Epidermal cysts, when intact, show arborizing telangiectasia; conversely, ruptured epidermal cysts reveal peripheral, linear, branched vessels (45). Dermoscopic features of steatocystoma multiplex, along with milia, as noted in reference (5), include a peripheral brown rim, linear vessels coursing through the lesion, and a uniform yellow background extending throughout. The presence of linear vessels in other cystic lesions contrasts with the distinct pattern of dotted, glomerular, and hairpin-shaped vessels found in pilonidal cysts. The differential diagnosis for pink nodular lesions must incorporate pilonidal cyst disease, amelanotic melanoma, basal cell carcinoma, squamous cell carcinoma, pyogenic granuloma, lymphoma, and pseudolymphoma (3). A pink background, central ulceration, peripherally arranged dotted vessels, and white lines are seemingly prevalent dermoscopic characteristics of pilonidal cyst disease, as observed in our cases and two previously reported cases. Central yellowish, structureless areas, along with peripheral hairpin and glomerular vessels, are dermoscopically observed features of pilonidal cyst disease, as per our findings. Summing up, distinguishing pilonidal cysts from other skin tumors is achievable through the previously noted dermoscopic characteristics, and dermoscopy supports a diagnosis in clinically suspicious cases. More research is necessary to thoroughly describe and assess the typical dermoscopic signs of this condition and their rate of occurrence.
To the Editor, segmental Darier disease (DD) is a rare medical condition, with roughly forty instances mentioned in English-language publications. The disease is hypothesized to stem, in part, from a post-zygotic somatic mutation of the calcium ATPase pump, restricted to the affected skin lesions. Patients with segmental DD, specifically type 1, showcase lesions that follow Blaschko's lines on one side of the body; type 2, conversely, displays focal areas of heightened severity within the context of generalized DD (1). The absence of a positive family history, the delayed onset of type 1 segmental DD in the third or fourth decade, and the lack of associated characteristics, all contribute to the difficulty in diagnosing the condition. Acquired papular dermatoses, including lichen planus, psoriasis, lichen striatus, and linear porokeratosis, are incorporated into the differential diagnosis of type 1 segmental DD, often displaying linear or zosteriform distributions (2). We highlight two cases of segmental DD; the first, a 43-year-old female, displayed pruritic skin conditions for five years, with symptoms exacerbated by seasonal factors. The examination showed a swirling pattern of small, keratotic papules, light brownish to reddish in color, on both the left abdomen and inframammary area (Figure 1a). The dermoscopic image (Figure 1b) showed polygonal or roundish, yellowish-brown lesions, surrounded by a band of whitish, featureless tissue. Guadecitabine in vitro Hyperkeratosis, parakeratosis, and dyskeratotic keratinocytes, observed in the biopsy specimen (Figure 1, c), are histopathologically correlated to dermoscopic brownish polygonal or round areas. Figure 1, displaying panel d, demonstrates the considerable improvement achieved by the patient after being prescribed 0.1% tretinoin gel. A zosteriform rash comprising small red-brown papules, eroded papules, and yellow crusts appeared on the right upper abdomen of a 62-year-old woman, forming the second case (Figure 2a). In the dermoscopic image (Figure 2b), polygonal, roundish, yellowish areas were observed, encircled by a structureless field characterized by whitish and reddish coloring. 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). As a consequence of being prescribed topical steroid cream and 0.1% adapalene cream, the patient's condition displayed an improvement. Both cases ultimately received a final diagnosis of type 1 segmental DD, established via a combination of clinical and histopathological assessments; the sole reliance on the histopathological report was insufficient to rule out acantholytic dyskeratotic epidermal nevus, whose clinical and histological features overlap significantly with segmental DD. The diagnosis of segmental DD was bolstered by the late emergence and worsening influenced by external factors, including heat, sunlight, and perspiration. Type 1 segmental DD is usually diagnosed through the combination of clinical and histopathological data, but dermoscopy effectively contributes to the diagnosis by eliminating potential alternatives and recognizing their unique dermoscopic characteristics.
