Multidisciplinary treatment of a massive head and neck keloid scar: A case report.

Keloid scars can lead to significant patient morbidity and disfigurement, especially when located on the head and neck. Massive keloid scars are particularly difficult to manage due to ulceration, infection, pain, and high recurrence rates following excision. We report the successful treatment of a massive head and neck keloid scar with excision and grafting, post-excisional radiotherapy, and ablative fractional laser-assisted topical corticosteroid delivery.

Acquired smooth muscle hamartoma: A case report on the lower extremity with hidrosis.

Smooth muscle hamartomas are benign dermal proliferations of smooth muscle cells. Smooth muscle hamartomas are sub-divided into congenital or acquired; the latter is a rare entity with less than 20 cases being reported in the English literature. Most often asymptomatic, acquired smooth muscle hamartomas follow an indolent course. Treatment in the form of surgical excision can be utilized for symptomatic or cosmetic purposes. Here, we report the first case of an acquired smooth muscle hamartomas of the shin which also uniquely presented with hidrosis. This case highlights the varied clinical spectrum of acquired smooth muscle hamartomas.

Dramatic response of scarring scalp discoid lupus erythematosus (DLE) to intravenous methylprednisolone, oral corticosteroids, and hydroxychloroquine in a 5-year-old child.

Discoid lupus erythematosus (DLE) is rare in childhood. We report the case of a 5-year-old girl who presented with erythematous scaly plaques, with scarring alopecia, involving approximately 40% of her scalp. Histopathology confirmed the diagnosis of DLE. Treatment with intravenous methylprednisolone, hydroxychloroquine, oral prednisone, topical corticosteroids, and sunscreen lead to reversal of scarring alopecia and re-growth of hair.

Treatment of facial lentigines in Peutz-Jeghers syndrome with an intense pulsed light source.

BACKGROUND: Peutz-Jeghers syndrome is a hereditary condition characterized by distinctive mucocutaneous lentigines and intestinal hamartomatous polyposis. The cutaneous lesions may be cosmetically disfiguring and frequently present a therapeutic challenge. OBJECTIVE: To determine if intense pulsed light (IPL) is effective in treating facial lentigines in Peutz-Jeghers syndrome. METHODS: The IPL, utilizing a 590 nm cutoff filter, was used to treat facial lentigines in a 10-year-old girl with Peutz-Jeghers syndrome. RESULTS: A series of 12 treatment sessions, each to different facial regions, resulted in complete clearance of lentigines in the treated areas. Most of the lentigines resolved after a single treatment, with a few areas requiring a second treatment. CONCLUSION: In this case, treatment with IPL resulted in dramatic improvement of cosmetically disfiguring lentigines. To our knowledge, this is the first report of using IPL in Peutz-Jeghers syndrome.

Cutaneous metastasis from an intracranial glioblastoma multiforme.

A 34-year-old white man with a history of an intracranial glioblastoma multiforme was treated with surgical excision and radiotherapy. Five months later, the patient had a rapidly growing scalp mass develop. This lesion was excised, and the histology revealed a tumor that was similar to the originally resected intracranial glioblastoma. Immunohistochemistry for general neuroepithelial derivation (S-100 protein) and for glial fibrillary acidic protein (GFAP) was positive, whereas mesenchymal, epithelial, and neuronal markers were negative. This immunohistochemistry pattern was identical to the original tumor. Although metastasis of this tumor is not uncommon, metastasis to the skin has never been reported. To our knowledge, this is the first reported case of cutaneous metastasis from glioblastoma in the world literature.