Perforating Calcinosis Cutis as a Complication of Intraosseous Fluid Infusion in the Setting of a Near-Drowning Event.

Iatrogenic calcinosis cutis represents a subset of calcinosis cutis resulting secondary to treatments or procedures. We present the first report of calcinosis cutis resulting from the intraosseous infusion and one of a few cases with associated transepidermal elimination. A previously healthy 2-year-old female presented with a new-onset unilateral shin rash 1 week following hospitalization for a near-drowning event. A dermatologic exam revealed multiple small, tender, firm, chalky-white papules with surrounding erythema, in addition to two erythematous macules superior and medial to the papular lesions, corresponding to prior intraosseous access sites. The rash persisted despite trials of topical mupirocin and acyclovir cream, prompting a referral to a dermatologist. An excisional biopsy was performed, revealing circumscribed dermal deposits of acellular basophilic material connected to the overlying epidermis through an invaginated keratin plug. A von Kossa silver stain highlighted the deposits, confirming the diagnosis of perforating calcinosis cutis. The lesions did not recur following the excisional biopsy. Iatrogenic calcinosis cutis may be seen as a complication of the infusion of calcium-containing fluids via intraosseous access, in addition to the more commonly observed peripheral intravenous access. Awareness of this disorder is important in order to distinguish it from an infectious mimic and guide the selection of therapy.

Malignant myopericytoma: Case report and review of the literature.

A 29-year-old male presented with a two-week history of a tender lesion on his right thigh. The lesion was a 1.5 cm erythematous nodule with overlying hemorrhagic crust. Histopathologic examination of a biopsy specimen revealed a highly cellular neoplasm with irregular vesicular nuclei, prominent nucleoli, and scattered mitotic figures. The cells within the lesion were rounded, ovoid and spindle shaped cells with perivascular growth. The architecture and staining pattern of the lesion were most consistent with a diagnosis of malignant myopericytoma, an exceedingly rare malignancy.

Exaggerated hyperkeratosis in a nursing home patient.

Scabies, caused by the mite Sarcoptes scabiei var hominis, is a common infestation that presents with intense itching. Crusted scabies, also known as Norwegian scabies, is a severe variant of classic scabies that is characterized by hyperkeratotic lesions and often manifests in immunosuppressed patients. There is both a high parasitic load and high infectivity with this form of scabies because crusted scabies can look similar to many conditions including psoriasis, eczema, and seborrheic dermatitis, diagnosis can be difficult and is based on both clinical findings and microscopic detection of the scabies mite, eggs, or fecal material (scybala). We describe a case of a 64-year-old female patient diagnosed with crusted scabies.

Squamous cell carcinoma or squamous proliferation associated with nivolumab treatment for metastatic melanoma.

Nivolumab is a programmed death-1 (PD1) immune checkpoint inhibitor that treats various types of cancers including non-small cell lung carcinoma and melanoma, among others. Although it serves as an effective immunotherapy, there are many associated immune-related adverse events. Even years after the introduction of nivolumab, the breadth of its side effect profile continues to expand. We present a case of squamous cell carcinoma associated with nivolumab treatment for metastatic melanoma.

Migrated Bulking Material (Solesta) Presenting as a Vaginal "Cyst": Histopathologic and Chemical Analytical Features.

Performing injections with a bulking agent consisting of nonanimal stabilized hyaluronic acid and dextranomer is a well-tolerated and efficacious treatment for mild to moderate fecal incontinence. Here, we discuss a case of a patient with a history of a bulking procedure for fecal incontinence who presented to the obstetrics/gynecology clinic for evaluation of a new vaginal "cyst," which was excised. Histopathologic examination revealed migrated bulking agent within the excised specimen.

From Buns to Braids and Ponytails: Entering a New Era of Female Military Hair-Grooming Standards.

Each of the US Military services imposes strict hair-grooming standards to ensure professionalism and the safety of servicemembers. Although in recent years there have been some progressive changes in grooming policies, they have not adequately accounted for the diversity within the US Armed Forces or variations in hair and skin types. Review of some antiquated grooming regulations resulted in the authorized wearing of locs across all 4 services over the last 4 years. The largest catalyst for improved grooming standards occurred in 2020 when former Defense Secretary Mark Esper requested that the Department of Defense review military policies for racial bias. To embrace diversity and inclusivity in the military services while addressing grooming-related health concerns, the US Air Force and the US Army recently authorized women to wear longer braids and ponytails. The updated hair-grooming regulations are anticipated to decrease the numbers of female servicemembers impacted by scalp symptoms and hair disease. This review highlights the history of female military hair-grooming standards and the most commonly associated scalp symptoms and disorders, including trichorrhexis nodosa (TN), extracranial headaches, and traction alopecia (TA).

Melanoma: An FP's guide to diagnosis and management.

This review details the latest recommendations on dermoscopy and excision techniques, indications for sentinel lymph node biopsy, and Tx options.