Steatocystoma multiplex treated with isotretinoin: a delayed response.

A patient with steatocystoma multiplex was treated with 0.75 mg per kg per day of oral isotretinoin. After one month of minimal improvement the patient discontinued therapy. Over the next two months he noted some shrinkage of his pre-existing lesions, which persisted for a follow-up period of six months. Isotretinoin may show a beneficial response in some cases of steatocystoma multiplex even after use of the drug is discontinued. Isotretinoin is known to have effects beyond its treatment period that are related to its long serum half-life. A small number of patients with steatocystoma multiplex have been treated with isotretinoin, with varied responses. This is the first case of a patient who discontinued therapy before a response occurred and then showed a response later.

Surgical corrections of acne scars.

Acne, a disease of the pilosebaceous gland, may be mild or severe. Scarring, which occurs in both mild and severe disease, produces a variety of skin defects. Careful assessment of the types of scars along with knowledge about the multiple techniques available results in development of the most optimal plan for reconstruction.

Eosinophilic pustular folliculitis.

Eosinophilic pustular folliculitis is characterized by the spontaneous development of recurrent, sterile papules, pustules, and plaques on the face, trunk, arms, and occasionally the palms and soles. Although the large majority of the reported cases have occurred in Eastern Asians, most patients in the United States have been infants or men seropositive for human immunodeficiency virus. We describe a North American woman with eosinophilic pustular folliculitis who was neither seropositive for human immunodeficiency virus nor of Asiatic descent.

Pigmented postacne osteoma cutis in a patient treated with minocycline: report and review of the literature.

Postacne osteoma cutis is a rare complication of acne vulgaris. If it occurs during a course of tetracycline or minocycline therapy, pigmented osteomas can occur as a result of tetracycline or minocycline bone complexes. We report a case of pigmented postacne osteoma cutis that developed after extensive acne surgery and a 2- to 3-month course of minocycline. Previously reported cases have been treated surgically, but our patient responded to 0.05% tretinoin cream, with transepidermal elimination of some osteomas.

Extensive Bowen's disease of the penile shaft treated with fresh tissue Mohs micrographic surgery in two separate operations.

Bowen's disease or squamous cell carcinoma in situ is uncommon on the penile shaft. While surgical excision is the treatment of choice, the Mohs micrographic surgical approach ensures microscopically controlled tumor-free margins with preservation of normal tissue. While small- or medium-sized penile excisions heal very well by second intention, large areas of involvement are often grafted to prevent debilitating contractures. We report a case of near circumferential penile Bowen's disease treated by two separate operations that healed by second intention with very good cosmetic and functional results.