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Dermatology Online Journal

Jordan V Wang, Dorota Z Korta, Christopher B Zachary
Gel manicures have become a popular beauty trend in recent years. The specially formulated nail polish must undergo curing under light-based units. The majority of these curing lamps emit high-intensity ultraviolet A, which can cause skin damage and increase the risk for skin cancers. Incorporating relevant information in patient education endeavors can help them practice avoidance, apply broad-spectrum sunscreen prior, or use nitrile exam gloves in order to prevent photoaging and skin cancer resulting from these procedures...
March 15, 2018: Dermatology Online Journal
Cristian Alejandro Valenzuela-Oñate, Jorge Magdaleno-Tapia, Blanca Ferrer-Guillen, Pablo Hernández-Bel
Intestinal mucosa implanted in skin is an exceedingly rare occurrence. Implantations are thought to occur during the creation of ostomy sites or other surgical procedures in which suture goes through bowel mucosa and then skin. Current ostomy literature reports this as a very uncommon complication. We present a 54-year-old man diagnosed with Crohn disease with severe perianal involvement who was referred to our outpatient clinic because of two persistent perianal cutaneous ulcerations. He previously underwent several interventions to drain complex perianal fistulas and abscesses, the last of them involved placing seton stitches to ensure continuous draining during the healing process...
March 15, 2018: Dermatology Online Journal
Lucas A Heldt Manica, Philip R Cohen
Staphylococcus lugdunensis is a part of the normal skin flora. However, this organism can be a pathogen in certain situations such as advanced age or immunosuppression. Further study regarding situations in which this bacterium becomes a pathogen is warranted.
March 15, 2018: Dermatology Online Journal
Eftychia Platsidaki, Nikolaos Kostopoulos, Ioannis Marnelakis, Pantelis Panagakis
Psoriasis is one of the most frequently occurring chronic inflammatory skin diseases. There are some specialized regions of the body that are considered difficult to treat. Secukinumab is a human monoclonal immunoglobulin G antibody that blocks the interleukin 17A ligand and has been shown to be highly efficacious in treating moderate-to-severe psoriasis. We studied two Greek patients, one with scalp psoriasis and the other with palmoplantar psoriasis, both resistant to treatment. Patients were treated with secukinumab and efficacy and safety were recorded...
March 15, 2018: Dermatology Online Journal
Jennifer L Strunck, Scott R Florell, Douglas Grossman
Hemangiomas are benign vascular neoplasms which arise in early adulthood. Herein we present a 79-year-old woman with a hemangioma of the lower flank masquerading as a cutaneous manifestation of a systemic fungal infection upon initial histological analysis. Decreased elastin and collagen within the lesion likely accounted for the clumping and splaying of the capillaries into "hyphae-like" structures. Loss of dermal elastic tissue and collagen apparently concentrated the capillary proliferation into an unusual morphology mimicking the hyphal structures...
March 15, 2018: Dermatology Online Journal
Ayşe Kavak, Nimet Yeşim Yıldız, Zeynep Topkarci, Bilgen Erdoğan, Nurten Sever, Didem Canoğlu
We present a case of eruptive generalized syringoma with vulvar involvement. This case is unique in terms of being a nonfamilial, linear variant, leading to pseudohypertrophy of the labia majora.
March 15, 2018: Dermatology Online Journal
Ann Xu, Viraat Patel, Leigh Sutton, Ida Orengo
The diagnosis of infiltrative basal cell carcinoma (BCC) can be delayed owing to its often subtle clinical findings. A 90-year-old woman presented with an asymptomatic annular pink plaque on her left shin that was clinically diagnosed as tinea corporis. After years of not responding to topical anti-fungal therapy, biopsies confirmed a diagnosis of infiltrative BCC. We discuss the differential diagnosis of the case, the difficulties in identifying infiltrative BCC, and the pathologic features of infiltrative BCC...
March 15, 2018: Dermatology Online Journal
Nerissa C D'Silva, Emily Behrens, Ashley Sturgeon, Cloyce Stetson
Circumscribed palmar hypokeratosis (CPH) is a benign dermatologic condition characterized by local thinning of the stratum corneum. Herein, we present a 52-year-old woman who presented with an asymptomatic pink depressed papule on the right palm. This was treated with clobetasol 0.05% topically twice a day with no improvement.
March 15, 2018: Dermatology Online Journal
M Rato, A Catarino, C Claro, I Viana
Subcutaneous fat necrosis of the newborn is an uncommon, transient, and self-healing panniculitis, mostly affecting term newborns with perinatal complications. The authors present a case of a female full-term neonate, born from an uncomplicated pregnancy, admitted into the neonatology unit 5 hours after delivery because of refractory multifocal seizures in the context of hypoxic-ischemic encephalopathy. Nine days after birth, indurated and erythematous nodules and plaques were noted on the left arm and back...
March 15, 2018: Dermatology Online Journal
Dylan E Lee, Benjamin H Kaffenberger, Alejandro A Gru, Dathan Hamann
We report a case of temozolomide (TMZ)-induced inflammation of disseminated superficial actinic porokeratosis (DSAP), an uncommon and pre-malignant cutaneous disorder. Dermatologists and oncologists should be aware of this cutaneous eruption of DSAP associated with TMZ to prevent the discontinuation of effective medical therapy in cancer patients.
March 15, 2018: Dermatology Online Journal
Cory Pettit, Catherine A Ulman, Gina Spohn, Jessica Kaffenberger
Darier disease is a rare autosomal dominant disorder that results from a mutation in the gene coding for the endoplasmic reticulum membrane calcium pump Ca2+-ATPase type 2 (SERCA2), leading to compromised intercellular adhesion. Patients typically present in the first two decades of life with keratotic, greasy papules in a seborrheic distribution. Segmental Darier disease is a variant with localized disease that follows Blaschko lines. Treatment options include topical and systemic agents including corticosteroids, retinoids, and antibiotics...
