Case Reports in Dermatological Medicine https://www.hindawi.com The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. A Case of Granuloma Annulare Associated with Secukinumab Use Mon, 22 May 2017 08:36:00 +0000 http://www.hindawi.com/journals/cridm/2017/5918708/ Granuloma annulare (GA) is a benign inflammatory dermatosis characterized clinically by dermal papules and annular plaques. The pathogenesis of GA is not well understood, although it is thought to result from a delayed-type hypersensitivity reaction in which inflammatory cells elicit connective tissue degradation. This condition has been seen following the use of several drugs, including tumor necrosis factor-alpha (TNF-) inhibitors, which paradoxically have also been reported to treat GA. We report the case of a patient who developed GA in association with secukinumab, an interleukin-17A antagonist, and discuss its implications for our understanding of the pathogenesis of GA. Lauren Bonomo, Sara Ghoneim, and Jacob Levitt Copyright © 2017 Lauren Bonomo et al. All rights reserved. Intracorneal Hematoma Showing Clinical and Dermoscopic Features of Acral Lentiginous Melanoma Mon, 08 May 2017 08:33:37 +0000 http://www.hindawi.com/journals/cridm/2017/3509146/ Intra- and subcorneal hematoma, a skin alteration seen palmar and plantar after trauma or physical exercise, can be challenging to distinguish from in situ or invasive acral lentiginous melanoma. Thus, careful examination including dermoscopic and histologic assessment may be necessary to make the correct diagnosis. We here present a case of a 67-year-old healthy female patient who presented with a pigmented plantar skin alteration. Differential diagnoses included benign skin lesions, for example, hematoma or melanocytic nevus, and also acral lentiginous melanoma or melanoma in situ. Since clinical and dermoscopic examinations did not rule out a malignant skin lesion, surgical excision was performed and confirmed an intracorneal hematoma. In summary, without adequate physical trigger, it may be clinically and dermoscopically challenging to make the correct diagnosis in pigmented palmar and plantar skin alterations. Thus, biopsy or surgical excision of the skin alteration may be necessary to rule out melanoma. Ugur Uslu, Franz Heppt, and Michael Erdmann Copyright © 2017 Ugur Uslu et al. All rights reserved. A Severe Case of Lymphomatoid Papulosis Type E Successfully Treated with Interferon-Alfa 2a Sun, 30 Apr 2017 06:08:36 +0000 http://www.hindawi.com/journals/cridm/2017/3194738/ Lymphomatoid papulosis (LyP) is a benign papulonodular skin eruption with histologic features of malignant lymphoma. A new variant of LyP which was termed “type E” was recently described with similar clinical and histological features to angiocentric and angiodestructive T-cell lymphoma. LyP type E is characterized with recurrent papulonodular lesions which rapidly turn into hemorrhagic necrotic ulcers and spontaneous regression by leaving a scar. None of the available treatment modalities affects the natural course of LyP. For therapy various modalities have been used such as topical and systemic steroids, PUVA, methotrexate, bexarotene, and IFN alfa-2b. Here we present a severe and devastating case with a very rare variant of LyP type E, which is, to our knowledge, the first case successfully treated with IFN alfa-2a. Now disease has been maintaining its remission status for six months. Aslı Bilgiç Temel, Betül Unal, Hatice Erdi Şanlı, Şeniz Duygulu, and Soner Uzun Copyright © 2017 Aslı Bilgiç Temel et al. All rights reserved. PUVA Induced Bullous Pemphigoid in a Patient with Mycosis Fungoides Sun, 16 Apr 2017 08:17:19 +0000 http://www.hindawi.com/journals/cridm/2017/6134752/ Background. Bullous pemphigoid is an autoimmune subepidermal blistering skin disease in which autoantibodies are directed against components of the basement membrane. The disease primarily affects the elderly people and in most of the patients inducing factors cannot be identified. Herein, we report a case of BP that occurred in a patient who was receiving PUVA therapy for the treatment of mycosis fungoides. Main Observation. A 26-year-old woman with mycosis fungoides developed blisters while receiving PUVA therapy. On physical examination tense bullae on the normal skin, remnants of blisters, and erosions were observed on her breasts, the chest wall, and the upper