http://www.rssboard.org/rss-specification 720 https://escholarship.org/uc/doj/rss Recent eScholarship items from Dermatology Online Journal Fri, 15 May 2026 22:25:07 +0000 https://escholarship.org/uc/item/9r27p22m Article processing charges in dermatology journals: a bibliometric analysis https://escholarship.org/uc/item/9r27p22m Tue, 17 Jun 2025 00:00:00 +0000 Yang, Kevin Kantamneni, Kavita Kole, Lauren CS https://escholarship.org/uc/item/9r09m0jf Axillary web syndrome, or cording, presents as fibrotic bands that develop beneath the skin, causing pain and restricted shoulder movement. Axillary web syndrome typically arises as a complication following axillary surgery for breast cancer. We present a unique case of a 38-year-old woman with no history of malignancy, breast surgery, or trauma, who developed AWS following a punch biopsy after initially presenting with a subcutaneous nodule in the right axilla. This case highlights the need for increased exploration of the pathogenesis of axillary web syndrome, suggesting a potentially higher incidence of axillary web syndrome than currently reported owing to its self-limiting nature. In addition, the case demonstrates the importance of dermatological awareness of this condition, as its presentation is not limited to breast cancer patients who have undergone major axillary and breast procedures. https://escholarship.org/uc/item/9r09m0jf Tue, 17 Jun 2025 00:00:00 +0000 Rahmani, Liora Lieberman, Miriam R Groysman, Tatyana Rosen, Meryl https://escholarship.org/uc/item/9p75464j Statistical mistakes can undermine research credibility. Identifying common errors may help researchers avoid them in future studies. This study evaluated the frequency and types of statistical mistakes in dermatology journal articles and identified article characteristics that predict these errors. A cross-sectional analysis was conducted on articles published in the 2023 volumes of 8 dermatology journals. Articles were screened for statistical tests, with a target sample of 200 selected pseudorandomly. Multivariable logistic regressions assessed predictors of statistical mistakes, including journal impact factor, statistician involvement, funding source, first author highest degree, and statistical package. Of the 189 articles analyzed, 78% contained at least one statistical mistake. Reporting mistakes were found in 67% and test selection errors in 46%. The absence of statistician involvement (aOR 2.49, P=0.03) and low journal impact factor (aOR 3.82, P=0.02) predicted the presence... https://escholarship.org/uc/item/9p75464j Tue, 17 Jun 2025 00:00:00 +0000 Woodie, Brad R Freking, Justin A Jones, Grace M Porter, Justin Fleischer, Sarah E Pauley, Annabella G Fleischer, Alan B https://escholarship.org/uc/item/80n5j2wm The Effect of anchoring on patients' likeliness to take an injection treatment for hidradenitis suppurativa https://escholarship.org/uc/item/80n5j2wm Tue, 17 Jun 2025 00:00:00 +0000 Smith, Aaron D Lyons, Catherine E Lovell, Katie Dao, Diem-Phuong D Feldman, Steven R https://escholarship.org/uc/item/7wk892h1 We present a case of human papillomavirus-associated squamous cell carcinoma arising between the ventral toes. A 60-year-old man presented with a 6-year history of a growth between the right fourth and fifth toes that had previously been thought to be secondary to hammertoe deformity. Initial biopsy favored verruca vulgaris with associated fungal hyphae and he was treated accordingly. Subsequent biopsy showed squamous cell carcinoma in situ with positive for high-risk human papillomavirus subtypes 16 and 18. He was successfully treated with Mohs surgery. This is the first published case of human papillomavirus 18-associated interdigital squamous cell carcinoma of the toes treated with Mohs surgery. https://escholarship.org/uc/item/7wk892h1 Tue, 17 Jun 2025 00:00:00 +0000 Wang, Annie Senthilnathan, Aditi Wang, Hongbei Bridges, Alina Sharon, Victoria https://escholarship.org/uc/item/7vw3x18s Inflammatory linear verrucous epidermal nevus is a rare benign epidermal nevus that classically presents in childhood with pruritic, linear, erythematous, scaly coalescing papules and plaques distributed along the lines of Blaschko. We report a 28-year-old woman with a long-standing history of photosensitive pruritic dermatosis, exhibiting minimal improvement with topical therapies, including clobetasol, cholesterol/lovastatin cream, and ruxolitinib. Histologic evaluation revealed psoriasiform epidermal hyperplasia with focal cornoid lamella. The combination of clinical and histologic features led to the diagnosis of porokeratotic inflammatory linear verrucous epidermal nevus, a proposed variant of inflammatory linear verrucous epidermal nevus with overlapping features of linear porokeratosis. The patient demonstrated substantial improvement following CO2 laser therapy, highlighting its potential as an effective treatment option for this variant of inflammatory linear verrucous... https://escholarship.org/uc/item/7vw3x18s Tue, 17 Jun 2025 00:00:00 +0000 Nugent, Matthew Bravo, Alexander Shackelton, Jeffrey https://escholarship.org/uc/item/7mf5r5c9 In vivo parallel relaxing incisions for scalp defect repairs https://escholarship.org/uc/item/7mf5r5c9 Tue, 17 Jun 2025 00:00:00 +0000 Clark, Marie M Que, Syril Keena T https://escholarship.org/uc/item/72466704 Response to: "Psychodermatology fellowship: is it time?" https://escholarship.org/uc/item/72466704 Tue, 17 Jun 2025 00:00:00 +0000 Modanlo, Nina Yan, Xiaofeng https://escholarship.org/uc/item/6m7229wp Discoid lupus erythematosus can present in various atypical forms, posing significant diagnostic challenges as it can mimic other infectious or neoplastic dermatoses. Herein, we detail two cases of strictly unilateral, multifocal discoid lupus erythematosus and compare them with previously reported cases. This report contributes to the limited literature on this unusual presentation, particularly in individuals with skin of color. https://escholarship.org/uc/item/6m7229wp Tue, 17 Jun 2025 00:00:00 +0000 Halim, P Anthony Rizky, Luddwi Achmad Fitri, Eyleny Meisyah Novianto, Endi Putri Maharani, Maria Angela Sirait, Sondang P Budianti, Windy Keumala https://escholarship.org/uc/item/6m03q9pt Colloid milium is a rare and clinically underdiagnosed dermatosis, characterized by deposition of amorphous material in the dermis. Definitive diagnosis is established by histopathology which reveals the presence of colloid in dermal papillae. Photo-exposed areas are the most frequently involved sites and include dorsa of hands, neck, and ears. We present an adult man with an outdoor occupation who had longstanding chronic actinic dermatitis. For one and a half years he had been developing skin colored to slightly erythematous papules and nodules on his face, anterior neck, and dorsal aspect of the hands, symmetrically. These discrete lesions arose on the background of his eczematous sun exposed skin. Skin biopsy for histopathology of these papules showed deposition of amorphous colloid material in the dermal papillae with an uninvolved Grenz zone along with dermal solar elastoses. The coexistence of colloid milium with chronic actinic dermatitis in the same patient has not been... https://escholarship.org/uc/item/6m03q9pt Tue, 17 Jun 2025 00:00:00 +0000 Aziz, Hira Rahman, Atiya Shafqat, Sara Altaf, Anam Bajwa, Akhtar https://escholarship.org/uc/item/6j13z3pr Cutaneous collagenous vasculopathy is a rare microangiopathy that presents with asymptomatic telangiectasias and distinct histopathological features, including hyaline material deposition in vessel walls. Diagnosis requires biopsy and differentiation from other telangiectatic disorders. Current treatment options are limited, but increased awareness may improve recognition and management of this rare condition. Herein, we describe an unusual presentation of cutaneous collagenous vasculopathy as asymptomatic, pink, mat-like telangiectatic macules on the trunk and proximal extremities of a 62-year-old woman. Histopathologic evaluation revealed dilated superficial dermal vessels with hyaline thickening of the vessel walls, consistent with a diagnosis of cutaneous collagenous vasculopathy. https://escholarship.org/uc/item/6j13z3pr Tue, 17 Jun 2025 00:00:00 +0000 Li, Christine Putterman, Elana Yim, Kaitlyn Deng, April Levin, Nikki A https://escholarship.org/uc/item/51c0100s Malignant melanoma lesions arising in tattoo pigment pose diagnostic challenges, but current literature lacks quantitative data on delayed diagnosis. This study reports a new case involving multiple melanoma lesions in tattoo pigment, alongside a systematic review of past cases. Our objectives were to evaluate the potential for delayed diagnosis in patients with melanoma lesions in tattoo pigment and its impact on prognosis, comparing tumor characteristics with large-scale melanoma studies. A systematic review was conducted using PubMed and Ovid MEDLINE. Included studies were English-language reports of melanoma lesions in tattoo pigment, identifying new cases via case reports/series. Independent review and discussion resolved discrepancies. The review yielded 37 articles with 42 reports of melanoma lesions in tattoo pigment, totaling 43 cases. Of these, 35 were invasive, with mean and median Breslow thickness of 2.49mm and 0.9mm, respectively, which is higher than in large-scale... https://escholarship.org/uc/item/51c0100s Tue, 17 Jun 2025 00:00:00 +0000 Benandi, Katherine Sieving, Devon Martin, Katherine Wolf, Kristin https://escholarship.org/uc/item/4vq5f2s6 A 39-year-old man with an unrecognized facial sinus tract under his chin initially presented with an innocuous lesion resembling an acne pimple. The patient's journey began with dermatologic intervention, involving systemic and topical antibiotics. Upon treatment failure, referral to a general dentist revealed a carious lesion on the lower right lateral incisor, prompting further investigation. A subsequent referral to an endodontic specialist led to the diagnosis of a chronic periapical abscess, and an endodontic intervention was initiated. Despite the persistence of intracanal purulent exudate, a strategic application of pure calcium hydroxide was implemented, followed by a temporary seal. A two-year follow-up demonstrated complete healing of the periapical lesion and resolution of the extraoral cutaneous sinus tract. The report showcases the intricate diagnostic journey, meticulous endodontic intervention, and successful management of an extraoral cutaneous sinus tract mimicking... https://escholarship.org/uc/item/4vq5f2s6 