Dermatology Practical & Conceptual

Basal cell carcinoma (BCC) is the most common malignant skin cancer. Its genital localization is rare, and the diagnosis in this site could be challenging. Here, we report two patients with vulvar BCC and describe their clinical, dermoscopic and in vivo and ex vivo reflectance confocal microscopic (RCM) features. Dermoscopy and RCM can be useful tools for helping the clinical diagnosis of vulvar BCC and for identifying the correct surgical margins.

Eruptive melanocytic nevi (EMN) is an unusual phenomenon characterized by the abrupt development of multiple melanocytic nevi over weeks to months in association with an underlying trigger. The underlying mechanisms are not fully understood, however, they have been associated with a variety of conditions. EMN is relatively uncommon and might be underreported due to the absence of close monitoring, insufficient recognition, and the presumed benign course of the condition. We describe the first case report of acral EMN associated with a burn wound on a 2-year-old child...

There have been limited reports describing reflectance confocal microscopy (RCM) features of Bowen's disease (BD). Herein, we describe the RCM features of a pigmented BD with atypical dermoscopic features, mimicking a melanoma. This case highlights the importance of RCM in a challenging BD.

LEOPARD syndrome, also known as Gorlin syndrome II, cardiocutaneous syndrome, lentiginosis profusa syndrome, Moynahan syndrome, was more recently coined as Noonan syndrome with multiple lentigines (NSML), inside the RASopathies. Historically, the acronym LEOPARD refers to the presence of distinctive clinical features such as: lentigines (L), electrocardiographic/conduction abnormalities (E), ocular hypertelorism (O), pulmonary stenosis (P), genital abnormalities (A), retardation of growth (R), and sensorineural deafness (D)...

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No abstract text is available yet for this article.

Verrucous hemangioma (VH) is a rare, congenital and localized vascular malformation, which usually presents as warty, bluish, vascular papules, plaques, or nodules, mainly on the lower extremities. Linear presentation of the disease is rare. A deep biopsy is necessary to confirm the clinical diagnosis by histopathological examination, with dermoscopy acting as a useful tool for evaluating the precise vascular structure. Here, we report on a 13-year-old female child with linear VH presenting over her foot since infancy and dermoscopic findings of VH along with the clinical-pathologic features...

No abstract text is available yet for this article.

Syringocystadenoma papilliferum (SCAP) is a benign hamartomatous tumor arising from pluripotent cells with either apocrine or eccrine differentiation. We report a rare case of de novo linear SCAP in a 12-year-old female child with lesions over the chest along with the dermoscopic findings.

Background: Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular proliferative disorder mainly located in the periauricular region. The etiopathogenesis of ALHE is unknown, and it is still controversial as to whether the entity represents a benign vascular neoplasm or an inflammatory process. Aim: Recently, the intracytoplasmic staining pattern of Wilms tumor 1 (WT1) on immunohistochemistry has highlighted true vascular neoplasms, such as microvenular hemangioma, tufted angioma, and spindle cell hemangioma, which has made it helpful to distinguish ALHE from vascular malformations, as there is a negative staining pattern in the other entities...

Background: Our routine treatment for ingrown toenail was removal of the surrounding soft tissue and shortening the bone of the distal phalanx. We determined the range and volume of excision based on our experience without an objective standard and routinely performed avulsion of the nail plate. Objective: To take the nail plate as an objective mark during surgical treatment of ingrown toenail to ensure accurate excision. Patients and Methods: Fifteen patients with ingrown toenails were treated with this technique...

The recent hype surrounding the antimelanogenic properties of glutathione has resulted in physicians frequently administering it as a "wonder" drug for skin lightening and treatment of hyperpigmentation, especially in ethnic populations with darker skin tones. This phenomenon has seen a recent surge owing to aggressive marketing and capitalization of pharma-cosmeceutical companies. However, the unbridled and prodigal use of it, especially as a parenteral formulation, seems unjustified, given the lacunae in our knowledge about its antimelanogenic potential, limited clinical evidence favoring its role in skin lightening, and the statutory ban/advisory issued by certain federal agencies...

Collagenoma is a type of connective tissue nevi, a rare hamartomatous malformation characterized by the predominant proliferation of normal collagen fibers and normal, decreased, or increased elastic fibers. Collagenomas present as multiple or solitary, hereditary or sporadic, asymptomatic, skin-colored papules, nodules, and plaques with variable sizes, and are usually located on the trunk, arm, and back. Here, we report on a 14-year-old boy who presented with an isolated giant collagenoma of the frontal area that dramatically responded to intralesional triamcinolone acetonide...

Microvenular hemangioma (MVH) is an acquired, benign type of hemangioma that usually manifests itself as a solitary, slowly growing, red to violaceous, asymptomatic papule, plaque or nodule. It is typically located on the trunk or extremities of young adults. It can be difficult to differentiate MVH from other types of hemangioma and Kaposi sarcoma. Herein we report a case of MVH unusual for its location, age of onset, and morphologic features. A 62-year-old man complained of an asymptomatic, bluish-red discoloration on the tip of his nose that had been present for two years...

Background: The majority of the patients affected by a new variant of endemic pemphigus foliaceus in El Bagre, Colombia (El Bagre EPF or pemphigus Abreu-Manu), have experienced vision problems; we have previously reported several ocular abnormalities. Methods: Here, we aimed to investigate reactivity to optic nerves in these patients. We utilized bovine, rat and mouse optic nerves, and performed immunofluorescence and confocal microscopy to test for optical nerve autoreactivity...

Background: Collision lesions as two independent and unrelated skin tumors often manifest an atypical morphology. Objective: To determine the combinations of collision skin lesions (CSLs). Methods: Twenty-one pigmented lesion clinics in nine countries included 77 histopathologically proven CSLs in this retrospective observational study. Results: Seventy-seven CSLs from 75 patients (median age 59.8 years) were analyzed; 24...

Mammary Paget disease is the intraepidermal adenocarcinoma of the nipple area which is characterized usually by a well-demarcated eczematous plaque. Reflectance confocal microscopy (RCM), is an in vivo noninvasive diagnostic tool with a high-resolution imaging of the skin, almost comparable to conventional histology. RCM findings of Paget disease are limited in the literature. Most of the reported cases are the extramammary type. In this report, we aimed to evaluate the RCM findings of a non-pigmented mammary Paget disease in a 65 year-old woman...

Neurofibromatosis type 1 (NF1) is a genetic disorder commonly associated with an increased risk for development of malignancy, including skin cancers. Herein we describe a case of invasive melanoma occurring in a patient with NF1 and discuss the association between these two diseases, highlighting the importance of comparative clinical and dermoscopic approaches in this category of patients in which the detection of melanoma can be difficult because of the presence of multiple skin tumors.