abdomen. Histopathological investigations revealed subepidermal blisters with eosinophilic infiltration and in direct immunofluorescence examination linear deposition of IgG along the basement membrane zone was observed. The diagnosis of bullous pemphigoid was also confirmed by ELISA and BIOCHIP mosaic-based indirect immunofluorescence test. Conclusions. PUVA therapy is an extremely rare physical factor capable of inducing bullous pemphigoid. So the development of blistering lesions during PUVA therapy may be suggestive sign of a bullous disease such as bullous pemphigoid and it should be excluded with proper clinical and laboratory approaches immediately after withdrawal of PUVA therapy. Birgül Özkesici, Saliha Koç, Ayşe Akman-Karakaş, Ertan Yılmaz, İbrahim Cumhur Başsorgun, and Soner Uzun Copyright © 2017 Birgül Özkesici et al. All rights reserved. A Tale of Two Cysts: Steatocystoma Multiplex and Eruptive Vellus Hair Cysts—Two Case Reports and a Review of the Literature Wed, 05 Apr 2017 09:40:28 +0000 http://www.hindawi.com/journals/cridm/2017/3861972/ Background. Steatocystoma multiplex (SM) and eruptive vellus hair cysts (EVHC) are uncommon benign tumors of the pilosebaceous unit. Both SM and EVHC are characterized by smooth, asymptomatic papules or nodules, most commonly presenting on the chest, limbs, and abdomen. Most cases of SM and EVHC are sporadic, although less common autosomal dominant inherited forms have been reported. Main Observation. In this report we present two cases of cutaneous cysts exhibiting characteristics of either SM or EVHC. Both patients presented with numerous 1-2 mm asymptomatic papules and responded well to surgical expression by incision and drainage (I&D). Conclusion. SM and EVHC are similar in clinical presentation and management. Previously reported “hybrid-type” tumors present strong evidence for a relationship between the two lesions pathologically. Due to potential similarity of EVHC and SM cyst contents, I&D and subsequent microscopic examination cannot definitely differentiate between EVHC, SM, and hybrid cysts. Rachel J. Waldemer-Streyer and Ellen Jacobsen Copyright © 2017 Rachel J. Waldemer-Streyer and Ellen Jacobsen. All rights reserved. Successful Treatment of Facial Acne Fulminans: Antimicrobial Agents and Oral Prednisolone as Promising Regimes Mon, 27 Mar 2017 00:00:00 +0000 http://www.hindawi.com/journals/cridm/2017/7092910/ Acne fulminans (AF), also known as acne maligna, is a rare painful ulcerative form of acne with an abrupt onset and systemic symptoms. Its incidence appears to be decreasing, possibly because of earlier and better treatment of acne. This report highlights a case on a necrotizing facial wound due to AF that was successfully treated with oral prednisolone and antimicrobial medication. Amir Hossein Siadat, Anis Bostakian, Bahareh Abtahi-Naeini, and Masoom Shahbazi Copyright © 2017 Amir Hossein Siadat et al. All rights reserved. Development of Asymmetric Facial Depigmentation in a Patient Treated with Dasatinib with New-Onset Hypovitaminosis D: Case Report and Review of the Literature Thu, 23 Mar 2017 00:00:00 +0000 http://www.hindawi.com/journals/cridm/2017/9359086/ Dasatinib is a second-generation tyrosine kinase inhibitor (TKI) used to treat imatinib-resistant chronic myelogenous leukemia (CML), as well as other Philadelphia chromosome-positive lymphoproliferative disorders. While the most commonly reported cutaneous side effects with this therapy include a morbilliform eruption, skin exfoliation, and skin irritation, pigmentary abnormalities have also been observed, albeit much more rarely. We present the case of a 72-year-old South Asian male with CML who presented with new-onset hypopigmentation of his face and scalp three years after a dose increase of dasatinib therapy, in the setting of newly discovered borderline hypovitaminosis D. Dasatinib and the other TKIs are believed to induce dyschromias via modulation of the c-kit receptor and its associated signaling pathway, which is involved in melanocyte survival, proliferation, and migration. Kirsten C. Webb, Magdalena Harasimowicz, Monica Janeczek, Jodi Speiser, James Swan, and Rebecca Tung Copyright © 2017 Kirsten C. Webb et al. All rights reserved. Eccrine Nevus Presenting with Umbilical Discharge: A Case Report and Review of the Literature Tue, 21 Mar 2017 07:12:22 +0000 http://www.hindawi.com/journals/cridm/2017/9761843/ Eccrine nevus is a rare skin lesion with protean manifestations like hyperhidrosis, discolored nodules, papules, and so forth, which has been reported in various anatomic parts of the body including the forearm, leg, thigh, back, and coccyx. Our patient was a 26-year-old male, who presented with increasing colorless and odorless episodic umbilical discharge. First impression for the patient was an umbilical sinus and the patient underwent surgery. Histopathological study revealed the lesion to be an eccrine nevus of the umbilicus. This is the first case of eccrine nevus presenting with umbilical discharge. We recommend that eccrine nevus should be considered as a differential diagnosis for umbilical discharge. Farahnaz Bidari-Zerehpoosh, Shahram Sabeti, Farid Arman, and Hania Shakeri Copyright © 2017 Farahnaz Bidari-Zerehpoosh et al. All rights reserved. Unusual Sites of Cutaneous Tuberculosis: A Report of Two Cases Mon, 27 Feb 2017 08:10:53 +0000 http://www.hindawi.com/journals/cridm/2017/7285169/ Cutaneous tuberculosis (CTB) is an uncommon small subset of extrapulmonary tuberculosis, comprising 1–1.5% of all extrapulmonary tuberculosis manifestations, which manifests only in 8.4–13.7% of all tuberculosis cases. Lupus vulgaris (LV) and tuberculosis verrucosa cutis (TBVC) are forms of reinfection tuberculosis and often occur in presensitized patients, by exogenous inoculation. We report two cases of cutaneous tuberculosis at unusual sites. A 35-year-old female having a forehead lesion for 2 years was diagnosed as having tuberculosis verrucosa cutis and another 16-year-old girl with lesion in left axilla for 10 years was proven to have lupus vulgaris. The delayed diagnosis was possibly due to lower clinical suspicion due to the presentation of CTB at unusual sites. This highlights the importance of keeping TB as an important differential as misdiagnosis or delayed diagnosis of this entity can lead to prolonged morbidity. Dimple Chopra, Vishal Chopra, Aastha Sharma, Siddharth Chopra, Shivali Aggarwal, and Deepak Goyal Copyright © 2017 Dimple Chopra et al. All rights reserved. An Unusual Location of Subungual Warty Dyskeratoma: A Case Report and Review of the Literature Thu, 23 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/cridm/2017/3613109/ Warty dyskeratoma is an uncommon entity characterized by a solitary keratotic papule or nodule usually located in the head and neck of young adults. The histopathology shows a pattern of acantholytic dyskeratosis. We report a 32-year-old man who presented pain, serous exudation, a distal onycholysis with subungual hyperkeratosis, and roundish erythronychia in the nail plate of his left first toe 2 years ago. A histopathologic diagnosis of subungual warty dyskeratoma was made. When dealing with focal acantholytic dyskeratosis several differential diagnoses should be considered including Darier’s disease, transient focal acantholytic dyskeratosis or Grover disease, and Hailey-Hailey disease. We present an unusual location of warty dyskeratoma in the nail bed using a clinicohistopathological correlation for the diagnosis. Elena Vargas-Laguna, Adrián Imbernón-Moya, Antonio Aguilar-Martínez, and Fernando Burgos Copyright © 2017 Elena Vargas-Laguna et al. All rights reserved. A Case of Nonuremic Calciphylaxis in a Caucasian Woman Mon, 16 Jan 2017 00:00:00 +0000 http://www.hindawi.com/journals/cridm/2017/6831703/ We report a case of nonuremic calcific arteriolopathy (NUCA) in an 82-year-old Caucasian woman from rural Australia. The patient had no history of kidney disease or dialysis. NUCA is rare disease suspected on cutaneous and clinical features and diagnosed by characteristic findings on skin biopsy and vasculature imaging. Calcification induced microvascular occlusion in the absence of renal failure may not be immediately apparent. Clinical suspicion and appropriate investigations are essential for making a diagnosis. A diagnosis of NUCA may be missed given the rarity of the disease, and dermatologists and patients alike would benefit from a greater awareness of this disease. Bonnie Fergie, Nishant Valecha, and Andrew Miller Copyright © 2017 Bonnie Fergie et al. All rights reserved. A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis Tue, 10 Jan 2017 08:24:43 +0000 http://www.hindawi.com/journals/cridm/2017/7318305/ Linear IgA bullous dermatosis (LABD) is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vancomycin. It is best characterized pathologically by subepidermal bulla (blister) formation with linear IgA deposition at the dermoepidermal junction. Here we report an 86-year-old male with a history of left knee osteoarthritis who underwent a left knee arthroplasty and subsequently developed a prosthetic joint infection. This infection was treated with intravenous vancomycin as well as placement of a vancomycin impregnated joint spacer. Five days following initiation of antibiotic therapy, he presented with a vesiculobullous eruption on an erythematous base over his trunk, extremities, and oral mucosa. The eruption resolved completely when intravenous vancomycin was discontinued and colchicine treatment was begun. Curiously, complete resolution occurred despite the presence of the vancomycin containing joint spacer. The diagnosis of vancomycin-induced linear IgA bullous dermatosis was made based on characteristic clinical and histopathologic presentations. Pinky Jha, Kurtis Swanson, Jeremiah Stromich, Basia M. Michalski, and Edit Olasz Copyright © 2017 Pinky Jha et al. All rights reserved. Pseudohypertension-Like Presentation: An Exceptionally Rare Presentation in an Athletic Female Patient with Morphea Thu, 29 Dec 2016 14:05:48 +0000 http://www.hindawi.com/journals/cridm/2016/7027352/ Introduction. Pseudohypertension is a condition which mainly occurs due to thickening-calcification of tunica intima of the arterial wall, leading to a faulty measurement of the intra-arterial blood pressure. To the best of our knowledge, this is the first case report in literature, of a pseudohypertension-like presentation in association with Morphea en plaque. Case Presentation. This is a rare presentation of a young athletic female and a professional tennis player, with pseudohypertension-like presentation. The patient had a traumatic injury to the right elbow joint; the injury occurred during a professional tennis match. The injury was managed by immobilization, physiotherapy, and Low-Level Laser Therapy. Soon after that, the patient had a circumscribed sclerotic ivory plaque affecting the skin of the right cubital fossa. The histopathology analysis, together with the serological-hematological tests and the clinical picture, along with positive Osler’s signs, leads to the conclusive diagnosis of Morphea en plaque. The peculiar anatomic localization of the plaque anterior to the brachial artery leads to faulty blood pressure measurement as recorded by mercurial sphygmomanometer. Conclusion. This unique presentation of Morphea en plaque carries an important message in relation to the basic medical practice and in relation to the accurate measurement of the vital signs. Ahmed Al-Imam Copyright © 2016 Ahmed Al-Imam. All rights reserved. Acrokeratosis Paraneoplastica Associated with Cervical Squamous Cell Carcinoma Thu, 22 Dec 2016 13:51:17 +0000 http://www.hindawi.com/journals/cridm/2016/7137691/ Background. Acrokeratosis paraneoplastica, or Bazex syndrome, is a paraneoplastic syndrome characterized by cutaneous psoriasiform lesions with associated acral erythema and scale, as well as nail changes, including onycholysis and ungual dystrophy. Its most advanced, severe form involves the trunk, elbows, and knees. It is typically associated with upper aerodigestive tract malignancies in males. Rare cases associated with gynecological cancers have been reported, including uterine adenocarcinoma, as well as ovarian and vulvar squamous cell carcinomas. Cutaneous manifestations often precede cancer diagnosis. In most reported cases, skin changes resolve when the underlying malignancy is adequately treated. Main Observations. We present the case of a 56-year-old female diagnosed with acrokeratosis paraneoplastica following the discovery of FIGO stage IIB cervical squamous cell carcinoma (SCC). Scaling, hyperpigmentation, xerosis, and fissuring were noted on the patient’s hands, feet, legs, arms, and lower back. Pitting was noted on her fingernails. Her cervical cancer was successfully treated with chemoradiotherapy, after which her cutaneous lesions persisted for two months before resolving. Conclusions. The presentation of acrokeratosis paraneoplastica in this context is atypical. Reports of associations with gynecological cancers, as in our patient’s case, are exceedingly rare. Bryan Squires, Steven