Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Diagnosis of Telangiectasia Macularis Eruptiva Perstans Using Dermoscopy and Reflectance Confocal Microscopy: A Case Report.","authors":"Jie Zhou, Shichen Jiang, Weimian Xiao","doi":"10.2147/CCID.S573062","DOIUrl":"10.2147/CCID.S573062","url":null,"abstract":"<p><p>Telangiectasia macularis eruptiva perstans (TMEP) is a rare subtype of cutaneous mastocytosis with a favorable prognosis and typically no systemic involvement. Although mast cell infiltration is a key histopathological feature, the cost and invasiveness of biopsy can deter patients from undergoing the procedure. Non-invasive techniques such as dermoscopy and reflectance confocal microscopy (RCM) can be helpful in the diagnosis of TMEP. However, the dermoscopic and RCM features of TMEP have not been fully elucidated. Herein, we report a case of TMEP and describe its dermoscopic and RCM features.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"573062"},"PeriodicalIF":2.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Facial and Scalp Lupus Erythematosus Tumidus: Diagnostic Challenges from Long-Term Misdiagnosis and Conflicting Histopathology.","authors":"Menglin Li, Tao Guo, Junling Zhang","doi":"10.2147/CCID.S636190","DOIUrl":"10.2147/CCID.S636190","url":null,"abstract":"<p><strong>Background: </strong>Lupus erythematosus tumidus (LET) is a rare photosensitive skin lupus subtype. Its erythematous swelling easily mimics erysipelas, cellulitis or herpes zoster, leading to frequent misdiagnosis. Atypical cases complicated by interface dermatitis and patient self-medication create prominent differential diagnostic difficulties.</p><p><strong>Case presentation: </strong>A 58-year-old woman had scalp and facial erythema swelling for 1 year, worsened over 4 days. She was repeatedly misdiagnosed with bacterial infectious skin diseases and given ineffective antibiotics. Before admission, she took herbal decoctions and received bloodletting acupuncture by herself, aggravating facial edema. Examination showed infiltrative erythema and scalp alopecia. Full autoantibody, complement and routine lab tests were nearly normal. Cheek biopsy showed typical LET mucin deposition and periadnexal lymphocytic infiltration, while scalp biopsy unexpectedly revealed focal basal liquefaction degeneration. The final diagnosis of atypical LET was made after comprehensive clinicopathological evaluation. Combined hydroxychloroquine and methylprednisolone therapy induced obvious lesion remission within 6 months of follow-up.</p><p><strong>Conclusion: </strong>This atypical LET case illustrates key differential diagnostic traps caused by long-term misdiagnosis and conflicting pathological findings. Unsupervised herbal treatment and blood-letting acupuncture disturbs clinical manifestations and delays formal therapy. For patients presenting with facial edematous erythema accompanied by atypical epidermal pathological changes, comprehensive serological screening and thorough histopathological examination are warranted. Early clinicopathological combined diagnosis, antimalarial drugs and strict sun protection help avoid misdiagnosis and recurrence.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"636190"},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Predictors of Clinically Significant Adverse Effects of Isotretinoin in Acne Vulgaris: A Retrospective Cohort Study from Saudi Arabia.","authors":"Saeed A Al-Qahtani, Amal A Alqahtani, Hadi Almansour, Moaddey Alfarhan, Amani Khardali, Mohammad Jaffar Sadiq Mantargi, Ali Mohamed Alshabi, Saleh Alghamdi, Mohammad Algarni","doi":"10.2147/CCID.S624648","DOIUrl":"10.2147/CCID.S624648","url":null,"abstract":"<p><strong>Purpose: </strong>Isotretinoin remains the most effective treatment for moderate-to-severe acne vulgaris; however, its use is frequently associated with mucocutaneous and metabolic adverse effects that may necessitate active clinical intervention. Data evaluating predictors of clinically significant toxicity in Saudi populations remain limited.</p><p><strong>Patients and methods: </strong>A retrospective cohort study was conducted at a tertiary academic hospital in Saudi Arabia. Electronic medical records of patients with acne vulgaris treated with isotretinoin between January 2020 and December 2024 were reviewed. Demographic variables, acne severity, isotretinoin dosing characteristics, laboratory findings, adverse effects, management strategies, and treatment outcomes were extracted. Multivariable regression analysis was performed to identify predictors of adverse effects requiring clinical intervention.</p><p><strong>Results: </strong>A total of 444 patients were included. Most participants were aged 21-30 years (60.4%), and females represented 50.9% of the cohort. Clinical intervention was required in 70.7% of patients, including supportive care, treatment reduction and dose discontinuation to manage isotretinoin-related adverse effects. Mucocutaneous adverse effects, particularly cheilitis and xerosis, were the most frequently documented complications. Laboratory abnormalities were observed less frequently, although elevated LDL levels were identified in 9.9% of patients, followed by elevated total cholesterol (7.2%) and triglycerides (4.5%). Elevated liver enzymes were relatively uncommon (AST 4.1%, ALT 3.2%). Higher cumulative dose, dose escalation during therapy, and higher maximum dose significantly increased the likelihood of requiring clinical intervention. Female sex and higher body weight were associated with lower odds of intervention. Major improvement was achieved in 37.4%, complete clearance in 28.8%, giving a combined rate of 66.2% while recurrence after discontinuation occurred in 19.4%.