Pembrolizumab-Associated Stevens-Johnson Syndrome in a Patient With Metastatic Non-small Cell Lung Cancer: A Case Report.

Pembrolizumab is a monoclonal antibody that binds to the programmed cell death-1 (PD-1) receptor and is approved for the treatment of several malignancies. We present a rare case of Stevens-Johnson syndrome (SJS) occurring in a 75-year-old female 14 days after receiving the first dose of pembrolizumab therapy to treat stage IV non-small cell carcinoma of the lungs with metastasis to the brain. Although pruritus and papular, erythematous rashes are documented after its use, severe reactions such as SJS and toxic epidermal necrolysis (TEN) are rarely seen in clinical practice. In addition to supportive care, the patient also received intravenous immunoglobulin (IVIG) and corticosteroid therapy and responded well to the therapy. Nearly complete re-epithelialization was achieved four weeks after the start of skin lesions. This case highlights a rare phenomenon of SJS- and TEN-associated adverse reactions following treatment with pembrolizumab.

Multiple Dermatomyofibromas in a Patient with Ehlers-Danlos Syndrome.

Dermatomyofibromas are a rare, benign, acquired neoplasm with less than 150 reported cases worldwide. The etiologic factors that contribute to the development of these lesions are currently unknown. To our knowledge, there have been only six previously reported cases of patients presenting with multiple dermatomyofibromas, and in each of these cases, there were less than ten lesions present. Herein, we describe a patient who developed more than 100 dermatomyofibromas over a period of years, and we argue that the patient's concurrent Ehlers-Danlos syndrome could have contributed to this unique presentation by inducing an increased fibroblast-to-myofibroblast transition.

Treatment of Reactive Keratoacanthomas with Acitretin Following Multiple Excisions and Mohs Surgery for Recurrent Squamous Cell Carcinoma.

Surgical intervention is seen as the gold standard in the treatment of Squamous cell carcinoma. Yet, in cases of recurrence, repeated surgical procedures may unwittingly foment the rise of reactive keratoacanthomas at the surgical margins or edge of a newly placed skin graft.

Upfront Radiotherapy with Concurrent and Adjuvant Vismodegib Is Effective and Well-Tolerated in a Patient with Advanced, Multifocal Basal Cell Carcinoma.

We present a case report of a male with multifocal and extensive basal cell carcinoma. Due to extremely large size and deep tumor infiltration, he was not a surgical candidate. Combined modality treatment of fractionated radiation with concurrent vismodegib was chosen. Concurrent treatment was previously reported in the palliative and recurrent setting. This is the first case of concurrent vismodegib and radiation therapy for upfront definitive management. The patient experienced complete response in all treated lesions.

Atypical fibroxanthoma arising within erosive pustular dermatosis of the scalp.

We describe a painful atypical fibroxanthoma (AFX) arising in a setting of erosive pustular dermatosis of the scalp. Complete excision was curative and also was associated with resolution of pain and clearance of the erosive pustular dermatosis of the scalp. We review the diagnosis and management of AFX and discuss the role of actinic damage in this process.

Congenital calcinosis cutis of the ear.

Congenital calcinosis cutis is a relatively rare event. Herein we report 3 cases of congenital calcinosis cutis that all appeared in the exact same location on the ear. A possible mechanism of pathogenesis is discussed.