Somaia Naassan, Marianne Baastrup Søndergaard, Celeste Porsbjerg, Ruben Due Lorentsen, Simon Francis Thomsen
{"title":"Dupilumab for Chronic Spontaneous Urticaria with Comorbid Type 2 Inflammatory Conditions: Case Report and Systematic Review of the Literature.","authors":"Somaia Naassan, Marianne Baastrup Søndergaard, Celeste Porsbjerg, Ruben Due Lorentsen, Simon Francis Thomsen","doi":"10.1159/000550758","DOIUrl":"10.1159/000550758","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic spontaneous urticaria (CSU) is a heterogeneous, Th2-driven condition where standard therapies, including antihistamines and omalizumab, are often insufficient. Dupilumab, an IL-4Rα antagonist approved for several Th2-mediated diseases, has shown efficacy in CSU. We present a rare case of CSU coexisting with both asthma and eosinophilic gastroenteritis, successfully treated with dupilumab, highlighting the potential effectiveness and appropriateness of dupilumab in patients with multiple, simultaneous Th2-mediated comorbidities, and provide a systematic review of the literature.</p><p><strong>Case presentation: </strong>A 32-year-old man with refractory CSU, asthma, and eosinophilic gastroenteritis was treated with dupilumab. The patient achieved complete remission of CSU, asthma, and eosinophilic gastroenteritis with dupilumab, with no reported side effects. A systematic literature search of PubMed and Embase identified eight studies comprising 25 CSU patients, most with coexisting atopic dermatitis or asthma. The majority achieved symptom control of urticaria as well as of the coexisting Th2 diseases, with only one report of mild side effects.</p><p><strong>Conclusions: </strong>Dupilumab is a suitable therapeutic option in patients with CSU and coexisting Th2-mediated conditions.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"160-169"},"PeriodicalIF":0.8,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509837","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 Co-Presentation of Two Skin Patterns in a Case of Granulomatosis with Polyangiitis: A Case Report and Literature Review.","authors":"Supakit Krailert, Suchaya Pajareeyaphan, Nuntouchaporn Amonchaisakda","doi":"10.1159/000550882","DOIUrl":"10.1159/000550882","url":null,"abstract":"<p><strong>Introduction: </strong>Granulomatosis with polyangiitis (GPA) is a rare necrotizing granulomatous vasculitis that affects small-to-medium-sized vessels. Cutaneous involvement is common, but highly variable in morphology, complicating diagnosis. Herein, we present a case of GPA co-presenting with two skin patterns.</p><p><strong>Case presentation: </strong>A 61-year-old Thai woman presented with chronic cough, constitutional symptoms, and weight loss. Chest computed tomography revealed multiple pulmonary nodules, and lung biopsy showed chronic granulomatous inflammation. Subsequently, the patient developed rapidly progressive glomerulonephritis with crescent features. During hospitalization, she exhibited two distinct cutaneous morphologies: erythematous hyperkeratotic umbilicated papules with crusting on both elbows and erythematous-to-violaceous vesiculopapules on both auricles. Histopathological examination of the elbow lesions revealed features consistent with early palisaded neutrophilic granulomatous dermatitis (PNGD), whereas the auricular lesions demonstrated bullous vasculitis. Although the 2022 ACR/EULAR GPA classification score was below the diagnostic threshold, the multidisciplinary team concluded that clinical, histopathological, and radiological findings supported the diagnosis of GPA. The patient responded well to immunosuppressive therapy, including intravenous methylprednisolone, cyclophosphamide, and plasma exchange therapy.</p><p><strong>Conclusions: </strong>This case shows an unusual combination of bullous vasculitis and PNGD in a patient with GPA, highlighting the importance of recognizing uncommon skin lesions as possible clues to underlying systemic vasculitis.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"153-159"},"PeriodicalIF":0.8,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509810","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":"Dermatofibrosarcoma Protuberans at the Presumed Injection Site following CoronaVac COVID-19 Vaccination: A Case Report.","authors":"Xiaoling Cao, Rong Yin, Dongming Lv, Zhongye Xu, Zhicheng Hu, Bing Tang","doi":"10.1159/000550437","DOIUrl":"https://doi.org/10.1159/000550437","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing, locally aggressive cutaneous sarcoma. Trauma and scars have been proposed as potential triggers in a subset of cases.</p><p><strong>Case presentation: </strong>We report a 30-year-old man who developed a progressively enlarging mass in the left deltoid region within several months after receiving two doses of the CoronaVac COVID-19 vaccine administered to the same arm. The lesion was diagnosed as DFSP approximately 19 months after vaccination. Histopathology showed a storiform spindle-cell neoplasm with diffuse CD34 positivity, and fluorescence in situ hybridization demonstrated the COL1A1-PDGFB fusion, consistent with DFSP. The tumor was managed with wide local excision with 2-cm clinical margins; final margins were negative. At 24 months of follow-up after surgery, there was no evidence of local recurrence or metastasis.</p><p><strong>Conclusions: </strong>This case illustrates a temporal association between a new mass at a presumed injection site and DFSP. While causality cannot be inferred from a single case, persistent post-injection nodules should prompt evaluation. The overall benefits of COVID-19 vaccination remain substantial.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"142-147"},"PeriodicalIF":0.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442804","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}
