Victoria Jiminez, Lawangeen Zeb, Lauren Graham, Anna Gray
Rosai-Dorfman disease (RDD) is a rare disorder of histiocytic origin with nodal, extranodal, and cutaneous classifications often presenting as eruptive rashes, most commonly affecting the face, trunk, and thigh. Due to its rarity, no consensus exists regarding standard of care for these lesions, as most knowledge regarding treatment is provided by case reports. To our knowledge, we report the first case of a patient with a recurrent lower extremity mass consistent with cutaneous RDD, despite surgical excision and topical steroids treatment. A 51-year-old female presented with recurrent RDD after failed treatment with clobetasol ointment and surgical excision at an outside practice. Examination revealed violaceous plaques with overlying scale, without lymphadenopathy. With the failure of the previous excision, the patient was prescribed 5 mg/ml intralesional Kenalog (ILK) injections to suppress inflammation of the lesion. She experienced improved clinical response to treatment and remission of active disease with residual post-inflammatory hyperpigmentation at 10 months after two rounds of injections, although the patient reported vast improvement at 5 months as well. Treatment of RDD is difficult due to its rarity, hindering clinical trial development. Therapeutics reported to be efficacious include topical, intralesional, and systemic steroids, retinoids, methotrexate, chemotherapy, cryotherapy, phototherapy, and radiation. Clinical management is variable and often requires multiple forms of treatment on a case-to-case basis, highlighting the need for larger clinical studies to establish a standard of care. Our case poses interest in the use of ILK for RDD and should be considered in recurrent cases after prior surgical excision.
{"title":"Intralesional Kenalog Injections for Recurrent Cutaneous Rosai-Dorfman Disease (RDD) in the Lower Extremity","authors":"Victoria Jiminez, Lawangeen Zeb, Lauren Graham, Anna Gray","doi":"10.25251/skin.8.3.15","DOIUrl":"https://doi.org/10.25251/skin.8.3.15","url":null,"abstract":"Rosai-Dorfman disease (RDD) is a rare disorder of histiocytic origin with nodal, extranodal, and cutaneous classifications often presenting as eruptive rashes, most commonly affecting the face, trunk, and thigh. Due to its rarity, no consensus exists regarding standard of care for these lesions, as most knowledge regarding treatment is provided by case reports. To our knowledge, we report the first case of a patient with a recurrent lower extremity mass consistent with cutaneous RDD, despite surgical excision and topical steroids treatment. A 51-year-old female presented with recurrent RDD after failed treatment with clobetasol ointment and surgical excision at an outside practice. Examination revealed violaceous plaques with overlying scale, without lymphadenopathy. With the failure of the previous excision, the patient was prescribed 5 mg/ml intralesional Kenalog (ILK) injections to suppress inflammation of the lesion. She experienced improved clinical response to treatment and remission of active disease with residual post-inflammatory hyperpigmentation at 10 months after two rounds of injections, although the patient reported vast improvement at 5 months as well. Treatment of RDD is difficult due to its rarity, hindering clinical trial development. Therapeutics reported to be efficacious include topical, intralesional, and systemic steroids, retinoids, methotrexate, chemotherapy, cryotherapy, phototherapy, and radiation. Clinical management is variable and often requires multiple forms of treatment on a case-to-case basis, highlighting the need for larger clinical studies to establish a standard of care. Our case poses interest in the use of ILK for RDD and should be considered in recurrent cases after prior surgical excision.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcus L Elias, Joshua Burshtein, Victoria R Sharon
Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine tumor. Primarily affecting the elderly, the incidence of MCC is 0.10 to 1.6 cases per 100,000 people per year. 1 MCC has a low overall survival (OS), ranging between 37 and 74% at 5 years. 1–5 The majority of lesions occur on the head and neck followed by the trunk and extremities
{"title":"Merkel cell carcinoma primary sites and overall survival: The prognostic indications of head and neck tumors","authors":"Marcus L Elias, Joshua Burshtein, Victoria R Sharon","doi":"10.25251/skin.8.3.6","DOIUrl":"https://doi.org/10.25251/skin.8.3.6","url":null,"abstract":"Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine tumor. Primarily affecting the elderly, the incidence of MCC is 0.10 to 1.6 cases per 100,000 people per year. 1 MCC has a low overall survival (OS), ranging between 37 and 74% at 5 years. 1–5 The majority of lesions occur on the head and neck followed by the trunk and extremities","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Forbes Kaprive, Romsin Zaya, Alexandra Loperfito, Craig J Garofola
Cutaneous angiosarcoma is a rare malignancy of endothelial cell origin that commonly presents in the head and neck region of elderly individuals and is known for high rates of lymph node metastasis and mortality. There is significant variability in the histopathologic features, and immunohistochemistry is necessary to help differentiate epithelioid angiosarcoma from lesions it may clinically mimic. Here, we report a rare case of poorly differentiated epithelioid angiosarcoma on the trunk initially diagnosed as poorly differentiated squamous cell carcinoma (SCC) on shave biopsy. A 56-year-old man presented for a full-body skin examination significant for a 5.6 x 2.8 mm brown-black macule on the left superomedial posterior trunk and a 5.0 x 2.7 mm pink, ulcerated papule on the right inferior posterior trunk. On histopathology, one lesion was found to be melanoma in situ, and the other showed ulcerated and infiltrative, poorly differentiated SCC. Post-excision histologic analysis of the right inferior back lesion revealed tumor cells immunoreactive to vimentin, ERG, and CD31 (PECAM-1). These findings suggested that the lesion previously diagnosed as SCC was an invasive, poorly differentiated epithelioid angiosarcoma. The patient underwent 40 sessions of radiotherapy. Epithelioid angiosarcoma occurring outside of the conventional epidemiologic profile is believed to portend higher mortality rates. This case highlights the importance of thorough clinical evaluation and appropriate histopathologic diagnosis of an aggressive neoplasm unlikely to present in this location. Further studies are required to explore potential risk factors, effective treatments, and long-term outcomes in patients with epithelioid angiosarcoma.
皮肤血管肉瘤是一种罕见的内皮细胞来源恶性肿瘤，常见于老年人的头颈部，淋巴结转移率和死亡率都很高。组织病理学特征存在很大的变异性，免疫组化有助于将上皮样血管肉瘤与其临床上可能模仿的病变区分开来。在此，我们报告了一例罕见的躯干上皮样血管肉瘤病例，该病例最初在剃须活检中被诊断为分化不良的鳞状细胞癌（SCC）。一名 56 岁的男子接受了全身皮肤检查，发现左侧躯干后上方有一个 5.6 x 2.8 毫米的棕黑色斑丘疹，右侧躯干后下方有一个 5.0 x 2.7 毫米的粉红色溃疡性丘疹。组织病理学检查发现，一个病变为原位黑色素瘤，另一个病变为溃疡和浸润性、分化不良的 SCC。切除后对右下背部病灶的组织学分析显示，肿瘤细胞对波形蛋白、ERG和CD31（PECAM-1）有免疫反应。这些结果表明，之前被诊断为 SCC 的病变是一种浸润性、分化不良的上皮样血管肉瘤。患者接受了 40 次放疗。上皮样血管肉瘤发生在传统流行病学特征之外，被认为预示着较高的死亡率。该病例强调了对这种不太可能出现在该部位的侵袭性肿瘤进行全面临床评估和适当组织病理学诊断的重要性。我们需要进一步研究上皮样血管肉瘤患者的潜在风险因素、有效治疗方法和长期预后。
{"title":"Epithelioid Angiosarcoma: A Diagnostic Dilemma with Clinically and Histopathologically Overlapping Features","authors":"Jessica Forbes Kaprive, Romsin Zaya, Alexandra Loperfito, Craig J Garofola","doi":"10.25251/skin.8.3.14","DOIUrl":"https://doi.org/10.25251/skin.8.3.14","url":null,"abstract":"Cutaneous angiosarcoma is a rare malignancy of endothelial cell origin that commonly presents in the head and neck region of elderly individuals and is known for high rates of lymph node metastasis and mortality. There is significant variability in the histopathologic features, and immunohistochemistry is necessary to help differentiate epithelioid angiosarcoma from lesions it may clinically