Case Reports in Dermatology最新文献

{"title":"Six Cases of Pemphigoid Nodularis during Treatment with Dipeptidyl Peptidase-4 Inhibitors.","authors":"Natsumi Norikawa, Misaki Kusano, Aki Honda, Toshiyuki Yamamoto","doi":"10.1159/000552572","DOIUrl":"10.1159/000552572","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated 6 cases of pemphigoid nodularis under treatment with dipeptidyl peptidase-4 (DPP-4) inhibitors.</p><p><strong>Case representation: </strong>In 3 cases, only nodules were observed at the initial presentation, but bullous lesions appeared during the course of the disease. All patients had diabetes mellitus and were taking DPP-4 inhibitors from 1 to 1.5 years. Anti-BP180Nc16a antibodies were positive in 3 cases, and low or negative in 3 cases. Full-length BP180 antibodies were analyzed in 2 of the 6 cases and were positive in both. Since patients with diabetes mellitus occasionally develop prurigo nodularis, it is important not to misdiagnose pemphigoid nodularis as prurigo nodularis.</p><p><strong>Conclusion: </strong>There are few reports of pemphigoid nodularis under DPP-4 inhibitors. It should be noted that not only bullous pemphigoid but also pemphigoid nodularis can be induced by DPP-4 inhibitors.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"675-683"},"PeriodicalIF":0.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Restrictive Composite Endpoint to Assess Best Response in Patients with Mild-to-Moderate Psoriasis Treated with CAL/BDP PAD Cream: A Case Series.","authors":"Andreas Pinter, Jordi Galván, Frank Freischläger","doi":"10.1159/000552884","DOIUrl":"10.1159/000552884","url":null,"abstract":"<p><strong>Introduction: </strong>In the assessment of a psoriasis treatment, traditional endpoints evaluated independently may not fully capture the multidimensional nature of treatment response. Best response to calcipotriol/betamethasone dipropionate (CAL/BDP) cream based on polyaphron dispersion (PAD) technology has recently been defined as a restrictive composite endpoint comprising two efficacy outcomes (Physician's Global Assessment [PGA] 0-1 and modified Psoriasis Area and Severity Index [mPASI] <2) and one quality-of-life outcome (Dermatology Life Quality Index [DLQI] 0-1).</p><p><strong>Case presentations: </strong>This retrospective case series aims to provide further insights into the demographics and outcomes of patients achieving best response to CAL/BDP PAD cream based on this newly defined composite endpoint. From the 213 patients with mild-to-moderate psoriasis who received CAL/BDP PAD cream in the European MC2-01-C7 phase 3 clinical trial (NCT03802344), 7 patients who achieved best response at week 4 and/or week 8 and had available clinical photographs were evaluated. The mean patient age was 55.0 years (range: 34-68), with a mean psoriasis duration of 19.9 years (range: 6.9-29.1). Results support the efficacy of CAL/BDP PAD cream in improving both clinical signs and quality of life.</p><p><strong>Conclusion: </strong>Despite existing variability in key baseline characteristics and long disease duration, all included patients met the novel restrictive composite endpoint after 8 weeks, which reflects complete/almost complete clearance of psoriasis and no impact on patient quality of life.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"684-694"},"PeriodicalIF":0.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exacerbation of Bullous Pemphigoid following a Closed Bone Fracture in an Elderly Patient: A Case Report.","authors":"Dinara Azanbayeva, Zulfiya Jetpisbayeva, Akmaral Nurmukhambetova, Issa Emir Ardakuly, Torgyn Ibrayeva, Ainur Botabaeva, Aizhan Shakhanova","doi":"10.1159/000553401","DOIUrl":"https://doi.org/10.1159/000553401","url":null,"abstract":"<p><strong>Introduction: </strong>Bullous pemphigoid (BP) is the most common autoimmune blistering disorder affecting the elderly population. While the etiology is predominantly idiopathic, physical trauma has been identified as a potential exacerbating factor. Most trauma-induced cases reported in the literature are associated with surgical incisions, burns, or open wounds. The development of generalized BP following a closed fracture, where the skin integrity remains initially intact, is an exceptionally rare phenomenon. The patient experienced a pre-bullous phase starting in June 2025, which significantly progressed to generalized BP following a closed radius fracture in October 2025.