Dermatology online journal最新文献

Discoid lupus erythematosus can present in various atypical forms, posing significant diagnostic challenges as it can mimic other infectious or neoplastic dermatoses. Herein, we detail two cases of strictly unilateral, multifocal discoid lupus erythematosus and compare them with previously reported cases. This report contributes to the limited literature on this unusual presentation, particularly in individuals with skin of color.

Purpura fulminans is a rare life-threatening presentation of disseminated intravascular congestion that presents with widespread purpura and skin necrosis secondary to considerable tissue thrombosis. It usually occurs in pediatric patients and can have various causes with acute infection being the most common. Common infectious triggers include Neisseria and Streptococcus pneumoniae as well as varicella. Our report describes a generally healthy adult patient who developed purpura fulminans in the setting of Group A Streptococcus bacteremia. Group A Streptococcus is a rare cause of purpura fulminans in adult patients with only a few documented cases reported in the literature.

Dermatofibrosarcoma protuberans is an uncommon locally aggressive mesenchymal neoplasm that classically presents with a proliferation of monomorphic spindled cells with thin nuclei and scant cytoplasm. We report a man in his twenties who presented for an unrelated skin concern and was incidentally noted to have a large, atrophic scar-like depression of the left supraclavicular neck and shoulder. The plaque was photographed and the patient was instructed to follow-up in one year, and careful photo comparison revealed the lesion had subtly enlarged and darkened in color. Accordingly, a punch biopsy revealed features of myxoid dermatofibrosarcoma protuberans, a dermal proliferation of spindled cells with mucinous degeneration and more cellular areas with extensive nuclear palisading resembling the Verocay bodies of a neurofibroma. Clinicians should be aware of the broad clinicopathologic spectrum of DFSP to ensure timely diagnosis and effective treatment. Myxoid dermatofibrosarcoma protuberans is a rare and clinically challenging diagnosis, as the mucinous areas can impart a bluish hue. Dermatofibrosarcoma protuberans can also be atrophic, with the loss of the normal dermal thickness corresponding to a clinical appearance easily mistaken for anetoderma or atrophic scar. Palisaded nuclei resembling the Verocay bodies of schwannoma are sometimes seen and can further obfuscate the diagnosis.

Cutaneous collagenous vasculopathy is a rare microangiopathy that presents with asymptomatic telangiectasias and distinct histopathological features, including hyaline material deposition in vessel walls. Diagnosis requires biopsy and differentiation from other telangiectatic disorders. Current treatment options are limited, but increased awareness may improve recognition and management of this rare condition. Herein, we describe an unusual presentation of cutaneous collagenous vasculopathy as asymptomatic, pink, mat-like telangiectatic macules on the trunk and proximal extremities of a 62-year-old woman. Histopathologic evaluation revealed dilated superficial dermal vessels with hyaline thickening of the vessel walls, consistent with a diagnosis of cutaneous collagenous vasculopathy.

A 39-year-old man with an unrecognized facial sinus tract under his chin initially presented with an innocuous lesion resembling an acne pimple. The patient's journey began with dermatologic intervention, involving systemic and topical antibiotics. Upon treatment failure, referral to a general dentist revealed a carious lesion on the lower right lateral incisor, prompting further investigation. A subsequent referral to an endodontic specialist led to the diagnosis of a chronic periapical abscess, and an endodontic intervention was initiated. Despite the persistence of intracanal purulent exudate, a strategic application of pure calcium hydroxide was implemented, followed by a temporary seal. A two-year follow-up demonstrated complete healing of the periapical lesion and resolution of the extraoral cutaneous sinus tract. The report showcases the intricate diagnostic journey, meticulous endodontic intervention, and successful management of an extraoral cutaneous sinus tract mimicking scar or cyst, emphasizing the importance of a correct diagnosis to avoid ineffective treatment.

Statistical mistakes can undermine research credibility. Identifying common errors may help researchers avoid them in future studies. This study evaluated the frequency and types of statistical mistakes in dermatology journal articles and identified article characteristics that predict these errors. A cross-sectional analysis was conducted on articles published in the 2023 volumes of 8 dermatology journals. Articles were screened for statistical tests, with a target sample of 200 selected pseudorandomly. Multivariable logistic regressions assessed predictors of statistical mistakes, including journal impact factor, statistician involvement, funding source, first author highest degree, and statistical package. Of the 189 articles analyzed, 78% contained at least one statistical mistake. Reporting mistakes were found in 67% and test selection errors in 46%. The absence of statistician involvement (aOR 2.49, P=0.03) and low journal impact factor (aOR 3.82, P=0.02) predicted the presence of at least one mistake. This sample from 8 journals is not representative of all dermatology literature. Original data were not available for testing of test assumptions, so appropriate test selection was determined using statistical conventions. Statistical mistakes are prevalent in dermatology literature. Researchers should review statistical best practices and consider involving a statistician in their work.

Angiomatoid melanoma is a rare variant of malignant melanoma not currently recognized by the World Health Organization classification system. In this study, we present a case of primary angiomatoid melanoma in a 57-year-old man who presented to clinic with a complaint of a growing lesion on the frontal scalp for four months. Microscopic examination of the lesion revealed cavernous spaces filled with extravasated red blood cells. Immunohistochemical markers were positive for melanoma and negative for vascular endothelium. We also review the literature on angiomatoid melanoma, finding distinct morphological differences in previously reported cases. Owing to these differences, we propose new diagnostic criteria and offer a mechanism for formation of blood-filled cavernous spaces while cautioning against misinterpretation of CD31 expression by macrophages in zones of immune regression. Angiomatoid melanoma is a diagnostic challenge because of its rarity, signaling a need for further histopathological evaluation and more complete awareness of its features.

eclare that the contents of this article are their own original unpublished findings. Title: Changes in public interest for Mohs micrographic surgery: a Google Trends analysis Authors: Joshua Burshtein1 MD, Milaan Shah2 MD, Danny Zakria3 MD MBA, Lauren DeBusk4 MD, Angela Rosenberg4 DO, Darrell Rigel5 MD MS Affiliations: 1Department of Dermatology, University of Illinois Chicago, Chicago, Illinois, USA, 2Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina, USA, 3Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA, 4Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas, USA, 5Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA Corresponding Author: Joshua Burshtein MD, 808 South Wood Street, Chicago, IL 60612, Tel: 845-596-9482, Email: jburshtein13@gmail.com.