{"title":"Bullous Vasculitis in Eosinophilic Granulomatosis with Polyangiitis: A Case Report.","authors":"Tiraporn Phumwiriya, Charussri Leeyaphan","doi":"10.1159/000544815","DOIUrl":"10.1159/000544815","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis affecting small- and medium-sized vessels. It is characterized by multiorgan involvement and can lead to severe outcomes if not diagnosed promptly. Cutaneous manifestations are common and typically include palpable purpura and subcutaneous nodules. Widespread bullous vasculitis affecting areas such as the forehead and ear presents an atypical presentation. We report a case of EGPA presenting with bullous vasculitis in an unusual location.</p><p><strong>Case presentation: </strong>A 40-year-old woman with a history of late-onset allergic rhinitis presented with a 2-week history of numbness in her right leg, along with multiple erythematous papules and vesicles, some with shallow erosions, located on the forehead and left ear. She also experienced fever, progressive dyspnea, and hemoptysis. She was diagnosed with pneumonitis, alveolar hemorrhage, and mononeuritis of the right leg. Laboratory findings revealed leukocytosis with eosinophilia, and the anti-myeloperoxidase antibody was positive. Histopathological examination of the bullous lesion on the forehead showed intraepidermal separation with necrotic keratinocytes and prominent eosinophil infiltration, along with focal leukocytoclastic vasculitis. The patient was diagnosed with EGPA and started on intravenous steroids and cyclophosphamide. EGPA is a rare disease characterized by multiorgan vasculitis, asthma, and granulomatous eosinophilic inflammation, which are its key hallmarks. While cutaneous involvement is common, bullous vasculitis is rarely observed on the forehead and ear.</p><p><strong>Conclusions: </strong>EGPA is a challenging diagnosis due to its variable presentation. While cutaneous manifestations are common, widespread bullous vasculitis may be atypical and rare clinical presentation. This case underscores the importance of considering EGPA in the differential diagnosis of bullous vasculitis, particularly when associated with systemic symptoms and eosinophilia. Early recognition and treatment are crucial for improving outcomes in this potentially life-threatening condition.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"74-79"},"PeriodicalIF":0.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708674","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":"<i>Curvularia lunata</i>-Induced Onychomycosis in an Unlikely Host: A Case Report.","authors":"Marwa Hallal, Grace Obeid","doi":"10.1159/000543525","DOIUrl":"10.1159/000543525","url":null,"abstract":"<p><strong>Introduction: </strong>Onychomycosis, a fungal infection of the nail apparatus, presents with various manifestations, including subungual hyperkeratosis, onycholysis, and nail plate destruction. Established risk factors include trauma, advanced age, and comorbidities such as diabetes and immunosuppression. <i>Trichophyton rubrum</i>, classified as a dermatophyte, is the primary causative agent, with dermatophytes contributing to 60-70% of cases. Nondermatophyte molds (NDM) account for 30-40% of onychomycosis with Candida species being the most commonly identified, while <i>Curvularia</i> species are rarely encountered. <i>Curvularia lunata</i>, a saprobic dematiaceous mold, is an infrequent human pathogen primarily residing in soil. While human diseases caused by <i>Curvularia</i> are rare, they encompass a spectrum from skin infections to endocarditis.</p><p><strong>Case presentation: </strong>This case report details a 53-year-old male engineer presenting with left big toenail discoloration, revealing a <i>C. lunata</i>-induced onychomycosis through positive KOH preparation and culture. Given the patient's concurrent use of ticagrelor, oral terbinafine hydrochloride was chosen as a therapeutic option, taking into account potential drug-drug interactions. This approach resulted in complete resolution. The discussion emphasizes distinctions in disease severity among immunocompromised and immunocompetent patients, the potential role of trauma in <i>Curvularia</i> infections, and the importance of comprehensive diagnostic examinations.</p><p><strong>Conclusion: </strong>This case report provides insight into the challenges of accurate diagnosis, emphasizing the need for routine fungal cultures. Additionally, it discusses the complexities of treatment options, considering factors such as drug interactions and patient-specific conditions, and highlighting the importance of tailored management plans. This case is reported because of the rarity of onychomycosis caused by <i>Curvularia</i> in immunocompetent individuals.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"61-67"},"PeriodicalIF":0.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566023","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}
