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Complement fragment 4d staining as a potential diagnostic tool for bullous disorders with esophageal involvement. 补体片段4d染色作为食道大泡性疾病的潜在诊断工具。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/yyrw8m35
Sophia Manduca, Neil Jairath, Alexandra Flamm, Prince Adotama
{"title":"Complement fragment 4d staining as a potential diagnostic tool for bullous disorders with esophageal involvement.","authors":"Sophia Manduca, Neil Jairath, Alexandra Flamm, Prince Adotama","doi":"10.25251/yyrw8m35","DOIUrl":"10.25251/yyrw8m35","url":null,"abstract":"<p><p>Mucous membrane pemphigoid (MMP) is an autoimmune blistering disorder that can involve the esophagus, potentially leading to complications such as stricture or stenosis. Diagnosis of MMP is challenging owing to overlapping clinical features with other subepithelial blistering diseases and limitations of current diagnostic techniques. Although direct immunofluorescence (DIF) remains the gold standard, it requires fresh tissue samples, which are not always available, particularly in cases without active mucosal or cutaneous lesions. Complement fragment 4d (C4d) immunohistochemistry (IHC) on formalin-fixed tissue has demonstrated diagnostic utility in bullous pemphigoid but has been less explored in MMP. This case highlights that C4d IHC may serve as a useful ancillary test to support MMP diagnosis, especially for mucosal or esophageal biopsies received in formalin, offering a potential diagnostic pathway when fresh biopsy samples are unavailable.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162336","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
Periungual palisaded encapsulated neuroma in skin of color. 趾甲周围有色皮肤的栅栏状包裹性神经瘤。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/71cbfr95
Christina M Pierce, Federico Galar, Joshua L Owen
{"title":"Periungual palisaded encapsulated neuroma in skin of color.","authors":"Christina M Pierce, Federico Galar, Joshua L Owen","doi":"10.25251/71cbfr95","DOIUrl":"10.25251/71cbfr95","url":null,"abstract":"<p><p>Palisaded encapsulated neuroma (PEN) is a nerve sheath tumor most commonly found on the face. These benign tumors are less commonly reported in skin of color and may be confused with other forms of nerve sheath tumors. Detection of the distinctive histopathologic features of PEN and recognition of its various subtypes are key to an accurate diagnosis. We report a 68-year-old Black man with a pink to skin-colored papule on the right second fingertip of 6- to 12-month duration. We describe the clinical and pathologic diagnosis of PEN and discuss the differential diagnosis. This case highlights the importance of maintaining a broad differential when managing and treating neoplasms of the nail unit, including rare or uncommon diagnoses.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162257","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
Blue nevus-like melanoma: A rare entity. 蓝色痣样黑色素瘤：一种罕见的实体。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/bxsdr559
Lanyu Sun, Mafalda Pinho, Catarina Quadros, Diogo de Sousa, Inês Abreu, Gustavo Silva, Pedro de Vasconcelos, Luís Soares-de-Almeida, Paulo Filipe
{"title":"Blue nevus-like melanoma: A rare entity.","authors":"Lanyu Sun, Mafalda Pinho, Catarina Quadros, Diogo de Sousa, Inês Abreu, Gustavo Silva, Pedro de Vasconcelos, Luís Soares-de-Almeida, Paulo Filipe","doi":"10.25251/bxsdr559","DOIUrl":"10.25251/bxsdr559","url":null,"abstract":"<p><p>A 34-year-old man from Guinea-Bissau presented with a rapidly growing tumor on his right foot over 6 months, arising from a long-standing pigmented papule present for more than 20 years. Clinical examination revealed an exophytic black tumor with ipsilateral inguinal lymphadenopathy. Histopathological analysis showed an epithelioid and fusiform melanocytic proliferation in the dermis with abundant melanin. Immunohistochemical staining demonstrated diffuse positivity for Sox-10, Melan-A, HMB45, and PRAME. A diagnosis of blue nevus-like melanoma (BNM) was confirmed. BRAF V600 mutation testing on a cutaneous metastasis was negative. Staging imaging revealed widespread metastases involving lymph nodes, brain, lungs, liver, stomach, duodenum, colon, adrenal glands, pancreas, gallbladder, and bones. Despite 4 cycles of ipilimumab/nivolumab immunotherapy, the disease progressed, and the patient died 4 months after diagnosis. BNM is a rare melanoma variant, often arising from a pre-existing blue nevus, with aggressive potential and frequent lymph node metastasis. The molecular heterogeneity of BNM and the limited therapeutic options underscore the need for further research into targeted therapies and prognostic biomarkers for this rare melanoma subtype.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162295","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
