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A 58-year-old man presented for evaluation and treatment of non-tender, non-pruritic, annular patches on the right temple and frontal aspect of the scalp that reddened with exercise. A biopsy specimen showed a purpuric dermatitis with features of lymphocytic vasculitis; a diagnosis of exercise-induced progressive pigmentary purpura was made. Whereas progressive pigmentary purpura is purported to be caused by exercise, other similar appearing entities are associated with exercise, namely exercise-induced vasculitis (EIV). EIV may be considered as an acute microcirculatory deficiency and thermoregulation decompensation that occurs after episodes of exhaustive major muscular activity or after unusual or excessive exercise. The combination of age greater than 50 years, heat, and prolonged exercise are the most potent contributing factors. This is the first report of exercise-induced progressive pigmentary purpura.

This case report seeks to alert the reader to the possibility that the keratoacanthoma (KA) may develop in tattoo sites, specifically in red tattoo sites. We further wish to describe the senior author's treatment of such a lesion using Mohs micrographic surgery and a rotation flap to preserve the integrity of the original tattoo design in an area of minimal skin laxity. We briefly discuss the etiology of the KA and review potential tattoo reactions as presented in the literature

Three hundred and sixteen patients with a diagnosis of tinea pedis were evaluated in two multicenter, double-blind randomized studies. One hundred and fifty-nine patients applied naftifine gel 1 percent and 157 applied gel vehicle to affected areas twice daily for four weeks. At the end of treatment, the naftifine-treated groups had higher mycologic cure rates (66 percent and 63 percent) than the respective vehicle-treated groups (34 percent and 27 percent, p is less than 0.01 and p is less than 0.001). The rate of global improvement in patients' conditions and the reduction in the incidence and severity of most signs and symptoms was greater for naftifine-treated patients in both studies. The results of these studies indicate that twice-daily use of naftifine gel 1 percent is safe and significantly more effective than vehicle in the treatment of tinea pedis. $$:

Cutaneous hyperpigmentation resembling acanthosis nigricans developed in two patients with malignant brain tumors following chemotherapy with triazinate (Baker's Antifol), a folic acid antagonist. In both cases, the eruption resolved after the cessation of drug administration and reappeared after the reinstitution of triazinate therapy. A skin biopsy specimen from one patient showed microscopic changes consistent with those found in acanthosis nigricans. The other patient had a decreased serum folate level that returned to normal as the hyperpigmentation resolved. Folate may have a role in triazinate-induced acanthosislike hyperpigmentation

Multiple pyogenic granuloma-like lesions occurring at punch graft sites are an unusual complication of hair transplantation heretofore unreported. While the etiology and pathogenesis of such lesions remain elusive, physicians performing hair transplantations should be aware of this potential sequela