Misdiagnosis of cutaneous epithelioid angiosarcoma as diabetic foot ulcer: a case study.

BACKGROUND: AS is a malignant tumor that originates from vascular endothelial cells and is known for a high rate of local recurrence and metastasis. CASE REPORT: A 48-year-old male presented with cutaneous epithelioid AS. Cutaneous AS of the foot is quite rare, especially in the absence of predisposing factors, and in this patient it was previously misdiagnosed as a DFU. CONCLUSION: Physicians should be aware of this rare presentation of cutaneous AS. The authors of the current report advise regular clinical reassessment of chronic ulcers and biopsies of nonhealing wounds, even when adequate wound treatment has been administered, with the goal of identifying ulcerated skin malignancies and preventing delay in providing appropriate treatment.

An extremely rare case of calcinosis cutis in human Cushing's disease.

Summary: Cushing's disease or pituitary adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome is considered a rare condition. It is caused by hypersecretion of the ACTH by a pituitary adenoma that ultimately induces endogenous hypercortisolism by stimulating the adrenal glands. It is responsible for significant morbidity and mortality. The clinical signs and symptoms of hypercortisolism are usually common and non-specific including obesity, moon face, hypertension, hirsutism and facial plethora. The association between Cushing's disease and calcinosis cutis which is defined as dystrophic calcium deposition in the skin and subcutaneous tissues is extremely rare. To the best of our knowledge, it has never been described previously in humans, probably like a symptom or complication of chronic and severe hypercortisolism. In this paper, we report a case of a 30-year-old female diagnosed with Cushing's disease and presented bilateral leg's calcinosis cutis complicated with ulceration. The evolution was favorable and the complete cicatrization was obtained 12 months following the suppression of systemic glucocorticoid excess. Learning points: Calcinosis cutis is common in autoimmune connective diseases. However, to our knowledge, it has never been reported in humans with Cushing's disease. Given the rarity of this association, the diagnostic approach to calcinosis cutis must exclude the other etiologies. Calcinosis cutis is challenging to treat with no gold standard therapy. In our case, the use of the combination of colchicine and bisphosphonates does not significantly improve the patient's outcomes. In fact, we suppose that without treating the endogenous hypercortisolism, the calcinosis cutis will not resolve.

Leser-Trelat sign preceding male breast cancer.

INTRODUCTION: Leser-Trelat sign is a paraneoplastic marker characerized by the abrupt appearance of seborrheic keratoses. It is described in association with many underlying malignant diseases. CASE REPORT: We report a case of coexistence of two rare entities, represented by the Leser-Trelat sign occurring with male breast cancer. DISCUSSION: The asscociation of male breast cancer and LT sign is decidedly unusual. To our knowledge, our case report is the second to describe the association of these two rare entities. CONCLUSION: A proper dermatological examination and a good knowledge of cutaneous paraneoplastic syndromes can be of great help in screening for multiple skin cancers.

When an uncommon condyloma revealed a multiple myeloma: Case report.

INTRODUCTION AND IMPORTANCE: Condyloma are a common and easily diagnosticated condition that could affect the area around and inside the anus. But a nodular perianal lesion is not always a simple condyloma. CASE PRESENTATION: We report a case of a 61-year-old patient with nodular perianal lesions mimicking condyloma that has revealed an amylosis and a multiple myeloma. CLINICAL DISCUSSION: The cutaneous manifestations of amyloidosis are diverse. Perianal nodular lesions were indicative of cutaneous amyloidosis in our patient. It is imperative to screen systemic involvement for amyloidosis. CONCLUSION: Our case report highlights the importance of minitious physical examination because some simple lesions can hide dangerous affections.

Half and half nail, is it a marker of severe COVID-19 infection?

INTRODUCTION: Several cutaneous manifestations have been described during COVID-19 infection, however ungual signs remain neglected. Half and half nail or Lindsay nails is a rare clinical finding, frequently seen in chronic renal failure, and many other disorders. CASE REPORT: We report 2 cases of half and half nail aspect occurring during severe COVID-19 infection, without a history of kidney disease, suggesting that 'Lindsay Nails' can be considered as a severity marker. DISCUSSION: An increasing number of nails changes has been reported since the COVID-19 outbreak. As well as the acral manifestations of COVID-19, the acute appearance of Half and half nail sign can be explained by a vascular involvement that may induce a transient matrix injury. CONCLUSION: We report the first description of acute onset of half and half nails during COVID-19 severe infection in 2 patients without a history of kidney failure or any other condition previously described, suggesting that it can be considered as a severity marker.

Lymphangioma circumscriptum of the scrotum: Case report.

INTRODUCTION AND IMPORTANCE: Lymphangioma circumscriptum (LC) is the most common form of cutaneous lymphangioma. However, scrotal LC is rare. CASE PRESENTATION: We report a case of a 37-year-old patient with a complaint of a slow growing painless scrotal grouped lesions present for the past ten years diagnosed as LC. CLINICAL DISCUSSION: The disorder is clinically identified by translucent or hazy vesicles of different sizes which are grouped like frog spawn or, less commonly, as diffuse swelling to a particular area. The definitive diagnosis is usually made by biopsy. LC tends to be asymptomatic. However, it can be complicated. The treatment involves medical and surgical procedures. CONCLUSION: Scrotal LC is rare and tends to mimic certain infectious diseases. The clinicians should be aware of LC in adult males without a prior disease to avoid missing the diagnosis and to prevent inappropriate treatment.

Erythema multiforme eruption due to SARS-COV 2: Case report.

INTRODUCTION: and importance: The COVID-19 is a global pandemic that is now responsible for more than 3 million deaths around the world. Its cutaneous manifestations in patients are being increasingly reported. This case brings additional data implementing the knowledge on the dermatological signs during COVID-19. CASE PRESENTATION: We report a new pattern with erythema multiforme (EM) lesions in a healthy patient with COVID-19 infection and no other medical background. CLINICAL DISCUSSION: We are facing challenging times in Dermatology. New information and cutaneous manifestations possibly related to COVID-19 are emerging every day. There are only a few case reports describing EM in patients with COVID-19. CONCLUSION: We suggest that this EM might be another pattern of exanthem associated with COVID-19 infection. Further studies are needed to evaluate whether these lesions are associated with the virus, the drug intake or any other conditions.

Giant squamous cell carcinomas of the shoulder.

Giant squamous cell carcinomas (SCC) larger than 5 cm in diameter are uncommon; there is no guideline on the size of an SCC that is considered giant. Treatment may be difficult with the need for large tissue resections and complex surgical reconstruction. We report a rare case of giant squamous cell carcinoma of the shoulder attached to deep anatomic planes. The entire mass was removed, resulting in a large defect that was repaired with myocutaneous flap rotation of the latissimus dorsi. Three courses of radiotherapy were performed after surgery. Fifteen months after the operation, the patient is well and working without any local recurrence and metastasis.

Skin involvement as the presenting sign of a male breast cancer.

Male breast cancer is a rare disease with an unknown etiopathogenesis. We report a case of a 50-year-old man with a breast cancer revealed by skin involvement.