The urethra's involvement by condyloma acuminatum, though rare, usually occurs only in its most distal segment. A range of therapeutic strategies have been described for urethral condylomas. 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. Laser therapy stands as the preferred treatment for intraurethral condylomata. A 25-year-old male patient presenting with meatal intraurethral warts was effectively treated using 5-FU after encountering treatment failures with laser therapy, electrosurgery, cryotherapy, imiquimod, and 80% trichloroacetic acid.
The group of skin disorders known as ichthyoses is characterized by erythroderma and a generalized scaling pattern. A clear delineation of the relationship between ichthyosis and melanoma has yet to be established. A unique case of acral melanoma, manifesting on the palm in an elderly patient with congenital ichthyosis vulgaris, is presented here. The biopsy findings indicated a melanoma with ulceration, exhibiting a pattern of superficial spread. To the best of our existing knowledge, no instances of acral melanoma have been documented in individuals exhibiting congenital ichthyosis. Patients with ichthyosis vulgaris, however, should undergo regular clinical and dermatoscopic assessments for melanoma, considering the possible spread and growth of the cancer.
A 55-year-old male, the subject of this report, was found to have penile squamous cell carcinoma (SCC). infection marker A mass, increasing in size over time, was observed within the patient's penis. The mass was removed via a partial penectomy procedure. A highly differentiated squamous cell carcinoma was evident from the histologic assessment. Detection of human papillomavirus (HPV) DNA was achieved using polymerase chain reaction technology. The squamous cell carcinoma's HPV presence, identified as type 58, was confirmed through sequencing.
Skin and extracutaneous abnormalities frequently accompany each other, as commonly seen in a range of genetic syndromes. Nevertheless, the possibility of undiscovered and unnamed symptom combinations persists. Biopsia líquida A patient with multiple basal cell carcinomas arising from a nevus sebaceous was admitted to the Dermatology Department; we present this case here. The patient's medical history indicated cutaneous malignancies, along with palmoplantar keratoderma, prurigo nodularis, hypothyroidism, multiple lumbar abnormalities, a uterine myoma, an ovarian cyst, and a highly atypical colon adenoma. The presence of multiple disorders in combination potentially indicates a genetic cause for the diseases.
Drug-induced vasculitis arises from drug exposure, initiating the inflammation of small blood vessels, ultimately damaging the affected tissue. Chemotherapy and combined chemoradiotherapy treatments have, in some rare cases, been associated with drug-induced vasculitis, as documented in medical literature. Small cell lung cancer (SCLC), stage IIIA (cT4N1M0), was the definitive diagnosis for our patient. Following the second cycle of carboplatin and etoposide (CE) chemotherapy, administered four weeks prior, the patient experienced the onset of cutaneous vasculitis and a rash localized to the lower extremities. Methylprednisolone therapy, a symptomatic treatment, replaced the CE chemotherapy regimen. Patients on a course of prescribed corticosteroids experienced an amelioration of the local condition. 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. Subsequent clinical examination revealed a continuing reduction in the cutaneous vasculitis. Consolidation chemotherapy treatment having concluded, the patient underwent elective brain radiotherapy. Monitoring the patient clinically was carried out until the onset of a disease relapse. 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.
Allergic contact dermatitis (ACD), a condition frequently caused by (meth)acrylates, is a traditionally occupational concern for dentists, printers, and fiberglass workers. Artificial nail applications have led to reported instances of complications, affecting both nail technicians and individuals who use the service. ACD, a consequence of (meth)acrylates in artificial nails, is a prevalent issue affecting both nail technicians and consumers. Following two years of employment as a nail technician, a 34-year-old woman displayed severe hand dermatitis, primarily on her fingertips, in conjunction with frequent occurrences of facial dermatitis. The patient's nails, frequently splitting, led to a four-month use of artificial nails, necessitating regular gel applications for their care. Her asthma manifested in several episodes while she was working at her workplace. Patch tests were carried out across baseline series, acrylate series, and the patient's own material.