Case Reports in Dermatology最新文献

{"title":"Cellulitis Caused by Mixed Infection with Group A Streptococci and Non-Toxigenic tox-Gene-Bearing <i>Corynebacterium diphtheriae</i>: A Case Report.","authors":"Mohammed Shanshal, Pallavi Sanjay Wadhe","doi":"10.1159/000552211","DOIUrl":"10.1159/000552211","url":null,"abstract":"<p><strong>Introduction: </strong>Cutaneous diphtheria has re-emerged in Europe, often presenting as skin-limited disease. Uncertainty around diagnosis, infection control, and toxigenicity testing can delay appropriate management.</p><p><strong>Case presentation: </strong>A 62-year-old woman experiencing homelessness presented with a 2-week history of a painful lower-leg eruption. This evolved from vesicles to bullae and shallow ulcers with a characteristic green-grey pseudomembrane, unresponsive to oral flucloxacillin. Swabs of the ulcer grew <i>Corynebacterium diphtheriae</i> and concurrent group A β-haemolytic streptococci, while throat swabs were negative. The national reference laboratory confirmed a non-toxigenic, tox-gene-bearing strain by tox polymerase chain reaction with a negative Elek test. After failing to respond to intravenous flucloxacillin, the patient was treated empirically with intravenous ceftriaxone, followed by oral azithromycin 500 mg once daily for 10 days, which led to complete clinical resolution.</p><p><strong>Conclusion: </strong>This case highlights that skin-limited <i>C. diphtheriae</i> can mimic common skin infections and coexist with other pathogens. Key management priorities include (1) early lesion culture with specific request for <i>C. diphtheriae</i> and tox-gene testing; (2) prompt notification to public health authorities; and (3) implementation of appropriate infection-control precautions. For non-toxigenic cutaneous disease, a macrolide or penicillin-based antibiotic course is typically sufficient, and diphtheria antitoxin is generally not required.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"322-327"},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343962","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":"Preconditioning with 1,570-nm Laser before Reduction Mammoplasty in a Patient with a Predisposition for Keloid Scars: A Case Report.","authors":"Sharon Moscovici, Omer Dor, Yoad Govrin, Yoav Eros, Lior Heller, Shaked Menashe","doi":"10.1159/000551985","DOIUrl":"10.1159/000551985","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Keloid formation remains a major challenge in high-risk surgical patients, and no standard prophylactic strategy has been established. This case reports the use of preoperative 1,570-nm fractional non-ablative laser preconditioning as part of a multimodal scar prevention protocol in a patient with a documented predisposition to keloid scarring. <b><i>Case Presentation:</i></b> A 24-year-old woman with symptomatic macromastia and marked tendency for pathological scarring underwent bilateral reduction mammoplasty after several surgeons had previously declined surgery because of her high risk of keloid formation. She received three preoperative 1,570-nm fractional laser sessions over 6 weeks, followed by reduction mammoplasty with meticulous low-tension, multilayered closure. Beginning 14 days postoperatively, she underwent five adjunctive treatment sessions at 6-week intervals using combined fractional 10,600-nm and 1,570-nm laser therapy, with selective intralesional triamcinolone acetonide and ultrasound-assisted delivery. Follow-up through 12 months included serial clinical, photographic, and Vancouver Scar Scale assessments. Healing was uneventful, with no wound dehiscence, infection, pain, pruritus, or functional limitation. No postoperative keloid formation was observed, and the scars remained flat, thin, and pliable throughout follow-up. The total Vancouver Scar Scale score improved from 9 at 3 months to 1 at 12 months, representing an 88.9% reduction. The patient reported high satisfaction with both functional and aesthetic outcomes. <b><i>Conclusion:</i></b> This case suggests that preoperative 1,570-nm laser preconditioning, when integrated with meticulous surgical technique and structured postoperative multimodal scar management, may be a feasible preventive approach in carefully selected patients at high risk for keloid formation. Prospective comparative studies are needed to clarify the incremental contribution of preconditioning within multimodal scar prevention strategies.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"328-336"},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343920","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":"Dapsone for Treatment of a Neutrophilic Predominant Variant of Polymorphous Light Eruption: A Case Report.","authors":"Oluwafunke Oluwatosin Ogunremi, Zachary Hopkins","doi":"10.1159/000552174","DOIUrl":"10.1159/000552174","url":null,"abstract":"<p><strong>Introduction: </strong>Polymorphous light eruption (PMLE) is a self-limiting immunologically mediated photodermatitis that results in the eruption of pruritic lesions hours to days after sun exposure.</p><p><strong>Case presentation: </strong>The case presented here highlights the clinical presentation of a 39-year-old Caucasian male with an itchy, blistering rash affecting the chest, abdomen, arms, and legs. History and examination findings were suggestive of a neutrophil predominant variant of PMLE. The rash was evaluated through laboratory testing, potassium hydroxide (KOH) microscopy, wound culture, and punch biopsy. The hematoxylin and eosin (H&E) stain results from the biopsy demonstrated eosinophilic and neutrophilic spongiosis. Various therapeutic modalities were explored in the treatment of this patient including topical steroids, oral steroids, oral antifungals, and oral antihistamines with a lack of remission of the symptoms. Due to the persistent nature of the rash and neutrophil predominance visualized on H&E, dapsone was begun with eventual cessation of symptoms and resolution of the rash.