{"title":"Development of Pyoderma Gangrenosum in a Patient with Acquired Reactive Perforating Collagenosis.","authors":"Yuki Mizutani, Kyoko Sugioka, Tomoko Akeda, Akinobu Hayashi, Keiichi Yamanaka","doi":"10.1159/000550460","DOIUrl":"10.1159/000550460","url":null,"abstract":"<p><strong>Introduction: </strong>Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis associated with systemic diseases, but its pathogenesis remains unclear. Acquired reactive perforating collagenosis (ARPC) is characterized by transepidermal elimination of degenerated collagen and is usually linked to diabetes mellitus or renal dysfunction. ARPC is not recognized as a precursor to PG. We report a rare case of PG occurring in a patient with ARPC, successfully treated with adalimumab.</p><p><strong>Case presentation: </strong>An 80-year-old woman with diabetes presented with generalized erythema and later developed multiple papules and nodules with central crusting. Histology confirmed ARPC. Despite topical corticosteroids, lesions ulcerated and progressed into painful necrotic ulcers on her extremities. Laboratory findings showed neutrophilia and elevated C-reactive protein, but no infection or autoimmune markers. Histopathology of the ulcers revealed dense neutrophilic infiltration with transepidermal elimination of collagen, consistent with PG. Diagnostic criteria (Delphi, Su, Paracelsus) supported PG secondary to ARPC. Topical corticosteroids were ineffective. Due to comorbid diabetes, high-dose systemic corticosteroids were avoided; instead, low-dose prednisolone with adalimumab was initiated. The patient received adalimumab induction (160 mg at week 0, 80 mg at week 2) followed by 40 mg weekly. The ulcers rapidly improved, and by 12 weeks, near-complete epithelialization was achieved without recurrence during steroid tapering.</p><p><strong>Conclusion: </strong>This case represents PG occurring in a patient with ARPC, suggesting that persistent epidermal injury in ARPC may trigger neutrophilic dermatosis. Adalimumab proved effective, offering a safe therapeutic option in PG patients with comorbidities limiting corticosteroid use. Recognition of this association may aid earlier diagnosis and optimize treatment strategies.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"123-129"},"PeriodicalIF":0.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375964","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":"Film-Forming Wound Gel for Preterm Infant Skin Injuries: A Case Series.","authors":"Rachael Fleming, Tobias Strunk","doi":"10.1159/000550642","DOIUrl":"10.1159/000550642","url":null,"abstract":"<p><strong>Introduction: </strong>Preterm infants are at unique risk of skin injury due to their immature skin structure. This risk increases with exposure to essential nursing and medical interventions during neonatal intensive care. Wound care for this population is challenging due to the unique properties of the preterm infant's skin and limited evidence base.</p><p><strong>Case presentation: </strong>This small, uncontrolled case series demonstrates the use of film-forming wound dressings (Stratamed, Stratpharma AG, Switzerland) for the treatment of a variety of preterm skin injuries.</p><p><strong>Conclusion: </strong>This case series suggests that film-forming dressings facilitate wound healing for preterm infant's skin.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"136-141"},"PeriodicalIF":0.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431123","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 Rare Adverse Effect of Methotrexate Mimicking Disease Progression in Folliculotropic Mycosis Fungoides: A Case Report.","authors":"Surachanee Likittanasombat, Manasmon Chairatchaneeboon","doi":"10.1159/000550569","DOIUrl":"10.1159/000550569","url":null,"abstract":"<p><strong>Introduction: </strong>Cutaneous ulceration is an uncommon adverse effect of methotrexate (MTX). This complication has been rarely described in cutaneous T-cell lymphoma and, to date, has not been reported in folliculotropic mycosis fungoides (FMF).</p><p><strong>Case report: </strong>A 66-year-old Thai man with stage IB FMF achieved excellent clinical improvement with low-dose MTX therapy for 13 months. He subsequently developed disseminated erythematous papules, plaques, and necrotic ulcers on the extremities. Laboratory evaluation revealed mild anemia, and microbial cultures were negative. Histopathologic examination demonstrated epidermal dysmaturation with necrotic keratinocytes, infiltration by eosinophils and neutrophils, and atypical lymphocytes with features consistent with FMF - findings suggestive of MTX-induced ulceration rather than tumor progression. Discontinuation of MTX led to dramatic resolution within 2 weeks, after which the patient was transitioned to acitretin, resulting in sustained disease control.