Giant proliferating pilomatricoma; report of a rare entity.

Proliferating pilomatricoma is a benign tumour and a rare variant of pilomatricoma that has the potential for local recurrence if incompletely excised. We report a case of giant proliferating pilomatricoma on the forearm of a 66-year-old woman. This tumour was unusually large and the presence of ulceration and rapid growth raised clinical suspicion of malignancy. The identification of shadow or ghost cells is a good clue to matrical differentiation, which can be confirmed by ß-catenin immunostaining.

Localized myxedema of the foot associated with trauma and surgery.

Localized extratibial myxedema is a rare presentation of thyroid disease that manifests with varied symptoms. Previous surgical or radioiodine treatment of hyperthyroidism is linked to the development of localized myxedema, as is prior trauma or surgery. We present the first known case of localized foot myxedema on a background of Graves disease following a traumatic and surgical precipitant and compare and discuss similar cases found in a literature review.

Closed digital artery injury.

Closed digital artery injury with secondary acute ischemia is a rare phenomenon. The most common injury pattern involves a crush mechanism with a resultant transverse fracture in proximity to the interphalangeal joints. Secondary acute ischemia requires urgent surgical exploration with digital arterial repair to avoid necrosis and associated decreased hand function. One should exercise an air of caution when examining significant closed trauma; neurovascular normality should be established by an adequately trained physician. We present a case of closed digital artery injury with secondary acute ischemia and a review of current literature.