Bashayr S Alhubayshi, Abdulaziz A Alnoshan, Ahmed A Alhumidi, Asem Shadid
{"title":"Bullous Lichen Planus Treated with Adalimumab: A Case Report.","authors":"Bashayr S Alhubayshi, Abdulaziz A Alnoshan, Ahmed A Alhumidi, Asem Shadid","doi":"10.1159/000543523","DOIUrl":"10.1159/000543523","url":null,"abstract":"<p><strong>Introduction: </strong>Bullous lichen planus is a rare variant of lichen planus that is characterized by vesiculobullous lesions developing in the setting of preexisting LP lesions with a burning and painful feeling. Bullous lichen planus treatment is difficult since so few examples of the condition have been documented in the literature.</p><p><strong>Case presentation: </strong>A 46-year-old female presented to our outpatient clinic with pruritic violaceous bullae involving lower extremities and oral mucosa for 8 years. After extensive investigations, a diagnosis of bullous lichen planus was made and successfully treated with adalimumab after failure of other treatment options.</p><p><strong>Conclusion: </strong>Adalimumab may represent a promising, efficacious, and safe monotherapy option for the management of bullous lichen planus. The therapeutic value of this novel off-label use should be assessed in controlled clinical trials.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"42-47"},"PeriodicalIF":0.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448246","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}
Andrea Malagón-Liceaga, Alejandra Juárez-Flores, Ana Lilia Ruelas-Villavicencio
{"title":"Reconstruction Techniques for the Medial Canthus and Lateral Nasal Wall: A Case-Based Learning Approach.","authors":"Andrea Malagón-Liceaga, Alejandra Juárez-Flores, Ana Lilia Ruelas-Villavicencio","doi":"10.1159/000543603","DOIUrl":"10.1159/000543603","url":null,"abstract":"<p><strong>Introduction: </strong>Reconstruction of the medial canthus and lateral nasal wall poses a significant challenge in dermatologic surgery due to the area's complex, concave, three-dimensional anatomy, and proximity to critical structures like the nasolacrimal system.</p><p><strong>Case presentation: </strong>This case-based learning approach details three different techniques on the management of extensive defects involving the medial canthus and lateral nasal wall, focusing on three different surgical techniques: the Mustardé flap, a combination of flaps with a graft, and a supraclavicular skin graft. All three approaches achieved satisfactory clinical and cosmetic outcomes.</p><p><strong>Conclusion: </strong>Successful reconstruction in this region requires a multidisciplinary approach that carefully integrates facial esthetic units while preserving the functional integrity.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"48-53"},"PeriodicalIF":0.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457019","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}
Aljoharah Al Saud, Reem Alsergani, Ahmed Alhumidi, Abdullah Aleisa
{"title":"Multiple Primary Cutaneous Anaplastic Large Cell Lymphoma: A Case Report.","authors":"Aljoharah Al Saud, Reem Alsergani, Ahmed Alhumidi, Abdullah Aleisa","doi":"10.1159/000543349","DOIUrl":"10.1159/000543349","url":null,"abstract":"<p><strong>Introduction: </strong>Anaplastic large cell lymphomas (ALCL) are a subtype of non-Hodgkin lymphoma categorized into systemic and cutaneous (cALCL) subtypes. cALCL are frequently characterized by their lack of ALK receptor expression, which differentiates them from their systemic counterparts. cALCLs present as solitary or grouped skin lesions. Due to their rarity, cALCLs are frequently misdiagnosed as other skin conditions.</p><p><strong>Case presentation: </strong>We report the case of a female with a 30-year history of expanding skin lesions on the upper and lower limbs, abdomen, and back. During her initial presentation, the lesions were thought to be due to an arthropod bite. However, lesion biopsy revealed ALK-negative cALCL and methicillin-resistant <i>Staphylococcus aureus.</i> A full workup excluded systemic ALCL and, therefore, confirmed the diagnosis of primary cALCL. The patient was placed on methotrexate to treat the lesions and sulfamethoxazole/trimethoprim to treat the infection.</p><p><strong>Conclusion: </strong>Our case highlights the need to consider cALCL in the differential diagnosis of patients with persistent skin lesions.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"68-73"},"PeriodicalIF":0.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566041","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}
