Adalimumab for treatment of severe ulcerative sarcoidosis.

Ulcerative sarcoidosis is a rare variant of cutaneous sarcoidosis that may present as ulceration with necrotic yellow plaques on the lower extremities, face, arms, trunk, or genital area. Adalimumab, a human monoclonal anti-TNF antibody, is an emerging treatment for recalcitrant cutaneous sarcoidosis. We describe severe ulcerative sarcoidosis in a 60-year-old woman with chronic ulcerative necrobiosis lipoidica-like plaques on her left arm for over 20 years. Her condition had not responded to previous treatments with hydroxychloroquine, methotrexate, and sulfasalazine. After a four-month course of adalimumab therapy in addition to pentoxifylline and prednisone with taper, the patient had significant improvement in her skin disease.

A Case of Subacute Cutaneous Lupus Erythematosus and Review of Cutaneous Lupus Clinical Variants.

Lupus erythematosus (LE) is a complex autoimmune disease that presents with a wide variety of clinical and immunopathological features, making it challenging to reach a correct and prompt diagnosis. Patients with LE most frequently present with cutaneous and rheumatologic manifestations. As cutaneous findings may be the first sign of disease, their timely recognition is important for proper workup and management of LE. Here we present a case of subacute cutaneous lupus erythematosus (SCLE) and review the cutaneous manifestations of lupus erythematosus and the histopathological correlates to raise awareness and promote faster times to diagnosis and treatment.

A Case of Severe Bullous Dermatitis With Mixed Bullous Pemphigoid and Pemphigus Vulgaris Cutaneous Manifestations.

Bullous dermatoses include the rare, chronic autoimmune diseases pemphigus vulgaris and bullous pemphigoid. These diseases are traditionally taught to be differentiated by the presence of mucosal lesions (pemphigus vulgaris) and bullae without mucosal involvement (bullous pemphigoid). In the clinical setting, however, these diseases often contain overlapping features that present challenges to care teams without access to dermatologic care and leave patients without a clear treatment pathway. The ability to differentiate these two diseases clinically is imperative as it determines treatment regimens which when applied can mitigate unnecessary morbidity and mortality. Identifying these conditions clinically for the correct treatment also allows providers to rely less on laboratory assessments which are often unavailable or may take considerable time to result. This report details the clinical course of a patient who presented with an undifferentiated bullous dermatitis with features of both pemphigus vulgaris and bullous pemphigoid and aims to highlight the features of presentation which overlap between pemphigus vulgaris and bullous pemphigoid and those which are more characteristic for one over the other.

Skin Cancer Prevention and Screening Behaviors among Agricultural Workers: A Survey of the Attendees of the Sioux Falls Farm Show.

INTRODUCTION: Agricultural workers are at a higher risk for skin cancer due to excessive amounts of sun exposure, poor sun safety practices, and limited access to healthcare. This study aimed to assess skin cancer history, sun protection practices, and skin cancer surveillance measures among Midwestern agricultural workers. METHODS: Individuals that attended the 2020 Sioux Falls Farm Show were asked to complete a 12-question survey on sun exposure, sun protective practices, and skin cancer surveillance. Survey responses were aggregated and analyzed using Microsoft Excel. RESULTS: A total of 99 individuals participated in the study, of which 70 identified as agricultural workers. Most individuals reported working outdoors eight to 10 hours daily for 10-12 months of the year. Most participants reported poor sun protection habits, such as limited sunscreen and limited wide-brimmed hat use. A large number of participants reported they had previously received a professional skin check, although 33 percent reported never examining their own skin for suspicious lesions. CONCLUSIONS: Midwestern agricultural workers present a unique population that could benefit from improved skin cancer prevention. Opportunities for improvement include education of skin cancer preventative measures using platforms that are likely to reach rural agricultural workers and education regarding skin self-examinations. This study identified high risk factors of this population including substantial sun exposure, poor sun protection, and minimal self-skin examinations. Our findings may help guide future methods to increase skin cancer education, prevention, and surveillance in agricultural workers.

A Case-Based Review of Systemic Mastocytosis and Its Cutaneous Manifestations.

Mastocytosis represents an uncommon spectrum of disorders where mast cells proliferate and accumulate in different organs and tissues throughout the body, most frequently affecting the skin. Here we present a case of systemic mastocytosis and review the manifestations of cutaneous and systemic mastocytosis to raise awareness and try to reduce the typical delay in diagnosis.

Vaping-induced lung injury in a 21-year-old woman.

In the last few years, there has been a significant increase in younger generations using vaping devices as an alternative to smoking. Social media and celebrities have played a major role in its increased popularity. Many consumers believe it to be a relatively safer and healthier choice. We present a case of a 21-year-old, female, non-smoker with vaping exposure who developed severe acute lung injury. Her workup was negative for any other cause of acute lung injury.