</p><p><strong>Conclusion: </strong>This case highlights MTX-induced cutaneous ulceration as a rare adverse event in FMF that can mimic disease progression. Recognition of the characteristic histopathologic features facilitates accurate diagnosis. Early discontinuation of MTX leads to rapid resolution, underscoring the importance of prompt recognition and management.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"108-114"},"PeriodicalIF":0.7,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364078","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":"Unusual Presentation of Plexiform Neurofibroma Embedded with Large Comedones: A Case Report.","authors":"Waseem Alhawsawi, Wafa Alghamdi, Maria AlSulami, Afnan Aljawi, Houriah Nukaly, Yassir Alotaibi","doi":"10.1159/000548908","DOIUrl":"10.1159/000548908","url":null,"abstract":"<p><strong>Introduction: </strong>Plexiform neurofibromas (PNFs) represent benign neoplasms associated with neurofibromatosis type 1 (NF1), a genetic disorder characterized by mutations in the <i>NF1</i> gene that lead to dysregulated Ras signaling and uncontrolled cell growth. NF1 manifests with various cutaneous features, including café-au-lait macules and axillary freckling, as well as the development of neurofibromas. PNFs are particularly complex due to their extensive involvement of nerve plexuses and their potential for malignant transformation.</p><p><strong>Case presentation: </strong>This case report documents a 42-year-old male who presented with numerous neurofibromas, café-au-lait macules, and axillary freckling. Notably, the patient had a large PNF on the right lower back, measuring 10 × 15 cm, which exhibited a \"bag of worms\" sensation upon palpation. Remarkably, this PNF contained multiple large comedones, each approximately 0.5 × 0.5 cm. Although histopathologic confirmation would have been valuable, a biopsy was not performed because the clinical appearance was clearly consistent with comedones, and the patient strongly refused the procedure due to pain at the lesion site.</p><p><strong>Conclusion: </strong>This case highlights an unusual presentation of PNF with large comedones, a manifestation not previously reported in the literature. The presence of comedones within a PNF emphasizes the need for thorough clinical evaluation and awareness of atypical manifestations in NF1 patients. This report contributes to the existing knowledge and underscores the importance of recognizing rare dermatological presentations to prevent misdiagnosis and ensure appropriate management.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"103-107"},"PeriodicalIF":0.7,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12916119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225662","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":"Multiple Hypertrophic Lichen Planus Mimicking Squamous Cell Carcinoma: A Case Report.","authors":"Sho Hirata, Daisuke Watabe, Toshihide Akasaka, Hiroo Amano","doi":"10.1159/000550461","DOIUrl":"10.1159/000550461","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertrophic lichen planus (HLP) with pseudoepitheliomatous hyperplasia (PEH) can closely mimic well-differentiated squamous cell carcinoma (SCC), creating a clinically important diagnostic pitfall. Fewer than 26 case reports in the literature describe HLP initially misdiagnosed as SCC, underscoring the need for careful clinicopathologic correlation.</p><p><strong>Case presentation: </strong>A 77-year-old woman developed multiple hyperkeratotic nodules and plaques on both legs and feet over 4 months. A punch biopsy led to an initial diagnosis of well-differentiated SCC. An additional elliptical incisional biopsy from a separate plaque showed irregular acanthosis with hypergranulosis, endophytic well-differentiated squamous epithelium, and a dense lichenoid interface infiltrate with focal basal vacuolar change and Max-Joseph spaces, without destructive invasion or significant atypia - findings consistent with HLP with PEH. The lesions flattened with topical clobetasol propionate under occlusion for 6 weeks, and no recurrence was observed during a 3-month follow-up.</p><p><strong>Conclusion: </strong>HLP can closely mimic well-differentiated SCC, making adequate tissue sampling and clinicopathologic correlation essential to avoid unnecessary surgery. This case adds to the limited literature on HLP misdiagnosed as SCC and highlights the need to also consider inflammatory mimickers.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"89-95"},"PeriodicalIF":0.