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Two Different Scenarios of Squamous Cell Carcinoma Within Advanced Basal Cell Carcinomas Cases Illustrating the Importance of Serial Biopsy During Vismodegib Usage

from ArchDerm - 01 Sep 14

ImportanceVismodegib is a Hedgehog signaling pathway inhibitor recently approved by the US Food and Drug Administration for advanced basal cell carcinoma. We present 2 cases of clinically significant squamous cell carcinoma within the tumor bed of locally advanced basal cell carcinoma found during vismodegib treatment.ObservationsThe first case is that of a patient with locally advanced basal cell carcinoma responsive to vismodegib but with an enlarging papule within the tumor bed. On biopsy, th



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Acquired Bilateral Telangiectatic Macules A Distinct Clinical Entity

from ArchDerm - 01 Sep 14

ImportanceWe evaluated 13 distinct patients with multiple telangiectatic pigmented macules confined mostly to the upper arms to determine if the clinical and histopathological features of these cases might represent a specific clinical entity.ObservationsWe retrospectively investigated the clinical, histopathologic, and immunohistochemical features of 13 patients with multiple telangiectatic pigmented macules on the upper arms who presented between January 2003 and December 2012. Epidermal pigme



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Congenital Volkmann Syndrome and Aplasia Cutis of the Forearm A Challenging Differential Diagnosis

from ArchDerm - 01 Sep 14

ImportanceDifferential diagnosis between congenital Volkmann ischemic contracture (CVIC) and unilateral aplasia cutis congenita (ACC) type VII of the forearm presents a clinical challenge. Both diseases share the same clinical presentation characterized by a stellate ulceration over the upper extremities and reported association with neuromuscular defects, but the diagnostic criteria to differentiate these 2 entities remain unclear.ObservationsA newborn girl presented with an ulceration of the l



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Mycobacterium mucogenicum Infection Following Dacryocystorhinostomy and Crawford Tube Placement

from ArchDerm - 01 Sep 14

ImportanceNontuberculous mycobacterial infections of the skin can be seen in cases of immunosuppression and/or traumatic implantation of contaminated objects. Surgical settings with appropriate sterilization techniques have been immune to these types of infections. We report a case of nosocomially derived infection from a sterile procedure.ObservationsA woman in her 70s presented with a facial lesion after an ophthalmologic procedure that was discovered to be a nontuberculous mycobacterial infec



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Blue-Gray Mucocutaneous Discoloration A New Adverse Effect of Ezogabine

from ArchDerm - 01 Sep 14

ImportanceMany drugs have been reported to induce skin and/or mucous membrane discoloration. Ezogabine (retigabine) was recently approved as an add-on drug for the treatment of partial seizures in adults with epilepsy. Mucocutaneous discoloration induced by antiepileptic drugs in general and ezogabine in particular has not been previously reported.ObservationsTwo patients who had received multiple antiepileptic drugs for several years presented with a blue-gray skin dyspigmentation that was most



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A Limited Form of Proteus Syndrome With Bilateral Plantar Cerebriform Collagenomas and Varicose Veins Secondary to a Mosaic AKT1 Mutation

from ArchDerm - 01 Sep 14

ImportanceProteus syndrome is an extremely rare disorder of mosaic postnatal overgrowth affecting multiple tissues including bone, soft tissue, and skin. It typically manifests in early childhood with asymmetric and progressive skeletal overgrowth that leads to severe distortion of the skeleton and disability. The genetic basis has recently been identified as a somatic activating mutation in the AKT1 gene, which encodes an enzyme mediating cell proliferation and apoptosis.ObservationsWe present



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Confocal Microscopy–Guided Laser Ablation for Superficial and Early Nodular Basal Cell Carcinoma A Promising Surgical Alternative for Superficial Skin Cancers

from ArchDerm - 01 Sep 14

ImportanceLaser ablation is a rapid and minimally invasive approach for the treatment of superficial skin cancers, but efficacy and reliability vary owing to lack of histologic margin control. High-resolution reflectance confocal microscopy (RCM) may offer a means for examining margins directly on the patient.ObservationsWe report successful elimination of superficial and early nodular basal cell carcinoma (BCC) in 2 cases using RCM imaging to guide Er:YAG laser ablation. Three-dimensional (3D)








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Overview Photography and Short-term Mole Monitoring in Patients Taking a BRAF Inhibitor

from ArchDerm - 01 Sep 14

Patients taking BRAF inhibitors develop new primary melanomas and nevi. Many of these neoplasms are BRAF wild-type, which may be due to the paradoxical activation of the RAF/MEK/ERK pathway via an alternative driver mutation, similar to the mechanism involved in inducing the development of squamous cell carcinomas in these patients. In addition, some nevi in these individuals involute, and many of these involuting lesions harbor a BRAFV600E (OMIM *164757) mutation.



