Mycosis fungoides with Psoriasiform plaques: A case report and review of the literature.

Mycosis fungoides (MF) is the most common variant of primary skin T-cell lymphoma. It typically manifests as an indolent progressing cutaneous eruption with erythematous scaly patches or plaques. Due to the nonspecific pathological findings, it can be easily misdiagnosed as psoriasis. A 34-year-old woman with a history of psoriasiform plaques for 12 years was referred to our dermatology clinic. In the beginning, the diagnosis of psoriasis was made and topical steroids were prescribed: it did not exhibit any clinical improvement. During the visit, skin biopsy was performed and the diagnosis of MF was confirmed. Treatment with PUVA, prednisolon, methotrexate, topical ointment including ucerin, urea, and clobetasol were initiated. Significant improvement in all lesions were observed after 1 month of the treatment, and within a year, the disease improved dramatically after PUVA therapy. In refractory cases of psoriasiform plaques that are progressive and/or ulcerative despite the optimal treatment, biopsy is required and a possible diagnosis of MF should be kept in mind.

Postherpetic neuralgia and recalcitrant cystic lesions following herpes zoster: A case report and review of treatment options.

Acute herpes zoster lesions in most cases are self-limited except in older and immunocompromised patients, wherein the pain can cause significant suffering. Postherpetic neuralgia is a painful situation for patients that can compromise the quality of life. Here, we report a 30-year-old healthy young man who developed treatment-resistant postherpetic neuralgia after herpes zoster (fourth/fifth thoracic segment) without any underlying immunocompromised state. He also developed some cystic lesions, which were removed by aspiration and surgery. The skin lesions improved 2 weeks after the surgery and postherpetic neuralgia was completely cured after 5 months, however cystic lesions recurred multiple times and were excised completely during each visit. Postherpetic neuralgia has a significant impact on the health-care cost borne by the society and affected individual, hence, it is essential to select appropriate treatment to manage the pain of postherpetic neuralgia.

Eosinophilic ulcer mimicking malignancy of the lower lip: A case report.

Eosinophilic ulcer (EU) is a rare self-limiting chronic benign lesion of the oral mucosa. It is an uncommon and benign disease, which may leading to diagnostic difficulties. Biopsy is recommended to rule out any malignant etiology.

Uncommon presentation of pigmented paraungual basal cell carcinoma on the first toe treated with total excision.

Basal cell carcinomas (BCCs) are the most common types of skin neoplasm. The finger, toe, and nail unit are uncommon and rare locations of BCC. Only a few patients with foot BCC have been reported, and ungual BCC is even less frequent. We present a patient with a BCC on the left first toe. Clinically, it appeared as a brown-colored plaque with an irregular border on the nail fold and dorsum of the left thumb. Histopathological findings were consistent with the pigmented type of BCC. Surgical approach with subsequent full thickness mesh graft led to a complete remission. Follow-up at 10 months revealed a functionally and cosmetically acceptable outcome. The clinical presentation of nail unit BCC is variable, and nonspecific manifestations occur more frequently. Our case stated the necessity of histopathologic examination in ulcerous lesions resistant to topical treatment.

Necrobiosis Lipoidica Mimicking Cutaneous Sarcoidosis Finally Treated With an Intralesional Injection of Corticosteroid: A Case Report

BACKGROUND: Necrobiosis lipoidica (NL) and sarcoidosis are granulomatous disorders with an unknown pathogenesis. They may coexist in the same patient, which suggests a possible overlap between these diseases among shared granulomatous inflammatory pathways. Case Presentation: This study presents the case of a non-diabetic 52-year-old woman who presented with red-yellowish border plaques on the face and upper extremities previously diagnosed as sarcoidosis. After 13 years of inappropriate treatment, histopathological findings consistent with the clinical and para-clinical examination suggested the diagnosis of NL. After treatment with an intralesional injection of steroids, significant improvement was observed, and no recurrent lesions were found. CONCLUSION: Necrobiosis lipoidica may mimic cutaneous sarcoidosis. Prompt recognition and treatment of NL can be helpful for managing the disease. J Drugs Dermatol. 2020;19(1):92-94. doi:10.36849/JDD.2020.4675

Intralesional Injection of the Measles-Mumps-Rubella Vaccine into Resistant Palmoplantar Warts: A Randomized Controlled Trial.

BACKGROUND: Common resistant-to-therapy warts pose a challenge to both clinicians and patients. Among many destructive and immunotherapeutic options, no single, fully effective treatment has been suggested yet. Many investigations, including those using intralesional antigen administrations, have demonstrated that cellular immunity plays a major role in the clearance of human papilloma virus (HPV) infection. The aim of the present study was to evaluate the effects of the intralesional injection of the measles-mumps-rubella (MMR) vaccine into resistant-to- treatment palmoplantar warts and its complications. METHODS: In this single-blind, randomized, controlled clinical trial, 60 cases with resistant-to-therapy palmoplantar warts referring to the Dermatology Clinic of Bou-Ali Sina Hospital of Sari between June 2015 and 2016 were randomly assigned to 2 equal groups: the MMR Group received intralesional MMR and the Placebo Group was given saline injection. The injections were administered at 2-week intervals until complete clearance was achieved or for a maximum of 5 injections (<5 injections at 2-week intervals). The study protocol was registered in the Iranian Registry of Randomised Clinical Trials (ID: IRCT2016101027636N3), and the statistical analyses were performed using SPSS, version 17.0. The χ2 test and the F-test were used as appropriate, and a P value less than 0.05 was considered statistically significant. RESULTS: Complete clearance was observed in 65.2% (14/23) of the patients presenting with resistant-to-therapy palmoplantar warts in the MMR Group and 23.85% (5/21) in the Placebo Group (P=0.021). Recurrence was not observed in any of the completely cured patients at 6 months' follow-up. CONCLUSION: Intralesional immunotherapy with the MMR vaccine may result in a desirable therapeutic response and can be used as an effective and safe treatment option for palmoplantar warts, particularly persistent ones. Trial Registration Number: IRCT2016101027636N3.

Anterior, frontal congenital triangular alopecia, redundancy in therapy without improvement.

Congenital triangular alopecia (CTA) is a benign noncicatricial localized pattern of hair loss with unknown etiology. Although referred to as "congenital," CTA may develop in adulthood. It is believed that many cases of CTA are never diagnosed or are misdiagnosed; causing the incidence to be underestimated. The present study evaluates a case of 20-year-old woman presenting with a single circular to oval area of hair-loss in the mid-frontal region of her scalp. To date, about 170 cases of CTA have been reported and we present the first case in which the alopecic patch is located in the mid-frontal region of the scalp. We present this case not only to challenge the preconceived notion that all CTAs are frontotemporal, but also to inform other practitioners about this rare condition and prevent redundant medical treatment.