</p><p><strong>Case report: </strong>We report the case of an 85-year-old woman who presented with a generalized blistering eruption 3 months after sustaining a closed fracture of the left radius. Physical examination revealed tense, fluid-filled bullae on an erythematous base involving the trunk and extremities. Histopathological analysis demonstrated a subepidermal blister with eosinophilic infiltration. The diagnosis was confirmed by direct immunofluorescence showing linear deposition of immunoglobulin G and C3 at the dermo-epidermal junction and enzyme-linked immunosorbent assay detecting high titers of anti-BP180 autoantibodies. The patient was treated with a tapering course of systemic prednisone, initiated at 90 mg/day. This regimen led to the cessation of new blister formation within 2 weeks and complete clinical remission with normalization of inflammatory markers within 3 weeks.</p><p><strong>Conclusion: </strong>This case highlights that closed skeletal trauma, even without surgical intervention, can serve as a precipitating factor for generalized BP. The mechanism likely involves the release of sequestered antigens and epitope spreading due to internal tissue damage. Clinicians should maintain a high index of suspicion for BP in elderly patients presenting with cutaneous eruptions following orthopedic injuries to ensure prompt diagnosis and effective management.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"695-703"},"PeriodicalIF":0.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pagetoid Reticulosis with Double-Negative CD4/CD8: A Rare Case Report.","authors":"Hadeel Alsulimani, Hamza Fadel, Amal Alomari, Hosam Alardati, Ghassan Niaz","doi":"10.1159/000551216","DOIUrl":"10.1159/000551216","url":null,"abstract":"<p><strong>Introduction: </strong>Pagetoid reticulosis (PR) is a rare variant of mycosis fungoides, characterized by localized patches or plaques mainly on the distal extremities with intraepidermal proliferation of neoplastic T cells. Typically, PR exhibits a CD4-positive, CD8-negative immunophenotype, whereas a CD4-/CD8- double-negative profile is distinctly uncommon, yet in localized pagetoid reticulosis it may be associated with an indolent clinical course and favorable therapeutic response.</p><p><strong>Case presentation: </strong>In this report, we present a case of a healthy 58-year-old male with a 3-year history of a persistent erythematous plaque on the left forearm. Histopathological analysis demonstrated atypical lymphocytes with prominent epidermotropism. Immunohistochemical staining showed double-negative CD4/CD8 phenotype with positive CD3, CD5, and CD7. The lesion responded completely to topical therapy followed by localized radiotherapy, with clinical remission at follow-up.</p><p><strong>Conclusion: </strong>The CD4-/CD8- immunophenotype in localized pagetoid reticulosis is rare but may still be associated with an indolent clinical course and favorable therapeutic response.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"750-755"},"PeriodicalIF":0.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hymenoptera Envenomation as a Potential Trigger for Acute Diffuse Alopecia Areata: A Case Report.","authors":"Oumaima El Kohen, Bianca Maria Piraccini, Fatima-Zahra Hammoud, Farida Benhadou","doi":"10.1159/000553302","DOIUrl":"10.1159/000553302","url":null,"abstract":"<p><strong>Introduction: </strong>Alopecia areata (AA) is an autoimmune hair loss disorder often triggered by genetic and environmental factors. Acute, massive shedding is unusual and may indicate a potent immune trigger.</p><p><strong>Case presentation: </strong>We report a 34-year-old woman with Hashimoto thyroiditis who developed rapid, diffuse AA 10 days after bee stings. Clinical examination showed marked hair loss (SALT score 30→70) affecting scalp, eyebrows, and eyelashes. Laboratory workup revealed elevated IgE and venom-specific hypersensitivity. Treatment with corticosteroid pulses followed by oral methylprednisolone and methotrexate led to progressive hair regrowth.</p><p><strong>Conclusion: </strong>This case highlights hymenoptera envenomation as a rare trigger of acute AA, emphasizing the importance of environmental history and immune evaluation in sudden-onset autoimmune hair loss.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"756-761"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe, Therapy-Resistant Generalized Lichen Sclerosus with Morphea Overlap Successfully Treated with Intravenous Immunoglobulin and Type 1 Interferon Receptor Monoclonal Antibody Infusion: A Case Report.","authors":"Abdulaziz Alhowaish, Dieter O Mayer, Hans Ulrich Gerth, Jivko Kamarachev, Fayez Alotaibi, Antonios G A Kolios, Myriam Hofer, Jürg Hafner","doi":"10.1159/000553417","DOIUrl":"10.1159/000553417","url":null,"abstract":"<p><strong>Introduction: </strong>Generalized extragenital lichen sclerosus with morphea overlap is a rare inflammatory and fibrosing dermatosis. Severe bullous-ulcerative disease remains therapeutically challenging and can cause major morbidity.