D. Daveluy, Michael C. Joiner, Newton Hurst, Michael Bishop, and Steven R. Miller Copyright © 2016 Bryan Squires et al. All rights reserved. Mycosis Fungoides of the Oral Cavity: Fungating Tumor Successfully Treated with Electron Beam Radiation and Maintenance Bexarotene Thu, 15 Dec 2016 11:21:27 +0000 http://www.hindawi.com/journals/cridm/2016/5857935/ Oral involvement in mycosis fungoides is unusual and portends a poor prognosis. The clinical findings of three new cases are described along with a differential diagnosis and review of the literature. For brevity, only one patient is discussed in detail below whereas the other two cases are solely described in table form. The patient had a four-year history of mycosis fungoides before developing an exophytic tongue tumor. He was treated with local electron beam radiation and is disease-free to date while being on maintenance therapy with oral bexarotene. Analysis of the data collected from our review of the literature and the present cases reveal key insights. Juri Bassuner, Roberto N. Miranda, Drew A. Emge, Beau A. DiCicco, Daniel J. Lewis, and Madeleine Duvic Copyright © 2016 Juri Bassuner et al. All rights reserved. Radiation-Induced Alopecia after Endovascular Embolization under Fluoroscopy Thu, 15 Dec 2016 07:53:27 +0000 http://www.hindawi.com/journals/cridm/2016/8202469/ Radiation-induced alopecia after fluoroscopically guided procedures is becoming more common due to an increasing use of endovascular procedures. It is characterized by geometric shapes of nonscarring alopecia related to the area of radiation. We report a case of a 46-year-old man presenting with asymptomatic, sharply demarcated rectangular, nonscarring alopecic patch on the occipital scalp following cerebral angiography with fistula embolization under fluoroscopy. His presentations were compatible with radiation-induced alopecia. Herein, we also report a novel scalp dermoscopic finding of blue-grey dots in a target pattern around yellow dots and follicles, which we detected in the lesion of radiation-induced alopecia. Vipawee Ounsakul, Wimolsiri Iamsumang, and Poonkiat Suchonwanit Copyright © 2016 Vipawee Ounsakul et al. All rights reserved. Unusual Presentation of Gianotti-Crosti Syndrome due to Epstein-Barr Virus Infection Mon, 05 Dec 2016 12:38:54 +0000 http://www.hindawi.com/journals/cridm/2016/1017524/ Gianotti-Crosti syndrome (GCS) is viral exanthema of childhood. It typically presents with a symmetric erythematous papular and papulovesicular eruption. It has been classically associated with hepatitis B virus, as well as rarely with Epstein-Barr virus (EBV). We report a case of GCS related to EBV infection without the classical systemic symptoms in a five-year-old male patient. Hind Saif Al Dhaheri, Amani Al Kaabi, Yasmin Kara Hamo, Aysha Al Kaabi, Salwa Al Kaabi, and Hossam Al Tatari Copyright © 2016 Hind Saif Al Dhaheri et al. All rights reserved. Nodular Fasciitis Complicating a Staged Surgical Excision of Dermatofibrosarcoma Protuberans Sun, 27 Nov 2016 12:43:51 +0000 http://www.hindawi.com/journals/cridm/2016/6074182/ Dermatofibrosarcoma protuberans (DFSP) is an unusual spindle cell tumor with a high rate of local recurrence with traditional excision. Fortunately, Mohs micrographic surgery yields excellent cure rates for this neoplasm due to contiguous tumor spread and meticulous tumor mapping and margin analysis. We present the unique case of a patient treated with a modified Mohs technique with an analysis of the final margin with permanent sections, who developed a spindle cell neoplasm in the margins of her second stage excision consistent with nodular fasciitis. Distinguishing residual DFSP from a benign reactive process was an essential and challenging component of this patient’s management. C. Helen Malone, Brandon Goodwin, Richard F. Wagner, Vicente Resto, and Brent Kelly Copyright © 2016 C. Helen Malone et al. All rights reserved. Evolution of Skin during Rehabilitation for Elephantiasis Using Intensive Treatment Thu, 24 Nov 2016 07:54:31 +0000 http://www.hindawi.com/journals/cridm/2016/4305910/ The objective of this study is to describe the evolution of the skin during rehabilitation for elephantiasis using intensive treatment. We report on the case of a 55-year-old patient with a seven-year history of leg edema. The patient reported that it began with repeated outbreaks of erysipelas over several