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Local heat urticaria

White, Forrest; Cobos, Gabriela; Soter, Nicholas A
We present a 38-year-old woman with local heat urticaria confirmed by heat provocation testing. Heat urticaria is a rare form of physical urticaria that istriggered by exposure to a heat source, such as hot water or sunlight. Although it is commonly localized and immediate, generalized and delayed onset forms exist. Treatment options include antihistamines and heat desensitization. A brisk, mechanical stroke elicited a linear wheal. Five minutes after exposure to hot water, she developed well-demarcated,erythematous blanching wheals that covered the distal forearm and entire hand.
PMID: 29447656
ISSN: 1087-2108
CID: 2958012

Frontal fibrosing alopecia in a 46-year-old man

White, Forrest; Callahan, Shields; Kim, Randie H; Meehan, Shane A; Stein, Jennifer
Frontal fibrosing alopecia is a scarring alopecia thatis characterized by recession of the frontotemporalhairline with the frequent loss of eyebrows. Itpredominantly affects postmenopausal womenand only rarely affects men. We report the caseof a 46-year-old man with a ten-year history of anerythematous patch with perifollicular erythemaat the superior aspect of the forehead andfrontotemporal hairline. A skin biopsy specimenshowed a perivascular, lymphocytic infiltrate withperiinfundibular fibrosis. These findings establisheda diagnosis of frontal fibrosing alopecia. Thepathogenesis of this condition is poorly understoodbut may be hormonally-mediated.
PMID: 28329549
ISSN: 1087-2108
CID: 2494752

Nodular amyloidosis

White, Forrest; Shvartsbeyn, Marianna; Meehan, Shane A; Ramachandran, Sarika
Nodular amyloidosis is the rarest form of primary cutaneous amyloidosis. We report the case of a 74-year-old woman with an eight-year history of asymptomatic, hyperpigmented plaques on the pretibial areas. A skin biopsy specimen showed deposits of amorphous eosinophilic material that extended throughout the dermis with apple-green birefringence with a Congo-red stain, which established a diagnosis of nodular amyloidosis. Patients with nodular amyloidosis should be evaluated for systemic disease and followed appropriately due to a small risk of progression to systemic amyloidosis.
PMID: 26990345
ISSN: 1087-2108
CID: 2051372

Benign familial pemphigus ( Hailey-Hailey disease)

White, Forrest; Shvartsbeyn, Marianna; Meehan, Shane A; Urbanek, Richard W
A 56-year-old man presented with a 15-year history of scaly red plaques on the trunk and axillae. Skin biopsy was consistent with Hailey-Hailey disease. His condition was refractory to multiple therapies, which included topical and oral antibiotics and topical, intralesional, and oral glucocorticoids. Treatment with subcutaneous botulinum toxin type A at the axillae and on the back led to a nearly complete resolution of plaques in those areas. Botulinum toxin type A should be considered in patients with extensive Hailey-Hailey disease who are fail traditional therapies.
PMID: 26990332
ISSN: 1087-2108
CID: 2051252

Granuloma annulare arising in association with pulmonary coccidioidomycosis [Case Report]

White, Forrest N; Zedek, Daniel C; Collins, David L; Boswell, J Scott
Granuloma annulare (GA) is a reactive process in the dermis, related to degeneration of collagen. It may occur as an idiopathic phenomenon or in conjunction with a myriad of systemic conditions, including infectious disease. We report an interesting case of GA precipitated by pulmonary coccidioidomycosis.
PMID: 22483518
ISSN: 1087-2108
CID: 2689802

Acneiform follicular mucinosis responding to hydroxychloroquine [Letter]

White, Forrest N; Bergstresser, Paul R; Lamontagne, Darci; Boswell, J Scott
PMID: 21242413
ISSN: 1538-3652
CID: 2689812