Tue, 17 Jun 2025 00:00:00 +0000 Castellano, Ariel Orlando F Alves, Maria Eduarda TF Alves, Flavio RF https://escholarship.org/uc/item/4818z4jr Dermatofibrosarcoma protuberans is an uncommon locally aggressive mesenchymal neoplasm that classically presents with a proliferation of monomorphic spindled cells with thin nuclei and scant cytoplasm. We report a man in his twenties who presented for an unrelated skin concern and was incidentally noted to have a large, atrophic scar-like depression of the left supraclavicular neck and shoulder. The plaque was photographed and the patient was instructed to follow-up in one year, and careful photo comparison revealed the lesion had subtly enlarged and darkened in color. Accordingly, a punch biopsy revealed features of myxoid dermatofibrosarcoma protuberans, a dermal proliferation of spindled cells with mucinous degeneration and more cellular areas with extensive nuclear palisading resembling the Verocay bodies of a neurofibroma. Clinicians should be aware of the broad clinicopathologic spectrum of DFSP to ensure timely diagnosis and effective treatment. Myxoid dermatofibrosarcoma... https://escholarship.org/uc/item/4818z4jr Tue, 17 Jun 2025 00:00:00 +0000 Kazmi, Maha Kusari, Ayan Haemel, Anna LeBoit, Philip E Yu, Siegrid S https://escholarship.org/uc/item/3k13p13t Purpura fulminans is a rare life-threatening presentation of disseminated intravascular congestion that presents with widespread purpura and skin necrosis secondary to considerable tissue thrombosis. It usually occurs in pediatric patients and can have various causes with acute infection being the most common. Common infectious triggers include Neisseria and Streptococcus pneumoniae as well as varicella. Our report describes a generally healthy adult patient who developed purpura fulminans in the setting of Group A Streptococcus bacteremia. Group A Streptococcus is a rare cause of purpura fulminans in adult patients with only a few documented cases reported in the literature. https://escholarship.org/uc/item/3k13p13t Tue, 17 Jun 2025 00:00:00 +0000 Hartmann, Bredesen Kemper, Kortni Blaise, Brittany https://escholarship.org/uc/item/3j09q8rh Osteoma cutis miliaris is a rare condition of bone formation in the dermis, often misdiagnosed. We present a 52-year-old woman with asymptomatic, hard papules on the forehead, initially treated as acne. Biopsy confirmed osteoma cutis, and surgical removal via microincisions successfully extracted the lesions with no recurrence. This case emphasizes the importance of accurate diagnosis and highlights a minimally invasive approach as an effective, low-risk treatment option. https://escholarship.org/uc/item/3j09q8rh Tue, 17 Jun 2025 00:00:00 +0000 Pinzon-Luna, Juliana Sanchez-Zapata, Maria J Rodriquez-Lechtig, Bladimir Sarmiento-Ruiz, Ana Rolon, Mariam Motta-Beltran, Adriana https://escholarship.org/uc/item/37r8s9rs Emergence of Microsporum audouinii in a tertiary hospital in Brazil https://escholarship.org/uc/item/37r8s9rs Tue, 17 Jun 2025 00:00:00 +0000 Alvim de Minas Santos, Priscilla Filippo Tavares Rodrigues, Felipe Fichman, Vivian Azulay-Abulafia, Luna https://escholarship.org/uc/item/1sx0x4j3 Mature plasmacytoid dendritic cell proliferation is a condition associated with myeloid neoplasms, most commonly chronic myelomonocytic leukemia. Plasmacytoid dendritic cells can resemble lymphocytes and histiocytes morphologically and immunophenotypically. Mature plasmacytoid dendritic cell proliferation may therefore go unrecognized if the diagnosis is not suspected and appropriate stains for plasmacytoid dendritic cells are not performed. Herein, we present a case of mature plasmacytoid dendritic cell proliferation masquerading clinically and histologically as histiocytoid Sweet syndrome. The patient, who had previously been diagnosed with mature plasmacytoid dendritic cell proliferation that presented as pink, edematous, pruritic papules and plaques, had initially resolved following induction chemotherapy for acute myelomonocytic leukemia. However, he presented later with indurated purpuric plaques on the trunk within weeks of receiving filgrastim for neutropenia. Biopsies... https://escholarship.org/uc/item/1sx0x4j3 Tue, 17 Jun 2025 00:00:00 +0000 Rypka, Katelyn Meisenheimer, John Shaver, Rob Ravishankar, Adarsh Peltola, Justin Mesa, Hector Jacobson-Dunlop, Erick Collier, Sigrid Gaddis, Kevin Goldfarb, Noah https://escholarship.org/uc/item/1nc1g9cn Gender-affirming hormone therapy with testosterone may be a component in the treatment plan for transmasculine individuals. Secondary erythrocytosis induced by testosterone therapy and its subsequent complications, such as pruritus, have been reported in the literature in cisgender men. This report presents two transmasculine patients who developed generalized pruritus shortly after initiating testosterone therapy for gender-affirming care. Both patients exhibited elevated hemoglobin and hematocrit levels indicative of testosterone-induced erythrocytosis. Despite treatments, including topical corticosteroids, antihistamines, gabapentin, and benzodiazepines, their symptoms persisted. Symptomatic relief was achieved through therapeutic phlebotomy. The occurrence of polycythemia vera-like pruritus underscores a significant but less commonly recognized side effect of testosterone therapy. Balancing effective gender-affirming care and patient goals with the management of associated... https://escholarship.org/uc/item/1nc1g9cn Tue, 17 Jun 2025 00:00:00 +0000 Galamgam, Jayden Baroni, Erin Tsai, Steven Cheng, Carol E https://escholarship.org/uc/item/1n658796 Dermatologist prescriptions for biologics contribute to thousands of tons of plastic waste https://escholarship.org/uc/item/1n658796 Tue, 17 Jun 2025 00:00:00 +0000 Nouafo, Micha Rivin, Gabrielle Fleischer, Jr, Alan https://escholarship.org/uc/item/0fz1214h An 82-year-old man with a history of hypertension, thyroid nodule, and parkinsonism on carbidopa/levodopa was referred for a sudden eruption of scattered purpuric macules. He noted fatigue, weakness, ankle swelling, abdominal fullness, headaches, lapses in memory, and dysphasia. On physical examination, he had thin and atrophied upper extremities and central obesity, as well as nonblanching red to purple macules on the lower abdomen and ecchymosis on bilateral arms. The patient denied the use of any corticosteroids. Lab workup showed an abnormally high post-dexamethasone cortisol level, which raised suspicion for Cushing syndrome. Further inquiry into the patient's medication and supplement history revealed that he was consuming Artri King, a supplement marketed for the treatment of joint pain and arthritis. Artri King can lead to numerous dermatological manifestations akin to endogenous Cushing syndrome such as thin skin, easy bruising, and purple striae. This case illustrates... https://escholarship.org/uc/item/0fz1214h Tue, 17 Jun 2025 00:00:00 +0000 Choi, Suyoung Youn, Christopher Yang, Vivian Bax, Christina Bae, Gordon https://escholarship.org/uc/item/0d16q2nd Enfortumab vedotin is a first-in-class antibody-drug conjugate used in the treatment of locally advanced or metastatic urothelial carcinoma. A range of cutaneous adverse events has been reported with enfortumab vedotin use. Nectin-4, a transmembrane protein overexpressed by urothelial carcinoma cells, is the intended target of enfortumab vedotin. However, as nectin-4 is also expressed by epidermal keratinocytes, sweat glands, and hair follicles, it is believed that cutaneous toxicity is mediated though off-target delivery of enfortumab vedotin. We present a patient with metastatic urothelial carcinoma who developed a grade 3 bullous dermatitis after his second treatment cycle of enfortumab vedotin and pembrolizumab therapy. Histopathologic findings showed intraepidermal blisters with prominent dyskeratotic and necrotic keratinocytes. Temporary withholding of enfortumab vedotin and pembrolizumab and treatment with potent topical corticosteroids led to significant improvement and... https://escholarship.org/uc/item/0d16q2nd Tue, 17 Jun 2025 00:00:00 +0000 Wang, Robin Fernandez, Kristen Zelman, Brandon Speiser, Jodi Dahiya, Madhu Eilers, David https://escholarship.org/uc/item/9jw9q7r1 A 76-year-old woman with a significant cardiac surgery and breast cancer history presented to the dermatology clinic with a three-year history of an enlarging, tender, nonhealing cutaneous nodule on her upper abdomen. A shave biopsy was attempted given concern for nonmelanoma skin cancer or cutaneous metastasis. The biopsy was halted after a white wire was visualized. Retrospective computed tomography (CT) imaging review revealed a hyperdense linear structure becoming superficial at the location of the nodule seen on examination. Discussion with a cardiothoracic surgeon revealed this wire was likely a retained temporary epicardial pacing wire that was placed at the time of the patient's cardiac surgery three years prior. The decision was made to excise the lesion to fully remove the wire. Given intraoperative resistance with traction, the wire was partially removed by cutting it flush to the skin's surface. The patient healed appropriately with complete resolution of her symptoms.... https://escholarship.org/uc/item/9jw9q7r1 Tue, 13 May 2025 00:00:00 +0000 Class, Madelyn Patel, Bansri M Yamane, Kentaro Ken, Kimberly M https://escholarship.org/uc/item/8zz4431f Landscape of dermatology education in allopathic medical schools across the United States https://escholarship.org/uc/item/8zz4431f Tue, 13 May 2025 00:00:00 +0000 Poppens, McKayla McClain, Weston Collier, Erin Cheng, Kyle Hogeling, Marcia https://escholarship.org/uc/item/8tq5q33q Janus kinase inhibitors are immunomodulatory drugs increasingly used to treat a broad range of inflammatory dermatologic conditions. Although effective, they carry a risk of serious adverse effects, including opportunistic infections. We present a patient who developed an atypical mycobacterial infection while on the Janus kinase 1 and Janus kinase 3 inhibitors, tofacitinib. A 76-year-old man was started on tofacitinib for a severe ulcerative colitis flare. Six weeks after starting therapy, he developed an erythematous papule on his right forearm that progressed into an ulcerating nodule. Initial biopsies suggested subcutaneous pyoderma gangrenosum. However, after failing multiple treatments, repeat biopsies and cultures were performed. An acid-fast bacilli stain was positive and specialized tissue cultures identified Mycobacterium chelonae. The lesions resolved after 6 weeks of