Intact epidermal cysts, similarly, showcase arborizing telangiectasia; however, ruptured epidermal cysts demonstrate peripheral, linearly branching vessels (45). As detailed in reference (5), a peripheral brown rim, linear vascular structures, and a consistent yellow background across the entire lesion are common dermoscopic findings for both steatocystoma multiplex and milia. It's noteworthy that, in contrast to the linear vessel structures observed in other cystic lesions, pilonidal cysts are marked by the presence of dotted, glomerular, and hairpin-shaped vessels. The differential diagnosis for pink nodular lesions must incorporate pilonidal cyst disease, amelanotic melanoma, basal cell carcinoma, squamous cell carcinoma, pyogenic granuloma, lymphoma, and pseudolymphoma (3). A pink background, central ulceration, peripherally arranged dotted vessels, and white lines are seemingly prevalent dermoscopic characteristics of pilonidal cyst disease, as observed in our cases and two previously reported cases. Our observations on pilonidal cyst disease show that dermoscopically, central, yellowish, structureless areas, alongside peripheral hairpin and glomerular vessels, are present. In essence, pilonidal cysts can be clearly distinguished from other skin tumors based on the previously described dermoscopic characteristics, and dermoscopy serves to validate clinical diagnoses of suspected pilonidal cysts. To better understand the typical dermoscopic features of this disease and their incidence, further studies are needed.
Dear Editor, in the English medical literature, the uncommon condition of segmental Darier disease (DD) has been reported in about 40 instances. A hypothesis posits a post-zygotic somatic mutation within the calcium ATPase pump, limited to lesional skin, as a potential driver of the disease. Segmental DD type 1 shows lesions aligned with Blaschko's lines, exclusively on one side, while segmental DD type 2 presents focal areas of increased severity in patients with generalized DD (1). Diagnosing type 1 segmental DD is problematic because family history is often negative, the disease's onset typically occurs late in the third or fourth decade of life, and there are no apparent characteristics linked to DD. A differential diagnosis for type 1 segmental DD involves acquired papular dermatoses, including lichen planus, psoriasis, lichen striatus, or linear porokeratosis, often arranged in linear or zosteriform patterns (2). A report of two cases of segmental DD is presented, the first being a 43-year-old female patient, who experienced pruritic skin changes that persisted for five years, with a history of worsening symptoms during allergy seasons. The left abdominal and inframammary regions exhibited a swirling array of small, keratotic papules, light brownish to reddish in hue, as observed during the examination (Figure 1a). Figure 1b highlights dermoscopic findings: polygonal or roundish yellowish-brown areas, surrounded by whitish, structureless tissue. Sports biomechanics Biopsy specimen (Figure 1, c) revealed hyperkeratosis, parakeratosis, and dyskeratotic keratinocytes, which correlate histopathologically with dermoscopic brownish polygonal or round areas. Marked improvement was observed in the patient, as evidenced by Figure 1, panel d, after the administration of 0.1% tretinoin gel. In the second case, a 62-year-old female presented with a zosteriform rash on her right upper abdomen, consisting of small red-brown papules, eroded papules, and yellowish crusts (Figure 2a). Surrounding structureless areas of whitish and reddish coloration encircled the polygonal, roundish, yellowish areas visualized in the dermoscopic image (Figure 2b). Microscopic examination revealed the key features of compact orthokeratosis, interspersed with small parakeratosis foci. Dyskeratotic keratinocytes within a marked granular layer and suprabasal acantholytic foci supported the diagnosis of DD (Figure 2, d, d). The patient's condition manifested improvement subsequent to being prescribed topical steroid cream and 0.1% adapalene cream. A final diagnosis of type 1 segmental DD was reached in both instances, confirming the clinico-histopathologic correlation; a definitive exclusion of acantholytic dyskeratotic epidermal nevus, indistinguishable from segmental DD clinically and histologically, was not possible based solely on the histopathology report. Despite a late presentation and worsening due to environmental factors such as heat, sunlight, and sweat, a diagnosis of segmental DD was strengthened. Type 1 segmental DD is usually diagnosed through the combination of clinical and histopathological data, but dermoscopy effectively contributes to the diagnosis by eliminating potential alternatives and recognizing their unique dermoscopic characteristics.
