Erosive lesion of the nipple: What is your diagnosis?

Erosive and oozing lesions of the nipple, especially when unilateral, should raise suspicion about malignant neoplasms. Herein we report a patient with typical clinical and histopathological features of erosive adenomatosis of the nipple (EAN). It is an uncommon, benign proliferative process of lactiferous ducts of the nipple. Clinically, EAN is characterized by erosion, serous discharge, edema, itching, and erythema of one of the nipples. Complete excision of the tumor yields excellent results. Although EAN is a rare disease, clinicians must be aware of this benign neoplasm in patients with erosive lesions of the nipple. The main concern is the need to rule out malignant proliferations in the differential diagnosis. Histology is the gold standard for diagnosis. The coexistence of nipple adenoma and breast cancer is well-reported in the literature. Thus, it is necessary to encourage patients with a history of EAN to maintain regular breast screening.

Chilblain-Like Eruption Unveiling Cutaneous Aleukemic Relapse of Acute Myeloid Leukemia.

ABSTRACT: Leukemia cutis corresponds to skin infiltration by malignant hematopoietic cells. It is most commonly reported in acute myeloid leukemia, particularly in subtypes with a monocytic component. Its clinical manifestations are extremely variable, and histopathologic diagnosis of cutaneous leukemic infiltrates may be challenging. We report the first case of cutaneous, that is, extramedullary, aleukemic relapse of acute myeloid leukemia within an unusual chilblain-like eruption that imposed a challenging clinical and histopathologic diagnosis. Primary chilblains are uncommon in the elderly, and a systemic underlying cause should be thoroughly investigated. In patients presenting with atypical chilblains (ie, persistent chilblains developing even without exposure to cold temperatures and/or refractory to therapy) and with a history of hematologic disorders such as leukemias, histopathologic examination is crucial to identify leukemic or aleukemic phases of relapse of underlying leukemia and initiate timely treatment.

Monkeypox Diagnosis by Cutaneous and Mucosal Findings.

A monkeypox outbreak has been reported in several countries since early May 2022. Human monkeypox (MPX) diagnosis is based on a clinical suspicion supported by typical skin and mucosal lesions, confirmed with molecular testing. We present the results of all MPX confirmed patients presenting to our department until July 15 of 2022, describing the characteristics of the lesions at diagnosis. In total, 47 patients were included, all men and 44.7% (n = 21) were HIV-positive. Skin lesions were noted in all patients. The most commonly affected area was the genital region (63.8%), followed by the anorectal region (46.8%). Extra anogenital mucosal (oral or conjunctival mucosa) involvement was reported in three patients. Typical skin findings included erythematous papules, whitish, umbilicated papules, some with a necrotic center and an elevated whitish border. Most patients had lesions in multiple phases presenting simultaneously. Correct identification of MPX skin and mucosal lesions is crucial to avoid late diagnosis and prevent further spreading, ensuring less worldwide morbidity.

Reasons for inpatient dermatological consultation requested by other specialities: a five-year data analysis of 1,052 patients from a Portuguese tertiary teaching hospital

Background: The involvement of a dermatologist in inpatient care can result in accurate diagnosis and prescription of appropriate treatment more promptly. Objectives: We aimed to analyse the main reasons for dermatological inpatient consultation in a tertiary centre. Materials & Methods: A retrospective analysis was performed based on clinical registries that included inpatients observed in emergency dermatology consultation between January 1st 2016 to December 31st 2020 at the Hospital de Santa Maria, a tertiary teaching hospital in Lisbon, Portugal. Results: In our dermatology emergency department, we performed 1,052 inpatient consultations during this five-year period. The most frequent diagnostic groups were infections and parasitic diseases (31.1%), inflammatory skin disorders (18.1%) and reactive erythemas (17.7%). Requests were most commonly (85.1%) made by medical specialities. Conclusion: Inpatient dermatological consultations grant access to expert management of drug-induced dermatoses, flares of chronic skin diseases, skin manifestations of systemic diseases and cutaneous infections. Prompt dermatological evaluation is essential for early diagnosis, thus enabling a better prognosis.