mimic. Here, we report a rare case of poorly differentiated epithelioid angiosarcoma on the trunk initially diagnosed as poorly differentiated squamous cell carcinoma (SCC) on shave biopsy. A 56-year-old man presented for a full-body skin examination significant for a 5.6 x 2.8 mm brown-black macule on the left superomedial posterior trunk and a 5.0 x 2.7 mm pink, ulcerated papule on the right inferior posterior trunk. On histopathology, one lesion was found to be melanoma in situ, and the other showed ulcerated and infiltrative, poorly differentiated SCC. Post-excision histologic analysis of the right inferior back lesion revealed tumor cells immunoreactive to vimentin, ERG, and CD31 (PECAM-1). These findings suggested that the lesion previously diagnosed as SCC was an invasive, poorly differentiated epithelioid angiosarcoma. The patient underwent 40 sessions of radiotherapy. Epithelioid angiosarcoma occurring outside of the conventional epidemiologic profile is believed to portend higher mortality rates. This case highlights the importance of thorough clinical evaluation and appropriate histopathologic diagnosis of an aggressive neoplasm unlikely to present in this location. Further studies are required to explore potential risk factors, effective treatments, and long-term outcomes in patients with epithelioid angiosarcoma.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Akash Rau, Anne Opalikhin, Kaitlin Kreuser, R. Ashack, Kurt Ashack
Primary cutaneous B-cell lymphomas (pcBCLs) are non-Hodgkin lymphomas that present with exclusive cutaneous disease at the time of diagnosis. The lesions may be indolent, subtle, or waxing and waning, making the diagnosis challenging. The ear is an uncommon location, and its frequency of involvement remains unknown. A retrospective analysis of a single patient with primary cutaneous marginal zone lymphoma of the ear. The patient was a 44-year-old male who presented with erythematous tender nodules on the left superior posterior helix. Shave biopsy revealed mixed dermal lymphoid infiltrate with eosinophils and telangiectasias. The patient was diagnosed with angiolymphoid hyperplasia with eosinophilia. Multiple treatment regiments were trialed but failed due to lack of therapeutic response, relapse, and clinical progression. The patient ultimately underwent Mohs surgery with biopsy findings that demonstrated CD-20 positive cells. Evaluation with B-cell histopathology and gene rearrangement studies confirmed the diagnosis of marginal zone lymphoma. This case report shows a unique presentation of marginal zone lymphoma of the ear, initially diagnosed as angiolymphoid hyperplasia with eosinophilia. Our findings demonstrate a relatively rare presentation for this disease and highlight the challenges in diagnosing primary cutaneous marginal zone lymphoma.
原发性皮肤 B 细胞淋巴瘤（pcBCL）是一种非霍奇金淋巴瘤，确诊时仅表现为皮肤疾病。病变可能不明显、不明显或时好时坏，因此诊断具有挑战性。耳部淋巴瘤并不常见，其受累频率仍不清楚。本文对一名耳部原发性皮肤边缘区淋巴瘤患者进行了回顾性分析。患者是一名 44 岁的男性，左耳后上螺旋出现红斑触痛性结节。刮片活检显示真皮淋巴混合浸润，伴有嗜酸性粒细胞和毛细血管扩张。患者被诊断为血管淋巴细胞增生症伴嗜酸性粒细胞增多。患者接受了多种治疗方案，但都因缺乏治疗反应、复发和临床进展而失败。患者最终接受了莫氏手术，活检结果显示细胞 CD-20 呈阳性。B 细胞组织病理学评估和基因重排研究证实了边缘区淋巴瘤的诊断。本病例报告显示了耳部边缘区淋巴瘤的独特表现，最初诊断为血管淋巴样增生伴嗜酸性粒细胞增多。我们的研究结果表明，这种疾病的表现形式相对罕见，并强调了诊断原发性皮肤边缘区淋巴瘤所面临的挑战。
{"title":"Unusual Presentation of Marginal Zone Lymphoma","authors":"Akash Rau, Anne Opalikhin, Kaitlin Kreuser, R. Ashack, Kurt Ashack","doi":"10.25251/skin.8.3.9","DOIUrl":"https://doi.org/10.25251/skin.8.3.9","url":null,"abstract":"Primary cutaneous B-cell lymphomas (pcBCLs) are non-Hodgkin lymphomas that present with exclusive cutaneous disease at the time of diagnosis. The lesions may be indolent, subtle, or waxing and waning, making the diagnosis challenging. The ear is an uncommon location, and its frequency of involvement remains unknown. A retrospective analysis of a single patient with primary cutaneous marginal zone lymphoma of the ear. The patient was a 44-year-old male who presented with erythematous tender nodules on the left superior posterior