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Bullous herpes zoster in a patient with bullous systemic lupus erythematosus. 系统性红斑狼疮患者的大疱性带状疱疹。
Dermatology online journal Pub Date : 2024-12-15 DOI: 10.5070/D330664685
Sandra Jaroonwanichkul, Yen Luu, Katherine Nguyen, Hongyan Dai, Anand Rajpara
{"title":"Bullous herpes zoster in a patient with bullous systemic lupus erythematosus.","authors":"Sandra Jaroonwanichkul, Yen Luu, Katherine Nguyen, Hongyan Dai, Anand Rajpara","doi":"10.5070/D330664685","DOIUrl":"10.5070/D330664685","url":null,"abstract":"<p><p>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 the diagnosis of bullous herpes zoster, leading to delays in diagnosis and management. Given high rates of morbidity and mortality in disseminated herpes zoster infection, the emergence of bullae in patients with SLE should raise a high index of suspicion for herpes zoster infection and prompt systemic workup.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rippled-pattern basal cell carcinoma: a unique characteristic of an otherwise common diagnosis. 波纹型基底细胞癌：一个独特的特征，否则常见的诊断。
Dermatology online journal Pub Date : 2024-12-15 DOI: 10.5070/D330664695
Douglas H Atmatzidis, Christos Zouzias, Arlene Rogachefsky, Kristyna Lee
{"title":"Rippled-pattern basal cell carcinoma: a unique characteristic of an otherwise common diagnosis.","authors":"Douglas H Atmatzidis, Christos Zouzias, Arlene Rogachefsky, Kristyna Lee","doi":"10.5070/D330664695","DOIUrl":"10.5070/D330664695","url":null,"abstract":"<p><p>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.`.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Skin necrosis following digital wart intralesional injection of cantharidin. 数字疣局部注射卡他林后皮肤坏死。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564434
Sebastian D Arango, Tristan B Weir, Andrew J Miller, Meredith N Osterman
{"title":"Skin necrosis following digital wart intralesional injection of cantharidin.","authors":"Sebastian D Arango, Tristan B Weir, Andrew J Miller, Meredith N Osterman","doi":"10.5070/D330564434","DOIUrl":"10.5070/D330564434","url":null,"abstract":"<p><p>A right-hand-dominant female presented 5 weeks following a right middle finger intralesional cantharidin injection for a common wart by a dermatologist. The patient experienced progressive stiffness, blistering, swelling, pain, and ultimately, full-thickness skin necrosis surrounding the injection site. Careful debridement followed by a full-thickness skin graft was performed with no evidence of involvement of the germinal matrix or terminal extensor tendon. At the 7-month postoperative mark, the patient's graft exhibited favorable healing and improved functionality that did not require further follow-up. Intralesional injection of cantharidin solutions for digital warts leads to progressive skin necrosis. Our case required prompt debridement and defect coverage. Involvement of the underlying anatomical structures was also a concern. Dermatologists and hand surgeons should be familiar with this complication as intralesional cantharidin injections are contraindicated.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The use of dupilumab for the treatment of alopecia areata. 使用杜必鲁单抗治疗斑秃。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564438
Iman Ali, Emelie E Nelson, Brandy Phan, Veda Kulkarni, Christina McGee, Emily Cao, Rashid M Rashid
{"title":"The use of dupilumab for the treatment of alopecia areata.","authors":"Iman Ali, Emelie E Nelson, Brandy Phan, Veda Kulkarni, Christina McGee, Emily Cao, Rashid M Rashid","doi":"10.5070/D330564438","DOIUrl":"https://doi.org/10.5070/D330564438","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Botryomycosis associated with retained hair piece and accompanying ethnic hair considerations. 与残留发片有关的肉孢子菌病以及随之而来的种族头发问题。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564440
Anna Conner, Amy Musiek, Ethan Barnes, Nupur Singh, Zachary Nahmias
{"title":"Botryomycosis associated with retained hair piece and accompanying ethnic hair considerations.","authors":"Anna Conner, Amy Musiek, Ethan Barnes, Nupur Singh, Zachary Nahmias","doi":"10.5070/D330564440","DOIUrl":"https://doi.org/10.5070/D330564440","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring opposing arguments in the call for randomized controlled trials to demonstrate benefit of Mohs micrographic surgery for cutaneous melanoma. 在呼吁进行随机对照试验以证明莫氏显微放射手术治疗皮肤黑色素瘤的益处时，探讨了对立的论点。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564424
Nahid Y Vidal, Keegan O'Hern, Aaron Steen, Sama Carley, Ji Won Ahn
{"title":"Exploring opposing arguments in the call for randomized controlled trials to demonstrate benefit of Mohs micrographic surgery for cutaneous melanoma.","authors":"Nahid Y Vidal, Keegan O'Hern, Aaron Steen, Sama Carley, Ji Won Ahn","doi":"10.5070/D330564424","DOIUrl":"https://doi.org/10.5070/D330564424","url":null,"abstract":"<p><strong>Importance: </strong>The call for robust randomized clinical trials (RCTs) comparing Mohs micrographic surgery (MMS) with wide local excision for treatment of melanoma has stymied the development of guidelines for MMS despite growing evidence of benefit. This commentary explores the controversy by detailing opposing arguments, reviewing the relevant evidence supporting the use of MMS for early-stage melanoma, and discussing the role that RCTs may play in development of national guidelines for surgical treatment options for melanoma. Randomized clinical trials are considered the gold standard of clinical research, but there are no such trials currently to support MMS for melanoma. However, there is a growing literature base of retrospective and prospective cohorts and meta-analyses consistently demonstrating the efficacy and cost-effectiveness of MMS for melanoma. The dearth of clear consensus guidelines has contributed to confusion by referring specialties, controversy across specialties managing melanoma, and inequality in access. Recognizing that this is an ongoing area of discussion within dermatologic surgery, we explore opposing arguments with regard to the demand for RCT data to support dermatologic surgery practices.