Faculty Bibliography

Steatocystoma multiplex is a rare condition that is characterized by cutaneous cysts and may be inherited in an autosomal dominant manner or may occur sporadically. The pathogenesis is hypothesized to involve mutations in the keratin 17 gene. There are no internal manifestations. The lesions are usually asymptomatic. However, a suppurative variant exists in which the lesions become inflamed and suppurative after minor trauma. Treatments include cryosurgery, aspiration, surgical excision, laser therapy, and modified surgical incision techniques. This report presents a case of steatocystoma multiplex, the suppurative variant, in a 26-year-old woman with involvement of rare locations on the buttocks, groin, and extremities.

Necrolytic acral erythema is a rare, cutaneous manifestation of hepatitis C virus infection that is characterized by erythematous, violaceous or dusky papules, blisters, and/or erosions in the early stages and by well-demarcated, hyperkeratotic, targetoid plaques with a peripheral rim of macular erythema, secondary lichenification and hyperpigmentation, and overlying fine micaceous or necrotic-appearing scale in the later stages. Because most topical modalities prove ineffective, treatment of the underlying viral infection or therapeutic zinc supplementation are required for clinical improvement.

Silicone in liquid and gel implantation may induce granuloma formation and migration. Although there are many complications associated with solid silicone implantation, there have been no published reports of distant granuloma formation. We present a case of a woman with clinical and serologic findings that are consistent with systemic lupus erythematosus and a histopathologic diagnosis of foreign body granulomatous dermatitis 20 years after solid silicone nasal implantation. We review the literature on silicone granulomas and their treatment and speculate on the potential etiologies of a challenging case presentation.

Introduction: Atherosclerosis is an inflammatory disease. Its major clinical manifestation, coronary artery disease, is the leading cause of death in the western world. The disease is caused by the rupture of macrophage-laden and highly-inflamed atherosclerotic plaques, which are prone to rupture and cause myocardial infarctions. Oral statin therapy is widely used to reduce blood cholesterol levels in patients with atherosclerosis, and it is believed to have modest anti-inflammatory effects. We previously developed a strategy that aims at amplifying these anti-inflammatory effects through statin delivery to plaque macrophages using a reconstituted high density lipoprotein (rHDL) nanoparticle as a delivery vehicle. This statin rHDL ([S]-rHDL) nanotherapy reduced plaque macrophages by 80% (Supplementary). In the current study, we set out a novel nanomedical treatment paradigm, based on the aforementioned [S]-rHDL nanotherapy, which aims at realizing rapid remodeling of advanced atherosclerotic plaques towards a favorable phenotype in Apolipoprotein E-/- (ApoE KO) mice. Design and Results: ApoE KO mice received 26 weeks of high-cholesterol diet to develop advanced atherosclerotic plaques. After the diet, the mice first received high dose [S]-rHDL for a week (60 mg/kg simvastatin, 4 intravenous injections /week), followed by either low dose [S]-rHDL (15 mg/kg simvastatin, 2 intravenous injections /week), oral simvastatin (15 mg/kg/day), or no treatment for another 8 weeks (A). We evaluated the efficacies of the therapies during the course of the 9-week treatment with a MATLAB-assisted histological assessment of aortic roots, and CD68 immunostaining and hematoxylin phloxine saffron stain (HPS)) were performed (B). In vivo magnetic resonance imaging (MRI) of abdominal aortas and blood tests were done as well. After one week high dose [S]-rHDL treatment, macrophage levels in aortic roots were reduced by 70% (P < 0.001). The low levels were maintained by a subsequent 8-week low dose [S]-rHDL (48 % lowe!

Pityriasis rubra pilaris (PRP) is an inflammatory condition of uncertain etiology. We present a case of PRP that demonstrates acantholysis on histopathologic examination, which is a characteristic feature that increasingly is recognized to aid in the diagnosis. We also review the clinical presentations and treatment options for this condition.