</p><p><strong>Case presentation: </strong>We report a 54-year-old woman with decade-long progressive generalized extragenital lichen sclerosus-morphea overlap, causing disabling hand sclerosis and widespread painful bullous-ulcerative leg lesions. Conventional first-line and extended immunomodulatory or immunosuppressive treatments, including potent topical corticosteroids, UVA-1 phototherapy, extracorporeal photopheresis, methotrexate, hydroxychloroquine, multiple biologics, and JAK inhibitors, showed little sustained benefit and were sometimes associated with deterioration or relevant immunosuppression. Intravenous immunoglobulin, initiated for secondary antibody deficiency, was associated with disease stabilization and complete ulcer healing; rituximab was subsequently continued as part of B-cell-directed background therapy. Persistent cutaneous inflammation under IVIG and rituximab was accompanied by elevated interferon-associated mediators, including interleukin-18, CXCL9, and CXCL10. Addition of anifrolumab, a type I interferon receptor antagonist, led to marked suppression of inflammatory activity, softening of sclerotic skin, normalization or reduction of several cytokine and chemokine abnormalities, and improved quality of life.</p><p><strong>Conclusion: </strong>In severe therapy-refractory lichen sclerosus-morphea overlap, combined IVIG, rituximab, and anifrolumab may help control skin inflammation, sclerosis, and skin ulceration. This case supports cytokine-guided, mechanism-based salvage therapy in selected therapy-refractory patients.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"580-593"},"PeriodicalIF":0.7,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Angiosarcoma Secondary to Giant Hemangioma of the Abdomen in a Young Woman: A Rare Case.","authors":"Hucheng Zhou, Yuan Xia, Xiaohui Zhao, Hui Xu, Yumei Li","doi":"10.1159/000551718","DOIUrl":"10.1159/000551718","url":null,"abstract":"<p><strong>Introduction: </strong>Cutaneous angiosarcoma (cAS) is a rare and aggressive malignancy of endothelial origin, most commonly affecting the scalp and face in elderly patients. Diagnosis is often challenging due to histological overlap with other vascular or epithelioid tumors. Secondary cAS typically arises following radiotherapy or chronic lymphedema.</p><p><strong>Case presentation: </strong>We report a rare case of secondary cAS in a 33-year-old woman developing from a congenital giant abdominal hemangioma, without prior radiation or lymphedema. The lesion progressed from erythema to a large nonhealing ulcer. Histopathology revealed poorly differentiated vascular tumor cells, confirmed by immunohistochemistry showing positivity for CD31, ERG, and FLI-1. Due to the extensive lesion, surgical excision was not feasible, and only supportive care was provided.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of early recognition and biopsy in atypical vascular lesions. Secondary cAS may arise from preexisting vascular anomalies even in the absence of classic risk factors, highlighting the need for individualized management.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"744-749"},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonidegib and Subsequent Photodynamic Therapy for Recurrent Nodular-Ulcerative Basal Cell Carcinoma of the Right Nose Post-Surgical Resection: A Case Report.","authors":"Limin Luo, Lingyun Qi, Yanyan Wu, Jianjun Qiao, Jun Lin","doi":"10.1159/000553400","DOIUrl":"10.1159/000553400","url":null,"abstract":"<p><strong>Introduction: </strong>Nodular-ulcerative basal cell carcinoma (NU-BCC) on the nose poses therapeutic challenges due to high recurrence rates and cosmetic concerns after wide excision. We present a case of recurrent nasal NU-BCC successfully managed with a sequential regimen of sonidegib, surgery, and photodynamic therapy (PDT) as a salvage strategy.</p><p><strong>Case presentation: </strong>A 62-year-old female presented with a recurrent black, ulcerated lesion at the surgical margin of a previously excised nasal BCC. She refused extensive reoperation due to esthetic concerns and fear of surgery. She received 6-month oral sonidegib phosphate (200 mg/day, adjusted to alternate-day dosing based on adverse events), followed by local shaving excision and 4 sessions of aminolevulinic acid-PDT. Six months after completion, pathological examination confirmed complete tumor clearance, and no recurrence was observed during 1-year follow-up, with excellent nasal esthetic preservation.