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Portable Shade Structure Use at a Youth Soccer Camp

from ArchDerm - 01 Sep 14

More than 3 million nonmelanoma skin cancers (NMSCs) are diagnosed annually in the United States. The incidence of malignant melanoma (MM) has increased annually by 2.4%. Open field activities in youth are a major source of sun exposure, which leads to skin cancer later in life. Few studies exist on the use of shade structures in open field sports, particularly soccer. In this pilot study, we assess the rate of use of portable shade structures among soccer-playing youths.



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An Oral Phosphodiesterase Inhibitor (Apremilast) for Inflammatory Rosacea in Adults: A Pilot Study

from ArchDerm - 01 Sep 14

Rosacea is a chronic skin disorder characterized by facial flushing, persistent erythema, telangiectasias, and inflammatory papules and pustules. In addition to the physical manifestations, rosacea may contribute to lower self-esteem, thereby having significant psychosocial implications. Some patients do not respond to conventional treatments for rosacea or are unable to tolerate the adverse effects; therefore, effective new therapies are needed. We sought to investigate the safety and efficacy



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Psoriasis Provoked or Exacerbated by Medications Identifying Culprit Drugs

from ArchDerm - 01 Sep 14

A critical practice gap exists in identifying the causes of psoriasis flares, especially medication-related causes. Some physicians may not consistently examine medications for their contribution to psoriasis flares. However, a careful consideration of the role of medications in psoriasis exacerbation may improve long-term psoriasis control.



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Tumoral Bacillary Angiomatosis in a Child With Human Immunodeficiency Virus

from ArchDerm - 01 Sep 14

Bacillary angiomatosis (BA) is a life-threatening infection caused by gram-negative organisms of the genus Bartonella that can be cured with appropriate therapy. The clinical manifestations of this infection are diverse, and a high index of suspicion and histopathologic analysis are often required to make the diagnosis.



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Development of Trichodysplasia Spinulosa Case Report of a Patient With Gorlin Syndrome Treated With Vismodegib

from ArchDerm - 01 Sep 14

Vismodegib is approved by the US Food and Drug Administration for the treatment of unresectable basal cell carcinoma (BCC) as well as for Gorlin syndrome (basal cell nevus syndrome).



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Mucinous Nevus Report of a Case and Review of the Literature

from ArchDerm - 01 Sep 14

Mucinous nevus is a rare entity characterized by mucin deposition in the papillary dermis. Herein we present a case and review the available literature.



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Poland Syndrome Coexisting With Blaschkolinear Congenital Melanocytic Nevi

from ArchDerm - 01 Sep 14

Poland syndrome is an uncommon congenital anomaly characterized by unilateral chest wall and upper extremity hypoplasia. It is theorized to be due to subclavian artery hypoplasia during embryogenesis. There have been only a few isolated reports of Poland syndrome with congenital dermatoses. Adding to this association list, we report a case of Poland syndrome with multiple congenital melanocytic nevi (CMN). Additionally, the nevi are in a Blaschkolinear arrangement, which is also rare; we know of




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Cutaneous Hemophagocytosis After Alemtuzumab Injection in a Patient With Sézary Syndrome

from ArchDerm - 01 Sep 14

Alemtuzumab, a CD52 monoclonal antibody, is increasingly used for treating advanced cutaneous T-cell lymphomas including Sézary syndrome (SS). While injection site reactions are common, the finding of localized cutaneous hemophagocytosis at the injection site without systemic hemophagocytosis is rare.




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Successful Treatment of Subungual Fibromas of Tuberous Sclerosis With Topical Rapamycin

from ArchDerm - 01 Sep 14

Ungual tumors, a major diagnostic criterion for tuberous sclerosis complex (TSC), are often symptomatic and have posed a therapeutic challenge. We present a case of successful treatment of a subungual fibroma with topical rapamycin.



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Somatic Forward (Nonrevertant) Mosaicism in Recessive Dystrophic Epidermolysis Bullosa

from ArchDerm - 01 Sep 14

Revertant somatic mosaicism is a recognized phenomenon in patients with epidermolysis bullosa (EB) and other inherited diseases. It occurs when spontaneous mutations result in correction of a germline mutation that underlies the genodermatosis, leading to phenotypic reversion and sometimes functional improvement. Revertant mosaicism occurs though several mechanisms, all causing a nonreciprocal transfer of genetic information from the parent cell to the daughter cells. Gene conversions, intrageni


 

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