</p><p><strong>Conclusion: </strong>Isotretinoin, proved efficacious clinically in the management of acne vulgaris, however was identified to be associated with high number of adverse effects which require active management. Multivariable regression identified that the increasing dose and cumulative dose were the most influential determinants of the drug therapy. Particularly, lipid abnormalities (elevated LDL) were clinically relevant for the included cohort of patients. The outcomes therefore emphasize the need for a personalised approach to dosing along with continuous monitoring to achieve the optimal results.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"624648"},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tofacitinib as a Promising Therapeutic Option for Vitiligo: A Systematic Review.","authors":"Mansooreh Ahmadkhani, Tahereh Dara, Mohsen Zabihi, Fatemeh Saghafi","doi":"10.2147/CCID.S628682","DOIUrl":"10.2147/CCID.S628682","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo is a chronic autoimmune disease characterized by depigmented patches on the skin. Despite the availability of several therapeutic options, treatment outcomes remain variable, particularly in extensive or refractory disease. Tofacitinib, a Janus kinase (JAK) inhibitor, has emerged as a potential therapeutic option for vitiligo. Here we aimed to review the existing evidence on the efficacy and safety of tofacitinib for the treatment of vitiligo.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Scopus, and Web of Science identify English-language studies evaluating the use of tofacitinib in vitiligo patients.</p><p><strong>Results: </strong>Twenty-five studies evaluating oral and topical tofacitinib were reviewed. Reported repigmentation rates ranged from 14.4% to 90%, with several studies also demonstrating improvements in disease activity scores. Most adverse events were mild and infrequent. However, the available evidence is derived predominantly from case reports, case series, and small observational studies, and many patients received concomitant therapies such as phototherapy, limiting the interpretation of treatment efficacy.</p><p><strong>Conclusion: </strong>Current evidence suggests that tofacitinib may represent a promising therapeutic option for vitiligo. However, the available evidence remains limited by the predominance of small uncontrolled studies, heterogeneous treatment protocols, and concomitant therapies. Larger prospective controlled studies are needed to better establish its efficacy, long-term safety, and role within current vitiligo treatment strategies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"628682"},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thematic Evolution and Diversification of Bullous Pemphigoid Research: A Bibliometric Analysis, 1959-2025.","authors":"Ming-Chi Lu, Meng-Chi Chiu, Malcolm Koo","doi":"10.2147/CCID.S622840","DOIUrl":"10.2147/CCID.S622840","url":null,"abstract":"<p><strong>Background: </strong>Bullous pemphigoid research spans autoantigen and basement membrane biology, diagnosis, comorbidity, inflammatory pathways, and treatment, but its long-term conceptual development has not been mapped.</p><p><strong>Methods: </strong>English-language articles and reviews indexed in the Science Citation Index Expanded through December 31, 2025, were retrieved from title, author-keyword, and abstract fields. Records underwent AI-assisted first-pass screening followed by human review. Bibliometrix and VOSviewer were used for parameter-tested author-keyword clustering and a full-corpus title-term sensitivity analysis.</p><p><strong>Results: </strong>Of 3,471 screened records, 2,121 were eligible. Annual output accelerated after 2015 and exceeded 100 publications in 2022, 2023, and 2025. Author keywords were available for 55.1% of publications. The selected network contained 112 keywords, 889 links, and eight clusters. Among 924 keyword-mappable publications, autoantigens, autoantibodies, and basement membrane zone biology declined from 51.9% in 1959-1998 to 14.6% in 2021-2025. Therapeutic management and clinical outcomes increased from 7.7% to 37.8%, epidemiology and comorbidities from 1.9% to 20.8%, dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid from 0% to 12.7%, and immune checkpoint inhibitor-associated bullous pemphigoid from 0% to 10.8%. Diagnosis and related autoimmune blistering diseases peaked at 50.0% in 1999-2013 before declining to 24.3%. Inflammatory and immune effector mechanisms showed no statistically significant period variation after multiplicity adjustment. The title-term analysis recovered the major domains.