An Asymptomatic Case of Invisible Mycosis Fungoides.

ABSTRACT: Mycosis fungoides has previously been reported in 'invisible' form, when biopsy of normal-appearing skin in the background of undifferentiated chronic pruritus demonstrated histopathologic findings of the malignancy. Asymptomatic cases have been reported more infrequently on biopsies of individual skin lesions. We present a case of invisible and asymptomatic mycosis fungoides, confirmed with immunohistochemical and T-cell receptor gene rearrangement studies, diagnosed on a re-excision specimen of an atypical melanocytic nevus. The case highlights the importance of alert examination of all tissue specimens for evidence of unrelated pathologic findings.

Rippled Macules and Papules on the Legs.

Eligible for 1 MOC SA CreditFrom the ABD This Photo Challenge in our print edition is eligible for 1 self-assessment credit for Maintenance of Certification from the American Board of Dermatology (ABD). After completing this activity, diplomates can visit the ABD website (http://www.abderm.org) to self-report the credits under the activity title "Cutis Photo Challenge." You may report the credit after each activity is completed or after accumulating multiple credits.

Fighting acne for the fighting forces.

Acne vulgaris is one of the most common dermatologic diseases, ranging from comedonal or inflammatory papules to large, painful, disfiguring cysts. Numerous treatment approaches are available, each with their own risks and benefits that must be weighed when selecting the best option for an individual patient. Active-duty military servicemembers face additional levels of complexity when pursuing acne therapy. Untreated acne may interfere with their assigned duties, while various therapies also may limit their medical readiness and fitness for duty. We present a review of various acne treatment modalities with a focus on the military population. Additionally, we present a case in which the pulsed dye laser (PDL) was successfully used to treat inflammatory acne in an active-duty servicemember to highlight the use of PDL as an available and effective treatment option for acne in this population.

Acne keloidalis nuchae in the armed forces.

Acne keloidalis nuchae (AKN) is a chronic inflammatory skin disease characterized by the development of keloidlike papules, pustules, and plaques on the occipital scalp and posterior neck following mechanical trauma and irritation. First-line therapy involves avoidance of aggravating factors including short and frequent haircuts. Medical treatments-from topical and intralesional steroids, oral antibiotics, and UV light to laser and surgical excision-have demonstrated varying degrees of efficacy. The active-duty military population faces unique challenges in the treatment of AKN because personal appearance and grooming standards restrict avoidance of the very factors that promote this disease process. In this population, early identification and treatment are critical to reducing overall patient morbidity and ensuring continued operational and medical readiness. This article reviews the clinical features, epidemiology, and treatments available in the management of AKN, with a special focus on the active-duty military population.

A Case of Penile Plaques in Afghanistan.

Deployed male soldiers may present with a myriad of dermatological conditions in the genital area. It is important to recognize the more common entities in the differential diagnosis for soldiers to receive optimal guidance and treatment. This is important in the deployed environment for unit strength to be maintained and to avoid unnecessary medical evacuations. We present a patient deployed to Afghanistan who sought care at his battalion aid station for penile plaques that were diagnosed as lichen planus. In this article, we discuss the differential diagnosis for penile plaques and other considerations for deployed patients diagnosed with lichen planus.