{"title":"Six Cases of Erythrodermic Pemphigus Foliaceus: A Case Report.","authors":"Natsumi Norikawa, Shohei Igari, Masato Ishikawa, Tatsuhiko Mori, Tomoko Hiraiwa, Nobuyuki Kikuchi, Yuka Hanami, Toshiyuki Yamamoto","doi":"10.1159/000525382","DOIUrl":"https://doi.org/10.1159/000525382","url":null,"abstract":"<p><p>Pemphigus foliaceus (PF) is one of the causes of erythroderma; however, to date, there have been relatively few reported cases. We herein describe 6 cases of erythrodermic PF. In all 6 cases, PF was a direct cause of erythroderma because the patients had not undergone any medical treatments and neither had any other skin diseases nor were taking any drugs that typically cause erythroderma. Serum levels of IgE and thymus and activation-regulated chemokine were elevated in 5 of the 6 cases, whereas soluble interleukin-2 receptor and squamous cell carcinoma-related antigen were markedly increased in all cases, suggesting that those markers are strong indicators of skin surface damage. All patients were treated with predonisolon (PSL), of which PSL pulse was added in 4 patients and intravenous immunoglobulin was added in 4 patients. Furthermore, all patients except for one were older adults, among whom 2 cases developed Kaposi's varicelliform eruption, and died, and another 2 patients, respectively, died of gastrointestinal bleeding and sepsis. Kaposi's varicelliform eruption is a complication of erythrodermic PF associated with poor prognosis, and thus caution is necessary when considering the diagnosis. Furthermore, elderly people are more likely to have complications due to PSL, which may result in death. Inappropriate treatment and delay in treatment may cause erythroderma, so early diagnosis and treatment are necessary.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"14 3","pages":"258-263"},"PeriodicalIF":0.9,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/83/cde-0014-0258.PMC9947519.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10794221","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 Case of Verrucous Carcinoma Treated by Combination of Radiotherapy and Mohs' Chemosurgery.","authors":"Kozo Kawaguchi, Yuichi Kurihara, Michiaki Akashi, Takeshi Nakahara","doi":"10.1159/000525751","DOIUrl":"https://doi.org/10.1159/000525751","url":null,"abstract":"<p><p>Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma. VC is histologically a benign tumor, but it grows significantly and eventually forms a huge mass. Many different treatments are known, but the first-line treatment is surgical resection. VC has strong local infiltration and frequently recurs, making its local control very difficult in unresectable cases. We present a rare case of VC that could be treated with combined radiotherapy and Mohs' chemosurgery, as a new option for unresectable VC.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"249-252"},"PeriodicalIF":0.9,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/33/cde-0014-0249.PMC9459585.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483786","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}
Fouad Mitri, Katharina Anna Kälber, Alexander H Enk, Ferdinand Toberer
{"title":"Persistent Facial Blanching after Botulinum Toxin Injection.","authors":"Fouad Mitri, Katharina Anna Kälber, Alexander H Enk, Ferdinand Toberer","doi":"10.1159/000525937","DOIUrl":"https://doi.org/10.1159/000525937","url":null,"abstract":"<p><p>We report the case of a 38-year-old male patient who presented with blanching of the face after strenuous exercise or physical exertion. The symptoms regressed in a relaxed state. Three years before presentation, he underwent botulinum toxin injections in the affected areas of the face. Facial blanching is a rare side effect of botulinum toxin injection. The postulated pathophysiology involves different transmitters mainly acetylcholine as well as co-transmitters implicated in vasodilation. Usually, facial blanching resolves shortly after waning of the botulinum toxin. However, in our case, the symptoms persisted for a longer time. Till date, therapy options for post-botulinum facial blanching are lacking, mainly due to the temporary aspect of the disease.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"253-256"},"PeriodicalIF":0.9,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/e3/cde-0014-0253.PMC9459515.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483787","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}
Til R Kiderlen, Nicola Delmastro, Friedemann Jobst, Maike de Wit