</p><p><strong>Conclusion: </strong>This sequential approach of sonidegib combined with surgery and PDT may be an effective and cosmetic-sparing option for selected patients with recurrent facial BCC who are unsuitable for or reluctant to undergo radical surgery. Further studies are warranted to validate its long-term efficacy.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"570-579"},"PeriodicalIF":0.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photothermal Biomodulated Autologous PRP Combined with Laser and LED Phototherapy for Acne Sequelae: A Report of Three Illustrative Cases.","authors":"Yosra Labidi Menif, Laura Cordero","doi":"10.1159/000553563","DOIUrl":"10.1159/000553563","url":null,"abstract":"<p><strong>Introduction: </strong>Acne vulgaris may lead to persistent sequelae, including post-inflammatory erythema, hyperpigmentation, and atrophic scarring. Multimodal regenerative approaches combining autologous biological therapies with light-based devices are increasingly used in clinical practice, although published clinical evidence remains limited.</p><p><strong>Case presentations: </strong>We report 3 female patients with distinct acne-related skin sequelae: (1) post-inflammatory erythema with active inflammatory lesions, (2) post-inflammatory hyperpigmentation with residual acne activity, and (3) atrophic acne scarring. Each patient was treated with a tailored multimodal protocol combining photothermal biomodulated autologous platelet-rich plasma (PRP), laser therapy (non-ablative or ablative erbium-doped yttrium aluminum garnet), and light-emitting diode (LED) phototherapy. Clinical outcomes were retrospectively assessed using serial clinical photographs obtained during routine follow-up. Where image quality allowed, approximate inflammatory lesion counts and semi-quantitative ordinal estimates of erythema, hyperpigmentation, scar visibility, and texture change were added post hoc. Follow-up ranged from 1 month to 12 months. All 3 patients showed photographic improvement in inflammatory activity, pigmentation, skin texture, and/or scar appearance at available follow-up time points. Treatments were well tolerated, with only transient local reactions such as redness and swelling.</p><p><strong>Conclusions: </strong>These case reports illustrate the feasibility and tolerability of combining photothermal biomodulated autologous PRP with laser and LED therapies for different acne sequelae. Because no validated objective scoring system was applied prospectively, the findings should be interpreted as descriptive and hypothesis generating. These observations support further controlled studies to evaluate standardized protocols and clinical outcomes.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"559-569"},"PeriodicalIF":0.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcinosis Cutis as the Leading Manifestation of Juvenile Dermatomyositis: A Case Report.","authors":"Emilio Peniche-Luna, Marianne Thérèse Signoret-Bravo, Karen Uriarte-Ruiz, Cristina Berumen-Glinz, María Elisa Vega-Memije","doi":"10.1159/000553661","DOIUrl":"https://doi.org/10.1159/000553661","url":null,"abstract":"<p><strong>Introduction: </strong>Juvenile dermatomyositis (JDM) is a rare autoimmune inflammatory myopathy of childhood. Initial manifestations may be atypical and lead to delays in diagnosis.</p><p><strong>Case report: </strong>An 11-year-old boy with a history of trauma of the left knee was initially treated with systemic antibiotics without clinical improvement. On physical examination, ulcerated plaques composed of multiple fistulous tracts with abundant purulent discharge were observed. A skin biopsy revealed findings consistent with calcinosis cutis. The autoantibody panel was positive for anti-Mi-2 antibodies, along with elevated muscle enzymes (CK = 2892 U/L). A diagnosis of JDM was established, and systemic treatment with prednisone at 1 mg/kg/day was initiated, resulting in an adequate clinical response of the lesions.</p><p><strong>Conclusion: </strong>JDM is a rare condition with a variable clinical presentation in the pediatric population. This case highlights the importance of considering JDM in the differential diagnosis of patients presenting with calcinosis, even in the absence of classic cutaneous manifestations and with only subtle or initially unrecognized muscle involvement.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"535-541"},"PeriodicalIF":0.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}