clarithromycin therapy. This case highlights the immunosuppressive effects of Janus kinase inhibitors,... https://escholarship.org/uc/item/8tq5q33q Tue, 13 May 2025 00:00:00 +0000 Valek, Stephanie A Black, T Austin Aboul-Fettouh, Nader Rogge, Megan N https://escholarship.org/uc/item/8p73r5h4 Comprehensive education in cosmetic and laser procedures is fundamental during dermatology residency to meet the demand for cosmetic medical procedures and effectively treat a myriad of complex dermatological conditions. This article highlights the importance of structured learning to provide step-wise opportunities for proficiency throughout residency. Although reading assignments and didactic sessions create a solid foundation, focused workshops, resident cosmetic clinics, and offsite electives serve as important experiences for residents to practice hands-on skills. This article provides guidance for curriculum development and establishing hands-on procedural learning. Additionally, the importance of joining professional societies to receive unique training as well as mentorship is highlighted. Having a structured and comprehensive cosmetic curriculum will equip dermatology residents with the toolkit to successfully care for diverse patient needs effectively and safely. https://escholarship.org/uc/item/8p73r5h4 Tue, 13 May 2025 00:00:00 +0000 Richmond, Alexandra Ray, Lucia Truong-Balderas, Kevin Almukhtar, Rawaa Minkis, Kira Eshaq, Milad Kuemmet, Travis Joo, Jayne S Desai, Shraddha Lucas, Roberta Wambier, Carlos Boucher, Alison Kang, Bianca Levin, Yakir Wyles, Saranya Alam, Murad https://escholarship.org/uc/item/8js5f928 Fingernails and toenails can be an important source of trace evidence at a crime scene investigation. Arsenic, gold, lead, mercury, selenium, silver, and thallium are heavy metals; exposure to these metals can result not only in dyschromia of the nail, but also dystrophy of the nail plate. Mees lines, either single or multiple transverse white bands on the nail, were originally described in association with arsenic exposure. Similar white horizontal bands of transverse leukonychia have also been observed in patients following exposure to selenium and thallium. A diagnostic clue for persons who investigate forensic crime scenes to the possibility of heavy metal toxicity in the victim can be changes in the fingernails and toenails. The nails can be photographed and subsequently analyzed for the presence of the causative metal when the possibility of heavy metal exposure is entertained by crime scene investigators and/or medical examiners or coroners. https://escholarship.org/uc/item/8js5f928 Tue, 13 May 2025 00:00:00 +0000 Cohen, Philip R. Sutton, Lerah https://escholarship.org/uc/item/8948t37q Personal lubricants vary appreciably in ingredient composition. Although some products are labeled hypoallergenic, these claims are seldom evidence-based. The objective was to determine the potential allergenicity of popular lubricants and elucidate the validity of hypoallergenic product claims. This cross-sectional study involved publicly available data on Amazon's 50 best-selling lubricants as of July 2023. Product ingredient lists were cross-referenced with the North American Contact Dermatitis Group and American Contact Dermatitis Society allergen series. Associations were explored between lubricant price per ounce, average customer rating, number of customer reviews, hypoallergenic claim, lubricant base, and allergen quantity using descriptive statistics, Kruskal-Wallis tests, Wilcoxon tests, ?2 tests, and Spearman correlation analyses. Of all studied, 30% (n=15) of products were allergen-free. Nine personal lubricants (18%) were advertised as hypoallergenic, 5 of which were... https://escholarship.org/uc/item/8948t37q Tue, 13 May 2025 00:00:00 +0000 Gessner, Nicholas Neman, Sophia Chiang, Chavy Lin, John Younessi, David Dommasch, Erica Akinshemoyin Vaughn, Olushola Liszewski, Walter Zampella, John Trinidad, John https://escholarship.org/uc/item/81z6p7ss Styling practices, crown thinning, and scalp health in Black women https://escholarship.org/uc/item/81z6p7ss Tue, 13 May 2025 00:00:00 +0000 Pyles, Josephine Olukoga, Chrislene Avashia-Khemka, Nidhi https://escholarship.org/uc/item/7j7943rv Anetoderma is commonly characterized by well-circumscribed areas of slack or baggy skin related to the loss of elastic fibers in the dermis. It has associations with some well-defined skin lesions, such as acne vulgaris and varicella. We report a 67-year-old woman with clinical and pathologically confirmed anetoderma at sites of previously documented lichen planus. https://escholarship.org/uc/item/7j7943rv Tue, 13 May 2025 00:00:00 +0000 Liu, Alex Y Borda, Luis J Pariser, Robert J https://escholarship.org/uc/item/7hp9d0nz Ovarian carcinoma ranks among the top causes of cancer-related fatalities among women in the United States [1]. In the spectrum of ovarian carcinomas, low-grade serous ovarian carcinoma (LGSOC) is a relatively rare form, constituting only 2-5% of all ovarian carcinomas [2]. Although metastasis to the peritoneum and other organs is frequently observed, cutaneous metastasis of ovarian carcinoma is uncommon, occurring in less than 4% of cases and occurring even less often in the serous subtype [3]. Owing to its rare and variable presentation, cutaneous involvement in ovarian carcinoma is particularly challenging to recognize. Patients presenting with skin lesions in the setting of a history of ovarian carcinoma should raise suspicion for cutaneous metastasis. We present a rare case of LGSOC with non-nodular cutaneous involvement presenting as asymptomatic erythematous papules and hyperpigmented patches on the upper chest, abdomen, and lower back. https://escholarship.org/uc/item/7hp9d0nz Tue, 13 May 2025 00:00:00 +0000 Padniewski, Jessica Esse, Ilhan Truong, Andrew Gaddis, Kevin https://escholarship.org/uc/item/77z0670n Traumatic tattoos result from the forceful implantation of foreign material into the skin and may present a significant cosmetic burden to patients. Long-lasting or permanent skin pigmentation in traumatic tattoo may arise from particles of numerous materials such as fireworks, metals, gunpowder, asphalt, and dust embedded within injured skin. Our aim was to demonstrate the appropriate and beneficial use of the Q-switched alexandrite laser to treat traumatic tattoos. The patient's pigmented scars were biopsied and processed using standard histological methods to demonstrate foreign material within the scars. Following patient consent and laser tolerance testing, pigmented scars on the face were treated on two occasions with the Q-switched alexandrite laser. Progress photos were obtained before and after each treatment. The pigmented lesions responded well to treatment with the Q-switched alexandrite laser and exhibited almost complete resolution of foreign body pigmentation after... https://escholarship.org/uc/item/77z0670n Tue, 13 May 2025 00:00:00 +0000 White, Harrison Ashchyan, Hovik Minkis, Kira https://escholarship.org/uc/item/5mh323cc Angiomatoid melanoma is a rare variant of malignant melanoma not currently recognized by the World Health Organization classification system. In this study, we present a case of primary angiomatoid melanoma in a 57-year-old man who presented to clinic with a complaint of a growing lesion on the frontal scalp for four months. Microscopic examination of the lesion revealed cavernous spaces filled with extravasated red blood cells. Immunohistochemical markers were positive for melanoma and negative for vascular endothelium. We also review the literature on angiomatoid melanoma, finding distinct morphological differences in previously reported cases. Owing to these differences, we propose new diagnostic criteria and offer a mechanism for formation of blood-filled cavernous spaces while cautioning against misinterpretation of CD31 expression by macrophages in zones of immune regression. Angiomatoid melanoma is a diagnostic challenge because of its rarity, signaling a need for further... https://escholarship.org/uc/item/5mh323cc Tue, 13 May 2025 00:00:00 +0000 Hulse, Jack Fraga, Garth Fink, Matthew https://escholarship.org/uc/item/5ck9m3f1 eclare that the contents of this article are their own original unpublished findings. Title: Changes in public interest for Mohs micrographic surgery: a Google Trends analysis Authors: Joshua Burshtein1 MD, Milaan Shah2 MD, Danny Zakria3 MD MBA, Lauren DeBusk4 MD, Angela Rosenberg4 DO, Darrell Rigel5 MD MS Affiliations: 1Department of Dermatology, University of Illinois Chicago, Chicago, Illinois, USA, 2Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina, USA, 3Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA, 4Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas, USA, 5Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA Corresponding Author: Joshua Burshtein MD, 808 South Wood Street, Chicago, IL 60612, Tel: 845-596-9482, Email: jburshtein13@gmail.com https://escholarship.org/uc/item/5ck9m3f1 Tue, 13 May 2025 00:00:00 +0000 Burshtein, Joshua Shah, Milaan Zakria, Danny DeBusk, Lauren Rosenberg, Angela Rigel, Darrell https://escholarship.org/uc/item/59g2t27m Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is an erythematous, photodistributed, scaly, and annular cutaneous eruption that is clinically similar to subacute cutaneous lupus erythematosus. However, DI-SCLE is associated with medication use and generally resolves or greatly improves following discontinuation. Chemotherapeutic agents are common triggers of DI-SCLE. We report a patient with breast cancer who experienced multiple episodes of DI-SCLE associated with the use of different chemotherapeutic agents for treatment-resistant cancer. Notably, to the best of our knowledge, this case highlights the first reported association of DI-SCLE with trastuzumab deruxtecan. Additionally, this case is unique owing to a component of radiation recall dermatitis, as the rash was prominent in areas that had prior ionizing radiation. A prior history of DI-SCLE in oncology patients who continue to undergo treatment should prompt clinicians to consider DI-SCLE when faced with... https://escholarship.org/uc/item/59g2t27m Tue, 13 May 2025 00:00:00 +0000 Trepanowski, Nicole Shah, Payal Bai, Heidi Yan, Shaofeng Fragoso, Natalie Barton, Dorothea https://escholarship.org/uc/item/55060583 Evaluating dermatology appointment lead times with Zocdoc: a cross-sectional study https://escholarship.org/uc/item/55060583 Tue, 13 May 2025 00:00:00 +0000 Aparicio, Mariana Dyson, Mary E Black, T Austin Anderson, Isabella