Hidden Basal Cell Carcinoma in the Intergluteal Crease
Basal cell carcinoma (BCC) is the most common cancer and often is found in sun-exposed areas, particularly the head and neck. However, BCCs also can arise in unexpected locations. Intergluteal crease BCC is a rare finding and often can be overlooked. When promptly identified, prognosis is good. Being educated on the existence of BCC in this sensitive area can aid proper diagnosis. This sensitive area should be included in a thorough skin examination to avoid missing this treatable cancer. We report the case of an 83-year-old woman with a BCC hidden in the intergluteal crease.
Annular elastolytic giant cell granuloma: mysterious enlarging scarring lesions
Night of the living thrips: an unusual outbreak of Thysanoptera dermatitis [Case Report]
Identifying the etiology of a cutaneous eruption in the setting of an acute cluster outbreak is of utmost importance due to the inherent potential public health impact. The differential diagnosis ranges from innocuous arthropod bites to more concerning causes such as infection, medication reaction, and environmental exposure. We report the simultaneous presentation of 15 US Marines who presented with numerous discrete papular skin eruptions. Subsequent thorough patient evaluation and history, literature review, immunization status reconciliation, entomological assessment, site survey, and skin biopsy were performed. This case series is one of the largest reported to date of a cluster outbreak of a papular dermatitis secondary to bites from thrips (ie, insects of the order Thysanoptera).
A scaly eruption on the body [Case Report]
Buschke-Ollendorff syndrome presenting as a painful nodule
Ramifications of poor medical education and screening in minority populations: an extensive acral melanoma [Case Report]
After 2 years of holistic self-treatment on his home island, an elderly Samoan man presented with a painful, hyperpigmented mass on his left heel. Physical examination revealed a black, friable tumour with necrotic tissue and superficial ulcerations with no other associated symptoms. Further investigation revealed that the mass was invasive. The tumour was treated with resection and a final diagnosis of acral lentiginous melanoma, stage T4b was made. Poor access to care and screening services are large barriers to care for minorities and patients with low socioeconomic status. Once access is obtained, however, patient compliance is not guaranteed. Healthcare practices often clash with societal beliefs, and so patient education regarding their disease and its possible progression, along with treatment options, is important. Furthermore, a lack of ethnically diverse physicians contributes to low cultural competency during interaction with patients from minorities, resulting in poor communication and low patient satisfaction.
Lupus erythematosus tumidus: a unique disease entity [Case Report]
Lupus erythematosus tumidus (LET) is a photosensitive skin disease characterized by succulent, edematous, and non-scarring plaques. Histologic features include perivascular and periadnexal lymphocytic infiltration and interstitial mucin deposition. Despite being first described in 1909, there are few case reports in the current literature describing this disease and even fewer that discuss treatment. We describe a case of a 22-year-old woman with systemic lupus erythematosus (SLE) and secondary class V lupus nephritis. She was referred to Dermatology for an intermittent pruritic facial eruption that was clinically and histologically consistent with LET. There is much controversy in literature as to whether or not LET is a unique variant of cutaneous lupus erythematosus. Interestingly, the mainstay of treatment for LET, in the limited case reports and series that exist, is with antimalarial drugs, which our patient had already been taking for SLE. This case exemplifies the need for complete disease characterization, evidence-based treatment, and a multidisciplinary approach.
Drug Reaction with Eosinophilia and Systemic Symptoms: DRESS following Initiation of Oxcarbazepine with Elevated Human Herpesvirus-6 Titer
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal severe cutaneous reaction, which has a delayed onset after the initiation of an inciting medication. After recognition and withdrawal of the causative agent, along with aggressive management, a majority of patients will have complete recovery over several months. We present a rare case of DRESS secondary to oxcarbazepine with an elevated human herpesvirus-6 titer.
A 50-year-old man with blistering skin lesions on both feet [Case Report]
Lupus erythematosus/lichen planus overlap syndrome: successful treatment with acitretin [Case Report]
Lupus erythematosus/lichen planus overlap syndrome is a rare disorder combining the clinical, histological and immunopathological features of both lupus erythematosus (LE) and lichen planus (LP). Cutaneous lesions mostly affect the distal arms, legs, face and trunk. Palmoplantar involvement is felt to be characteristic of this condition. Plaques are often painful, centrally atrophic, bluish-red to hypopigmented in color, large, and scaly. On biopsy of clinically ambiguous lesions, histopathological features of one or both processes can be found, obscuring the diagnosis and complicating prognosis and treatment. Thus, direct immunofluorescence has become an essential tool in helping to diagnose this condition. In this report we describe the unique clinical and immunohistopathological manifestations of lupus erythematosus/lichen planus overlap syndrome along with a successful response to treatment with acitretin.