Linear Depigmentation After an Intralesional Corticosteroid Injection.

Corticosteroid injections are an effective treatment for many medical conditions. However, clinicians must be aware of potential side effects of this treatment modality so that proper patient counseling can take place. Patients with pigmentary alteration after intra-articular or intralesional corticosteroid injections have rarely been reported in literature. We present an adult male patient with linear depigmentation after an intralesional corticosteroid injection for a Morton's neuroma.

Lichen Myxedematosus: Case Report and Review of Literature.

Lichen myxedematosus (LM) is an idiopathic cutaneous mucinosis, commonly described as localized scleromyxedema. In contrast to scleromyxedema, there is typically no systemic involvement. Treatment options are limited and spontaneous resolution has been reported. We present the case of a 66-year-old Hispanic male referred by his primary care physician for evaluation of asymptomatic dark spots on his trunk and extremities present for about one-year. Physical exam revealed smooth, brown hyperpigmented papules coalescing into plaques on the trunk. Multiple well-demarcated oval dark brown plaques measuring 3 cm in size were located on the upper back, peri-umbilical area, bilateral lower extremities, and buttocks. A diagnosis of lichen myxedematosus was made based on histologic features observed in the dermis. There are 5 subtypes of LM: a discrete papular form, acral persistent papular mucinosis, self-healing papular mucinosis, papular mucinosis of infancy, and a pure nodular form. Occasional patients with LM have atypical features or features intermediate between scleromyxedema and localized LM. We present a case of atypical LM with mixed features of the different subtypes. Herein we will review the varied clinical presentations of LM and highlight the distinguishing features of scleromyxedema. J Drugs Dermatol. 2020;19(3): 320-322 doi:10.36849/JDD.2020.4864.

A Case of Lichen Planus Pigmentosus with Facial Dyspigmentation Responsive to Combination Therapy with Chemical Peels and Topical Retinoids.

Lichen planus pigmentosus is a photodistributed dyschromia of unknown etiology described clinically as hyperpigmented gray-blue or brown-black macules or patches in a photodistributed pattern. Although there has been some debate, lichen planus pigmentosus is considered by many to be a separate diagnostic entity from ashy dermatosis or erythema dyschromicum perstans, which shares similar characteristics. Various treatment strategies have been applied to help resolve or improve the appearance of lichen planus pigmentosus lesions; however, an optimal treatment method is yet to be elucidated. The authors present a case of an 18-year-old Hispanic man with lichen planus pigmentosus whose skin findings responded dramatically to a combined regimen of daily topical azelaic acid foam and tretinoin cream with twice-monthly chemical peels using glycolic acid and Jessner's solution. The authors have noted a sparcity of therapeutic literature for lichen planus pigmentosus, and hope to aid clinicians in therapeutic management strategy for this patient subset.

To treat or not to treat? Management of guttate psoriasis and pityriasis rosea in patients with evidence of group A Streptococcal infection.

The association between guttate psoriasis and pityriasis rosea with Streptococcus pyogenes (S. pyogenes) is well established in the literature; however treatment guidelines and necessity have not been clarified with respect to the infectious etiology. Also, the exact role of Streptococcus in the immunopathogenesis of these entities, and the associated risk of development of scarlet fever and poststreptococcal sequelae, are not centrally reported. No single report or case series definitively establishes the coexistence between guttate psoriasis and post-streptococcal sequelae in the same patient, supporting the theories of autoimmune protection conferred between these entities. Laboratory investigations and treatment of Streptococcus in the setting of guttate psoriasis are not necessary, as anti-streptococcal treatment does not significantly modify the course of cutaneous disease, and there is no theoretical or documented risk of post-streptococcal sequelae. However, due to minimal data, antibiotics may still have a role in pityriasis rosea.

Vitamin B12 deficiency: a case report of ongoing cutaneous hyperpigmentation.

We describe an interesting case of a man with recurrent cutaneous and hematologic manifestations of vitamin B12 deficiency. In this deficiency, the skin, central nervous system, blood, and blood-forming tissues are commonly involved. We describe an overview of vitamin B12 deficiency and the successful treatment of a patient's ongoing cutaneous hyperpigmentation.

A case report of bacillary angiomatosis in a patient infected with human immunodeficiency virus.

A man infected with human immunodeficiency virus (HIV) presented with a few-month history of an enlarging friable growth on the medial area of the left foot and a one-week history of bilateral lower extremity edema. Clinical and histologic examination led to a diagnosis of bacillary angiomatosis, and the patient responded to antibiotic therapy We provide an overview of bacillary angiomatosis, a rare disorder that affects immunocompromised patients with CD4 cell counts less than 100/microL.