Delayed Diagnosis of Retronychia: How Ultrasound Can Nail the Diagnosis in Clinically Subtle Patients.

A 47-year-old man presented to the dermatologic surgery clinic with a 7-month history of a painful, swollen left great toe after minor trauma. Intermittently, the toe became exquisitely tender such that even weight of a blanket exacerbated pain. The patient initially presented to primary care with purulence and pain, but the culture of expressed purulence revealed normal flora. Condition of the patient did not improve despite evaluation by several medical specialists and multiple rounds of topical antifungal and steroid creams, vinegar soaks, and oral antibiotics.

An update on long-term outcomes of pediatric follicular mucinosis over a 20-year period: a retrospective cohort study.

BACKGROUND: Follicular mucinosis (FM) is a rare disease characterized by mucin accumulation in the follicular unit. FM's etiology is still widely debated since its first description in 1957. Follicular mucinosis is usually reported to be benign in children, although reports of malignant transformation, most commonly mycosis fungoides, exist. The present project aims to demonstrate that children with a diagnosis of follicular mucinosis have positive long-term outcomes and do not develop mycosis fungoides. MATERIALS AND METHODS: This is a retrospective cohort study where patients with a diagnosis of follicular mucinosis ages 22 years and below were identified. Data surrounding the patient's diagnosis of FM, differential diagnosis, treatments, and long-term outcomes were collected. Patients who were lost to follow-up were contacted by phone for an update on the status of their skin and overall health. RESULTS: Out of 14 patients with follow-up information, none developed subsequent mycosis fungoides or other hematologic malignancies. CONCLUSION: Pediatric patients with follicular mucinosis will likely present with limited disease and not experience malignant transformation.

Blue-black hyperpigmentation on the extremities.

In some cases, diagnosis entails less "what is it?" and more "what caused it?"

Social media use in residency recruitment during the COVID-19 pandemic.

To investigate the extent to which dermatology programs use social media to connect with applicants, we conducted a search of all 140 residency programs on Instagram, Facebook, Twitter, and YouTube. Our search revealed 74 (53%) Instagram, 21 (15%) Facebook, 20 (14%) Twitter, and four (3%) YouTube accounts for dermatology programs, with the number of Instagram accounts increasing five-fold from the end of 2019 to present. Our results demonstrate that conditions created during the coronavirus disease 2019 (COVID-19) pandemic accelerated dermatology residency programs' acceptance of social media, particularly Instagram, as a means to communicate and share information with applicants.

Oral erosions associated with surreptitious marijuana vaping in an adolescent boy.

A 15-year-old boy presented with painful ulcerations affecting the oral mucosa that were eventually attributed to marijuana vaping. In this case report, we highlight cannabis vaping as a potential cause of oral erosions due to injury and chronic inflammation of the oral mucosa.

Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome.

Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, the most common periodic disorder of childhood, presents with the cardinal symptoms of periodic fever, aphthous stomatitis, pharyngitis, and adenitis typically before age 5. This review presents the recent literature on PFAPA and summarizes key findings in the pathogenesis, evaluation, and treatment of the disease. Theories surrounding the pathogenesis of PFAPA include a faulty innate immunologic response in conjunction with dysregulated T-cell activation. A potential genetic link is also under consideration. Mediterranean fever (MEFV) gene variants have been implicated and appear to modify disease severity. In individuals with the heterozygous variant, PFAPA episodes are milder and shorter in duration. Diagnostic criteria include the traditional clinical signs, in addition to the following biomarkers: elevated C-reactive protein in the absence of elevated procalcitonin, vitamin D, CD64, mean corpuscular volume, and other nonspecific inflammatory mediators in the absence of an infectious explanation for fever. Treatment of PFAPA includes tonsillectomy, a single dose of corticosteroids, and, most recently, interleukin 1 blockers such as anakinra, rilonacept, and canakinumab. Tonsillectomy remains the only permanent treatment modality.