R Rashid, Rashid M https://escholarship.org/uc/item/4r33j5mp Deconstructing the prevalence of undifferentiated pleomorphic sarcoma across socio-demographic groups: a potential launchpad for future research https://escholarship.org/uc/item/4r33j5mp Tue, 13 May 2025 00:00:00 +0000 Fu, Shangyi Taing, Matthew Huynh, Danny Keeling, Brett Ahmed, Ammar https://escholarship.org/uc/item/4mm2z13p Given the rise of radiation based medical procedures, cutaneous radiation reactions are increasing in frequency. Diagnosis of fluoroscopic radiation-related cutaneous injuries are challenging, as patients are often unaware of or cannot recall radiation exposure. It is important to maintain clinical suspicion of radiation induced skin injuries in patients with persistent morpheaform areas and localized areas of dermatitis or ulceration. Several cutaneous radiation induced injuries have overlapping clinical presentations. Histopathology may be required to help differentiate between these distinct disorders. Treatment of cutaneous radiation reactions may vary, dictated by a variety of factors, including the disease process, the severity of the lesions, and the presence of comorbidities. Herein, we present two cases to highlight the spectrum of fluoroscopic radiation induced cutaneous injuries. https://escholarship.org/uc/item/4mm2z13p Tue, 13 May 2025 00:00:00 +0000 Young, Kelly Z Kolli, Sree S Kwa, Michael C McHargue, Chauncey https://escholarship.org/uc/item/47x6c53r Skin tension lines are fundamental guidelines in surgical procedures for determining optimal incision placement to enhance healing and minimize visible scarring. This paper delves into the historical development and practical implications of Langer lines and relaxed skin tension lines. Utilization of relaxed skin tension lines enhances the precision of incisions and closures by considering facial muscle tension, an aspect not addressed by Langer cleavage lines. Relaxed skin tension lines more accurately reflect skin dynamics, underscoring the importance of patient positioning. Additionally, Cornelius Kraissl played a significant role in highlighting the alignment of scars with wrinkle lines. The interchangeable use of relaxed skin tension lines and Langer lines often leads to confusion within the field. Clarifying their distinct origins and criteria is crucial for the optimization of surgical outcomes. https://escholarship.org/uc/item/47x6c53r Tue, 13 May 2025 00:00:00 +0000 Pomerantz, Erin R Griffin, Nicole L Brownstone, Nicholas D https://escholarship.org/uc/item/3qk6r1sz Unilateral acne: think about cell-phone acne https://escholarship.org/uc/item/3qk6r1sz Tue, 13 May 2025 00:00:00 +0000 Rachadi, Hanane Elfatoiki, FZ Hali, F Chiheb, Soumiya https://escholarship.org/uc/item/2399t7xv Erlotinib is one of the epithelial growth factor receptor tyrosine kinase inhibitors that have been developed and extensively employed in the treatment of non-small cell lung cancer, particularly in individuals with activating epithelial growth factor receptor mutations. This report presents a case of erlotinib induced eyelash trichomegaly and irritation, a rare side effect in a woman who received erlotinib for lung adenocarcinoma. Following the detection of an epithelial growth factor receptor mutation in tumor tissue from a non-small cell lung cancer in a nonsmoking woman, the patient was initiated on erlotinib therapy. After several months, she experienced significant overgrowth of both eyelashes, leading to vision problems. Dermoscopy findings revealed an increase in the length and thickness of the eyelashes associated with inflammation of the eyelid's edges. It has been hypothesized that the inhibition of epithelial growth factor receptor signaling by epithelial growth factor... https://escholarship.org/uc/item/2399t7xv Tue, 13 May 2025 00:00:00 +0000 El Haddad, Meriem El Jouari, Ouiame Salim, Gallouj https://escholarship.org/uc/item/1nr8d8vk Enchondromas are frequently occurring cartilaginous tumors, accounting for 10-25% of all benign bone neoplasms. We present a distinctive case involving distal clubbing of the right third toenail with a painless, 5mm-wide red longitudinal streak. Clinical examination, nail matrix biopsy, and imaging confirmed the presence of an enchondroma in the distal phalanx. Although solitary enchondromas often present with pain or pathological fractures, asymptomatic cases like this one are quite rare. Given the low risk of malignant transformation, the patient chose regular magnetic resonance imaging (MRI) monitoring. This case highlights the need to consider enchondromas in the differential diagnosis of painless longitudinal erythronychia, an infrequent manifestation. Proper diagnosis is essential to differentiate these lesions from malignant chondrosarcomas, which have a different management approach. https://escholarship.org/uc/item/1nr8d8vk Tue, 13 May 2025 00:00:00 +0000 Levian, Brandon Ravi, Vignesh Mosallaei, Daniel Cruz, Sebastian Chiu, Melvin DeClerck, Brittney Hu, Jenny https://escholarship.org/uc/item/1gc1m39j Occupational dermatologic conditions in nail salon technicians https://escholarship.org/uc/item/1gc1m39j Tue, 13 May 2025 00:00:00 +0000 Pham, Vy X Briones, Naomi F Park, Helen H Jiang, Shang I Brian https://escholarship.org/uc/item/1bv6h239 Melanoma, an invasive and potentially fatal form of skin cancer, is projected to comprise 5% of new cancer cases and 1.4% of cancer-related deaths in 2024 alone [1]. Survival rates are closely linked to the stage at detection, with thicker tumors at initial diagnosis associated with reduced overall survival rate [2,3]. Increased distance to healthcare providers creates barriers to early detection; disparities in sun exposure and healthcare access between rural and urban populations underscore the need for targeted interventions. This review explores the relationship between rurality and distance to providers with melanoma staging at detection. A search was conducted of the PubMed and Embase databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines [4]. The included studies examined melanoma staging and Breslow thickness in rural versus urban areas and the impact of distance to healthcare provider. Greater distance to healthcare providers... https://escholarship.org/uc/item/1bv6h239 Tue, 13 May 2025 00:00:00 +0000 Hitchcock, Dakota Loczi-Storm, Angela Patel, Arya Bolen, Rebecca Tchernogorova, Elizabeth Brinzo, Paige Szmanski, Tionna Deehan, Emily Dellavalle, Robert https://escholarship.org/uc/item/1353g84q Blue rubber bleb nevus syndrome (BRBNS) and familial multiple glomuvenous malformations (GVM) are genetic disorders characterized by multiple cutaneous vascular malformations. Unlike multiple GVM, BRBNS comprises a risk of systemic involvement with vascular malformations in other organs, potentially causing life-threatening bleeding. The correct distinction between these two conditions is challenging due to their clinical similarity, but it is crucial in light of the pivotal differences in prognosis and follow-up. We report a case of multiple glomuvenous malformations in a child with lower gastrointestinal bleeding that posed a thought-provoking diagnosis. https://escholarship.org/uc/item/1353g84q Tue, 13 May 2025 00:00:00 +0000 Brazao, Claudia Mancha, Dora Sun, Lanyu Antunes-Duarte, Sofia Fernandes, Sonia Rodrigues, Luis Rodrigues, Marcia de Vasconcelos, Pedro Soares-de-Almeida, Luis Filipe, Paulo https://escholarship.org/uc/item/1103r44c United States public interest in melanoma and prevention and its association with incidence, mortality, and dermatologist density https://escholarship.org/uc/item/1103r44c Tue, 13 May 2025 00:00:00 +0000 Burshtein, Joshua Shah, Milaan Zakria, Danny DeBusk, Lauren Rosenberg, Angela Rigel, Darrell https://escholarship.org/uc/item/9w42773z Bacillary angiomatosis is a rare cutaneous manifestation caused by infection with Bartonella henselae that is most often seen in immunocompromised individuals, particularly those with HIV. We present an HIV-negative elderly man with bacillary angiomatosis with unexplained pancytopenia. The patient presented with a solitary, pedunculated, vascular nodule on his right forearm, and a shave biopsy was performed to rule out metastatic cancer. Biopsy results were consistent with bacillary angiomatosis, which was confirmed with polymerase chain reaction. Further evaluation revealed severely low CD4 counts in our patient, despite two negative HIV tests and lack of immunosuppressive drugs or conditions besides cytopenia. He eventually met criteria for idiopathic CD4 lymphocytopenia and was treated with doxycycline for coverage of possible disseminated infection. This case demonstrates the importance of keeping bacillary angiomatosis in the differential diagnosis in patients presenting... https://escholarship.org/uc/item/9w42773z Tue, 4 Mar 2025 00:00:00 +0000 Vivancos Koopman, Irene Mpunga, Ndanzia Menezes, Andrew Rivero-Moragrega, Paloma Siddiqui, Huma Cadena-Zuluaga, Jose Danaher, Patrick J. Hivnor, Chad https://escholarship.org/uc/item/9nw2w1fx A case of mixed mycosis fungoides and superficial morphea: a clinicohistopathologic challenge https://escholarship.org/uc/item/9nw2w1fx Tue, 4 Mar 2025 00:00:00 +0000 Adeuyan, Oluwaseyi O. Schreidah, Celine M Fahmy, Lauren M Gordon, Emily R Lapolla, Brigit A Geskin, Larisa J https://escholarship.org/uc/item/8t195690 Repair of adjacent defects on the nasal dorsum and nasal sidewall https://escholarship.org/uc/item/8t195690 Tue, 4 Mar 2025 00:00:00 +0000 Levin, Adam Zahir, Amir Fakhoury, Tamara Kouba, David https://escholarship.org/uc/item/8jv391mc Malignant syphilis, also known as lues maligna, is an atypical and aggressive form of secondary syphilis characterized by nodules and ulcers associated with a spectrum of nonspecific systemic manifestations. The underlying states of immunosuppression represent the primary risk factor. We present a 30-year-old immunocompetent man exhibiting dermatological lesions at various stages clinically and histologically consistent with the established criteria for malignant syphilis. He received antibiotic therapy with complete clearing. Furthermore, we emphasize the importance of proper interpretation of serological tests, both for diagnosis and systematic monitoring. https://escholarship.org/uc/item/8jv391mc Tue, 4 Mar 2025 00:00:00 +0000 Duenaz-Diaz, Jesus Enrique Paz-Luna, Dinorah Elizabeth Duenaz-Diaz, Isaias Giovanni Salcedo-Gomez, Astrid Aguilar-Roman, Gema Yasmin Paredes-Solis, Vanesa Chavez-Guzman, Sara Elena Zavala-Alvarez, Elsa Daniela https://escholarship.org/uc/item/7jn105cb