helix. Shave biopsy revealed mixed dermal lymphoid infiltrate with eosinophils and telangiectasias. The patient was diagnosed with angiolymphoid hyperplasia with eosinophilia. Multiple treatment regiments were trialed but failed due to lack of therapeutic response, relapse, and clinical progression. The patient ultimately underwent Mohs surgery with biopsy findings that demonstrated CD-20 positive cells. Evaluation with B-cell histopathology and gene rearrangement studies confirmed the diagnosis of marginal zone lymphoma. This case report shows a unique presentation of marginal zone lymphoma of the ear, initially diagnosed as angiolymphoid hyperplasia with eosinophilia. Our findings demonstrate a relatively rare presentation for this disease and highlight the challenges in diagnosing primary cutaneous marginal zone lymphoma.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic wounds pose a significant healthcare challenge, affecting millions of individuals and incurring substantial healthcare costs. In this case study, we present the successful treatment of a chronic lower extremity wound in an 80-year-old female using PuraPly™, a Type I collagen matrix embedded with polyhexylmethylene biguanide (PHMB). The patient initially sustained the injury, which had become infected and resistant to conventional treatments. After applying PuraPly™, the wound showed rapid improvement, ultimately resulting in complete closure. Our findings highlight the utility of PuraPly™ as an effective intervention for chronic wounds, thereby improving treatment outcomes and the quality of life for these patients.
{"title":"Type I Collagen Matrix with Polyhexylmethylene Biguanide in a Chronic Lower Extremity Wound","authors":"K. Aoki, Simona Bartos","doi":"10.25251/skin.8.3.16","DOIUrl":"https://doi.org/10.25251/skin.8.3.16","url":null,"abstract":"Chronic wounds pose a significant healthcare challenge, affecting millions of individuals and incurring substantial healthcare costs. In this case study, we present the successful treatment of a chronic lower extremity wound in an 80-year-old female using PuraPly™, a Type I collagen matrix embedded with polyhexylmethylene biguanide (PHMB). The patient initially sustained the injury, which had become infected and resistant to conventional treatments. After applying PuraPly™, the wound showed rapid improvement, ultimately resulting in complete closure. Our findings highlight the utility of PuraPly™ as an effective intervention for chronic wounds, thereby improving treatment outcomes and the quality of life for these patients.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Importance: Although there are many available treatments for psoriasis and psoriatic arthritis (PsA), there are patients resistant to standard conventional therapy. For these patients, combination therapy of biologic agents and upadacitinib may be a viable alternative option; however, there is limited data on concomitant usage. Objective: To evaluate the safety and efficacy of combination therapy of upadacitinib and biologic agents for the treatment of refractory psoriasis and psoriatic arthritis. Design: We report the results of a retrospective chart review of 3 patients in a single practice treated with a combination of upadacitinib and biologics for psoriasis and PsA. The risks, benefits, and safety warnings of combination therapy of upadacitinib and biologic agents were discussed before initiation. After shared decision-making with the provider, patients were placed on a trial of combination therapy. Results: All three patients, previously refractory to monotherapy, experienced significant improvement of their symptoms while on combination therapy. No adverse reactions (malignancy, cardiovascular events, venous thromboembolism) occurred during treatment. However, one patient experienced a shingles outbreak and diverticulitis while on combination treatment. Further studies are needed to determine long-term efficacy with a larger sample size.