years. One leg evolved with significant edema leading to an inability to ambulate and for about one month the patient said that he could not get out of bed. Moreover the patient was obese weighing 130 kilos and with a BMI of 39. Intensive treatment was performed over three weeks resulting in a significant reduction in limb volume. The treatment consisted of Mechanical Lymphatic Therapy (RAGodoy), Cervical Lymphatic Stimulation (Godoy & Godoy technique), and a custom-made inelastic stocking of a grosgrain textile. What caught the attention during therapy were the open wounds resulting from fragmentation of the plaque as the edema reduced; the plaque was about 0.5 cm thick. As the treatment evolved the plaque disappeared and the wounds healed. The limb size decreased by more than 80% in three weeks after which the patient began to be treated in an outpatient setting with ambulation using a grosgrain stocking. Henrique Jose Pereira de Godoy, Ricardo Budtinger Filho, Maria de Fatima Guerreiro Godoy, and José Maria Pereira de Godoy Copyright © 2016 Henrique Jose Pereira de Godoy et al. All rights reserved. Clinical Manifestation, Histopathology, and Imaging of Traumatic Injuries Caused by Brazilian Porcupine (Sphiggurus villosus) Quills Thu, 17 Nov 2016 11:54:39 +0000 http://www.hindawi.com/journals/cridm/2016/7851986/ Injuries to humans caused by porcupines are rare. However, they may occur due to the proximity of urban areas and the animal’s habitat in areas such as the Floresta da Tijuca in Rio de Janeiro. Outdoor sports and leisure activities in areas close to forests or in the rain forest are also relevant for incidents of this kind and a better knowledge of the local forest fauna would prevent such undesirable accidents. Porcupine quills have microscopic barbs at their tips which facilitate skin penetration, but hampering their removal. Once the spines are lodged in tissue, the microscopic backward-facing deployable barbs at the tips cause trauma if anyone tries to remove them. Local haemorrhage and an inflammatory response to the contaminated foreign body occur. Depending on the time lapse in removing the spines either septic or sterile foreign body reactions may occur. There is also the risk of migration of the spines, where fatal cases have been reported in human and veterinary medicine. Herein we report two unusual cases of accidents involving humans and the South American porcupine. The Sphiggurus villosus spines removed from scalp skin were also documented through Scanning Electron Microscopy. Lívia M. Araújo Jorge, Fred Bernardes Filho, Fabrício Lamy, Laila Klotz A. Balassiano, Loan Towersey, Roderick Hay, and Marco Andrey C. Frade Copyright © 2016 Lívia M. Araújo Jorge et al. All rights reserved. Effects of Cryolipolysis on Abdominal Adiposity Tue, 08 Nov 2016 13:48:27 +0000 http://www.hindawi.com/journals/cridm/2016/6052194/ Cryolipolysis is a noninvasive technique of localized fat reduction. Controlled cold exposure is performed in the selective destruction of fat cells. The aim of this study was to investigate the effects of cryolipolysis on adipocytes elimination through histological and sonographic analyses. This study reports the case of a 46-year-old female patient, with complaint of localized abdominal fat and in the preoperative period of abdominoplasty. The patient was submitted to a single 60-minute application of cryolipolysis, temperature of −5°C, on the hypogastrium area, 5 cm below the umbilicus. To study the effects of this treatment, ultrasound images taken before the session and 7, 15, 30, and 45 days after the therapy were analysed. After the abdominoplasty, parts of the treated and the untreated withdrawn abdominal tissues were evaluated macro- and microscopically. In ultrasound images, as well as in macroscopic and histological analyses, significant adipocytes destruction was detected, with consequent fat layer reduction and integrity of areas that were adjacent to the treated tissue. The presence of fibrosis observed during therapy and acknowledged through performed analyses encourages further studies to clarify such finding. Patricia Froes Meyer, Rodrigo Marcel Valentim da Silva, Glenda Oliveira, Maely Azevedo da Silva Tavares, Melyssa Lima Medeiros, Camila Procopio Andrada, and Luis Gonzaga de Araujo Neto Copyright © 2016 Patricia Froes Meyer et al. All rights reserved. Generational Expression