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12880845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140654","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":"Emergence of Vitiligo during Treatment with Risankizumab-Rzaa for Plaque Psoriasis: A Case Report.","authors":"Kevin V Thomas, Jennifer M Tran, Lisa M Cotter","doi":"10.1159/000548980","DOIUrl":"10.1159/000548980","url":null,"abstract":"<p><strong>Introduction: </strong>Risankizumab-rzaa (Skyrizi) is a humanized monoclonal antibody (IgG1) approved for the treatment of severe plaque psoriasis. It selectively blocks the p19 subunit of the IL-23 pathway, leading to reduced keratinocyte proliferation reducing the inflammatory response.</p><p><strong>Case presentation: </strong>We present a case of de novo vitiligo in a patient being treated with risankizumab-rzaa (Skyrizi) for plaque psoriasis. Our patient had extensive plaque psoriasis affecting his trunk, upper extremities, and scalp, encompassing 30% of his total body surface area. He was treated with risankizumab-rzaa, an IL-23 inhibitor, with significant improvement of his psoriasis and residual hyperpigmented, post-inflammatory patches. In addition, he developed new-onset vitiligo, for which he declined treatment and was continued on risankizumab-rzaa. On subsequent follow-up over a year later, there were extensive areas of vitiligo now with a trichrome pattern suggestive of active vitiligo.</p><p><strong>Conclusion: </strong>To our knowledge, no cases of de novo vitiligo associated with risankizumab-rzaa have been reported in the literature, and our patient may represent the first reported case. The role of IL-23 remains unclear, and our case represents the importance of further research to better elucidate IL-23's role in vitiligo.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"64-69"},"PeriodicalIF":0.8,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028440","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}
Antonino Colloca, Domenico Michele D'Angiolella, Gabriele Laezza, Chiara Cesaro, Maria Cristina Giugliano, Filippo Sepe, Francesco Caraglia, Miriam Forte, Silvana Cozzolino, Alfonso Esposito, Vincenzo Terrano, Andrea Ronchi, Francesca Pagliuca, Vincenzo De Falco, Stefania Napolitano, Teresa Troiani, Lorenzo Lobianco
{"title":"Metastatic Syringocystadenocarcinoma Papilliferum Treated with Enzalutamide: A Case Report and a Review of the Literature.","authors":"Antonino Colloca, Domenico Michele D'Angiolella, Gabriele Laezza, Chiara Cesaro, Maria Cristina Giugliano, Filippo Sepe, Francesco Caraglia, Miriam Forte, Silvana Cozzolino, Alfonso Esposito, Vincenzo Terrano, Andrea Ronchi, Francesca Pagliuca, Vincenzo De Falco, Stefania Napolitano, Teresa Troiani, Lorenzo Lobianco","doi":"10.1159/000548401","DOIUrl":"10.1159/000548401","url":null,"abstract":"<p><strong>Introduction: </strong>Syringocystadenocarcinoma papilliferum (SCACP) is a rare malignancy of the elderly originating from apocrine adnexal glands, mostly developing in the head and neck district. To date, there is no established treatment for metastatic SCACP, leaving affected patients with small therapeutic opportunities.</p><p><strong>Case presentation: </strong>Herein, it is described the case of a 70-year-old man affected by metastatic SCACP, treated with three different sequential therapy lines: carboplatin plus paclitaxel, epirubicin, and an off-label protocol with enzalutamide, achieving 41 months overall survival. Off-label enzalutamide treatment has been justified by androgen receptor expression by SCACP cells, a common feature of apocrine glands derived tumors. Interestingly, SCACP demonstrated to be responsive to enzalutamide treatment, even though the patient precociously stopped the treatment due to severe toxicity.</p><p><strong>Conclusion: </strong>This case represents the first evidence of hormonotherapy administration in a SCACP patient, possibly providing the base for a new therapeutic opportunity for this rare malignancy.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"25-31"},"PeriodicalIF":0.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964930","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}
Waseem Alhawsawi, Houriah Nukaly, Abdulhadi Jfri, Razan S Al-Luhaibi, Abdulmajeed Aljarallah, Sarah M Fageeh, Khalid Al Hawsawi
