Development of squamous cell carcinoma in the setting of chronic discoid lupus erythematosus may be associated with plasmacytoid dendritic cell inflammation.

Discoid lupus erythematosus (DLE) is the most common type of cutaneous lupus and is clinically characterized by alopecia, depigmentation, and scars on sun-exposed skin. Squamous cell carcinoma is a potential long-term complication. The most important risk factor for squamous cell carcinoma development in people with dark skin is chronic scarring and inflammation, such as those seen in long-standing discoid plaques. African Americans who develop squamous cell carcinoma in the setting of chronic scarring and inflammation have a greater risk of metastasis and recurrence compared to sun-induced squamous cell carcinoma seen in whites. Despite this, the pathogenesis of squamous cell carcinoma development in chronic DLE is not fully understood. Herein, we describe a case of an African American patient who developed squamous cell carcinoma on a long-standing discoid plaque. Analysis of the lesion revealed a null type pattern of p53 protein expression and abundant CD123+ plasmacytoid dendritic cells, as potential drivers of oncogenesis and inflammation, respectively. Dermatologists should be aware of the increased risk of squamous cell carcinoma development within long-standing discoid plaques for a prompt early diagnosis and active long-term surveillance.

Cutaneous Presentation of T-Cell Prolymphocytic Leukemia Mimicking Dermatomyositis.

ABSTRACT: T-cell prolymphocytic leukemia (TPLL) is a rare form of leukemia by T lymphocytes at a post-thymic intermediate stage of development with an α/ß immunophenotype. Facial involvement is common in TPLL and displays significant heterogeneity of the lesions' description and location. TPLL also contains a wide array of histology findings, cell cytology, and molecular studies. Here, we describe a TPLL patient who presented with an ill-defined erythematous patch involving the right axilla progressing to the left axilla, upper back, and face that resembled dermatomyositis. The diagnosis of TPLL was established using flow cytometry of bone marrow and peripheral blood, and histopathology of the involved skin. Dermatologists should be aware of these unique features.

Analysis of patient perceptions of Mohs surgery on social media platforms.

This study assessed social media content to improve understanding of patient experiences with Mohs surgery. An initial search of public Instagram posts and tweets tagged with "#mohssurgery" or "@mohssurgery" identified 1692 Instagram posts and 115 tweets, of which 1390 and 94 were eliminated, respectively, given that they did not directly include a patient's own experience. The team analyzed the posts/tweets for patient gender, timing of post prior to or after their procedure, and classified themes related to patients' experience with Mohs. Analysis showed that 91.4% of Instagram posts and 75.0% of tweets were published post-Mohs surgery, with the majority made by women. The most common theme on Twitter was updating followers on treatment progress (30.0%) and on Instagram, the most common theme was spreading awareness of skin cancer/encouraging others to protect their skin (18.9%). Other common themes included concern of appearance during recovery process, scars after treatment, and healing progress. Social media has the ability to provide a platform for patients to impart their personal experiences with Mohs surgery performed on skin cancer lesions.