Eruptive Penile Syringomas in an Adolescent: Novel Approach with Serial Microexcisions and Suture-Adhesive Repair.

Penile syringomas are benign adnexal tumors that are usually asymptomatic but can be cosmetically distressing. Because of the delicate nature of skin in this region, treatment is difficult, and there are few case reports of procedural destruction of these tumors. We report a case of successful surgical excision using Castroviejo ophthalmic scissors followed by primary closure with fast-absorbing plain gut suture and a cyanoacrylate adhesive application. This procedure was well tolerated and had an impressive cosmetic outcome.

Influence of clinical and pathologic features on the pathologist's diagnosis of mycosis fungoides: a pilot study.

Although clinicopathologic correlation is critical in the diagnosis of early mycosis fungoides (MF), how clinical information directly affects the pathologist's interpretation is unknown. This pilot study aimed to assess the influence of provided clinical information and specific histopathologic features on the histopathologic diagnosis of MF vs. its inflammatory simulants. A computerized survey recorded diagnostic impressions by 24 dermatopathologists of 30 hematoxylin-eosin stained images, including 15 MF images and 15 dermatitis images. Images were accompanied by concordant clinical descriptions (33%), no clinical information (33%) or discordant clinical descriptions (33%). Percentage of correctly classified MF histopathologic images for the three scenarios of concordant clinical information, no clinical information or discordant clinical information were 32% (kappa 0.19), 56% (kappa 0.12) and 16% (kappa 0.33), respectively. The percentage of correctly classified slides presented with no clinical information was different from the other two groups (p < 0.0001). Pautrier collections were most associated with correct classification. Clinical information may play a significant role in the histopathologic diagnosis of MF, although there may be some value in initial blinded histopathologic interpretation. Specific histopathologic features differ in relative importance in the diagnosis of MF.

Patient Preferences and Comparative Outcomes Regarding Cryosurgery versus Electrodesiccation in the Removal of Truncal Seborrheic Keratoses.

Background: Seborrheic keratoses (SKs) are one of the most common benign epithelial tumors seen by dermatologists. Many people elect to have these lesions removed, most commonly by way of cryosurgery or electrodesiccation. Objective: We sought to evaluate the comparative efficacy and patient preferences regarding cryosurgery and electrodesiccation for the treatment of truncal SK lesions. Methods: In this randomized, blinded clinical trial, 33 eligible subjects with two similar truncal SKs were assigned to receive treatment with cryosurgery and electrodesiccation applied to separate lesions. Patients rated their pain and preference at the time of treatment and follow up at two and eight weeks. Physicians rated the color, texture, and efficacy of lesion removal at eight weeks. Results: Patients did not have a treatment preference (p=0.10) and there was no significant difference in pain when comparing cryosurgery to electrodesiccation (p=0.43). Both treatment modalities were similar in terms of efficacy (p=0.50). Skin texture was rated similarly (p=0.64); however, lesions treated with cryosurgery were nominally less likely to have posttreatment hyperpigmentation compared to lesions treated with electrodesiccation (odds ratio: 0.35, 95% confidence interval: 0.12-1.002; p=0.0504). Conclusion: Cryosurgery and electrodesiccation are both effective treatment modalities for truncal SKs. While cosmetic outcomes were similar, cryosurgery resulted in less postinflammatory hyperpigmentation.