Folliculitis decalvans is a chronic and progressive scarring alopecia at the vertex and occipital scalp with a predilection for middle-aged men. Squamous cell carcinoma is an exceedingly rare complication of folliculitis decalvans, reported in 5 cases to date. Herein, we present a case of squamous cell carcinoma of the scalp in a patient diagnosed with recalcitrant folliculitis decalvans and review the clinicopathologic characteristics of all reported cases in the literature. https://escholarship.org/uc/item/7jn105cb Tue, 4 Mar 2025 00:00:00 +0000 Luu, Yen Kimmis, Brooks D. Pulumati, Anika Jaroonwanichkul, Sandra Fraga, Garth Rajpara, Anand https://escholarship.org/uc/item/78b6k3p6 Milia are small, benign firm white papules that commonly manifest on the face and torso. Several subtypes exist, including multiple eruptive milia-a condition characterized by the eruption of numerous milia that arise over the course of weeks to months. Although limited literature exists on this rare presentation, there seems to be no uniform patient demographic, etiology, or consistent anatomical localization of the milia. We describe a case of multiple eruptive milia presenting diffusely across the cheeks, forehead, superior neck, and preauricular and postauricular skin of an adult female. Additionally, this case is particularly unique as biopsies of representative lesions demonstrate a distinct lymphohistiocytic infiltrate. This atypical presentation underscores a gap in literature regarding multiple eruptive milia and calls into question whether a subtype of milia may exist with an inflammatory component. https://escholarship.org/uc/item/78b6k3p6 Tue, 4 Mar 2025 00:00:00 +0000 DiLeo, Mckenzie Moore, Reece Nelson, Emelie E. Rashid, Rashid M. https://escholarship.org/uc/item/6pt4p4qq _Case Presentation X Photo Vignette _Letter Authors declare that the contents of this article are their own original unpublished findings. Title: Metastatic lung cancer mimicking varicella-zoster virus Authors: Katherine Snow1 BA, Rylee Moody1 MD, Michael Kremer2 MD, Sofia Chaudhry2 MD Affiliations: 1Saint Louis University, School of Medicine, St. Louis, Missouri, USA, 2SSM Health Saint Louis University Hospital, Department of Dermatology, St. Louis, Missouri, USA Corresponding Author: Katherine Snow, 1008 South Spring Avenue, St. Louis, MO 63110, Tel: 314-617-2660, Email: katherine.snow@health.slu.edu Abstract: Cutaneous metastases from lung adenocarcinoma are rare and usually signify advanced disease with a poor prognosis. This case describes a 63-year-old woman with stage IV lung adenocarcinoma who presented with a painful, initially unilateral, rash on her breast. The clinical appearance of erythematous plaques with vesiculo-papules suggested disseminated herpes... https://escholarship.org/uc/item/6pt4p4qq Tue, 4 Mar 2025 00:00:00 +0000 Snow, Katherine Moody, Rylee Kremer, Michael Chaudhry, Sofia https://escholarship.org/uc/item/6m073615 Lupus miliaris disseminatus faciei is a rare papular eruption primarily affecting the face, but extrafacial involvement can occur, which poses diagnostic challenges. We present a young woman with both facial and axillary involvement of lupus miliaris disseminatus faciei and review the literature to highlight less common extrafacial locations. Despite its rarity, lupus miliaris disseminatus faciei should be considered in the differential diagnosis of persistent papular eruptions. Histopathologic confirmation is essential, particularly in cases lacking facial involvement. Early recognition and treatment can minimize scarring, but a uniformly successful treatment option is lacking. Our report emphasizes the importance of biopsy to establish a diagnosis, especially in the absence of facial involvement given the misleading nature of the current nomenclature. https://escholarship.org/uc/item/6m073615 Tue, 4 Mar 2025 00:00:00 +0000 Fields, Alicia B Margheim, Ashlee M Callen, Jeffrey P Strickley, John D Malone, Janine C https://escholarship.org/uc/item/65m72953 Topical corticosteroids are a first-line therapy for inflammatory skin diseases and are commonly used for chronic management. Topical corticosteroids can lead to cutaneous and systemic adverse events. The purpose of this expert consensus panel was to review published literature on the safety and efficacy of topical corticosteroids and role for advanced targeted topical therapies for inflammatory skin diseases. A comprehensive literature search was completed using a combination of keywords: "topical," "corticosteroid," "non-steroid," "efficacy," "adverse effects," "malpractice," and "inflammatory skin diseases." Articles were screened for relevance to topic of safety and efficacy of topical corticosteroids and noncorticosteroid therapies for inflammatory skin diseases. A panel of four dermatologists with expertise treating inflammatory skin diseases reviewed the articles and created consensus statements. A modified Delphi process was used to approve each statement and a strength... https://escholarship.org/uc/item/65m72953 Tue, 4 Mar 2025 00:00:00 +0000 Burshtein, Joshua Chovatiya, Raj Golant, Alexandra Zakria, Danny Shah, Milaan Lio, Peter Lebwohl, Mark https://escholarship.org/uc/item/5wh9n9p4 Urgent care in dermatology: first year experience of an academic clinic https://escholarship.org/uc/item/5wh9n9p4 Tue, 4 Mar 2025 00:00:00 +0000 Suresh, Tara Pollard, Bruin Hajda, Hana Chen, Lily Rosman, Ilana https://escholarship.org/uc/item/5vh4j2z1 Hepatotoxicity is a known but very rare side effect of oral terbinafine therapy. To our knowledge, there are no reported cases of patients with cleared hepatitis B infection prescribed oral terbinafine. We report an 82-year-old woman with previous hepatitis B exposure who experienced asymptomatic elevation of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase levels following 28 days of therapy with 250mg of oral terbinafine daily for onychomycosis treatment. After drug discontinuation, her liver function tests returned to baseline about three months later, without permanent liver damage. Oral terbinafine therapy, although typically efficacious and well-tolerated for onychomycosis treatment, rarely causes hepatoxicity. Physician knowledge of this rare but important side effect is necessary to prevent morbidity and mortality resulting from continued therapy. Oral terbinafine therapy might not reactivate hepatitis B in patients with past infection. https://escholarship.org/uc/item/5vh4j2z1 Tue, 4 Mar 2025 00:00:00 +0000 Hill, Rachel C. Lipner, Shari R. https://escholarship.org/uc/item/5c29n8sh Dystrophic calcinosis cutis is the aberrant deposition of insoluble calcium in cutaneous tissue generally secondary to inflammatory connective tissue disease. Although calcinosis cutis is commonly seen in juvenile dermatomyositis, it is a relatively rare occurrence in adult disease. Herein, we discuss an 82-year-old woman with extensive history of dermatomyositis of the scalp who presented with new-onset calcinosis cutis of the scalp. https://escholarship.org/uc/item/5c29n8sh Tue, 4 Mar 2025 00:00:00 +0000 Teames, Charles Florell, Scott R Hansen, Christopher https://escholarship.org/uc/item/4rs4s68r Primary systemic amyloidosis is a condition marked by the extracellular deposition of amyloid proteins within various organ systems in the body. Although cutaneous involvement is well-described, scalp involvement in the form of alopecia is rarely reported. We report a case of amyloid associated alopecia confirmed by histologic analysis to highlight this rare scalp manifestation associated with systemic amyloidosis. https://escholarship.org/uc/item/4rs4s68r Tue, 4 Mar 2025 00:00:00 +0000 Principe, Patricia Wong, Lulu Luke, Janiene https://escholarship.org/uc/item/4mw0f778 Recalcitrant Nicolau syndrome following repeated intramuscular diclofenac injections https://escholarship.org/uc/item/4mw0f778 Tue, 4 Mar 2025 00:00:00 +0000 Unal, Ismail H. Akoglu, Gulsen Simsek, Gulcin https://escholarship.org/uc/item/41t3v7fn Cutaneous plasmacytosis has <60 cases worldwide, typically characterized by multiple asymmetric facial and truncal cutaneous nodules and plaques. We describe the case of a 68-year-old woman with erythematous plaques on the feet who had a biopsy showing primary cutaneous plasmacytosis and subsequent workup revealing celiac disease. Our patient's clinical presentation of symmetric plaques on the dorsal feet is previously unreported. Additionally, plasmacytosis occurs predominantly in Japanese patients and men younger than 40. Cutaneous plasmacytosis is hypothesized to be reactive from overreaction to stimuli including trauma, infections, or malignancies. The origin of our patient's reactive process could be related to celiac disease or could be unknown. Plasmacytosis in bone marrow has been reported with celiac disease, but to our knowledge, this is the first report of cutaneous plasmacytosis in a patient with celiac disease. https://escholarship.org/uc/item/41t3v7fn Tue, 4 Mar 2025 00:00:00 +0000 Gordon, Emily R Trager, Megan H Adeuyan, Oluwaseyi Lapolla, Brigit A Gru, Alejandro A Magro, Cynthia M Geskin, Larisa J https://escholarship.org/uc/item/37z2x4nv Blastic plasmacytoid dendritic cell neoplasm is an uncommon, aggressive hematologic neoplasm carrying a poor prognosis with a median survival of one year, making early detection vital. Patients present with a number of characteristic cutaneous manifestations and are treated with chemotherapy and hematopoietic stem cell transplantation, which may improve survival. In this case, a 65-year-old man with a history of basal cell carcinoma presented with a nodule on his forehead with a honey-crusted border. Although the patient was treated with intralesional triamcinolone and a 7-day course of cephalexin for concurrent staphylococcal infection, the patient reported rapid growth of the nodule, new ecchymosis and edema involving his right cheek, and erythematous patches of the right temple and neck. Biopsy of lesions and  immunohistochemical analysis confirmed the diagnosis of blastic plasmacytoid dendritic cell neoplasm. The patient was referred for further management, leading to... https://escholarship.org/uc/item/37z2x4nv Tue, 4 Mar 2025 00:00:00 +0000 Flynn, Elaine N. Dadras, Soheil S. Petty, Anna Olugbade, Idowu D. Imahiyerobo-Ip, Joyce https://escholarship.org/uc/item/2n6608jq Fox-Fordyce disease is a rare, chronic, pruritic papular eruption affecting apocrine gland-rich areas, predominantly in premenopausal women. There is no standardized treatment for Fox-Fordyce disease and various therapies have yielded mixed