</p><p><strong>Conclusion: </strong>Bullous pemphigoid research diversified from structural, immunological, and diagnostic foundations toward treatment, clinical outcomes, comorbidity, and medication-associated disease. Although author-keyword availability was incomplete and varied substantially over time, the findings provide a longitudinal map of the field, with temporal estimates reflecting relative prominence within keyword-mappable publications.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"622840"},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab for Drug-Induced Bullous Pemphigoid: A Case Series and Literature Review.","authors":"Nawara Sakpuwadol, Suthinee Rutnin, Wimolsiri Iamsumang, Kumutnart Chanprapaph","doi":"10.2147/CCID.S619965","DOIUrl":"10.2147/CCID.S619965","url":null,"abstract":"<p><p>Drug-induced bullous pemphigoid (BP) is an increasingly recognized variant of BP with unique challenges in management, particularly when patients require continuation of the offending medication or are contraindicated to conventional immunosuppressive therapies. We report 4 patients with drug-induced BP, three associated with dipeptidyl peptidase-4 inhibitors and one with immune checkpoint inhibitor, successfully treated with dupilumab. All four patients had failed or were intolerant to conventional therapies. Following dupilumab initiation, all patients experienced significant improvement in pruritus within 2 weeks. Complete remission was achieved in 3 patients within 1-5 months of treatment and one patient had stable disease, enabling him to resume pembrolizumab therapy for esophageal cancer while on dupilumab. No significant adverse effects were reported during treatment periods. Our findings, supported by a literature review, suggest that dupilumab demonstrates promising efficacy and safety in treating drug-induced BP, with rapid improvement in pruritus and resolution of skin lesions. It may offer a valuable therapeutic alternative as a steroid sparing agent for elderly patients with multiple comorbidities and provides the potential to continue necessary medications (eg, cancer therapy) that may have triggered BP.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"619965"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aesthetic Thermotherapy-Induced Panniculitis in a Patient with Psoriasis: A Case Report.","authors":"Ximei Ma, Lan Ying","doi":"10.2147/CCID.S628906","DOIUrl":"10.2147/CCID.S628906","url":null,"abstract":"<p><strong>Purpose: </strong>We describe a rare case of panniculitis following aesthetic thermotherapy in a patient with psoriasis, who responded well to tofacitinib. To the best of our knowledge, this is the first reported case of aesthetic thermotherapy-induced panniculitis in a patient with psoriasis.</p><p><strong>Case report: </strong>A 39-year-old female with a 4-year history of psoriasis vulgaris developed multiple subcutaneous nodules on the extremities and abdomen one month after completing a one-week course of whole-body aesthetic thermotherapy (approximately 40-50 ^<b>°</b> C, approximately one hour per session). Physical examination revealed firm, mobile, mildly tender nodules, with the largest measuring 5 cm in diameter and overlying skin appearing normal or slightly reddish. Laboratory investigations to exclude other causes of panniculitis, including autoimmune markers and infection screening, were unremarkable except for an elevated C-reactive protein level (118.6 mg/L). Ultrasound demonstrated subcutaneous inflammatory changes, and percutaneous biopsy confirmed chronic inflammation with histiocytic infiltration, consistent with panniculitis. The patient was treated with oral tofacitinib (5 mg once daily) for six months, resulting in significant clinical improvement during follow-up; the underlying psoriasis remained stable.</p><p><strong>Conclusion: </strong>Aesthetic thermotherapy can rarely induce panniculitis, especially in patients with underlying psoriasis and immune dysregulation. This case highlights the need to consider panniculitis when patients present with new subcutaneous nodules after cosmetic thermal procedures. Tofacitinib appears to be an effective treatment option.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"628906"},"PeriodicalIF":2.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapokibart for Facial-Predominant AD-Like Dermatoses: A Retrospective Real-World Case Series Highlighting Response Heterogeneity.","authors":"Yunkai Zhu, Jingchun Chen, Peng Wang, Peiyi Feng, Xia Wang","doi":"10.2147/CCID.S632078","DOIUrl":"10.2147/CCID.S632078","url":null,"abstract":"<p><strong>Background: </strong>Facial-predominant inflammatory dermatoses are diagnostically heterogeneous and may overlap with atopic dermatitis (AD), contact dermatitis, rosacea-like inflammation, and autoimmune mimics. Stapokibart, an IL-4Rα-targeted monoclonal antibody, has demonstrated efficacy in moderate-to-severe AD, but real-world experience in facial-predominant AD-like presentations remains limited.