of Muir-Torre Syndrome in a Canadian Family Sun, 16 Oct 2016 08:18:30 +0000 http://www.hindawi.com/journals/cridm/2016/1712527/ Muir-Torre syndrome (MTS) is a rare autosomal dominant inherited genodermatosis that is considered to be a phenotypic subtype of hereditary nonpolyposis colorectal cancer (HNPCC), commonly referred to as Lynch syndrome. We describe the clinical course of a 57-year-old female patient with MTS. She has a confirmed HMSH2 mutation. Recently she presented with two nodular lesions. Histologic examination confirmed these lesions to be sebaceous neoplasms. The patient has a history of endometrial and colorectal adenocarcinoma as well as several nonspecific sebaceous lesions throughout her life. She has a confirmed extensive family history of MTS with both male and female family members harbouring either HMLH1 or HSMH2 mutations. Affected relatives have presented at different ages throughout their lives with cutaneous neoplasms and visceral malignancies, including malignancies rarely associated with MTS. MTS presents a diagnostic challenge for clinicians. The case demonstrates that the management of MTS, a potentially underreported syndrome, requires a multiprofessional approach incorporating vigilance, screening, and expert knowledge for successful diagnosis and potentially improved prognosis for patients and their families. The case also demonstrates the varied heritability of MTS and prompts the question of how MTS is expressed in succeeding generations. Kaitlin Alexandra Vanderbeck, R. Gary Sibbald, and Nirosha Murugan Copyright © 2016 Kaitlin Alexandra Vanderbeck et al. All rights reserved. Sudden Appearance of Indurated Erythematous Plaques on a Man’s Face Thu, 15 Sep 2016 07:44:35 +0000 http://www.hindawi.com/journals/cridm/2016/5192689/ Rosacea fulminans (RF), previously known as pyoderma faciale, is a rare presentation of rosacea mostly seen in young women. RF is seen very rarely in men. We present below a case of a fifty-year-old male who presented with RF and was successfully treated with a combination of corticosteroids and isotretinoin. A. Carter, K. Viswanathan, and K. Shulman Copyright © 2016 A. Carter et al. All rights reserved. Unusual Localisation for Onychomatricoma on the 5th Toenail: A Case Report and Review of the Literature Wed, 13 Jul 2016 11:31:05 +0000 http://www.hindawi.com/journals/cridm/2016/1853495/ Onychomatricoma is a rare and benign tumour of the nail matrix but originates rarely from the ventral portion of the proximal nail fold. This tumour is characterised by fingerlike projections that invade the nail plate. This lesion, of unknown aetiology, is typically asymptomatic with slow progression. Localisation on the finger is the most frequently described. We report the case of a 68-year-old woman who has an onychomatricoma in an unusual location, the fifth toe of the left foot. Due to its clinical appearance, the tumour can be confused with and treated as onychomycosis. However, if it is resistant to an oral antifungal well behaved treatment, one must consider onychomatricoma diagnosis. A. Coutellier, I. Théate, and O. Vanhooteghem Copyright © 2016 A. Coutellier et al. All rights reserved. Mugwort-Mustard Allergy Syndrome due to Broccoli Consumption Wed, 13 Jul 2016 09:02:03 +0000 http://www.hindawi.com/journals/cridm/2016/8413767/ Pollen-food allergy syndrome (PFAS) is a relatively rare form of food allergy which develops in individuals who are sensitized to pollen. Tree pollens, especially birch pollen, frequently induce PFAS; however, the incidence of PFAS due to grass or weed pollens such as ragweed or mugwort is relatively rare. Mugwort-mustard allergy syndrome (MMAS) is an example of a PFAS in which individuals sensitized to mugwort may develop an allergy to mustard and experience severe reactions. We herein describe a case of MMAS due to broccoli consumption. Yuri Sugita, Teruhiko Makino, Megumi Mizawa, and Tadamichi Shimizu Copyright © 2016 Yuri Sugita et al. All rights reserved. Corrigendum to “Cutaneous Plasmacytosis with Perineural Involvement” Mon, 04 Jul 2016 08:21:40 +0000 http://www.hindawi.com/journals/cridm/2016/8614078/ Elizabeth A. Brezinski, Maxwell A. Fung, and Nasim Fazel Copyright © 2016 Elizabeth A. Brezinski et al. All rights reserved. A Challenging Giant Dermatofibrosarcoma Protuberans on the Face Wed, 29 Jun 2016 08:56:48 +0000 