The urethra, although rarely involved in condyloma acuminatum cases, is typically restricted to the most distal region when affected. Urethral condylomas are addressed through a spectrum of treatment options. Extensive and variable treatments consist of laser treatment, electrosurgery, cryotherapy, and topical applications of cytotoxic agents like 80% trichloroacetic acid, 5-fluorouracil cream (5-FU), podophyllin, podophyllotoxin, and imiquimod. For treating intraurethral condylomata, laser therapy remains the preferred form of treatment. This case study describes the effective treatment of meatal intraurethral warts in a 25-year-old male patient through the application of 5-FU, following unsuccessful therapies including laser treatment, electrosurgery, cryotherapy, imiquimod, and 80% trichloroacetic acid.
Ichthyoses, a heterogeneous group of skin conditions, display characteristic features of erythroderma and generalized scaling. A comprehensive characterization of the association between ichthyosis and melanoma is lacking. An elderly patient with congenital ichthyosis vulgaris presents here with an unusual case of palm acral melanoma. Ulceration accompanied the superficially spreading melanoma, as revealed by the biopsy. No acral melanomas have been reported, to the best of our current understanding, in individuals suffering from congenital ichthyosis. Patients with ichthyosis vulgaris should, nevertheless, undergo regular clinical and dermatoscopic screening processes to detect melanoma due to its potential invasiveness and metastasis.
We describe the case of a 55-year-old man, who was diagnosed with penile squamous cell carcinoma (SCC). fungal infection The patient's penis housed a mass, incrementally expanding in size. A portion of the penis was surgically removed to address the mass, through a partial penectomy. Through histopathological analysis, a highly differentiated squamous cell carcinoma was ascertained. Human papillomavirus (HPV) DNA was found to be present by means of polymerase chain reaction. Analysis of the squamous cell carcinoma specimen indicated the presence of HPV type 58, as determined by sequencing.
Diverse genetic syndromes frequently display a concurrence of cutaneous and extracutaneous abnormalities, a phenomenon extensively characterized by medical professionals. Undoubtedly, additional and previously unrecognized symptom combinations may remain to be elucidated. check details A case report concerns a patient admitted to the Dermatology Department for multiple basal cell carcinomas originating in a nevus sebaceous. Along with cutaneous malignancies, the patient displayed palmoplantar keratoderma, prurigo nodularis, hypothyroidism, multiple lumbar abnormalities, a uterine myoma, an ovarian cyst, and a highly atypical colon adenoma. A confluence of multiple disorders might suggest a genetic basis for the ailments.
Drug-induced vasculitis arises from drug exposure, initiating the inflammation of small blood vessels, ultimately damaging the affected tissue. Medical publications have described infrequent cases of drug-induced vasculitis, often connected with chemotherapy or chemoradiotherapy treatments. The medical evaluation of our patient led to a diagnosis of small cell lung cancer, stage IIIA (cT4N1M0). The second cycle of carboplatin and etoposide (CE) chemotherapy, administered four weeks beforehand, was followed by the emergence of cutaneous vasculitis and a rash, specifically affecting the lower extremities of the patient. In the wake of CE chemotherapy discontinuation, symptomatic relief was achieved through the use of methylprednisolone. With the prescribed corticosteroid treatment, there was a positive change in the local indicators. After the chemo-radiotherapy course was finished, the patient continued with four cycles of consolidation chemotherapy containing cisplatin for a total of six cycles. A clinical review substantiated the progressive reduction of the cutaneous vasculitis. Elective radiotherapy of the brain was carried out in the post-consolidation chemotherapy phase. Clinical monitoring of the patient continued until the recurrence of the disease. Additional rounds of chemotherapy were given for the platinum-resistant condition. Sadly, the patient's life ended seventeen months after receiving an SCLC diagnosis. This case, to our knowledge, is the first instance in the medical literature of lower extremity vasculitis occurring in a patient receiving both radiotherapy and CE chemotherapy concurrently, as part of the primary treatment for SCLC.
The occupational groups of dentists, printers, and fiberglass workers are traditionally susceptible to allergic contact dermatitis (ACD) caused by (meth)acrylates. Artificial nails have been implicated in reported instances of adverse events, impacting nail technicians and those who choose to wear them. The problem of ACD, associated with (meth)acrylates found in artificial nails, warrants attention from both nail professionals and consumers. A 34-year-old woman working in a nail art salon for two years exhibited severe hand dermatitis, with a particular focus on her fingertips, accompanied by frequent eruptions of facial dermatitis. The patient's artificial nails, in use for the past four months, were a result of her nails' tendency to split, which required regular gel treatment for protection. At work, she suffered a series of asthmatic episodes. Patch tests were carried out across baseline series, acrylate series, and the patient's own material.