</p><p><strong>Methods: </strong>We retrospectively reviewed five unpublished patients with facial-predominant inflammatory dermatoses treated with stapokibart in routine practice. Clinical phenotype, diagnostic work-up, prior and concomitant therapy, dosing, symptom scores, treatment course, recurrence, and adverse events were summarized descriptively. The cohort was not intended as a diagnostically uniform efficacy population, and no formal hypothesis testing was performed.</p><p><strong>Results: </strong>Five women aged 28-75 years were included. Pruritus numerical rating scale changed from a median of 3 (range, 2-4) at baseline to 1 (range, 0-3) at first follow-up; four patients improved and one worsened. All three patients with a well-supported facial-predominant AD phenotype showed rapid improvement in facial lesions and pruritus after stapokibart. One of these patients developed an injection-site reaction that led to treatment discontinuation; no serious adverse events were observed. One patient initially treated for AD-like facial dermatitis was subsequently evaluated for possible early clinically amyopathic dermatomyositis after telangiectatic and mildly atrophic features became more apparent. Another patient with an incompletely characterized AD-like facial eruption worsened on day 2 after stapokibart.</p><p><strong>Conclusion: </strong>In this small case series, rapid improvement was observed in all three patients with a well-supported facial-predominant AD phenotype, whereas atypical or incompletely characterized eruptions showed greater diagnostic complexity and variable outcomes. These preliminary observations support further investigation of stapokibart in facial-predominant AD while underscoring the need for careful phenotyping before IL-4Rα blockade.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"632078"},"PeriodicalIF":2.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isotretinoin-Associated Serum Creatinine Elevation During Acne Treatment: A Case Report.","authors":"Yi Chen, Ye-Ping Qin, Yan Li, Jing-Peng Chen, Ren-Jie Li, Ruo-Zhou Qi, Bao-Chen Zhu, Hui-Shang Feng","doi":"10.2147/CCID.S628487","DOIUrl":"10.2147/CCID.S628487","url":null,"abstract":"<p><strong>Background: </strong>Isotretinoin is first-line for moderate-to-severe acne. Its common adverse reactions involve the mucocutaneous system, liver, and lipid metabolism, while renal dysfunction is often overlooked with scarce reports.</p><p><strong>Case presentation: </strong>A 34-year-old female without prior renal dysfunction received isotretinoin 20 mg/day for acne. Serum creatinine rose after 3 weeks, reached 82.6 μmol/L by week 5, then decreased stepwise after discontinuation and normalized on follow-up. Urinary ultrasound was unremarkable.</p><p><strong>Observations and analysis: </strong>The Naranjo score was 7, indicating a probable association. Unlike previous renal adverse events presenting with dysuria, edema, flank pain, or hematuria, this case was asymptomatic, which may be attributed to individual differences in drug metabolism.</p><p><strong>Conclusion: </strong>This case report describes a mild elevation in serum creatinine that was possibly associated with isotretinoin therapy and highlights the importance of clinical awareness of potential renal function changes during treatment, particularly in patients receiving long-term therapy or concomitant medications.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"628487"},"PeriodicalIF":2.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Squamous Cell Carcinoma Arising Within a Mycosis Fungoides Plaque: A Case Report.","authors":"Ying Zhang, Xueying Wang, Xiaoli Jin, Yanhua Wang","doi":"10.2147/CCID.S625749","DOIUrl":"10.2147/CCID.S625749","url":null,"abstract":"<p><strong>Background: </strong>Squamous cell carcinoma (SCC) rarely develops within mycosis fungoides (MF) lesions. Recognizing a new epithelial malignancy within a longstanding MF plaque is important because clinical change may otherwise be attributed to lymphoma progression.</p><p><strong>Case presentation: </strong>A 71-year-old man with a 30-year history of MF, no prior systemic therapy, psoralen plus ultraviolet A phototherapy, or topical chemotherapy, and limited prediagnostic narrowband ultraviolet B exposure developed a rapidly enlarging ulcerated mass within a lumbar MF plaque. Histopathology showed moderately differentiated keratinizing SCC adjacent to plaque-stage MF. Immunohistochemistry demonstrated a mixed CD4/CD8 lymphoid infiltrate; Ki-67 labeling was approximately 5% in the MF lymphoid compartment and 40-50% in SCC epithelial cells. Wide local excision with 1-cm margins, bilateral advancement flaps, and full-thickness skin grafting achieved clear margins.</p><p><strong>Results: </strong>Recovery was uncomplicated, and no clinical recurrence was detected at 6 months. The surrounding MF plaques appeared less erythematous and infiltrated, although the significance of this observation is uncertain.</p><p><strong>Conclusion: </strong>A rapidly growing, ulcerated, or otherwise changing lesion within longstanding MF warrants prompt biopsy to exclude a second cutaneous malignancy. Compartment-specific interpretation of immunohistochemical findings is essential, and surgical excision can be feasible in MF-affected skin.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"625749"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}