Disguised discoloration: Minocycline-induced pigmented cardiac valves. 隐蔽性变色：二甲胺四环素诱导的色素心脏瓣膜。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/0sy2g960
Natasha L Salmen, Taylor M Pong, Sabrina Bennett, Deborah L Cook, Joseph C Pierson
{"title":"Disguised discoloration: Minocycline-induced pigmented cardiac valves.","authors":"Natasha L Salmen, Taylor M Pong, Sabrina Bennett, Deborah L Cook, Joseph C Pierson","doi":"10.25251/0sy2g960","DOIUrl":"10.25251/0sy2g960","url":null,"abstract":"<p><p>Tetracyclines are used for a variety of dermatologic conditions, and a known side effect of this therapy is hyperpigmentation in multiple tissues throughout the body. We present the case of a 66-year-old man who underwent aortic valve replacement and was found to have discoloration of the aortic valve leaflets associated with his chronic use of minocycline for rosacea. Minocycline-induced pigmentation of cardiac valves is a documented, although uncommon, phenomenon. There is no evidence linking valve pigmentation to functional valve defects. This case highlights an infrequent manifestation of minocycline-induced pigmentation.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162315","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
Aquagenic wrinkling of the palms in a healthy adolescent. 健康青少年的手掌生皱。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/cvgw0d47
César Bimbi, Amanda Nichele, João Pedro Locatelli Cezar, Camila Machado, André Anjos da Silva
{"title":"Aquagenic wrinkling of the palms in a healthy adolescent.","authors":"César Bimbi, Amanda Nichele, João Pedro Locatelli Cezar, Camila Machado, André Anjos da Silva","doi":"10.25251/cvgw0d47","DOIUrl":"10.25251/cvgw0d47","url":null,"abstract":"<p><p>Aquagenic wrinkling of the palms (AWP) is a rare dermatologic condition characterized by rapid wrinkling, edema, and papules on the palms after brief water exposure. It is commonly associated with cystic fibrosis (CF) or CF carrier status but can also occur in individuals without these conditions. We report a healthy 12-year-old girl who presented with AWP without a family history of CF or related symptoms. After 4 minutes of water immersion, she exhibited typical wrinkling and translucent papules on the palms, which resolved completely within 15 minutes. A sweat test for CF was negative. The patient was managed with moisturizers and advised to minimize prolonged water exposure. This case highlights AWP as a potential early marker for CF or carrier status, even in the absence of other symptoms. Recognition of AWP may guide genetic screening and early intervention, underscoring the role of dermatologists in identifying this condition and facilitating timely diagnosis and management of CF.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162156","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
Scalp cooling and chemotherapy-induced alopecia: Evaluating cost-effectiveness and insurance coverage. 头皮冷却和化疗引起的脱发：评估成本效益和保险范围。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/asnyyf41
Lauren N McGrath, Alice Mikulinsky, Steven R Feldman
{"title":"Scalp cooling and chemotherapy-induced alopecia: Evaluating cost-effectiveness and insurance coverage.","authors":"Lauren N McGrath, Alice Mikulinsky, Steven R Feldman","doi":"10.25251/asnyyf41","DOIUrl":"10.25251/asnyyf41","url":null,"abstract":"<p><p>Chemotherapy-induced alopecia (CIA) substantially affects patients' quality of life. Scalp cooling, or cold capping, reduces chemotherapy uptake in hair follicles and can help preserve hair, but insurance coverage remains inconsistent, limiting access. We conducted a cost-effectiveness analysis from a payer perspective comparing scalp cooling with 2 dermatologic management strategies for CIA. The incremental cost-effectiveness ratio (ICER) for scalp cooling was $3,050 per QALY versus dermatologic management plus minoxidil and -$2,950 per QALY versus dermatologic management plus minoxidil and platelet-rich plasma. Both ICERs fall below common United States willingness-to-pay thresholds, indicating that scalp cooling is cost-effective. These findings suggest that scalp cooling is a financially reasonable supportive care intervention and should be considered for routine insurance coverage.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162390","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
Characterizing barriers to care in patients with hidradenitis suppurativa. 化脓性汗腺炎患者护理障碍的特征分析。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/zv612447
Josiah Williams, Veronica K Emmerich, Emily Moya, Anita Rong, Steven R Feldman, Rita O Pichardo