{"title":"Immunochemotherapy - A Missed Opportunity for Metastasized Malignant Melanoma? Reporting a Therapeutic Success with Checkpoint Inhibitor Rechallenge after Cytotoxic Immuno-Priming in a Heavily Pretreated Patient.","authors":"Til R Kiderlen, Nicola Delmastro, Friedemann Jobst, Maike de Wit","doi":"10.1159/000525153","DOIUrl":"https://doi.org/10.1159/000525153","url":null,"abstract":"<p><p>Treatment of metastasized malignant melanoma still has very limited therapeutic options. After exhaustion of immuno-checkpoint inhibition (ICI) and potentially targeted therapy, no promising alternatives are currently available. We report on an 83-year-old patient suffering from disseminated metastatic melanoma who showed an almost complete response to ICI following chemotherapy, after repeated failure of different regimens including two nonresponsive regimens of ICI. The presented outcome suggests a cytotoxic immuno-priming, facilitating a response to prior nonresponsive ICI. As this concept has not been established until now for malignant melanoma, in contrast to multiple other cancer entities, our case report corroborates previous evidence and therefore suggests a new treatment option, which should be researched further.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"243-248"},"PeriodicalIF":0.9,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/a0/cde-0014-0243.PMC9459574.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485195","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}
Jose W Ricardo, Kalee Shah, Kira Minkis, Shari R Lipner
{"title":"Blue Skin, Nail, and Scleral Pigmentation Associated with Minocycline.","authors":"Jose W Ricardo, Kalee Shah, Kira Minkis, Shari R Lipner","doi":"10.1159/000526067","DOIUrl":"https://doi.org/10.1159/000526067","url":null,"abstract":"<p><p>Minocycline, a semisynthetic derivative of tetracycline that is used to treat various infectious and noninfectious conditions, can cause tissue hyperpigmentation. The skin, oral mucosa, sclera, and rarely the nails, can all be affected. The discoloration varies from blue, slate-gray, or brown, and it typically occurs in a dose-dependent fashion. The mechanism of hyperpigmentation, however, remains largely unknown. Herein, we present a case of gray-blue hyperpigmentation of the skin, sclera, and nails after long-term treatment with minocycline for acne.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"239-242"},"PeriodicalIF":0.9,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/73/cde-0014-0239.PMC9459581.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483788","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}
Abdulmajeed Alajlan, Abdulaziz Madani, Tala Ammar Qadoumi, Alhanouf Aljaloud, Mohammed Alessa
{"title":"Erythrodermic Psoriasis Managed with Risankizumab.","authors":"Abdulmajeed Alajlan, Abdulaziz Madani, Tala Ammar Qadoumi, Alhanouf Aljaloud, Mohammed Alessa","doi":"10.1159/000525774","DOIUrl":"https://doi.org/10.1159/000525774","url":null,"abstract":"<p><p>Erythrodermic psoriasis (EP) is a severe, often refractory, variant of psoriasis. Due to the high morbidity and mortality rate associated with EP and other causes of erythroderma, they are often classified as dermatologic emergencies. EP is usually a therapeutic challenge, where topical and conventional systemic therapies have yielded a less than satisfactory result in several patients. Furthermore, there are a limited number of studies evaluating other therapeutic modalities, such as biologic agents, with no clear treatment guidelines. In this case report, we present a patient who was diagnosed as a case of EP and showed an impressive response to risankizumab.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"219-224"},"PeriodicalIF":0.9,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/a6/cde-0014-0219.PMC9459644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484746","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":"Keloid-like Pilomatricoma of the Auricle: A Case Report and Review of Literature.","authors":"Shinta Trilaksmi Dewi, Hanggoro Tri Rinonce, Kristiana Etnawati, Yohanes Widodo Wirohadidjojo","doi":"10.1159/000525895","DOIUrl":"https://doi.org/10.1159/000525895","url":null,"abstract":"<p><p>Pilomatricoma is a rare benign skin adnexal tumor arising from hair matrix cells. It usually manifests as a firm-to-hard, well-circumscribed, nontender nodule often mistaken as a dermoid cyst. However, its clinical presentation has been reported to mimic keloid. In addition, although it occurs most frequently in the head and neck area, pilomatricoma is rarely reported on the auricle. Herein, we reported a case of pilomatricoma occurring on the posterior part of a 9-year-old girl's auricle. Unlike classic pilomatricoma, the tumor closely resembled a keloid. Nevertheless, histological examination following excision of the tumor revealed a dermal tumor arranged in solid nests consisting of basaloid and ghost cells along with foreign body reaction, calcification, and ossification, confirming the diagnosis of pilomatricoma. The rarity, atypical clinical presentation, and unique location of this tumor contributed to the misdiagnosis of this case. Therefore, we reviewed previous cases of pilomatricoma of the auricle reported in the literature to provide a comprehensive understanding of this rare entity.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"230-238"},"PeriodicalIF":0.9,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/18/cde-0014-0230.PMC9459629.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484743","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}