{"title":"Safety and Efficacy of Combination Therapy of Upadacitinib and Biologic Agents for Treatment-Resistant Psoriasis and Psoriatic Arthritis","authors":"Shivkar Amara, Aarav Patel, M. Lebwohl","doi":"10.25251/skin.8.3.17","DOIUrl":"https://doi.org/10.25251/skin.8.3.17","url":null,"abstract":"Importance: Although there are many available treatments for psoriasis and psoriatic arthritis (PsA), there are patients resistant to standard conventional therapy. For these patients, combination therapy of biologic agents and upadacitinib may be a viable alternative option; however, there is limited data on concomitant usage. \u0000Objective: To evaluate the safety and efficacy of combination therapy of upadacitinib and biologic agents for the treatment of refractory psoriasis and psoriatic arthritis. \u0000Design: We report the results of a retrospective chart review of 3 patients in a single practice treated with a combination of upadacitinib and biologics for psoriasis and PsA. The risks, benefits, and safety warnings of combination therapy of upadacitinib and biologic agents were discussed before initiation. After shared decision-making with the provider, patients were placed on a trial of combination therapy. \u0000Results: All three patients, previously refractory to monotherapy, experienced significant improvement of their symptoms while on combination therapy. No adverse reactions (malignancy, cardiovascular events, venous thromboembolism) occurred during treatment. However, one patient experienced a shingles outbreak and diverticulitis while on combination treatment. Further studies are needed to determine long-term efficacy with a larger sample size. \u0000 ","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Devine Thomas, Yousef Salem, Naser Asfoor, Mohamad Jabin, Mojahed M. K. Shalabi, Stephen Baker, Shovendra Gautam
{"title":"Scratching the Surface: A Paraneoplastic Pruritus Phenomenon in a Mediastinal Mass","authors":"Devine Thomas, Yousef Salem, Naser Asfoor, Mohamad Jabin, Mojahed M. K. Shalabi, Stephen Baker, Shovendra Gautam","doi":"10.25251/skin.8.3.24","DOIUrl":"https://doi.org/10.25251/skin.8.3.24","url":null,"abstract":"","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mounia Sidki, M. Aboudourib, Maryam El Ouazzani, A. Belbachir, H. Rais, Yassine Benchamkha, O. Hocar, S. Amal
Primary cutaneous apocrine carcinoma (PCAC) is a rare adnexal neoplasm. Due to its clinical presentation, it can mimic other tumors, especially metastasis. We present a case of primary apocrine carcinoma of the axilla mimicking breast carcinoma metastasis in a 54-year-old woman. The patient presented with a painless, lobed, and erythematous nodule in the left axilla of one year duration. We suspected an adnexal neoplasm but also considered metastasis from breast carcinoma. Histological examination revealed apocrine proliferation. Immunohistochemistry stains of tumor cells were positive for AE1/AE3, and negative for CK7, CK20, p63 and GATA3. Radiological explorations did not reveal any signs of malignancy. Considering all these features, the conclusive diagnosis was primary cutaneous apocrine carcinoma. Treatment was wide excision without adjuvant therapy, and no recurrence was noted. Due to the rarity of this carcinoma, its various clinical presentations, and histological overlaps with breast cancer metastasis, making the diagnosis may be challenging. A comprehensive evaluation of all findings is necessary to rule out other tumors. There is any consensus on the management strategy. The standard treatment is surgical excision, but adjuvant therapies such as radiotherapy or chemotherapy can be proposed in advanced stage disease.
{"title":"Primary Cutaneous Apocrine Carcinoma: Diagnostic and Management Difficulties of an Uncommon Neoplasm","authors":"Mounia Sidki, M. Aboudourib, Maryam El Ouazzani, A. Belbachir, H. Rais, Yassine Benchamkha, O. Hocar, S. Amal","doi":"10.25251/skin.8.3.20","DOIUrl":"https://doi.org/10.25251/skin.8.3.20","url":null,"abstract":"Primary cutaneous apocrine carcinoma (PCAC) is a rare adnexal neoplasm. Due to its clinical presentation, it can mimic other tumors, especially metastasis. We present a case of primary apocrine carcinoma of the axilla mimicking breast carcinoma metastasis in a 54-year-old woman. The patient presented with a painless, lobed, and erythematous nodule in the left axilla of one year duration. We suspected an adnexal neoplasm but also considered metastasis from breast carcinoma. Histological examination revealed apocrine proliferation. Immunohistochemistry stains of tumor cells were positive for AE1/AE3, and negative for CK7, CK20, p63 and GATA3. Radiological explorations did not reveal any signs of malignancy. Considering all these features, the conclusive diagnosis was primary cutaneous apocrine carcinoma. Treatment was wide excision without adjuvant therapy, and no recurrence was noted. Due to the rarity of this carcinoma, its various clinical presentations, and histological overlaps with breast cancer metastasis, making the diagnosis may be challenging. A comprehensive evaluation of all findings is necessary to rule out other tumors. There is any consensus on the management strategy. The standard treatment is surgical excision, but adjuvant therapies such as radiotherapy or chemotherapy can be proposed in advanced stage disease.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Lapides, Hannah J Porter, Deborah Cook, Keith Morley
Incontinentia pigmenti (IP) is an X-linked disorder characterized by a variety of findings that affect different systems, including cutaneous, ophthalmologic, neurologic, and dental. The cutaneous findings occur in 4 consecutive stages, generally referred to as vesicular, verrucous, hyperpigmented, and atrophic. The first stage is often observed in infancy, and this may be the first indication of IP in an infant. Early diagnosis is critical so that interventions can be implemented as soon as possible to monitor for complications and mitigate the effects of IP given the potential for multisystem involvement. Here, we describe a case of IP that was diagnosed in a female infant with no prior family history of IP. Prompt diagnosis and family counseling is critical, as early interventions can help optimize patients’ quality of life and genetic testing may help families make informed future family planning decisions.
