Unruptured epidermal cysts, importantly, exhibit branching telangiectasia; ruptured ones, conversely, demonstrate peripheral linear branched vessels (45). The dermoscopic presentation of steatocystoma multiplex, similar to milia, typically includes a peripheral brown border, linear vascular patterns, and a homogeneous yellow coloration of the involved area, as reported in reference (5). Distinguishing characteristics of cystic lesions, especially those noted previously, are linear vessels in other cases, whereas pilonidal cysts exhibit distinctive dotted, glomerular, and hairpin-shaped vessels. Among the differential diagnoses for pink nodular lesions are pilonidal cyst disease, amelanotic melanoma, basal cell carcinoma, squamous cell carcinoma, pyogenic granuloma, lymphoma, and pseudolymphoma (3). The dermoscopic presentation of pilonidal cyst disease, as seen in our cases and supported by two documented instances, typically includes a pink background, central ulceration, peripheral dot-like vessels, and visible white lines. As our observations show, the dermoscopic features of pilonidal cyst disease encompass central yellowish, structureless areas and peripheral hairpin and glomerular vessels. In closing, the dermoscopic features previously highlighted offer a clear distinction between pilonidal cysts and other skin neoplasms, and dermoscopy is valuable in confirming clinical suspicions of pilonidal cysts. To further delineate typical dermoscopic features and their rate of occurrence in this disease, prospective research is warranted.
Dear Editor, in the English medical literature, the uncommon condition of segmental Darier disease (DD) has been reported in about 40 instances. Researchers hypothesize that the presence of a post-zygotic somatic mutation in the calcium ATPase pump, exclusively in lesional skin, may contribute to the development of the disease. Segmental DD type 1 demonstrates lesions that follow Blaschko's lines on one side only; conversely, segmental DD type 2 showcases focal areas of increased severity in patients with a generalized presentation of DD (1). A positive family history is often absent, and the late onset of type 1 segmental DD, typically in the third or fourth decade, along with the lack of associated features, all conspire to make diagnosis difficult. Within the differential diagnosis of type 1 segmental DD, acquired papular dermatoses, exemplified by lichen planus, psoriasis, lichen striatus, or linear porokeratosis, are characterized by a linear or zosteriform arrangement (2). In this report, we present two cases of segmental DD, the first being a 43-year-old female who had suffered from pruritic skin alterations for five years, with symptoms worsening during specific seasons. A swirling pattern of light brownish to reddish keratotic small papules was observed on the left abdomen and inframammary area during the examination (Figure 1a). Dermoscopic analysis revealed polygonal or roundish areas of yellowish-brown coloration, circumscribed by a wider band of whitish, structureless tissue (Figure 1b). genetic carrier screening The biopsy specimen (Figure 1, c) displayed hyperkeratosis, parakeratosis, and dyskeratotic keratinocytes, features that histopathologically correspond to the dermoscopic brownish polygonal or round areas. The patient experienced notable improvement, documented in Figure 1, part d, after being prescribed 0.1% tretinoin gel. The second case involved a 62-year-old woman who experienced an outbreak characterized by small red-brown papules, eroded papules, and yellow crusts in a zosteriform pattern on the right side of her upper abdomen (Figure 2a). Figure 2b depicts dermoscopic findings: polygonal, roundish, yellowish areas outlined by a structureless field of whitish and reddish tones. In the histopathological assessment, compact orthokeratosis was prevalent, along with small parakeratosis foci. The marked granular layer contained dyskeratotic keratinocytes and displayed foci of suprabasal acantholysis, consistent with a diagnosis of DD (Figure 2, d, d). Topical steroid cream and 0.1% adapalene cream were prescribed to the patient, resulting in an improvement. Clinico-histopathologic correlation led to a final diagnosis of type 1 segmental DD in both cases; acantholytic dyskeratotic epidermal nevus, indistinguishable in both clinical and histological presentations from segmental DD, could not be excluded from the diagnosis solely based on the histopathological findings. Supporting the diagnosis of segmental DD was the late emergence of symptoms and their worsening due to external factors, for instance, heat, sunlight, and sweat. A clinico-histopathological approach is generally used for the final diagnosis of type 1 segmental DD; however, dermoscopy significantly aids in the process by differentiating the condition from various alternatives, recognizing the dermoscopic signatures of each.