Davide Fattore, Teresa Battista, Mario De Lucia, Maria Carmela Annunziata, Gabriella Fabbrocini
{"title":"Scleroderma-like Syndrome in the Setting of Pembrolizumab Therapy for Non-Small Cell Lung Cancer: Diagnosis and Dermatologic Management.","authors":"Davide Fattore, Teresa Battista, Mario De Lucia, Maria Carmela Annunziata, Gabriella Fabbrocini","doi":"10.1159/000525887","DOIUrl":"https://doi.org/10.1159/000525887","url":null,"abstract":"<p><p>Immune checkpoint inhibitors play an important role in the treatment of malignancies. ICIs consist of monoclonal antibodies directed against inhibitory immune receptors cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death 1 (PD-1), or programmed cell death-ligand 1 (PD-L1). PD-1 is a receptor expressed by T lymphocytes and has the role of inhibiting their activation. Pembrolizumab is a humanized anti-PD-1 monoclonal antibody. It can improve the immune function of T-cells, which results in significant clinical benefit in the treatment of cancer. Despite its wide use, immunotherapy is associated with a spectrum of side effects known as immune-related adverse events. We present a case of an 82-year-old patient with widespread fibroatrophic skin areas that occurred during a treatment with pembrolizumab for non-small cell lung cancer. Clinical, serological, and histopathological examinations led to the diagnosis of generalized morphea. The patient discontinued pembrolizumab and switched to chemotherapy with pemetrexed and carboplatin. A good therapeutic response was obtained with phototherapy, corticosteroids, and topical calcineurin inhibitors. A focus on the therapeutic management of this skin toxicity in oncological patients is provided.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"225-229"},"PeriodicalIF":0.9,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/e0/cde-0014-0225.PMC9459594.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483785","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}
Santo Raffaele Mercuri, Giovanni Paolino, Pina Brianti, Matteo Riccardo Di Nicola, Alberto Martini, Andrea Necchi, Francesco Montorsi
{"title":"UltraPulse Carbon Dioxide Laser Plus Methyl Aminolevulinate-Photodynamic Therapy for the Treatment of Penile Cancer.","authors":"Santo Raffaele Mercuri, Giovanni Paolino, Pina Brianti, Matteo Riccardo Di Nicola, Alberto Martini, Andrea Necchi, Francesco Montorsi","doi":"10.1159/000524963","DOIUrl":"https://doi.org/10.1159/000524963","url":null,"abstract":"<p><p>The treatment of early-stage penile carcinoma is usually represented by wide excision or partial penectomy with or without inguinal lymph node dissection. However, laser ablation of the tumor may have a prominent role as an organ-sparing approach. In this regard, the combination of UltraPulse CO<sub>2</sub> laser and photodynamic therapy (PDT) may be a valid option, especially when surgery is not feasible or refused. UltraPulse CO<sub>2</sub> laser allows for the formation of gentle cutaneous abrasion that destroys the malignant tissue and, at the same time, improving the uptake of methyl aminolevulinate and amplifying the photochemical reaction of PDT in the tumor and surrounding tissue.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"210-213"},"PeriodicalIF":0.9,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/fa/cde-0014-0210.PMC9459641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484744","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}
Ronan Talty, Goran Micevic, Alice Wang, Christine J Ko, William Damsky
{"title":"Leukoderma Induced by Rotigotine Patch, a Transdermal Dopamine Agonist.","authors":"Ronan Talty, Goran Micevic, Alice Wang, Christine J Ko, William Damsky","doi":"10.1159/000525894","DOIUrl":"https://doi.org/10.1159/000525894","url":null,"abstract":"<p><p>Leukoderma, or hypomelanosis of the skin, can occur in response to various chemical and pharmacologic substances ranging from topical medications to optic preparations and systemic medications. In this case report, we present a 78-year-old man with a history of restless leg syndrome (RLS) who had been using rotigotine transdermal patches once daily for 1 year and developed leukoderma on the bilateral anterior shoulders in the area of patch application. Histopathologic examination showed an absence of melanocytes at the dermal-epidermal junction confirmed by Melan A stain. While the patient was not bothered by the depigmentation and elected to continue the rotigotine patch for his RLS, this case highlights leukoderma as a potential side effect of dopamine transdermal patches and offers insight into the potential mechanism of hypopigmentation in response to dopamine agonism.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":" ","pages":"214-218"},"PeriodicalIF":0.9,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/83/cde-0014-0214.PMC9459519.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483784","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}