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fungating mass on the breast of a male patient. 一名男性患者乳房上的瘘管肿块。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564436
Jeremy K Bray, Christina Dai, Olayemi Sokumbi
{"title":"Fungating mass on the breast of a male patient.","authors":"Jeremy K Bray, Christina Dai, Olayemi Sokumbi","doi":"10.5070/D330564436","DOIUrl":"https://doi.org/10.5070/D330564436","url":null,"abstract":"<p><p>Breast cancer is one of the most common malignancies that can lead to cutaneous metastasis. Dermatopathologists often play an important role in the diagnosis of breast cancer metastasis to the skin. Rarely, dermatopathologists render a histopathologic diagnosis of primary breast cancer. We discuss a 51-year-old man with metastatic breast adenocarcinoma who presented after admission to the intensive care unit in the setting of altered mental status and critical anemia. Examination revealed a 14cmx12cm ulcerated, fungating tumor occupying the left breast. A four mm punch biopsy from the mass showed cords of atypical cells infiltrating the mid-to-deep dermis positive for CK7, GATA3, ER and PR. CK20, P40, p63, and TTF1 stains were negative. HER2/NEU immunoperoxidase stain was negative. CA15-3 was elevated at 75U/ml. Taken together, he was diagnosed with primary left breast ductal adenocarcinoma, grade two with subsequent visceral metastases to the bones, lymph nodes, and lungs. Although male breast cancer makes up less than 1% of all breast cancers, its incidence has been increasing worldwide. Recognition of the unique clinical and histologic findings of primary breast carcinoma is important to avoid delay in the diagnosis and initiation of appropriate treatment.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rural access to dermatology services: a call to action. 农村获得皮肤科服务：行动呼吁。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564425
Bethany Brumbaugh, Jag Lally, Robert Brodell
{"title":"Rural access to dermatology services: a call to action.","authors":"Bethany Brumbaugh, Jag Lally, Robert Brodell","doi":"10.5070/D330564425","DOIUrl":"https://doi.org/10.5070/D330564425","url":null,"abstract":"<p><p>This commentary underscores the urgent issue of limited access to dermatologic care in rural areas, leading to adverse health outcomes. With only 10% of dermatologists practicing in rural America, the \"rural mortality penalty\" contributes to escalating morbidity and mortality. Disparities in dermatologist distribution, particularly in minority-majority counties with lower incomes, worsen health inequities. Despite these challenges, initiatives such as pipeline programs, rural university offices, rural dermatology residency tracks, teledermatology, and Project ECHO (a collaborative model of medical education and care) are promising. This commentary stresses the need for academic dermatologists to recruit more rural medical students and train more residents with a rural upbringing. This predicts future practice in such communities. Immediate action to address the widening rural dermatology gap is needed. The formation of the Rural Access to Dermatology Society, with its first meeting in the spring of 2024 at the annual meeting of the American Academy of Dermatology, is a key part of this process.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A cross-sectional analysis of insurance acceptance among Mohs micrographic surgeons in New York City. 对纽约市莫氏显微手术外科医生接受保险情况的横断面分析。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564439
Katie Roster, Sumaiya Islam, Farhha Feroz, Shelcie Fabre, Zahidul Islam, Abigail Cline, Shari R Lipner
{"title":"A cross-sectional analysis of insurance acceptance among Mohs micrographic surgeons in New York City.","authors":"Katie Roster, Sumaiya Islam, Farhha Feroz, Shelcie Fabre, Zahidul Islam, Abigail Cline, Shari R Lipner","doi":"10.5070/D330564439","DOIUrl":"https://doi.org/10.5070/D330564439","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comments on a recent paper Jellyfish envenomation with delayed hypersensitivity and concurrent SARS-CoV-2 infection. 对最近发表的一篇论文的评论 水母螫伤伴有迟发性超敏反应和并发 SARS-CoV-2 感染。
Dermatology online journal Pub Date : 2024-10-15 DOI: 10.5070/D330564443
Gerald L Crow, Brenden S Holland
{"title":"Comments on a recent paper Jellyfish envenomation with delayed hypersensitivity and concurrent SARS-CoV-2 infection.","authors":"Gerald L Crow, Brenden S Holland","doi":"10.5070/D330564443","DOIUrl":"https://doi.org/10.5070/D330564443","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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