March 15, 2018: Dermatology Online Journal
Lisa Ishii, Nicholas A Richmond, Stephanie J Carstens, Vladimir Vincek
Nail apparatus melanomas are rare and may present with a wide variety of clinical presentations. In particular, the amelanotic subtype can pose a diagnostic challenge, often leading to a poor prognosis related to a delayed diagnosis. We report a 69-year-old man with an unusual subungual amelanotic melanoma presenting as a persistent single nail dystrophy that was repeatedly treated as onychomycosis. Owing to the delayed diagnosis of the melanoma and to minimize recurrence risk, the patient underwent a partial amputation of his left thumb...
March 15, 2018: Dermatology Online Journal
Julia L Accetta, Melissa M Helm, Lin Lin
Persistent nevi are commonly encountered in clinical and dermatopathology practice. Although they may mimic melanoma on clinical presentation as well as microscopic review, they behave in a benign fashion and are not associated with more aggressive behavior than the original nevus. Persistent nevi may exhibit asymmetry and irregular features that prompt concern for melanoma. However, the relative circumscription and restriction of pigment to the surgical scar provides a valuable clue to diagnosis. Some persistent nevi may have a linear pattern when they are confined to a widening scar...
March 15, 2018: Dermatology Online Journal
Omar Bari, Aria Vazirnia, Philip R Cohen, Laura S Romero
Genitogluteal porokeratosis is a disorder of keratinization that may present in men in their fourth decade of life. We describe a 52-year-old human immunodeficiency virus (HIV)-positive man with history of anal squamous cell carcinoma who developed verrucous lesions on the buttocks and genitals. The buttock lesions presented shortly after radiotherapy for anal carcinoma a decade prior, whereas the genital lesions presented three months prior in areas treated with injectable medication for erectile dysfunction...
March 15, 2018: Dermatology Online Journal
Crystal Aguh, Shawn G Kwatra, Alice He, Ginette A Okoye
Prurigo nodularis (PN) is a highly pruritic skin condition that is caused by chronic scratching. It occurs in patients with chronic itch and is characterized by multiple hyperkeratotic papules and nodules. The pathogenesis of PN is unclear, but involves a complex interplay of numerous pathways including neurogenic and inflammatory factors. As such, PN is very difficult to treat and patients are often refractory to multiple medications before finding a treatment that is effective. We present a woman with a 20-year history of exuberant prurigo nodularis who failed multiple therapies, including dapsone, azathioprine, mycophenolic acid, prednisone, topical steroids, and phototherapy...
March 15, 2018: Dermatology Online Journal
Kevin Chao, Samuel Balin, Eric Sorenson, Scott Worswick
Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a disease characterized by mucosal involvement with variable cutaneous manifestations induced by M. pneumoniae infection. Previously reported rash morphologies include vesiculobullous, targetoid, papular, macular, and morbilliform lesions. Pustulosis is a rare presentation of MIRM that has been described only once before in the literature to our knowledge. We report a case of a 13-year-old boy presenting with a pustular skin eruption induced by Mycoplasma infection...
March 15, 2018: Dermatology Online Journal
Ângela Roda, Ana Rita Travassos, Luís Soares-de-Almeida, Cristina Has
Kindler syndrome is a rare, autosomal recessive genodermatosis, caused by mutations in the FERMT1 gene. It is thought to be primarily a skin disease, but other organs may also be involved. We report a case of a novel mutation of FERMT1 gene in a patient with a probable new phenotype of Kindler syndrome, including colitis and primary sclerosing cholangitis. A 42-year-old man, born to first cousin parents, was referred to our outpatient dermatology clinic with an unknown dermatosis since birth. He presented with neonatal blistering and developed photosensitivity and changes in skin pigmentation during childhood...
March 15, 2018: Dermatology Online Journal
Philip R Cohen
Osteoma cutis, the development of bone in the dermis and/or subcutaneous fat, can occur as either a primary or secondary condition. Perforating osteoma cutis is rare. A man with a solitary lesion of perforating osteoma cutis is described and the features of individuals with a single perforating osteoma cutis skin lesion are reviewed. A solitary lesion of either primary or secondary perforating osteoma cutis has only been observed in two men and one woman; the lesions had been present from less than one month to 19 or 20 years prior to establishing the diagnosis...
March 15, 2018: Dermatology Online Journal
Samantha Venkatesh, Mayra Bc Maymone, Neelam A Vashi
This commentary considers the reasons for rejection of manuscripts during the peer-review process. Poor methodology, inappropriate statistical analysis, irrelevance, and technical errors are cited frequently as motives for manuscript rejection. Guidance, such as selecting an applicable journal, conducting a rigorous study, and writing efficiently, is provided for authors to prevent initial rejection. Researchers are reassured that rejection is a common consequence of peer-review and subsequent submissions to other journals are often successful publications...
March 15, 2018: Dermatology Online Journal
Michael R Gionfriddo, Rebecca A Pulk, Dev R Sahni, Sonal G Vijayanagar, Joseph J Chronowski, Laney K Jones, Michael A Evans, Steven R Feldman, Howard Pride
There are a variety of evidence-based treatments available for psoriasis. The transition of this evidence into practice is challenging. In this article, we describe the design of our disease management approach for Psoriasis (ProvenCare®) and present preliminary evidence of the effect of its implementation. In designing our approach, we identified three barriers to optimal care: 1) lack of a standardized and discrete disease activity measure within the electronic health record, 2) lack of a system-wide, standardized approach to care, and 3) non-uniform financial access to appropriate non-pharmacologic treatments...
March 15, 2018: Dermatology Online Journal
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