Xinru Chen, Na Zhang, Hongping Ge, Xiaoli Zhai, Meiyan Wang, Min Zhang
{"title":"Pigmented Superficial Basal Cell Carcinoma of the Nipple-Areola Complex: A Case Report.","authors":"Xinru Chen, Na Zhang, Hongping Ge, Xiaoli Zhai, Meiyan Wang, Min Zhang","doi":"10.1159/000542168","DOIUrl":"10.1159/000542168","url":null,"abstract":"<p><strong>Introduction: </strong>Basal cell carcinoma (BCC) is the most common type of skin malignancy, accounting for approximately 80% of all non-melanoma skin cancers (NMSCs). Ultraviolet (UV) exposure is a significant risk factor for BCC development, which typically occurs in sun-exposed areas. BCC arising in non-sun-exposed regions, such as the nipple-areola complex (NAC), is exceedingly rare, with fewer than 100 cases reported globally. This report describes a case of pigmented superficial BCC in the NAC of a 76-year-old Asian woman.</p><p><strong>Case presentation: </strong>A 76-year-old Asian female presented with a 5-year history of a slowly enlarging lesion on her left breast, with recent rapid growth. Physical examination revealed a 10 mm × 8 mm blue-gray, pearl-like plaque on the NAC. Histopathology confirmed pigmented superficial BCC. Preoperative imaging, including breast ultrasound, chest computed tomography (CT), SPECT-CT, and axillary lymph node ultrasound, showed no evidence of metastasis. The patient underwent standard surgical excision with a 10 mm margin, followed by pathologic evaluation, confirming clear margins. The patient was discharged on the second postoperative day and remained asymptomatic at a 3-month follow-up.</p><p><strong>Conclusion: </strong>Pigmented superficial BCC of the NAC is an uncommon presentation due to the area's minimal sun exposure and lack of pilosebaceous units. This case underscores the importance of considering BCC in non-sun-exposed areas, particularly in elderly patients. While nonsurgical options such as photodynamic therapy may offer superior esthetic outcomes, the patient's financial constraints led to the selection of a cost-effective surgical excision, which successfully eliminated the tumor.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"19-25"},"PeriodicalIF":0.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000551","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}
Ali Sadeghinia, Yasaman Sadeghi, Alireza Ghanadan, Elham Mazaherpour
{"title":"Verrucous Eccrine Angiomatous Hamartoma: A Case Report.","authors":"Ali Sadeghinia, Yasaman Sadeghi, Alireza Ghanadan, Elham Mazaherpour","doi":"10.1159/000533667","DOIUrl":"10.1159/000533667","url":null,"abstract":"<p><p>Eccrine angiomatous hamartoma (EAH) is a rare malformation presenting with the proliferation of eccrine glands and other dermal structures. It typically presents as a solitary lesion on extremities that appears at birth or during childhood. It is generally asymptomatic but may be associated with hyperhidrosis or pain. Here we report a case of verrucous EAH located on the heel of a 27-year-old man, which is an uncommon presentation of this tumor, and review the clinical characteristics, histologic findings, and prognosis of this rare condition.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"38-41"},"PeriodicalIF":0.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078146","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}
Anvar Paraparambil Vellamgot, Rajesh Pattu Valappil, Ahmed Hosny Tomerak, Hakam Khatib, Khalil Salameh
{"title":"Frieden's Group-V Aplasia Cutis Congenita with in utero Scarring in a Dichorionic Twin: A Case Report and Comprehensive Literature Review.","authors":"Anvar Paraparambil Vellamgot, Rajesh Pattu Valappil, Ahmed Hosny Tomerak, Hakam Khatib, Khalil Salameh","doi":"10.1159/000541676","DOIUrl":"10.1159/000541676","url":null,"abstract":"<p><strong>Introduction: </strong>Aplasia cutis congenita (ACC) is a rare congenital disorder characterized by the localized absence of skin at birth, primarily affecting the scalp but also affecting the trunk and limbs. Nine different presentations have been reported. Group V-ACC (G-V ACC) is a rare type associated with fetus papyraceus. The pathogenesis is speculated to involve ischemia from acute hypovolemia or disseminated intravascular coagulation due to thrombotic tissue affecting the surviving twin. Management of ACC depends on lesion severity, focusing on preventing infection and promoting healing, with conservative measures in most cases and surgical intervention in some cases. The long-term prognosis for isolated G-V ACC is generally favorable unless associated with systemic complications.