</p><p><strong>Conclusion: </strong>This case highlights the importance of scrutinizing the underlying pathophysiology of a patient's symptoms despite variations in the suspected clinical picture for effective management of symptoms.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"337-345"},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350924","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":"Topical Statins in Porokeratosis: Case Report with Focused Literature Review.","authors":"Mohammed Shanshal","doi":"10.1159/000552057","DOIUrl":"10.1159/000552057","url":null,"abstract":"<p><strong>Introduction: </strong>Porokeratosis is a disorder of keratinisation linked to mevalonate pathway defects and often resistant to conventional therapy. Topical statins, which target this pathway directly, represent a rational mechanism-based treatment.</p><p><strong>Case presentation: </strong>A 63-year-old woman with disseminated superficial actinic porokeratosis (DSAP), refractory to calcipotriol and 5-fluorouracil, was treated with compounded simvastatin 2% cream twice daily. After 6 months, erythema and scale were markedly reduced; thin papules flattened almost completely, whereas hyperkeratotic plaques improved only partially. Treatment was well tolerated without systemic adverse effects, and the patient was maintained on once-daily application to prevent relapse.</p><p><strong>Literature review: </strong>Evidence from 10 representative reports - including one randomised controlled trial (RCT) and one controlled split-body study - shows reproducible benefit of topical statins across DSAP and selected other variants. Early inflammatory lesions often flatten fastest, whereas older hyperkeratotic plaques improve more slowly; relapse has been reported after discontinuation, supporting the use of maintenance therapy. Safety is favourable, largely mild local irritation, with rare events such as allergic contact dermatitis to simvastatin and transient creatine kinase elevation/myalgia. The role of cholesterol co-formulation remains uncertain: the RCT found no added benefit, while split-face and case reports suggest activity of cholesterol alone in limited contexts. Standardised formulations and larger controlled trials are needed.</p><p><strong>Conclusion: </strong>Topical statins are a promising, low-toxicity therapy for porokeratosis. Larger, controlled studies are needed to standardise formulations, optimise maintenance, and confirm long-term safety.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"284-291"},"PeriodicalIF":0.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270569","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 Associated with Lymphoid Follicles Harboring Germinal Center: A Case Report.","authors":"Masatoshi Deguchi, Moyuka Wada-Irimada, Hitoshi Terui, Takuya Takahashi, Yoshihide Asano","doi":"10.1159/000552058","DOIUrl":"10.1159/000552058","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatofibromas (DFs) are common, benign firm dermal nodules. It is well known that their onsets often follow minor injuries, including insect bites or arthropod assaults on-site. The frequency of DF cases associated with lymphoid follicles (LF) harboring germinal center (GC) amounts to around 1∼4%. The pathogenesis of this peculiar association is currently unknown, leaving a challenging topic for interpretation.</p><p><strong>Case presentation: </strong>We present a case of a 55-year-old, otherwise healthy woman with a slightly erythematous flat nodule on the right side of her neck. It had occurred 3 months after a mosquito bite on the same site, and the lesion was tender. The nodule was eradicated completely from the right side of her neck as excisional biopsy after the treatment of secondary infection. Histopathological specimen revealed a fibrocollagenous type of DF with well-organized multiple B-cell secondary LFs. Their GCs indicated harboring bcl-6-positive, CXCR5-positive follicular helper T cells in the network of follicular dendritic cells. In addition, they were surrounded by CD163-positive-DC-SIGN (CD209)-positive macrophages expressing Toll-like receptor (TLR) 4. We diagnosed the lesion as DF associated with LF harboring GC, presumably driven by the Th27/Th2 microenvironment.</p><p><strong>Conclusion: </strong>Given that GC-associating LF in the present case is presumed to manifest Th27/Th2 microenvironment formation, the implication is that it plays a role in humoral immunity against extracellular pathogens. When miscellaneous pathogens bearing fucose-containing carbohydrate antigens happened to invade the dermis through minor injuries, DC-SIGN, a pattern recognition receptor, and TLR4 on macrophages may have modulated Th differentiation into Th27/Th2 to generate follicular helper T cells and GC to induce humoral immunity. Accumulation of reports is required to check the validity of this speculation.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"297-301"},"PeriodicalIF":0.