Faculty Bibliography

Primary infection with varicella-zoster virus (VZV) during pregnancy can lead to devastating outcomes for both the mother and fetus. We describe a case of VZV infection in a pregnant woman who presented at 38 weeks' gestation. We also review the literature regarding management and prevention. Varicella-zoster virus-associated pneumonia in the mother is important to recognize. Outcomes in the newborn largely are dependent on gestational age at the time of infection. Prevention is paramount to management.

The specific dermatoses of pregnancy represent a diverse group of intensely pruritic dermatoses, occurring only in the puerperal state. The relative rarity of these conditions, the often variable clinical appearance, and the lack of definitive diagnostic tests have led to confusion regarding the appropriate diagnosis and management of the specific dermatoses of pregnancy. Herein we review the clinical characteristics, diagnosis and treatment of five dermatoses occurring during pregnancy: pruritic urticarial papules and plaques of pregnancy, atopic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy, and pustular psoriasis of pregnancy.

Multiple endocrine neoplasia type 1 (MEN1) is a familial tumor syndrome with autosomal dominant inheritance. Cutaneous tumors in MEN1, which include multiple angiofibromas, collagenomas, and lipomas can easily be overlooked because of their subtle appearance. As markers of this tumor syndrome, recognition of the mucocutaneous manifestations of MEN1 is important in order to facilitate early interdisciplinary care and diagnosis of associated internal disease in both patients and family members.

Disseminated superficial actinic porokeratosis, which was described in 1966, is characterized by small, atrophic patches with distinctive keratin rims that occur on sun-exposed areas of the extremities, shoulders, and back. The diagnosis is based on the histopathologic finding of a cornoid lamella, absence of a granular layer, and often a thin epidermis. It is associated with exposure to ultraviolet radiation. Gene studies suggest a pathway defect in which several mutations in keratinocyte proliferation and differentiation lead to development of porokeratosis.

The authors present a case of erythema multiforme-like drug reaction to the multikinase inhibitor sorafenib. While considered targeted therapy, multikinase inhibitors have been demonstrated to have various cutaneous effects. It is important to distinguish allergic reactions from adverse side effects as the latter may permit cautious re-challenge with medications that can potentially prolong survival in patients with advanced or metastatic disease

A 36-year-old man with a prior diagnosis of primary cutaneous marginal-zone B cell lymphoma presented with newly-developed, small, erythematous papules and nodules on his upper left arm and pink-to-skin-colored, clustered papules on his left forearm. A biopsy specimen and immunohistochemical analysis of the left arm lesions showed a lymphocytic infiltrate which stained positively for CD20 and Bcl-2 and negatively for CD10. A PET-CT scan was negative for any extra-cutaneous manifestations of disease. These clinicopathologic findings are indicative of recurrent localized primary cutaneous marginal-zone B cell lymphoma.