色素失禁症（IP）是一种 X 连锁障碍性疾病，其特征是影响皮肤、眼科、神经和牙科等不同系统的多种病变。皮肤症状分为四个连续的阶段，一般称为水泡期、疣状期、色素沉着期和萎缩期。第一阶段通常在婴儿期出现，这可能是婴儿患 IP 的第一个迹象。鉴于 IP 可能累及多个系统，因此早期诊断至关重要，这样才能尽快采取干预措施，监测并发症并减轻 IP 的影响。在此，我们描述了一例被确诊为 IP 的女婴，她之前并无 IP 家族史。及时诊断和家庭咨询至关重要，因为早期干预有助于优化患者的生活质量，基因检测可帮助家庭做出明智的未来计划生育决定。
{"title":"Incontinentia Pigmenti In a Female Infant: A Case Report","authors":"Rebecca Lapides, Hannah J Porter, Deborah Cook, Keith Morley","doi":"10.25251/skin.8.3.11","DOIUrl":"https://doi.org/10.25251/skin.8.3.11","url":null,"abstract":"Incontinentia pigmenti (IP) is an X-linked disorder characterized by a variety of findings that affect different systems, including cutaneous, ophthalmologic, neurologic, and dental. The cutaneous findings occur in 4 consecutive stages, generally referred to as vesicular, verrucous, hyperpigmented, and atrophic. The first stage is often observed in infancy, and this may be the first indication of IP in an infant. Early diagnosis is critical so that interventions can be implemented as soon as possible to monitor for complications and mitigate the effects of IP given the potential for multisystem involvement. Here, we describe a case of IP that was diagnosed in a female infant with no prior family history of IP. Prompt diagnosis and family counseling is critical, as early interventions can help optimize patients’ quality of life and genetic testing may help families make informed future family planning decisions. ","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epidermal inclusion cysts are common cutaneous lesions that can develop anywhere on the body. While benign, these cysts can become inflamed and symptomatic. Symptomatic epidermal inclusion cysts can be treated with intralesional steroid injections or antibiotics, but surgical excision is often necessary for definitive treatment. We present a unique case of tacrolimus-induced eruptive epidermal inclusion cysts on the head and trunk of an adult male post-renal transplantation. Physicians should be familiar with this potential adverse effect, especially due to the difficulty of obtaining definitive treatment for a multitude of epidermal inclusion cysts.
{"title":"Eruptive Epidermal Inclusion Cysts in a Renal Transplant Patient on Tacrolimus","authors":"Meredith Burns, Hoang Ho-Pham, Lauren Kole","doi":"10.25251/skin.8.3.13","DOIUrl":"https://doi.org/10.25251/skin.8.3.13","url":null,"abstract":"Epidermal inclusion cysts are common cutaneous lesions that can develop anywhere on the body. While benign, these cysts can become inflamed and symptomatic. Symptomatic epidermal inclusion cysts can be treated with intralesional steroid injections or antibiotics, but surgical excision is often necessary for definitive treatment. We present a unique case of tacrolimus-induced eruptive epidermal inclusion cysts on the head and trunk of an adult male post-renal transplantation. Physicians should be familiar with this potential adverse effect, especially due to the difficulty of obtaining definitive treatment for a multitude of epidermal inclusion cysts.","PeriodicalId":22013,"journal":{"name":"SKIN The Journal of Cutaneous Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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