{"title":"Characterizing barriers to care in patients with hidradenitis suppurativa.","authors":"Josiah Williams, Veronica K Emmerich, Emily Moya, Anita Rong, Steven R Feldman, Rita O Pichardo","doi":"10.25251/zv612447","DOIUrl":"https://doi.org/10.25251/zv612447","url":null,"abstract":"","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162313","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
Lupus erythematosus panniculitis in a 77-year-old woman. 77岁女性红斑狼疮泛膜性炎。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/r3kc1726
Allison Bai, Erika Elliott, Gabriela Cobos
{"title":"Lupus erythematosus panniculitis in a 77-year-old woman.","authors":"Allison Bai, Erika Elliott, Gabriela Cobos","doi":"10.25251/r3kc1726","DOIUrl":"10.25251/r3kc1726","url":null,"abstract":"<p><p>Lupus erythematosus panniculitis (LEP) is an uncommon variant of lupus erythematosus, characterized by subcutaneous indurated nodules or plaques that often heal with lipoatrophy or scarring. We report a 77-year-old woman who presented with a 4-month history of painful subcutaneous nodules and erythematous plaques. She had a history of discoid lupus erythematosus in her 30s, which was successfully managed with topical treatments and had since resolved. Deep incisional biopsy of a plaque on her back confirmed the diagnosis of LEP. The patient improved with treatment including methotrexate, folic acid, and prednisone. This case highlights a unique clinical presentation of LEP, both in terms of patient age and lesion distribution, and underscores the critical role of histopathology in excluding subcutaneous panniculitis-like T-cell lymphoma.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162320","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
New-onset erythrodermic psoriasis associated with antiepileptic drug use. 新发红皮病型银屑病与抗癫痫药物使用相关。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/5bv66v50
James Feng, Payal Shah, Jeffrey Cloutier, Jonathan S Glass, Dorothea T Barton
{"title":"New-onset erythrodermic psoriasis associated with antiepileptic drug use.","authors":"James Feng, Payal Shah, Jeffrey Cloutier, Jonathan S Glass, Dorothea T Barton","doi":"10.25251/5bv66v50","DOIUrl":"10.25251/5bv66v50","url":null,"abstract":"<p><p>Erythrodermic psoriasis is a severe and potentially life-threatening dermatologic condition that can be triggered or unmasked by medications. We report the case of a 73-year-old patient who developed new-onset erythrodermic psoriasis following treatment with antiepileptic drugs (AEDs), specifically carbamazepine and levetiracetam, for autoimmune encephalitis. Despite discontinuation of the AEDs, the patient's condition persisted and improved only after systemic biological therapy. Clinical presentation, together with histopathologic findings, supported a diagnosis of new-onset psoriasis rather than a drug-induced psoriasiform reaction. This case highlights the importance of recognizing AEDs as potential triggers for psoriasis in patients with no prior history. Given the severe complications associated with erythroderma, timely diagnosis and initiation of appropriate therapy are essential. Clinicians should maintain a high index of suspicion for medication-induced dermatologic conditions in patients presenting with new or progressive skin eruptions.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162296","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
Applicability of bilobed transposition flaps in extranasal locations. 双叶转位皮瓣在鼻外位置的适用性。
Dermatology online journal Pub Date : 2026-01-05 DOI: 10.25251/84zcss45
Bárbara Vieira Granja, Carlos Marques
{"title":"Applicability of bilobed transposition flaps in extranasal locations.","authors":"Bárbara Vieira Granja, Carlos Marques","doi":"10.25251/84zcss45","DOIUrl":"10.25251/84zcss45","url":null,"abstract":"<p><p>The bilobed flap is a local transposition flap originally described for the reconstruction of surgical defects of the nose. Its success and versatility are well recognized in this anatomical region; however, its use in extranasal reconstructions is less common. We present 5 clinical cases of extranasal applications of the bilobed flap that highlight its versatility across a wide range of anatomical sites. The locations include the hand (n = 1), foot (n = 1), ear and periauricular region (n = 1), chin (n = 1), and temporal region (n = 1). The surgical defects ranged from medium to large in size, with maximum diameters between 20 and 55 mm. All procedures were performed in a single session under local anesthesia, with no associated complications. All patients achieved good functional and aesthetic outcomes.</p>","PeriodicalId":11040,"journal":{"name":"Dermatology online journal","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162237","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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