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307089","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":"Zoonotic Orthopoxvirus Infection.","authors":"Bernadett Kurz, Dennis Niebel, Susanne Bauer, Julian Kögel, Mark Berneburg, Sigrid Karrer","doi":"10.1159/000551842","DOIUrl":"10.1159/000551842","url":null,"abstract":"<p><strong>Introduction: </strong>Cowpox virus (CPXV) is a rare zoonotic orthopoxvirus infection, most commonly transmitted to humans via infected domestic cats. It typically causes necrotic skin lesions accompanied by systemic symptoms such as fever and lymphadenopathy. Diagnosis is confirmed by polymerase chain reaction (PCR) and sequencing, and management is mainly supportive.</p><p><strong>Case presentation: </strong>A 64-year-old farmer presented with painful, clustered necrotic lesions on the face and neck evolving over 10 days, associated with fever and lymphadenopathy. Due to the facial distribution and severity, broad empirical treatment with intravenous acyclovir and ceftriaxone was initiated. Diagnostic testing for common infectious causes was negative, and bacterial cultures showed no growth. Based on lesion morphology and relevant animal exposure, orthopoxvirus infection was suspected. PCR of skin swab material confirmed orthopoxvirus DNA, and sequencing identified CPXV/catpox virus.</p><p><strong>Conclusion: </strong>This case highlights CPXV infection in an older host with prominent facial clustering, initially requiring broad empirical therapy. CPXV should be considered in patients with necrotic facial lesions and animal exposure. PCR-based diagnostics are essential for confirmation, and the clinical course is usually benign with supportive management, although residual scarring may occur.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"292-296"},"PeriodicalIF":0.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276223","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":"Erratum.","authors":"","doi":"10.1159/000551340","DOIUrl":"10.1159/000551340","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000549986.].</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"182"},"PeriodicalIF":0.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643989","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":"Erratum.","authors":"","doi":"10.1159/000551341","DOIUrl":"10.1159/000551341","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000549963.].</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"183"},"PeriodicalIF":0.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644063","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":"Rapid Remission through Multimodal Therapy in a Severe Form of PASH Syndrome: A Case Report.","authors":"Caspar Bernhard Lohmer, Jennifer von Stebut-Marx, Tabea Wilhelm, Claudia Rasche, Sylke Schneider-Burrus","doi":"10.1159/000551256","DOIUrl":"10.1159/000551256","url":null,"abstract":"<p><strong>Introduction: </strong>PASH syndrome is a rare autoinflammatory dermatosis characterized by the triad of pyoderma gangrenosum (PG), acne conglobata, and hidradenitis suppurativa (HS), driven by innate immune dysregulation and IL-1-mediated neutrophilic inflammation.</p><p><strong>Case presentation: </strong>We report a 38-year-old woman presenting with severe HS (Hurley stage III), chronic nodulocystic facial acne, and PG-like ulcers, consistent with PASH syndrome. Her condition was marked by debilitating pain (VAS 8/10), malodorous discharge, and extensive ulceration, necessitating examination under general anesthesia. Previous therapies, including antibiotics and adalimumab, had failed. Surgical intervention involved fistula excision, wound debridement, and drainage. Histopathology confirmed neutrophilic inflammation without systemic disease. A combination of intravenous ertapenem, high-dose corticosteroids, and oral cyclosporine A led to rapid clinical improvement: pain resolution, mobility recovery, and complete healing of lesions within 8 weeks.</p><p><strong>Conclusion: </strong>This case highlights the importance of early recognition of PASH through its cutaneous triad. Given the absence of standardized treatment guidelines, a multimodal, individualized approach, incorporating surgery, antimicrobial therapy, and immunosuppression is crucial. Our findings support the effectiveness of cyclosporine A and corticosteroids in achieving remission and underscore the need for multidisciplinary care in managing this complex dermatosis.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"256-263"},"PeriodicalIF":0.7,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197517","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 Perifollicular Fibrous Papules of the Neck Mimicking Verruca Plana in an Elderly Woman: A Case Report.","authors":"Ahmad Assiri","doi":"10.1159/000551900","DOIUrl":"10.1159/000551900","url":null,"abstract":"<p><strong>Background: </strong>Multiple small papular lesions on the neck and face in adults are commonly attributed to viral warts or adnexal tumors, but benign mesenchymal proliferations such as perifollicular fibromas may be overlooked and misdiagnosed.</p><p><strong>Case presentation: </strong>A 64-year-old woman presented with numerous asymptomatic, skin-colored papules on the lateral and posterior neck and face, progressively increasing over years. Clinical differentials included verruca plana, syringoma, and benign adnexal tumors. Punch biopsy revealed concentric perifollicular dermal fibrosis without viral cytopathic changes or adnexal proliferation, consistent with multiple perifollicular fibromas.</p><p><strong>Conclusion: </strong>Multiple perifollicular fibromas can clinically mimic viral warts. Histopathology remains essential for accurate diagnosis, preventing unnecessary destructive or antiviral therapies.</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"18 1","pages":"271-277"},"PeriodicalIF":0.7,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223412","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}