Primary Cutaneous CD8+ T-cell Lymphoma, an Indolent and Locally Aggressive Form Mimicking Paronychia.

CD8 T-cell lymphomas comprise a wide spectrum of lymphomas, many which have yet to be formally classified. We present a case of a 43-year-old woman with an enlarging tumor distal to the distal interphalangeal joint of the fourth finger, compressing the underlying nail matrix. Magnetic resonance imaging showed bony involvement of the underlying distal phalanx. Histology showed a dense epidermotropic and pandermal infiltrate composed of medium-sized, uniformly pleomorphic lymphocytes with cleaved nuclei, which raised the possibility of primary cutaneous CD8 aggressive epidermotropic cytotoxic T-cell lymphoma. However, the patient's clinical photograph was inconsistent with this diagnosis. Other diagnoses, such as primary cutaneous acral CD8 T-cell lymphoma-a provisional entity, were also considered but did not capture all the features of this patient's lymphoma. We propose to classify this case as a primary cutaneous CD8 T-cell lymphoma, an indolent and locally aggressive form.

Quantitative Assessment of Facial Asymmetry Using Three-Dimensional Surface Imaging in Adults: Validating the Precision and Repeatability of a Global Approach.

OBJECTIVE: Comparison of global versus landmark analyses of facial asymmetry using three-dimensional photogrammetry to establish a precise method for evaluating facial asymmetry. DESIGN: The landmark-based approach utilized anthropometric data points. Our global approach involved registration of mirror images, independent of a midplane, to calculate a root mean square (RMS) value. We analyzed precision and technical and operator error of both methods. PARTICIPANTS: Three hundred fifty adults participated in this study. RESULTS: We found that the global method has better precision and repeatability with a significantly lower error rate than the landmark-based method. In adults, the average RMS was 0.6253 mm with a standard deviation of 0.16. CONCLUSIONS: Our facial asymmetry measurement is more accurate than landmark-based measurements. This method is quick, reliable, and results in generation of a RMS score and a corresponding color-coded facial map that highlights regions of higher and lower asymmetry. This method may be used as a screening tool for asymmetry in both the clinical and research settings.

Allergic contact dermatitis associated with Biosyn suture in a patient with gastroesophageal junction cancer.

A PUBMED literature review revealed no reports of allergic contact dermatitis to Biosyn(™) suture material. We present the first case of such an allergic reaction. The case emphasizes the need to remember that suture material can occasionally elicit an allergic dermatitis which may increase the complications and morbidity associated with any surgical procedure.

Epistaxis secondary to panitumumab in a patient with colon cancer.

Epidermal growth factor receptor inhibitors (EGFRIs) have become an integral part of therapy for many types of solid malignancy, including colorectal cancer. The drug class has proven to be effective without causing many of the side-effects associated with chemotherapy or other growth factor receptor inhibitors. Epistaxis, a common side-effect of Vascular Endothelial Growth Factor inhibitors, is rarely noted with EGFRIs. We report on one patient, a 51-year-old man with metastatic colon cancer, who developed severe epistaxis with the use of panitumumab. We discuss the other reported cases of EGFRIs causing epistaxis and hypothesize on possible mechanisms by which this drug class might cause mucosal bleeding.

Pancreatic cancer and thromboembolism in the ambulatory community.

Pancreatic exocrine adenocarcinoma is one of the most common malignancies associated with thromboembolism. The authors summarize the two abstracts (#368 and #273) presented at the 2012 ASCO Gastrointestinal Cancers Symposium which were focused on pancreatic thrombosis in ambulatory patients. In addition, they discuss the risk of thrombosis associated with malignancy, chemotherapy, and erythropoietin stimulating agents and the management and implications thereof.