Although the urethra is not commonly affected by condyloma acuminatum, when it does involve the urethra, it is largely restricted to the distal segment. Multiple interventions for urethral condyloma have been described and studied. Laser treatment, electrosurgery, cryotherapy, and topical cytotoxic agents like 80% trichloroacetic acid, 5-fluorouracil cream (5-FU), podophyllin, podophyllotoxin, and imiquimod are components of the extensive and diverse treatments. For treating intraurethral condylomata, laser therapy remains the preferred form of treatment. A case of meatal intraurethral warts in a 25-year-old male patient is presented, where 5-FU proved successful after numerous failed treatments, including laser treatment, electrosurgery, cryotherapy, imiquimod, and 80% trichloroacetic acid.
Ichthyoses, a heterogeneous group of skin conditions, display characteristic features of erythroderma and generalized scaling. The nature of the connection between ichthyosis and melanoma remains poorly understood. We report a singular instance of acral melanoma of the palm in a senior patient with co-existing congenital ichthyosis vulgaris. Through the process of biopsy, a melanoma with ulceration and a superficial spreading pattern was diagnosed. In the patients with congenital ichthyosis, no cases of acral melanomas have been observed, as far as we are aware. Although ichthyosis vulgaris is a factor, the risk of melanoma infiltration and spread compels regular clinical and dermatoscopic screenings for patients.
A case of penile squamous cell carcinoma (SCC) is presented, involving a 55-year-old man. Epalrestat In the patient's penis, a mass was identified, its size expanding gradually over time. In order to remove the mass, we performed a partial penectomy. The histopathological specimen exhibited features characteristic of a well-differentiated squamous cell carcinoma. Through the use of polymerase chain reaction, human papillomavirus (HPV) DNA was ascertained. HPV type 58 was detected in the squamous cell carcinoma through sequencing analysis.
The presence of both cutaneous and extracutaneous features is a prevalent observation in various genetic syndromes, extensively documented. Nevertheless, the possibility of undiscovered and unnamed symptom combinations persists. bioremediation simulation tests The Dermatology Department received a patient with multiple basal cell carcinomas, the source of which was a nevus sebaceous, a case report we present here. The patient's cutaneous malignancies were accompanied by palmoplantar keratoderma, prurigo nodularis, hypothyroidism, multiple lumbar abnormalities, a uterine myoma, an ovarian cyst, and a highly dysplastic colon adenoma. The co-existence of multiple disorders might suggest a genetic predisposition to the diseases.
Subsequent inflammation of small blood vessels, after drug exposure, is the mechanism behind drug-induced vasculitis, causing damage to the affected tissue. In the medical literature, there are documented instances of drug-induced vasculitis, a rare occurrence, associated with chemotherapy or concurrent chemoradiotherapy. A diagnosis of stage IIIA (cT4N1M0) small cell lung cancer (SCLC) was made for our patient. After four weeks from the commencement of the second cycle of carboplatin and etoposide (CE) chemotherapy, the patient developed a rash and cutaneous vasculitis concentrated on the lower limbs. The cessation of CE chemotherapy led to the commencement of symptomatic therapy with methylprednisolone. Following the prescribed corticosteroid regimen, there was a noticeable enhancement in the local findings. Post chemo-radiotherapy completion, the patient's treatment continued with a consolidation chemotherapy regimen of four cycles, employing cisplatin, for a total of six chemotherapy cycles. The cutaneous vasculitis demonstrated further regression, as confirmed by a clinical examination. After the consolidation chemotherapy concluded, a course of elective brain radiotherapy was undertaken. The patient was kept under clinical watch until the disease's return. Subsequent chemotherapy regimens were delivered to address the platinum-resistant disease. Subsequent to the SCLC diagnosis by seventeen months, the patient expired. To our knowledge, this is the initial documented instance of a patient experiencing vasculitis in their lower limbs concurrent with radiotherapy and CE chemotherapy administered as part of the initial treatment protocol for SCLC.
Amongst dentists, printers, and fiberglass workers, allergic contact dermatitis (ACD) stemming from (meth)acrylates has historically been a prevalent occupational affliction. Artificial nail applications have led to reported instances of complications, affecting both nail technicians and individuals who use the service. (Meth)acrylates in artificial nails are a significant factor in ACD, raising concerns among both nail technicians and consumers. A 34-year-old woman, employed in a nail art salon for two years, experienced the onset of severe hand dermatitis, particularly affecting her fingertips, accompanied by recurrent facial dermatitis. The patient's nails, prone to splitting, necessitated the use of artificial nails for the past four months, complemented by regular gel applications for reinforcement. She reported multiple incidents of asthma during her time at the office. The patch test procedure was employed on the baseline series, acrylate series, and the patient's own material.