M Voloshynovych, T Boichuk, O Berezkin, G Girnyk, N Matkovska, I Berezkina
{"title":"Subungual chondroma in a teenager.","authors":"M Voloshynovych, T Boichuk, O Berezkin, G Girnyk, N Matkovska, I Berezkina","doi":"10.5070/D330664698","DOIUrl":"https://doi.org/10.5070/D330664698","url":null,"abstract":"<p><p>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.</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":"144316094","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}
{"title":"Wolf isotopic response: immunotherapy-related lichenoid eruption localizing to prior radiation site.","authors":"Alexander J Jafari, Drew Kuraitis","doi":"10.5070/D330664696","DOIUrl":"10.5070/D330664696","url":null,"abstract":"<p><p>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.</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":"144316097","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}
Carlton T Faulk, Mark R Pittelkow, Steven R Feldman, David L Swanson
{"title":"The most powerful topical anti-inflammatory: the cautionary and enlightening story of SKIN-CAP.","authors":"Carlton T Faulk, Mark R Pittelkow, Steven R Feldman, David L Swanson","doi":"10.5070/D330664682","DOIUrl":"https://doi.org/10.5070/D330664682","url":null,"abstract":"<p><p>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 a consequence of an interaction between the zinc pyrithione and the clobetasol. However, no synergistic efficacy was identified, and there was no greater drug delivery. Better adherence to the SKIN-CAP product may explain the efficacy. The SKIN-CAP story provides insights into the need for healthy skepticism, the importance of treatment adherence, and ways to encourage better adherence to topical medications.</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":"144316095","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}
Helana Ghali, Logan R Smith, Amanda Krenitsky, Alexia M Joseph, David Aung-Din, Kerry Hennessy, Sarah Moore, James M Grichnik
{"title":"Topical cantharidin use in dermatology: an updated review.","authors":"Helana Ghali, Logan R Smith, Amanda Krenitsky, Alexia M Joseph, David Aung-Din, Kerry Hennessy, Sarah Moore, James M Grichnik","doi":"10.5070/D330664680","DOIUrl":"https://doi.org/10.5070/D330664680","url":null,"abstract":"<p><p>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 the indications reviewed herein yielded a poor response to topical cantharidin. Overall, topical cantharidin resulted in a good-to-excellent clinical response in several conditions with mild and transient adverse events. The results of this review suggest the safe and efficacious use of topical cantharidin in the field of dermatology and highlight the potential for future use.</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":"144316096","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}
Abir Bouhamdi, Chaimae Bouhamdi, Jean Junior Tassa, Zakia Douhi, Layla Tahiri, Mounia Serraj, Mohammed El Biaze, Mohammed Chakib Benjelloun, Fatima Zahrae Mernissi, Bouchra Amara
{"title":"Drug reaction with eosinophilia and systemic symptoms (DRESS)with anti-tuberculosis drugs, a rare and serious complication.","authors":"Abir Bouhamdi, Chaimae Bouhamdi, Jean Junior Tassa, Zakia Douhi, Layla Tahiri, Mounia Serraj, Mohammed El Biaze, Mohammed Chakib Benjelloun, Fatima Zahrae Mernissi, Bouchra Amara","doi":"10.5070/D330664691","DOIUrl":"10.5070/D330664691","url":null,"abstract":"<p><p>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.</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":"144316081","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}
{"title":"Enfortumab vedotin-induced widespread vesiculobullous eruption mimicking disseminated herpetic infection in a patient with metastatic urothelial carcinoma.","authors":"Aman Nihal, Pearl Bacon, Susan Pei","doi":"10.5070/D330664684","DOIUrl":"10.5070/D330664684","url":null,"abstract":"<p><p>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.</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":"144316083","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}
Genevieve S Silva, Jeromy W Gotschall, Misha Rosenbach
{"title":"Actionable avenues for dermatologists to reduce their environmental impact.","authors":"Genevieve S Silva, Jeromy W Gotschall, Misha Rosenbach","doi":"10.5070/D330664683","DOIUrl":"https://doi.org/10.5070/D330664683","url":null,"abstract":"<p><p>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 policies. We also address nuances in promoting environmentally-conscious transit, maximizing the efficient use of technology, supporting alternatives to single-use items, leveraging resources for patient education, assessing appropriate use of carbon credits, and bolstering community climate resilience.</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":"144316132","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}
{"title":"Mohs micrographic surgery for superficial leiomyosarcoma: a systematic review.","authors":"Eric C Olsen, Steven A Svoboda","doi":"10.5070/D330664681","DOIUrl":"https://doi.org/10.5070/D330664681","url":null,"abstract":"<p><p>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 the value of Mohs micrographic surgery in treating superficial leiomyosarcoma and specifically, the subcutaneous variant.</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":"144316088","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}
Abhinav Birda, Mallory L Zaino, Michael H Gold, Steven R Feldman, Brad A Yentzer
{"title":"Basics of building a private dermatology practice--a startup guide.","authors":"Abhinav Birda, Mallory L Zaino, Michael H Gold, Steven R Feldman, Brad A Yentzer","doi":"10.5070/D330664704","DOIUrl":"https://doi.org/10.5070/D330664704","url":null,"abstract":"<p><p>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.</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":"144316134","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}