Jordan Book, Ty Theriot, Jonathan Joseph, Christopher Haas
{"title":"Relapse of Juvenile Dermatomyositis following Eight Years in Remission: A Case Report.","authors":"Jordan Book, Ty Theriot, Jonathan Joseph, Christopher Haas","doi":"10.1159/000549462","DOIUrl":"https://doi.org/10.1159/000549462","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatomyositis is an autoimmune inflammatory condition that is characterized by proximal muscle weakness and a variety of cutaneous manifestations.</p><p><strong>Case presentation: </strong>In this report, we discuss the case of a 27-year-old white female who developed a relapse of juvenile dermatomyositis (JDM) 8 years after remission. The patient presented with a 4-month history of progressive proximal muscle weakness and rash, as well as a more recent onset of dysphagia. Severe cutaneous involvement was apparent on examination with ulcerated, pruritic plaques, violaceous papules, and diffuse erythema. Laboratories revealed elevated CK, aldolase, and CRP, with positive anti-NXP2, anti-U1 RNP, and anti-U2 RNP antibodies. Based on the clinical picture and diagnostic results, a relapse of JDM was diagnosed and various medication trials were initiated. Since initial presentation, the patient has improved and is currently stable on a regimen of hydroxychloroquine, IVIG, low-dose corticosteroids, tofacitinib, and gabapentin. Her myositis is in remission; however, she continues to experience burdensome cutaneous symptoms and overall significant disease impact.</p><p><strong>Conclusion: </strong>This case highlights the possibility of JDM relapse even after prolonged remission, underscoring the importance of maintaining a high index of suspicion for symptom recurrence. It also offers a thorough example of multimodal therapy use for refractory JDM.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"148-152"},"PeriodicalIF":0.8,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497729","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":"Successful Treatment of Refractory Erythroderma with Abrocitinib: A Case Report.","authors":"Yuping Zhang, Chen Li, Chuanjian Lu, Jingjie Yu","doi":"10.1159/000550416","DOIUrl":"https://doi.org/10.1159/000550416","url":null,"abstract":"<p><strong>Introduction: </strong>Erythroderma represents a severe dermatological condition often challenging to treat, especially in cases unresponsive to standard therapies. Currently, evidence for the use of abrocitinib in this setting is limited, leaving a gap in available treatment options.</p><p><strong>Case presentation: </strong>We report the case of an adult patient with refractory erythroderma who failed to respond to conventional treatments, including glucocorticoids, immunosuppressants, and biologics. To manage the acute flare, abrocitinib was initiated alongside a tapering course of glucocorticoids. Over the treatment course, the patient demonstrated significant clinical improvement, including reduction in erythema, associated symptoms, and hair regrowth. Importantly, the glucocorticoids were successfully discontinued, and no recurrence or serious adverse events were observed during a 6-month follow-up.</p><p><strong>Conclusion: </strong>This case indicates that abrocitinib may be a promising therapeutic option for patients with erythroderma resistant to existing treatments. Further research with larger patient cohorts is necessary to establish its efficacy and safety in this context.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"130-135"},"PeriodicalIF":0.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431135","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}
Guikuan Nie, Yahong Zhang, Xichuan Wu, Yan Luo, Huiyong Song, Hao Li, Qiyang He, Qinping Wu, Rongmeng Chen
{"title":"Holistic Treatment Incorporating Moist Wound Healing for Postoperative Radiation-Induced Perineal Ulcer in Rectal Malignancy: A Case Report.","authors":"Guikuan Nie, Yahong Zhang, Xichuan Wu, Yan Luo, Huiyong Song, Hao Li, Qiyang He, Qinping Wu, Rongmeng Chen","doi":"10.1159/000550713","DOIUrl":"10.1159/000550713","url":null,"abstract":"<p><strong>Introduction: </strong>Radiation-induced perineal ulcers are often refractory to conventional dry exposure therapies. This article reports a case of extensive radiation-induced ulceration successfully managed using a moist wound healing protocol.</p><p><strong>Case presentation: </strong>A 67-year-old male developed progressive perianal, scrotal, and penile ulceration following radiotherapy for rectal carcinoma. Four weeks of conventional dry exposure therapy proved ineffective. Upon admission, the patient was transitioned to a holistic treatment incorporating moist wound healing. This approach resulted in complete reepithelialization of the lesions within 1 week.</p><p><strong>Conclusion: </strong>This case demonstrates the limitations of dry healing protocols for radiation-induced cutaneous injuries. The application of moist wound healing principles provided rapid efficacy. This offers a valuable clinical strategy for managing refractory perineal radiation ulcers.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"115-122"},"PeriodicalIF":0.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376057","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":"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":0.8,"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":"https://doi.org/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":0.8,"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":"https://doi.org/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":0.8,"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":"https://doi.org/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":0.8,"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}