Dermatology online journal最新文献

Purpuric and pigmented lichenoid dermatitis of Gougerot and Blum is a form of purpuric pigmented dermatosis. These entities are rarely described, but are likely underdiagnosed. Herein, we present a patient with this condition that is unusual in is its diffuse nature and its delayed diagnosis after twenty years of evolution.

Serratia marcescens is an uncommon cause of cutaneous infections, especially in immunocompetent individuals. We present a 31-year-old woman with a chronic erythematous nodule on the nasal supratip, three years post-rhinoplasty. Initial treatments, including intralesional corticosteroids, oral doxycycline, and topical metronidazole, failed to resolve the infection. Initially thought to be a contaminant, repeat tissue culture confirmed the presence of S. marcescens. The patient's abscess resolved following a course of levofloxacin but surgery was required to remove remnant scar tissue. This case underscores the importance of considering atypical pathogens in chronic cutaneous infections following cosmetic procedures, even in immunocompetent patients. Increased awareness among clinicians can aid in prompt diagnosis and targeted therapy.

Cutaneous metastases from malignancies of gynecological origin are rare but have been described over the vulvovaginal area in the setting of ovarian, endometrial, and fallopian tube neoplasia. We present an 89-year-old woman with multiple non-tender, fleshy, skin-colored nodules with central ulceration and bleeding over the mons pubis. Skin biopsy and immunohistochemistry of these tumors were in keeping with metastatic high-grade serous adenocarcinoma secondary to a gynecological malignancy. This brief report aims to raise physician awareness about this rare skin presentation, which is unfortunately associated with a poor prognosis.

Sweet syndrome, or acute febrile neutrophilic dermatosis is an inflammatory condition that may be idiopathic, paraneoplastic, parainflammatory, or drug associated. Recently, immune checkpoint inhibitors have been implicated in Sweet syndrome. Herein, we describe a patient with nonsmall cell lung cancer who  developed Sweet syndrome in the setting of the immune checkpoint inhibitor, pembrolizumab. We also include a discussion of current literature of immune checkpoint inhibitors-induced Sweet syndrome and the histopathologic differential diagnosis of Sweet syndrome.

Artificial intelligence may enhance medical education. This study evaluates ChatGPT-4o's accuracy in answering sample questions from the American Board of Dermatology BASIC, CORE, and APPLIED examinations. Fifty publicly available questions, with and without images, were analyzed for accuracy and performance across difficulty levels and categories. Its performance varied significantly between text-only and image-based questions, with lower accuracy on image-based questions (47%). Improvements in artificial intelligence for the use in dermatology residency education are necessary, as limitations in visual diagnostic skills were evident.

Sarcoidosis is a chronic multisystemic, inflammatory disease characterized by the formation of noncaseating granulomas, with cutaneous involvement in a fraction of patients. Although existing literature reports dupilumab to cause sarcoidosis-like reactions, we present a 57-year-old man with erythrodermic sarcoidosis and atopic dermatitis refractory to numerous systemic medications that later improved with dupilumab. The improvement of his pruritus and cutaneous lesions after dupilumab initiation, followed by worsening after temporary discontinuation, then re-improvement after re-initiation supported dupilumab's therapeutic role. IL-4 and IL-13 stimulate tissue fibrosis and irreversible tissue damage in sarcoidosis, perhaps explaining dupilumab's therapeutic mechanism in this patient's case. For patients with severe sarcoidosis refractory to numerous medications, clinicians should keep in mind dupilumab as a potential option, particularly for those patients with concomitant atopic dermatitis.