http://www.hindawi.com/journals/cridm/2016/5926307/ Dermatofibrosarcoma protuberans (DFSP) is a malignant fibrohistiocytic tumor that appears exclusively on the skin. It is a low-grade malignant soft tissue tumor of subcutaneous tissues that has a propensity for local recurrence but seldom metastasizes. It may rarely occur on the head and neck accounting for less than one percent of total head and neck malignancies. We present a man with a giant DFSP on the face. Oncological, functional, and aesthetic aspects are set forth. Gimena Castro Pérez, Cintia Arias, Paula Luna, Irene Sorín, and Luis Daniel Mazzuoccolo Copyright © 2016 Gimena Castro Pérez et al. All rights reserved. Idiopathic Sporadic Onychomadesis of Toenails Wed, 29 Jun 2016 08:27:40 +0000 http://www.hindawi.com/journals/cridm/2016/6451327/ Onychomadesis is a clinical sign of nail plate separation due to transient or permanent arrest of nail matrix activities. Onychomadesis can be considered as a severe form of Beau’s line. This condition usually occurs after trauma, causal diseases, or medications, yet it rarely occurs as an idiopathic condition. We report a case of a 38-year-old Thai female who developed recurrence onychomadesis in several toenails in the absence of predisposing factors or associated conditions. To the best of our knowledge, our patient is the first reported case of idiopathic onychomadesis limited to toenails. Poonkiat Suchonwanit and Sunatra Nitayavardhana Copyright © 2016 Poonkiat Suchonwanit and Sunatra Nitayavardhana. All rights reserved. Familial Pemphigus Vulgaris Occured in a Father and Son as the First Confirmed Cases Wed, 15 Jun 2016 10:34:37 +0000 http://www.hindawi.com/journals/cridm/2016/1653507/ Pemphigus vulgaris (PV) is a chronic autoimmune bullous disease of the skin and mucous membranes. Although there is some evidence pointing towards a genetic predisposition by some human leukocyte antigen (HLA) genes, familial occurrence of PV is very rare. Most of the familial PV cases so far reported have been in mother and daughter and in siblings. PV in father and son, as presented here, has not been reported in the literature before, except an unconfirmed report. The diagnosis of PV was established by histologic, cytologic studies and enzyme linked immunosorbent assay (ELISA) in Case and by ELISA and BIOCHIP indirect immunofluorescence test in Case . The son was responsive to moderate doses of methylprednisolone, with the treatment continuing with tapered doses. The father was in a subclinic condition; consequently, only close follow-up was recommended. HLA typing studies revealed identical HLA alleles of HLA-DR4 () and HLA- in both of our cases; this had been found to be associated with PV in prior studies. Familial occurrences of PV and related HLA genes indicate the importance of genetic predisposition. The first occurrence of confirmed familial PV in father and son is reported here. Ali Haydar Eskiocak, Birgul Ozkesici, and Soner Uzun Copyright © 2016 Ali Haydar Eskiocak et al. All rights reserved. Mutation in LEMD3 (Man1) Associated with Osteopoikilosis and Late-Onset Generalized Morphea: A New Buschke-Ollendorf Syndrome Variant Mon, 13 Jun 2016 09:36:20 +0000 http://www.hindawi.com/journals/cridm/2016/2483041/ Introduction. Buschke-Ollendorf syndrome (BOS) is an uncommon syndrome characterized by osteopoikilosis and other bone abnormalities, accompanied by skin lesions, most frequently connective tissue nevi. BOS is caused by mutations in the LEMD3 gene, which encodes the inner nuclear membrane protein Man1. We describe a unique case of osteopoikilosis associated with late-onset localized scleroderma and familial LEMD3 mutations. Case Report. A 72-year-old woman presented with adult-onset diffuse morphea and bullous skin lesions. Evaluation revealed multiple hyperostotic lesions (osteopoikilosis) suggestive of BOS. DNA sequencing identified a previously undescribed nonsense mutation (Trp621X) in the LEMD3 gene encoding Man1. Two additional family members were found to have osteopoikilosis and carry the same LEMD3 mutation. Conclusions and Relevance. We report a unique familial LEMD3 mutation in an individual with osteopoikilosis and late-onset morphea. We propose that this constellation represents a novel syndromic variant of BOS. Benjamin Korman, Jun Wei, Anne Laumann, Polly Ferguson, and John Varga Copyright © 2016 Benjamin Korman et al. All rights reserved.