Failure of Nasal Defect Closures Following the Use of Continuous Positive Airway Pressure.

In this paper, we report a case series of three patients who developed nasal tip necrosis following Mohs micrographic surgery (MMS), complicated by the concomitant use of a continuous positive airway pressure (CPAP) machine for sleep apnea.

Chromoblastomycosis Presenting as a Solitary Lesion in a Non-endemic Region.

Chromoblastomycosis is a neglected tropical disease typically found in endemic tropical and subtropical regions. Herein, we discuss a rare case of a 55-year-old man in Texas who presented with an exophytic papule on the forearm, diagnosed to have chromoblastomycosis by shave biopsy and subsequent histopathological analysis. Treatment options for chromoblastomycosis include long-term oral antifungal therapy with itraconazole, physical modalities such as heat therapy in conjunction with oral antifungals, and surgical interventions such as cryosurgery or surgical excision.

A case of filgrastim-induced neutrophilic dermatosis of the dorsal hands in a patient with Felty Syndrome.

Neutrophilic dermatosis of the dorsal hands (NDDH) is a variant of Sweet syndrome that presents with erythematous bullae, papules/plaques, or pustules on the dorsal hands. It is most commonly associated with hematologic and solid organ malignancies, though cases of NDDH associated with inflammatory bowel disease, rheumatologic disorders, and medication exposure have also been described in the literature. Felty syndrome is a rare complication of long-standing rheumatoid arthritis characterized by neuropathy, splenomegaly, and neutropenia. Granulocyte colony stimulating factors (e.g., filgrastim) can be utilized to rescue the neutropenia observed in Felty syndrome, but this treatment may subsequently cause Sweet syndrome. Herein, we present a 64-year-old man with Felty syndrome and a complex medical history who presented with sudden onset, painful blisters located on the dorsal and palmar aspects of his bilateral hands. Given the patient's past medical history, a broad differential diagnosis, including disseminated fungal and viral infection was initially considered. A punch biopsy of the skin lesion disclosed neutrophilic dermatosis, which together with laboratory data satisfied the von den Driesch criteria for Sweet syndrome. As the lesions were localized exclusively on the patient's hands, the qualification of NDDH was also endorsed.

Bipolar fractionated radiofrequency midface lift: A retrospective review.

INTRODUCTION: Midface rejuvenation is an important component of overall facial rejuvenation. Traditionally, midfacial skin laxity and volume loss have been addressed with surgical midfacial lifting and soft tissue augmentation with dermal fillers. We present a novel noninvasive approach to midface rejuvenation with a bipolar fractionated radiofrequency (FRF) device that addresses both volume loss and improves skin laxity. METHODS: An institutional review board-approved retrospective review was performed and included subjects who received midfacial treatment with a bipolar FRF device. Follow-up photographs were objectively assessed by a blinded evaluator using a validated scale, the Facial Laxity Rating Scale. Paired t tests were used to evaluate the results for statistical significance. RESULTS: A total of 15 subjects were included in the study. The average age was 64 and ranged from 48 to 73. The average midface laxity score prior to treatment was 5.6 and post-treatment was 6.3 (p < 0.01). CONCLUSION: Bipolar FRF is a promising noninvasive intervention for midface rejuvenation.

Mohs micrographic surgery: a treatment method for many non-melanocytic skin cancers.

Mohs micrographic surgery (MMS) is a breakthrough surgical technique that has changed the management of neoplasms in dermatology. Through continued practice and evolution, MMS now can successfully treat a variety of rare non-melanocytic cutaneous malignancies for which achieving remission and the optimal aesthetic result after surgery was previously challenging. Mohs micrographic surgery has utility for conditions besides melanoma. Herein, we discuss this versatility of Mohs micrographic surgery. Specifically, Mohs micrographic surgery can be successfully used for cases such as dermatofibrosarcoma protuberans, atypical fibroxanthomas, extramammary Paget disease, Merkel cell carcinoma, sebaceous carcinoma, and microcystic adnexal carcinoma.

White Fibrous Papulosis of the Axillae and Neck.

Fibroelastolytic papulosis of the neck (FEPN) consists of two disorders: white fibrous papulosis of the neck (WFPN) and pseudoxanthoma elasticum-like papillary dermal elastolysis (PXE-PDE). The neck and supraclavicular areas are frequently involved; however, axillary involvement is significantly more rare, especially for white fibrous papulosis. Herein, we present an unusual case of white fibrous papulosis of the axillae, in addition to the neck, in a Caucasian woman.

A Rare Presentation of Nodular Amyloidosis on the Lower Back.

Primary localized cutaneous amyloidosis (PLCA) occurs when amyloid is deposited only within the skin and there is no evidence of systemic involvement. Nodular amyloidosis is the rarest subtype of PLCA. It typically involves the acral regions but can sometimes present on the head and neck. The condition usually presents clinically as a single tan or yellow nodule or plaque that may appear waxy. Herein, we present a rare case of a 66-year-old man with nodular amyloidosis on the lower back.

Spiny Keratoderma of Nonfamilial Nature and Without Systemic Disease in a Woman.

Spiny keratoderma is a rare condition that presents as many small, firm hyperkeratotic papules on the palms and soles. This condition can be familial, typically arising in adolescence or young adulthood. However, if the condition arises later in adulthood, it is more frequently associated with internal malignancy. Therefore, a thorough workup is required to identify a potential underlying cancer. It is rare for spiny keratoderma to spontaneously arise in individuals in adulthood and yet not be associated with systemic disease, but such is the scenario for our patient.