Nodular lichen myxoedematous: a new adverse event associated with ustekinumab.

Nodular lichen myxoedematosus is a localised form of lichen myxoedematosus, a chronic idiopathic cutaneous mucinosis of known aetiology. Ustekinumab is a human interleukin-12/23 monoclonal antibody that could directly or indirectly increase mucin production. Herein, we report for the first time a case of nodular lichen myxoedematosus associated with ustekinumab.

Study of shrinkage of cutaneous surgical specimens.

BACKGROUND: The assessment of discrepancies between surgical and histopathological measurements of specimens is important in order to avoid repeat surgery and unnecessary follow-ups. OBJECTIVES: The objective of this study was to quantify the degree, time and influential factors of shrinkage of cutaneous surgical specimens. METHODS: Data of 111 patients were gathered on age, sex, localization, diagnosis and specimen width and length before surgical excision (in vivo), at 5 min postsurgery (ex vivo) and after 24 h of fixation in 10% buffered formalin (postfixation). RESULTS: The length and width were significantly lower in the postfixation vs. in vivo specimens, with a mean shrinkage of 17.0% in the length (p < 0.01) and 9.5% in the width (p < 0.01). 81.8% and 92.3% of the total shrinkage in length and weight was observed between in vivo and ex vivo measurements. No significant differences were observed as a function of sex, age or diagnosis. A greater shrinkage in length between in vivo and postfixation was found in specimens from the trunk. LIMITATIONS: The most of the skin samples were diseased. CONCLUSION: The largest proportion of specimen shrinkage occurred within 5 min of its excision and the shrinkage was greater in specimens from the trunk.

The role of accessibility policies and other determinants of health care provision in the initial prognosis of malignant melanoma: a cross-sectional study.

BACKGROUND: The prognostic benefit of health care service provision and delivery policies for patients with malignant melanoma (MM) is not yet clear. OBJECTIVE: To analyze the role of health care provision determinants in the initial prognosis of MM. METHODS: A multicenter cross-sectional study was conducted at 14 public hospitals and recruited 3550 patients with MM between 2000 and 2009. The study variables were analyzed using univariate and multivariate models to identify their role in the variations observed. RESULTS: In a 10-year period, the number of patients with MM increased by 78.54%, with primary in situ MM (Tis) or MMs with a Breslow thickness <1 mm (T1) representing 51.72% of the total number of MMs in 2000, increasing to 62.23% by the end of the study period (P = .005). Among the variables that explained the variation in MM frequency the year of diagnosis after 2004 (univariate odds ratio [OR], 1.43 [P < .001]; multivariate OR, 1.36 [P = .005]) and diagnosis in centers with specific fast-track referral systems (univariate OR, 1.24 [P = .01]; multivariate OR, 1.59 [P = .025]) were shown to explain the increasing frequency of Tis-T1 MM. LIMITATIONS: The primary potential limitation of this study is its retrospective nature. CONCLUSION: Health care provision policies and interventions aimed at improving accessibility to specialized care appear to explain the increasing frequency of Tis-T1 MM.

Squamous cell carcinoma in lichen planopilaris.

BACKGROUND: Lichen planopilaris (LPP) is a rare variant of cutaneous lichen planus that preferentially involves hair follicles. OBSERVATION: We describe the case of an 87-year-old woman with cicatricial alopecia due to lichen planopilaris. The diagnosis was based on clinical evaluation, histopathology and trichoscopy. Squamous cell carcinoma developed within the hairless area after 18 years of evolution. CONCLUSION: It is necessary to consider the association between lichen planopilaris and squamous cell carcinoma and to ensure a close follow-up of LPP patients, especially when there is a long history of the disease or new a lesion develops, which does not correspond clinically or in trichoscopy to lichen planopilaris.

Soft tissue extramedullary plasmacytoma.

We present the uncommon case of a subcutaneous fascia-based extramedullary plasmacytoma in the leg, which was confirmed by the pathology report and followed up until its remission. We report the differential diagnosis with other more common soft tissue masses. Imaging findings are nonspecific but are important to determine the tumour extension and to plan the biopsy.