</p><p><strong>Case presentation: </strong>We report a neonate diagnosed with Group G-V ACC associated with fetus papyraceus from a dichorionic diamniotic twin pregnancy. Born to a 28-year-old Asian mother, this female infant presented with extensive, healed, scar-like lesions on her flanks and upper thighs. These lesions were consistent with the \"H\"-shaped distribution commonly described in ACC linked to fetus papyraceus. Despite significant dermatological manifestations, the infant showed no other external abnormalities or systemic involvement, and comprehensive screenings, including ultrasounds and chromosomal microarray, were normal.</p><p><strong>Conclusion: </strong>This discussion highlights the rarity of ACC associated with fetus papyraceus, with only a few over 100 cases reported globally. This case underscores the importance of recognizing the patterns and potential complications of ACC in twins, contributing to better diagnostic acumen and management strategies for neonatal care.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"1-8"},"PeriodicalIF":0.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876248","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}
Soma Nakaso, Nobuaki Ishii, Masataka Akimoto, Rei Ogawa
{"title":"Diagnostic Imaging of Primary Cutaneous Osteoma of the Forehead.","authors":"Soma Nakaso, Nobuaki Ishii, Masataka Akimoto, Rei Ogawa","doi":"10.1159/000543125","DOIUrl":"10.1159/000543125","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoma cutis is a rare benign cutaneous nodule characterized by ectopic bone formation in the dermis or subcutaneous tissue. While most cases of osteoma cutes are secondary to inflammation, tumors, or scars, there are rare primary cases with no apparent preceding lesion. Primary osteoma cutis can be broadly classified into two categories: those associated with metabolic abnormalities, such as pseudohypoparathyroidism and Albright's hereditary osteodystrophy, and those without such underlying conditions in a more specific sense.</p><p><strong>Case presentation: </strong>We present a case of primary osteoma cutis specifically located on the forehead in a young woman. Histopathological findings revealed a nodule of bone tissue within the dermis, along with some contiguous cartilage tissue. The patient underwent preoperative ultrasonography, computed tomography, and magnetic resonance imaging.</p><p><strong>Conclusion: </strong>We report this case because there have been no reports of primary osteoma cutis with complete preoperative imaging findings to the best of our knowledge.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"26-32"},"PeriodicalIF":0.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467005","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":"Atypical Bilateral Hyperpigmented Macules on the Lower Legs Possibly due to Cyclophosphamide.","authors":"Jun Yamamoto, Taku Fujimura, Yoshihide Asano","doi":"10.1159/000543124","DOIUrl":"10.1159/000543124","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapeutic agents occasionally induce various cutaneous adverse events, but hyperpigmentation due to cyclophosphamide is extremely rare.</p><p><strong>Case presentation: </strong>A case of atypical bilateral hyperpigmented macules on the lower legs possibly due to cyclophosphamide was presented. A physical examination on his initial visit revealed xerotic skin exhibiting brownish discoloration with black scales on both lower legs. In addition, diffuse pigmented macules were distributed on the nail beds and tongues. Dermoscopic findings revealed brownish unstructured areas and black dots consistent with follicles. A biopsy specimen from his lower leg showed an increased melanin in the basal and stratum corneum. We diagnosed him as having bilateral hyperpigmented macules on the lower legs possibly due to cyclophosphamide.</p><p><strong>Conclusion: </strong>Although the mechanism of hyperpigmentation caused by cyclophosphamide is still unknown, our present case suggests that cutaneous hyperpigmentation is likely due to direct stimulation of hair follicles by cyclophosphamide.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"14-18"},"PeriodicalIF":0.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467003","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}