results. Botulinum toxin type A injections have shown promise in at least three refractory cases reported in literature. We present an additional case of Fox-Fordyce disease that improved after a single treatment with Botulinum toxin type A. https://escholarship.org/uc/item/2n6608jq Tue, 4 Mar 2025 00:00:00 +0000 Sun, Lanyu Brazao, Claudia Sousa, Diogo de Patrocinio, Joao Vasconcelos, Pedro de Soares-de-Almeida, Luis Filipe, Paulo https://escholarship.org/uc/item/29r7v39p Dermatomyositis is one type among a heterogeneous group of idiopathic inflammatory myopathies. Among these anti-TIF1 gamma dermatomyositis is characterized by specific skin lesions, often severe and refractory to conventional treatments. We report a 58-year-old woman who had fatigue associated with myalgia with proximal and bilateral muscle weakness along with a generalized lilac erythematous rash on the face with Gottron papules on the metacarpophalangeal joints and periungual erythema on both hands. She also exhibited a widespread dark-violaceous-red skin eruption on the whole trunk. She was diagnosed with anti-TIF1 gamma dermatomyositis and received a treatment regimen of topical corticosteroids, hydroxychloroquine, oral corticosteroids, and conventional immunosuppressive drugs (methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, and immunoglobulins) with no improvement of the skin rash. Therefore, she received rituximab, and three months later, the skin lesions... https://escholarship.org/uc/item/29r7v39p Tue, 4 Mar 2025 00:00:00 +0000 Said, Fatma Jridi, Maysam Naceur, Ines Ben Achour, Tayssir Smiti, Monia https://escholarship.org/uc/item/19q4s9tf Hair is a defining feature of human appearance and plays an essential role in personality and identity development. Currently, about 1.6% of US adults identify as transgender. Within the transgender community, hair serves not only as a means of self-expression but also as a crucial element in affirming gender identity, helping individuals to align their outward appearance with their inner sense of self. However, there are significant disparities in the care provided to transgender patients, particularly those seeking a more masculine or feminine appearance through hormone replacement therapy. Studies on transgender patient satisfaction with current therapies are limited but indicate overall dissatisfaction with the standard of care. Dermatologists play a pivotal role in advocating and caring for transgender patients regarding their hair and skin needs. A deeper understanding of hormone replacement therapy and hair growth/loss therapy is crucial to prescribing medications aligned... https://escholarship.org/uc/item/19q4s9tf Tue, 4 Mar 2025 00:00:00 +0000 Onejeme, Chinenye Fitzgibbon, Mary Jimenez, Antonio Ross, Lindy https://escholarship.org/uc/item/0dr6s72d Patient perception of delays in the dermatology clinic https://escholarship.org/uc/item/0dr6s72d Tue, 4 Mar 2025 00:00:00 +0000 Hunter, Emily R Bhatti, Safiyyah McGrath, Lauren N Jackson, Stephanie R Jones, Elizabeth https://escholarship.org/uc/item/01z1q2bd The heterogeneous syndromes caused by germline mutations in genes belonging to the RAS/mitogen-activated protein kinase pathway are often referred to as RASopathies. Abnormal activation of this pathway plays a key role in the development of these disorders. Pathogenic variants in RASA1 gene cause an autosomal dominant syndrome called capillary malformation-arteriovenous malformation syndrome type 1 characterized by a broad phenotypic variability, even within the same family. In this syndrome, multifocal capillary and arteriovenous malformations are mainly localized in the central nervous system and skin. Herein, we report a patient with capillary malformation-arteriovenous malformation syndrome type 1 with a novel deletion on RASA1 gene. As this syndrome has been described just over two decades ago, it is most likely underdiagnosed. These kinds of skin lesions, even if unremarkable, should be evaluated by an experienced dermatologist. https://escholarship.org/uc/item/01z1q2bd Tue, 4 Mar 2025 00:00:00 +0000 Matos, Pedro Rolo Granja, Barbara Oliveira, Renata Costa, Catarina Nogueira, Ana https://escholarship.org/uc/item/9f3615ks Personal protective equipment modification by health care workers owing to skin concerns during the COVID-19 pandemic: a multicenter cross-sectional study https://escholarship.org/uc/item/9f3615ks Fri, 3 Jan 2025 00:00:00 +0000 Trepanowski, Nicole Raef, Haya S Elmariah, Sarina B Goldminz, Ari M Larson, Allison R Meltzer, Rachel https://escholarship.org/uc/item/8jv9d3bf Lichen planus pigmentosus (LPP) is recognized as a rare variant of lichen planus, characterized by dermal hyperpigmentation. Specifically, a particular intertriginous variant of LPP is known as lichen planus pigmentosus inversus (LPPI). In our case, the patient presented with symmetric, hyperpigmented dark brown patches mainly in axillary areas, closely resembling the features of acanthosis nigricans (AN). The differential diagnosis considered included LPPI, AN, post-inflammatory hyperpigmentation related to contact dermatitis, symmetrical drug-related intertriginous and flexural exanthema, fixed drug eruption, and erythema dyschromicum perstans (EDP). Histopathological examination revealed the absence of hyperkeratosis and papillomatosis, typically associated with AN. Dermoscopy revealed diffuse brownish hue along with dots and globules of inconsistent size, which suggests dermal pigmentary incontinence and the likelihood of LPPI. This case illustrates the challenge in differentiating... https://escholarship.org/uc/item/8jv9d3bf Fri, 3 Jan 2025 00:00:00 +0000 Youh, Joohyung Iwata, Hiroaki Kitamura, Shinya Ujiie, Hideyuki https://escholarship.org/uc/item/83g6t19z From squats to spots: vitiligo koebnerization triggered by powerlifting https://escholarship.org/uc/item/83g6t19z Fri, 3 Jan 2025 00:00:00 +0000 Snow, Katherine Poole, Mackenzie Mehrmal, Sino Guo, Aibing Mary https://escholarship.org/uc/item/8142w7md Paracoccidioidomycosis is a systemic fungal disease with a highly variable distribution, endemic to Central and South America with the highest prevalence in Brazil, Argentina, and Colombia. The chronic presentation of the disease is commonly observed in adult men and they manifest with pulmonary and mucocutaneous lesions. We report a fatal case of disseminated paracoccidioidomycosis in a 68-year-old immunocompetent man, with pulmonary, skin, mucosal, and cerebral involvement. Mucocutaneous lesions were decisive for the etiological diagnosis. https://escholarship.org/uc/item/8142w7md Fri, 3 Jan 2025 00:00:00 +0000 Martins, Ezequias B Alves, Halber FM Vilte, Remberto MC Pantaleao, Luciana da Silva, Isadora OCP Silva, Natalia CZ Ferreira, Laura C Ronchini, Karla ROM Vieira, Thais O M, Maria Vitoria Leite, Veronica RB M, Patricia Yvonne https://escholarship.org/uc/item/7zx9962p Enfortumab vedotin (EV) is a monoclonal antibody drug conjugate composed of antibody against nectin-4 and linked to the microtubule inhibitor monomethyl auristatin E that is used to treat metastatic urothelial carcinoma. Enfortumab vedotin-associated cutaneous adverse events are common and are clinically diverse, ranging from papulosquamous eruption to vesiculobullous eruptions such as Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme-like eruption with vesiculobullae. Despite clinically diverse appearance, histopathology of EV-associated cutaneous adverse reactions often demonstrates interface dermatitis. We present the clinical and histopathologic features in a unique case of EV-associated widespread vesiculobullous eruption initially concerning for disseminated herpetic infection in a patient undergoing treatment of metastatic urothelial carcinoma with EV and pembrolizumab. https://escholarship.org/uc/item/7zx9962p Fri, 3 Jan 2025 00:00:00 +0000 Nihal, Aman Bacon, Pearl Pei, Susan https://escholarship.org/uc/item/7zn1x7vc Blastomyces dermatitidis is a dimorphic fungus that can disseminate in the immunocompetent and immunodeficient. Many infected patients display heterogenous cutaneous findings, making it one of dermatology's great clinical mimics. Cases presenting as single lesions are often mistaken for neoplasms or other infections. We report a patient with diabetes mellitus who presented to the emergency department with a two-month history of an ulcerated jawline nodule. Treatment with incision/drainage and doxycycline for presumed bacterial abscess was unsuccessful. Upon re-presentation 10 days later, biopsy and fungal culture of the tumor confirmed infection with B. dermatitidis. Chest computed tomography revealed disease dissemination. Halfway through a 6-month course of itraconazole, cutaneous and pulmonary findings were notably improved. Diabetes is an emerging risk factor for dissemination that likely contributed to the severity in our case. Early biopsy can prevent potentially life-threatening... https://escholarship.org/uc/item/7zn1x7vc Fri, 3 Jan 2025 00:00:00 +0000 Snow, Katherine Poole, Mackenzie Mehrmal, Sino Khoshnoodi, Pooria Burkemper, Nicole Chaudhry, Sofia B https://escholarship.org/uc/item/7mc5q99v Solar elastosis is a form of photoaging theorized to result from long-term exposure to ultraviolet radiation. Clinically, solar elastosis manifests as yellow, atrophic, rhytid skin with a leathery appearance, most commonly affecting sun-exposed areas such as the face, neck, chest, or arms. Owing to its well-documented association with an elevated risk of skin cancer, recognizing the presence of solar elastosis is essential for clinicians. In this case, we evaluate a presentation of solar elastosis confined strictly to the perioral region, sparing the remainder of sun-exposed facial areas. https://escholarship.org/uc/item/7mc5q99v Fri, 3 Jan 2025 00:00:00 +0000 Keatts, Sydney A Shin, Riley Black, T Austin Rashid, Rashid M https://escholarship.org/uc/item/6bs4c7qz Drug hypersensitivity syndrome or DRESS (drug reaction with eosinophilia and systemic symptoms) is a severe reaction with an estimated mortality of 10%. Antibacillary drugs are rarely incriminated. A 28-year-old patient with tubercular miliaria who developed antibacillary-induced DRESS is presented. The dermatological lesions appeared four weeks after the beginning of the antitubercular treatment. The diagnosis of DRESS was made when all the Registry of Severe Toxidermia (RegiSCAR) criteria were present. The treatment was stopped and the patient was put on symptomatic treatment under supervision in the intensive care unit, with progressive improvement. Substitution with