstrated ossification with deposition of trabecular bone in proximity to normal elastic cartilage.

Traumatic pseudoaneurysm of the superficial temporal artery: two cases and review of the literature.

Aneurysms of the facial vasculature have been reported since the mid-seventeenth century from a variety of accidental, violent, and surgical injuries. Of the 386 cases of facial aneurysm reported in the world literature, 327 involve the superficial temporal artery. The nomenclature is somewhat confusing, because pseudoaneurysms are often referred to as simply "aneurysms" in the literature. Given that superficial temporal artery pseudoaneurysms might be seen in the guise of a cyst or lipoma, it is imperative that the dermatologist be aware of their presentation. To date, there have been 7 cases reported in the dermatologic literature. We report 2 additional cases of traumatic superficial temporal artery pseudoaneurysm and review the dermatologic literature.