{"title":"Familial Annular Erythema Effectively Responded to Phototherapy: A Case Report of an Extremely Rare Entity and Literature Review.","authors":"Waseem Alhawsawi, Houriah Nukaly, Abdulhadi Jfri, Razan S Al-Luhaibi, Abdulmajeed Aljarallah, Sarah M Fageeh, Khalid Al Hawsawi","doi":"10.1159/000549976","DOIUrl":"10.1159/000549976","url":null,"abstract":"<p><strong>Introduction: </strong>Familial annular erythema is the inherited form of erythema annular centrifugum, in an autosomal dominant fashion. It is an extremely rare cutaneous condition characterized by asymptomatic or mildly itchy annular, arcuate or polycyclic erythematous plaques that appears few days after birth with no systemic manifestations. Histopathological features are consistent with erythema annular centrifugum. To this date, only five families have been reported to the literature.</p><p><strong>Case presentation: </strong>Herein, we report a family with three generations of affected individuals. The index patient was a 23-year-old female, presented with mildly itchy non-scaly annular and arcuate erythematous plaques that appeared since birth. Her paternal grandmother, father, sister and two male cousins have similar condition. Review of system and laboratory workup was unremarkable. Skin biopsy showed focal compact orthohyperkeratosis, spongiosis, basal cell degeneration, prominent papillary edema with moderate superficial and deep perivascular eosinophilic infiltrate. The index patient was started on narrowband ultraviolet B therapy and showed complete clearance for at least 3 months.</p><p><strong>Conclusion: </strong>This extremely rare entity is not known to be associated with other organ involvement, apart from the skin. It poses diagnostic difficulty as it resembles other annular conditions during infancy. The presence of similar cases within her family underscores the genetic component of this condition, warranting further investigation and discussion. Possible effective therapeutic options include phototherapy.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"70-80"},"PeriodicalIF":0.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112040","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":"Dermatofibroma with Hypopigmented Meyerson Halo: A Case Report and Review of Non-Melanocytic Hosts.","authors":"Mohammed Shanshal, Muna M Abuayyash","doi":"10.1159/000549986","DOIUrl":"10.1159/000549986","url":null,"abstract":"<p><strong>Introduction: </strong>Meyerson phenomenon denotes a perilesional, classically eczematous halo around a pre-existing lesion, most often melanocytic. Non-melanocytic halos are uncommon and can mimic regression in a melanocytic lesion, including melanoma, leading to urgent referrals.</p><p><strong>Case presentation: </strong>We report a 37-year-old woman with a \"mole with a halo\" on her arm. Examination revealed a 5-mm pink papule with a thin whitish collarette and a faint, ill-defined hypopigmented ring. Dermoscopy showed a structureless pink centre with a pinpoint crust and delicate collarette, but no pigment network or organised vascular pattern. Excisional biopsy revealed a dermal spindle-cell proliferation characteristic of dermatofibroma; the diagnosis was confirmed by negative SOX10 and positive Factor XIIIa staining. Notably, there was no spongiotic perilesional dermatitis. A targeted literature review confirmed the rarity of halos around dermatofibromas, which are typically eczematous.</p><p><strong>Conclusion: </strong>Our case expands the clinicopathologic spectrum to include a hypopigmented, non-eczematous Meyerson-like (\"forme-fruste\") halo variant and supports a dermoscopy-first approach to avoid over-triage to melanoma and help streamline care.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"56-63"},"PeriodicalIF":0.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017224","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":"Pseudoephedrine-Associated Erythromelalgia: A Case Report of a Rare Drug Reaction.","authors":"Liang Zhi Wong, Georgios Kravvas","doi":"10.1159/000549963","DOIUrl":"10.1159/000549963","url":null,"abstract":"<p><strong>Introduction: </strong>Erythromelalgia is a rare disorder characterized by severe burning extremity pain, erythema, and increased skin temperature. Symptoms are aggravated by warming and alleviated by cooling. It is known to be associated with multiple underlying conditions, as well as reactions in response to medications.</p><p><strong>Case presentation: </strong>A 38-year-old man experienced two distinct episodes of redness and swelling of his hands after taking \"cold\" tablets containing paracetamol and pseudoephedrine. His symptoms peaked 72 h after onset despite discontinuing the medication. Upon being made aware that there was an association between pseudoephedrine and erythromelalgia, he avoided all pseudoephedrine-containing medications with no recurrence.</p><p><strong>Conclusion: </strong>This case represents the second documented report of pseudoephedrine-associated erythromelalgia in the literature, with a proposed direct link due to the sympathetic adrenergic effects of pseudoephedrine on the vasculature.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"51-55"},"PeriodicalIF":0.7,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997438","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}