second-line antituberculosis drugs was necessary and was done with caution. DRESS with antituberculosis drugs is rare and its management is not codified. https://escholarship.org/uc/item/6bs4c7qz Fri, 3 Jan 2025 00:00:00 +0000 Bouhamdi, Abir Bouhamdi, Chaimae Tassa, Jean Junior Douhi, Zakia Tahiri, Layla Serraj, Mounia El Biaze, Mohammed Benjelloun, Mohammed Chakib Mernissi, Fatima Zahrae Amara, Bouchra https://escholarship.org/uc/item/64g973kq Adiposis dolorosa (Dercum disease) is a rare condition characterized by diffuse and recurring painful lipomas on the trunk and extremities. Patients are typically middle-aged females with an elevated BMI presenting with chronic pain. Physical examination reveals soft subcutaneous nodules and masses, tender to palpation. The associated pain significantly impacts quality of life and requires therapeutic intervention. The most common treatment option is surgical excision. Alternative options should be considered for patients with numerous lipomas where surgical management is not practical or is not desired. Deoxycholic acid injections are a viable alternative non-surgical technique. We present a case of a 55-year-old woman who presented with a history of Dercum disease and worsening pain associated with multiple lipomas. The patient desired a non-surgical intervention. She was subsequently treated with three rounds of deoxycholic acid injections with reduction in pain and improved... https://escholarship.org/uc/item/64g973kq Fri, 3 Jan 2025 00:00:00 +0000 Schwartz, Ziv Brockmeyer, Kayla Nikbakht, Neda https://escholarship.org/uc/item/5tp780kn Soft tissue chondroma is a rare benign tumor that occurs more often in the distal limbs and is unattached to the underlying bone. An 11-year-old boy, presented with a nodule of the subungual area of the right big toe. Objectively, the nail plate was partially destroyed owing to protrusion. Digital dermoscopy revealed yellow keratinous masses in the subungual area, with fibers adhering to the surface. Post-traumatic hemorrhages were observed in the tumor. Owing to functional discomfort, the patient underwent removal of the mass under local anesthesia. The histological picture is consistent with subungual soft tissue chondroma. Subungual soft tissue chondroma is more common in adults, but can affect people of all ages. https://escholarship.org/uc/item/5tp780kn Fri, 3 Jan 2025 00:00:00 +0000 Voloshynovych, M Boichuk, T Berezkin, O Girnyk, G Matkovska, N Berezkina, I https://escholarship.org/uc/item/5dk2h0wj Climate change poses an increasing threat to human health, with well-documented impacts on dermatologic conditions. However, the U.S. healthcare sector is paradoxically a significant contributor to climate change-worsening greenhouse gas emissions. To address this negative externality, calls to action to decarbonize healthcare delivery have spurred research and initiatives around improving the environmental sustainability of medicine. Published sustainability recommendations for dermatologic practices have addressed themes such as renewable energy, single-use disposable materials, regulated medical waste, and clinician advocacy. Our current commentary provides an analysis of the potential of existing recommendations and outlines additional, novel, and actionable interventions. We highlight recently released decarbonization resources and regulatory changes. We emphasize the importance of reassessing procedure kits, minimizing medication waste, and implementing green procurement... https://escholarship.org/uc/item/5dk2h0wj Fri, 3 Jan 2025 00:00:00 +0000 Silva, Genevieve S Gotschall, Jeromy W Rosenbach, Misha https://escholarship.org/uc/item/4fs883qg Bullous systemic lupus erythematosus (SLE) is a rare cutaneous manifestation of SLE characterized by sudden vesiculobullous eruptions. Herpes zoster infection may lead to rapid bullae development in patients with known bullous SLE. Herein, we describe a case of rapid development of bullous herpes zoster in a patient with bullous SLE. Patients with SLE and lupus nephritis exhibit an increased risk for herpes zoster infection. Bullous herpes zoster has been described in a previous patient with SLE and lupus nephritis. The current case illustrates that the presence of bullous SLE may have precipitated the development of bullous variant herpes zoster, as blisters leading to breakages in the skin increase risk for superinfection by viral pathogens. The current case highlights the importance of monitoring for skin changes in patients with SLE and maintaining a low threshold for infectious workup. Furthermore, it is important to recognize that the presence of bullae in SLE may confuse... https://escholarship.org/uc/item/4fs883qg Fri, 3 Jan 2025 00:00:00 +0000 Jaroonwanichkul, Sandra Luu, Yen Nguyen, Katherine Dai, Hongyan Rajpara, Anand https://escholarship.org/uc/item/48t2z35h Herein we present a 48-year-old man who was diagnosed with a nodular basal cell carcinoma (BCC) of the left chin that was revealed on Mohs frozen sections to be a rippled-pattern BCC with invasion into muscle and necessitated interdisciplinary care for concern for a concurrent salivary gland carcinoma. Rippled-pattern BCC has been documented in fewer than ten cases, though this may also be attributed to confusion regarding nomenclature. Microscopically, rippled-pattern BCC exhibits distinctive features that differentiates it from other patterns. The tumor cells form interconnected networks or cords with intervening mucinous spaces within a fibrotic stroma resulting in a rippled appearance. As they are generally considered nodular BCCs, management of rippled-pattern BCCs can involve surgical excision, Mohs micrographic surgery, or other appropriate treatment modalities based on the tumor's location, size, and degree of invasion.` https://escholarship.org/uc/item/48t2z35h Fri, 3 Jan 2025 00:00:00 +0000 Atmatzidis, Douglas H Zouzias, Christos Rogachefsky, Arlene Lee, Kristyna https://escholarship.org/uc/item/47m5h7vj A 68-year-old woman with a history of seizures on cenobamate presented with an itchy rash all over her body. The rash started about one month prior to her presentation to the dermatology clinic. The rash was initially treated with topical triamcinolone with improvement at one-month follow-up. However, four months later the rash flared and there was concern that cenobamate was the cause. Biopsy was performed showing vacuolar interface dermatitis with atrophy, suggestive of subacute lupus erythematosus. Blood work revealed positive antinuclear antibody, anti-ribonucleoprotein antibody, Sjogren Anti-SS-A and positive histone antibody. Given the worsening rash, positive labs, and cenobamate as the only changed drug several months before initial onset, she was diagnosed with drug-induced subacute cutaneous lupus erythematous and her cenobamate was discontinued. To the best of your knowledge, this is the first reported case of a medication in the carbamate family leading to drug induced... https://escholarship.org/uc/item/47m5h7vj Fri, 3 Jan 2025 00:00:00 +0000 Bhatti, Safiyyah A Joffe, Daniel Webster, Timothy Lee, Jason B https://escholarship.org/uc/item/47j356b3 Prescription trends of antipsychotic medications in dermatology among Medicare patients, 2013-2020 https://escholarship.org/uc/item/47j356b3 Fri, 3 Jan 2025 00:00:00 +0000 Roster, Katie Erickson, Katherine M Zufall, Alina Pereira, Frederick A https://escholarship.org/uc/item/3hm0x02t Topical treatment with glucocorticosteroids is a mainstay therapy for many dermatologic conditions. Though efficacious in many, topical therapies often fail to achieve desired positive results in clinical practice. SKIN-CAP spray (Cheminova Laboratories International SA, Madrid, Spain), a product containing activated zinc pyrithione, and subsequently found to have contained clobetasol, provided unprecedented clearing of psoriasis even when ultra-high potency topical glucocorticosteroids had failed. A PubMed for terms related to corticosteroids, topical therapy, patient adherence, and SKIN-CAP spray was performed. Articles from 1997 to 2023 were included in the review of SKIN-CAP spray. In this review, we report the background of SKIN-CAP as well as studies that were performed in an attempt to explain its perceived high efficacy. The remarkable efficacy that occurred with SKIN-CAP over other delivery systems for high potency topical corticosteroids was initially speculated to be... https://escholarship.org/uc/item/3hm0x02t Fri, 3 Jan 2025 00:00:00 +0000 Faulk, Carlton T Pittelkow, Mark R Feldman, Steven R Swanson, David L https://escholarship.org/uc/item/2jk4c4vq Erythematous-purpuric lesions in a one-year-old child revealing a case of acute hemorrhagic edema of childhood. https://escholarship.org/uc/item/2jk4c4vq Fri, 3 Jan 2025 00:00:00 +0000 Klitzke, Aline Schultz Goral, Roberto Andre Destefani, Carolina Airao Barbosa, Sandra Maria https://escholarship.org/uc/item/1xc4770m We present a patient with human immunodeficiency virus who developed multiple painful lesions that previously in the past had speciated as Cryptococcus neoformans cutaneously, and in the lung. Despite induction therapy for presumed re-infection, the patient did not improve so a biopsy was performed and this was speciated as Mycobacterium avium complex, with final diagnosis being disseminated Mycobacterium avium complex. This case highlights the importance of considering a broad differential diagnosis for any new lesions regardless of prior culture data. https://escholarship.org/uc/item/1xc4770m Fri, 3 Jan 2025 00:00:00 +0000 Patel, Jay Sayyadioskoie, Shannon Siatecka, Hanna Rosen, Theodore https://escholarship.org/uc/item/1vp142v5 Acquired reactive perforating collagenosis is an uncommon disorder that present as keratotic plugs on the skin owing to transepidermal perforation of dermal connective tissue. Etiology is unclear, although the condition has been associated with renal disease, diabetes, and HIV. It can frequently be misdiagnosed and lead to significant impact on quality of life, particularly in patients with skin of color. Herein, we present an skin of color patient with this condition who experienced severe pruritus over years before receiving a definitive diagnosis. Clobetasol improved her condition and quality of life over several months. https://escholarship.org/uc/item/1vp142v5 Fri, 3 Jan 2025 00:00:00 +0000 McClure, Spencer P Liakos, William Seger, Edward W Abdo, Maryam Murray, Abigail Gillihan, Ryan https://escholarship.org/uc/item/1qs895xr The growing demand for dermatologic services and shortage of dermatologic providers