A Rapidly Growing Forearm Pilomatricoma in an Elderly Patient.

Pilomatricoma is a benign skin tumor of epithelial hair matrix cells that typically presents as a solitary nodule on the head or upper trunk. It occurs most often in children and young adults. While considered uncommon in middle-aged and elderly patients, there are reports of elderly patients with histopathologically diagnosed pilomatricomas; however, these cases primarily occurred on the face. We present a case of an 88-year-old female with a history of non-melanoma skin cancer who presented with a new, rapidly enlarging, biopsy-proven pilomatricoma on the forearm. This case highlights a unique age of onset and location for this skin tumor, suggesting that pilomatricomas are not limited to children and young adults and should be considered in the differential diagnosis of rapidly growing skin lesions in elderly patients. Diagnosis should be confirmed with biopsy in elderly patients, as pilomatricomas may mimic malignant skin lesions.

Online Readability Analysis: Mohs Micrographic Surgery Postsurgical Wound Care.

OBJECTIVE: Although various treatment modalities exist for skin cancer care, Mohs micrographic surgery (MMS) is one of the most effective and cosmetically sensitive surgical techniques. The readability of online informational materials specifically related to MMS postsurgical wound care is extremely relevant for patients given the high rates of skin cancer in the US and the number of patients utilizing the internet for information. METHODS: Investigators conducted Google searches to evaluate the current state of readability on MMS postsurgical wound care using the specific keywords "healing after Mohs surgery" and "wound care Mohs surgery." The readabilities of individual websites were analyzed using the WebFX online software. Health-specific click-through rate was used to select the number of samples assessed. RESULTS: Based on the 33 unique websites evaluated, the aggregate readability of online MMS postsurgical wound care materials was 11.3, corresponding to an 11th-grade reading level by US standards. CONCLUSIONS: Although this level of readability is an improvement in online MMS postsurgical wound care information relative to prior literature, there is still considerable work to be done by the dermatologic community in improving the readability of online patient materials regarding MMS.

Basal cell carcinoma arising within a longstanding hemangioma.

Basal cell carcinomas have been reported to arise within several different tumors. Without careful attention to detail, basal cell carcinomas may go unnoticed when presenting within or directly adjacent to another distinct tumor. The increased use and accessibility of dermoscopy has allowed dermatologists to detect skin cancers that might otherwise be undetected by the naked eye. This case report details a collision, detected by dermoscopy, of a basal cell carcinoma developing within a long-standing hemangioma (cherry angioma) on the left lower eyelid of a 75-year-old man.

Dermatologic Care for the Uninsured West Texas Population at a Student-run Free Clinic.

We highlight the operations of The Free Clinic at Lubbock Impact, describing its services and the patient population it serves. Dermatology Nights have been an integral part to the clinic, addressing skin conditions that the uninsured and homeless population experience.

Is your patient a candidate for Mohs micrographic surgery?

This guide for family physicians describes the advantages of Mohs surgery and which patients make good candidates for the procedure.

COVID-19 and dermatological personal protective equipment considerations.

Cutaneous injury and irritation among health care workers has substantially risen during the COVID-19 pandemic. In a field already laden with skin-induced injury and irritation due to high levels of handwashing and glove wearing, increases have been reported in handwashing-induced xerosis, irritant dermatitis, and contact dermatitis from N95 respirators and other surgical masks. Masks, goggles, face shields, and gloves all potentially create abrasions from long hours of use, leading to itching, pain, and aggravation of underlying skin conditions. Personal protective equipment (PPE)-related skin injury can be serious, and the American Academy of Dermatology has released recommendations on preventing and treating occupationally induced dermatologic conditions during the COVID-19 pandemic. These are reviewed and discussed in conjunction with overarching guidelines for mitigating the spread of the virus.

Ulcerated zosteriform nodules in adenocarcinoma of the colon.

Histiocytoid Sweet's syndrome (HSS) is a rare variant of Sweet's syndrome that typically has similar clinical findings to the classic variant but is diagnosed after histologic review. It is characterized by a dermal infiltrate composed of immature, nonblastic myeloid cells with a histiocytic appearance. In this report, we present a case of a 56-year-old Hispanic man with history of stage IIIB adenocarcinoma of the colon who presented with a case of HSS that mimicked a zosteriform cutaneous metastasis. Several types of cancers can metastasize to the skin, leading to varying cutaneous presentations. In particular, a zosteriform dermatomal distribution of cutaneous metastasis is common in melanoma and has been reported in other cancers, such as colon and breast. To our knowledge, this is the first case in which the clinical presentation of HSS appeared in a zosteriform pattern and distribution.

Allergic contact dermatitis of adjacent normal skin from 5-fluorouracil for the treatment of flat facial warts.

Topical 5-fluorouracil has proven to be an effective treatment for flat warts. Although cases of local irritation at the site of application have been reported, allergic contact dermatitis on the adjacent normal skin is generally uncommon. Reactions to propylene glycol and stearyl alcohol, two vehicle components of 5-fluorouracil, have also been described. In this report, we present a 21-year-old woman who developed allergic contact dermatitis of the adjacent normal skin after topical application of 5-fluorouracil to the face for the treatment of flat warts.

Value of Dermatology Nights at a student-run free clinic.

The Free Clinic at Lubbock Impact is a student-run free clinic affiliated with the Texas Tech University Health Sciences Center in Lubbock, Texas. Every Wednesday, the clinic provides free health services to the uninsured patient population of Lubbock and the surrounding West Texas regions. In addition to the weekly essential primary care services, "Dermatology Night" is held once a month for patients in need of dermatologic care. The study presents a cost analysis of the dermatologic procedures performed at The Free Clinic Dermatology Nights over a 2-year period from February 2018 through January 2020 using current procedural terminology codes and Medicare reimbursement rates. The dermatologic procedures performed in this time were valued at $8412.37. The study emphasizes the value of Dermatology Nights at a free clinic and reflects the dermatologic-specific needs of the uninsured Lubbock and West Texas patient population.

Paraneoplastic eczematous eruption associated with Hodgkin's lymphoma.

Hodgkin's disease (HD) is a common malignant lymphoma that classically presents with painless lymphadenopathy, weight loss, nocturnal sweats, fever, and generalized pruritus. Unlike other lymphoproliferative disorders, cutaneous involvement is uncommon with HD. Diffuse hyperpigmentation, prurigo nodularis, acquired ichthyosis, erythema nodosum, mycosis fungoides, herpes zoster, and vasculitis have all been described as nonspecific or paraneoplastic manifestations of HD. A small set of cases of adult new-onset recalcitrant eczema has recently been described as a nonspecific cutaneous manifestation of HD. In agreement with these reports, we present a case of a 28-year-old woman who initially presented with persistent lymphadenopathy and a pruritic eczematous dermatitis that preceded the diagnosis of HD.

Circumscribed palmar hypokeratosis.

Circumscribed palmar hypokeratosis (CPH) is a benign dermatologic condition characterized by local thinning of the stratum corneum. Herein, we present a 52-year-old woman who presented with an asymptomatic pink depressed papule on the right palm. This was treated with clobetasol 0.05% topically twice a day with no improvement.