sets the stage for favorable market conditions to open a private dermatology practice. However, business-related education in medicine is lacking and the concept of starting a new practice may be daunting for dermatologists in any stage of training. We describe key components of starting a private dermatology practice. Topics include strategies to build a business plan, find a location, explore financial options, structure a legal framework, and incorporate branding and marketing. https://escholarship.org/uc/item/1qs895xr Fri, 3 Jan 2025 00:00:00 +0000 Birda, Abhinav Zaino, Mallory L Gold, Michael H Feldman, Steven R Yentzer, Brad A https://escholarship.org/uc/item/1m88116m Superficial leiomyosarcoma is a rare malignancy of muscular origin arising in the skin and soft tissues. Although wide local excision is the standard of care for these tumors, Mohs micrographic surgery is a promising treatment option as it provides for optimal margin control. The object of this systematic review is to examine the efficacy of micrographic surgery in the management of superficial leiomyosarcoma. A literature search was conducted using the PubMed/Medline and Cochrane databases; 14 studies representing 66 patients were included. Analysis demonstrated a notably low rate of recurrence (1.5%) and metastasis (0.0%) in tumors treated with micrographic surgery, contrasting with increased rates of recurrence and metastasis in tumors treated with wide local excision. These data may be influenced by a shortage of subcutaneous leiomyosarcoma in the included patients, as subcutaneous tumors are more likely to recur and metastasize. Further research is warranted to determine... https://escholarship.org/uc/item/1m88116m Fri, 3 Jan 2025 00:00:00 +0000 Olsen, Eric C Svoboda, Steven A https://escholarship.org/uc/item/0qj5d2h2 Subcutaneous fat necrosis of the newborn is a disease affecting neonates in the first weeks to months of life. It is characterized by dermal edema and underlying fat necrosis, typically presenting with firm, erythematous subcutaneous plaques and nodules, often located on the shoulders, back, buttocks, thighs, and extremities. We report an unusual presentation of liquefactive subcutaneous fat necrosis of the newborn in a two-week old term infant. The neonatal period was complicated by respiratory failure requiring intubation and severe encephalopathy. After completion of therapeutic hypothermia, the patient developed fluctuant and liquefactive nodules on her back. The neonate also had initial hypocalcemia that required treatment and then developed hypercalcemia, that resolved without intervention. The nodules and plaques on her back persisted into the first year of life and then gradually started to improve when she was 13 months old. https://escholarship.org/uc/item/0qj5d2h2 Fri, 3 Jan 2025 00:00:00 +0000 Esfandiari, Negar Porter, Hannah J Morley, Keith https://escholarship.org/uc/item/0bh1f71j Atrichia with papular lesions mimicking alopecia areata universalis https://escholarship.org/uc/item/0bh1f71j Fri, 3 Jan 2025 00:00:00 +0000 Antakanavar, Gajanand M Relhan, Vineet Chauhan, Neha https://escholarship.org/uc/item/09x443x6 Cantharidin, a natural toxin produced by the blister beetle, is a topical agent that induces acantholysis of the epidermis, breaking down desmosome plaques through the release of serine proteases. Cantharidin is available in three liquid forms: Ycanth (0.7%), Canthacur (0.7%), and Canthacur PS (1% cantharidin, 30% salicylic acid, 2% podophyllotoxin). Ycanth is used to treat molluscum contagiosum (MC). Canthacur is routinely used to treat a variety of dermatologic conditions including MC, plantar warts, and common warts, whereas Canthacur PS is a more potent formulation indicated for treatment of plantar warts only. The objective of this review is to highlight the efficacy, safety, and diverse use of topical cantharidin in the treatment of various skin conditions. Conditions in which treatment with topical cantharidin yielded a good-to-excellent response include MC, plantar warts, and common warts. Topical cantharidin treatment of anogenital warts yielded mixed results. None of... https://escholarship.org/uc/item/09x443x6 Fri, 3 Jan 2025 00:00:00 +0000 Ghali, Helana Smith, Logan R Krenitsky, Amanda Joseph, Alexia M Aung-Din, David Hennessy, Kerry Moore, Sarah Grichnik, James M https://escholarship.org/uc/item/0733g17s Wolf isotopic response refers to a new skin disorder manifesting in the area of a previous skin lesion that has healed. A variety of disease processes and dermatoses have been described that evoke an isotopic response. We report a man with metastatic hepatocellular carcinoma who received palliative radiation and later experienced a pembrolizumab-induced lichenoid dermatitis at the same site of radiation, representing a cutaneous immune-related adverse event displaying an isotopic response. https://escholarship.org/uc/item/0733g17s Fri, 3 Jan 2025 00:00:00 +0000 Jafari, Alexander J Kuraitis, Drew https://escholarship.org/uc/item/92m5p62m Patients with granulomatosis with polyangiitis occasionally present with cutaneous manifestations, which are important clues for the early diagnosis. Although pyoderma gangrenosum-like ulcers are rarely observed, a unique case with unusual clinical features is presented herein. A 75-year-old woman with positive proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) repeatedly developed aseptic abscesses on the abdomen, buttock, lower legs, and forearms. Histopathological features of biopsy taken from ulcers showed necrotizing granulomatous inflammation with multinucleated giant cells without leukocytoclastic vasculitis. The present case was initially diagnosed as limited granulomatosis with polyangiitis without renal and lung involvement. However, two years later, she died of cerebral hemorrhage. https://escholarship.org/uc/item/92m5p62m Thu, 31 Oct 2024 00:00:00 +0000 Yamamoto, Toshiyuki https://escholarship.org/uc/item/9107p3v4 Exudative (wet) age-related macular degeneration can be treated with the vascular endothelial growth factor (VEGF)-inhibiting monoclonal antibody bevacizumab. Currently, bevacizumab therapy is associated with known skin-related side effects, such as rash, mucosal hemorrhage, and hemorrhagic ulcers. While subungual "splinter" hemorrhage is a documented side effect of VEGF receptor antagonists and Raf protein inhibitors, there are no prior reports of bevacizumab-induced subungual hemorrhage to the best of our knowledge. Thus, we present the case of a 71-year-old female diagnosed with bilateral age-related macular degeneration, who, during six months of intravitreal bevacizumab treatment, began noticing fingernail discoloration, described as similar to that of a bruise. Given our patient's history of bevacizumab therapy and the documented reports of bevacizumab-associated mucosal and ulcerative hemorrhage, we hypothesize that the discoloration and hemorrhage are likely unreported... https://escholarship.org/uc/item/9107p3v4 Thu, 31 Oct 2024 00:00:00 +0000 Owen, Jacob J Long, Sloan Mullinax, Kimberly Griffin, John https://escholarship.org/uc/item/8v94f6ks Granuloma annulare (GA) is an idiopathic inflammatory skin condition with a chronic and unpredictable course. Although localized GA is usually cleared with topical or systemic corticosteroids, generalized GA is often difficult to treat owing to the lack of treatment options and recurrence with treatment. Recent evidence has helped to elucidate the etiology behind GA, with growing confirmation for the use of JAK inhibitors as a possible treatment for GA. We present a 61-year-old woman with recalcitrant GA who responded successfully to pulse therapy upadacitinib, a JAK1 inhibitor. Our findings demonstrate the utility of this alternative and practical treatment strategy that may reduce the cumulative toxicity of upadacitinib and optimize its risk/benefit ratio. https://escholarship.org/uc/item/8v94f6ks Thu, 31 Oct 2024 00:00:00 +0000 Trees, Alanna Smithem, Cassi Bialick, Mallorie Kabigting, Filamer https://escholarship.org/uc/item/8g94r7fr Protothecosis is a rare but emerging infectious disease, caused by algae from the genus Prototheca. It presents predominantly as cutaneous lesions and poses a diagnostic challenge owing to its diverse clinical presentation. Typically, it occurs in exposed areas of the skin, associated with trauma. Diagnosis relies mainly on histopathology and culture. This article presents an elderly diabetic woman with cutaneous protothecosis from Rio de Janeiro, Brazil. We emphasize clinical features, histopathology, and successful treatment with itraconazole, along with a brief review of the 12 previously reported cases from Brazil. https://escholarship.org/uc/item/8g94r7fr Thu, 31 Oct 2024 00:00:00 +0000 Aguinaga, Felipe Carranza, Katherine Azulay, Vitoria Zarco, Olga Milena Quintella, Danielle Carvalho Cuzzi, Tullia https://escholarship.org/uc/item/8698d218 What your patients need to know about skin supplements https://escholarship.org/uc/item/8698d218 Thu, 31 Oct 2024 00:00:00 +0000 Katta, Rajani She, Jenny Perez-Sanchez, Ariadna https://escholarship.org/uc/item/82h1b1k8 Phacomatosis spilorosea and phacomatosis melanorosea: further phenotype expansion https://escholarship.org/uc/item/82h1b1k8 Thu, 31 Oct 2024 00:00:00 +0000 Torchia, Daniele https://escholarship.org/uc/item/7zp7j0mt Comments on a recent paper Jellyfish envenomation with delayed hypersensitivity and concurrent SARS-CoV-2 infection https://escholarship.org/uc/item/7zp7j0mt Thu, 31 Oct 2024 00:00:00 +0000 Crow, Gerald L Holland, Brenden S https://escholarship.org/uc/item/7t19r3gx Pseudoxanthoma elasticum-like papillary dermal elastolysis is a rare, benign, acquired, gradually-developing chronic elastic tissue disorder that almost exclusively affects post-menopausal women. It is essential to recognize this disease as it mimics the inherited pseudoxanthoma clinically. The pathophysiology behind this disease is multifactorial; it includes intrinsic skin aging, ultraviolet radiation exposure, and genetic components. We report two patients with pseudoxanthoma elasticum-papillary dermal elastolysis diagnosis based on clinicopathologic correlation in two post-menopausal women who presented with multiple asymptomatic papules over the neck that developed gradually without systemic involvement, and were managed conservatively. We also discuss this disease's clinical, dermoscopic, and histopathologic features. https://escholarship.org/uc/item/7t19r3gx Thu, 31 Oct 2024 00:00:00 +0000 Murshidi, Rand Bani Hamad, Salsabiela Al-Tarawneh, Awad