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  • 1.

    【2hr】Acute Generalized Exanthematous Pustulosis with Multiple Organ Failure

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    机译 具有多器官衰竭的急性广义蠕虫脓疱病
    摘要：Acute generalized exanthematous pustulosis (AGEP) is a rare, self-limiting condition. It presents with sterile skin pustules. We present a middle-aged lady with fluid nonresponsive circulatory shock and multiple organ dysfunction secondary to AGEP.
  • 2.

    【2hr】Spontaneous Regression of Palmar Warts after Suffering from Diffuse Contact Dermatitis against Alkyl Bromide

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    机译 在患有羟基溴脱落后脱裂性接触性皮炎后的棕榈疣的自发回归
    摘要：Contact immunotherapy with several sensitizing chemicals such as diphenylcyclopropenone (DPCP) or squaric acid dibutyl ester (SADBE) have been used for the treatment of recalcitrant or multiple warts. Here, we report a case of multiple verrucae vulgaris (VV) on the palm which spontaneously resolved after the development of systemic contact dermatitis against alkyl bromide. We considered that our case accidentally mimics contact immunotherapy against multiple VV. VV sometimes regress spontaneously, which may be triggered by accidental contact dermatitis, as shown in our case.
  • 3.

    【2hr】Eosinophilic Vulvar Leukoderma

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    机译 嗜酸性外阴Leukoderma
    摘要：We report the case of a 54-year-old woman with asthma and atopic dermatitis who presented a white spot on the genitalia. Histologic examination showed numerous eosinophils in the epithelium and the dermis. Eosinophilic esophagitis is defined as an esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by an eosinophil-predominant inflammation. We discuss the possible relationship between the two diseases.
  • 4.

    【2hr】Papulopustular and Ocular Rosacea with an Alleged Coincidence of Cutaneous Lupus Erythematosus: A Case Report

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    机译 带有涉嫌甘蔗丛红斑狼疮的椎弓束和眼镜皮肌瘤：案例报告
    摘要：Rosacea is a chronic inflammatory skin disease characterized by central facial erythema with or without ocular involvement. It is often difficult to distinguish rosacea from other malar rashes, one of which is acute cutaneous lupus erythematosus (CLE), particularly when there is an increase in antinuclear antibody (ANA) level. We report the case of a 16-year old woman with facial erythematous plaque accompanied by papules and pustules, reddened eyes, and swollen eyelids since the last one year. Dermoscopic examination revealed telangiectasia, and skin scraping examination with 20% potassium hydroxide identified the presence of Demodex folliculorum. Further ocular examination also revealed blepharitis, dysfunction of Meibomian gland, cicatrix, and corneal neovascularization. The ANA titer was positive (1:320), while the anti-dsDNA was negative. The patient was treated according to standard treatment for rosacea. The patient showed a satisfactory response following 2 weeks of therapy. Signs of recurring red patches with papules, pustules, telangiectasia, and identification of D. folliculorum on skin scraping examination led to the diagnosis of papulopustular rosacea. A positive ANA test may also be present in other diseases, e.g. acute CLE. Therefore, the diagnosis of rosacea remains a challenge. Thorough observation and examination must be done in order to yield an accurate diagnosis of rosacea.
  • 5.

    【2hr】Acne Vulgaris Mimicking Cutaneous Lupus Erythematosus in an Adolescent: Report of a Rare Case

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    机译 痤疮寻常毒素模仿皮肤狼疮红斑狼疮在青少年：罕见案例的报告
    摘要：Acne vulgaris is a chronic and self-limiting disorder of the pilosebaceous unit which is primarily seen in adolescents. Acne vulgaris presents as polymorphic lesions, consisting of comedones, papules, pustules, cysts, nodules, scarring, and dyspigmentation. Acneiform presentation of cutaneous lupus erythematosus (CLE) is extremely rare. The presentation of CLE is notoriously diverse and often mimics a broad range of unrelated skin disorders. We present a case by referring to American College of Rheumatology (ACR) criteria for systemic lupus erythematosus (SLE); our patient's conditions did not meet any of the clinical criteria of the Systemic Lupus International Collaborating Clinics (SLICC) for SLE. Subsequent to thorough history-taking, physical examination, and laboratory evaluations, the diagnosis of acne vulgaris was established, and a diagnosis of CLE was excluded. As acneiform presentation of CLE is rare, we here present a case which resembled both acne vulgaris and CLE. We describe our experience in establishing the diagnosis of severe acne vulgaris accompanied by scars in a 12-year-old boy with a malar rash and scars on his frontal and malar area who had initially been misdiagnosed as having CLE. This unusual case highlights the broad spectrum of adolescent acne and the importance of clinical identification of the disease so that unnecessary workups might be avoided.
  • 6.

    【2hr】Respiratory Distress Syndrome Associated with Erythrodermic Psoriasis

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    机译 呼吸窘迫综合征与红细胞牛皮癣相关
    摘要：Erythrodermic psoriasis is an uncommon and severe variant of psoriasis which may be associated with rare and severe complications such as acute respiratory distress syndrome. Early recognition of this life-threatening condition can allow prompt appropriate treatment. We report the case of a 69-year-old man with a long history of psoriasis who developed acute respiratory distress during a disease flare-up. There was no relevant past history (except for mild emphysema), known allergy, or recent treatment. Chest X-ray revealed new bilateral infiltrates, confirmed at chest computed tomography scan. Repeated cultures on aspirate of the bronchoalveolar lavage remained negative for viruses, bacteria, and parasites. Cardiac ultrasound was normal and high-dose corticosteroid therapy was initiated. Within a few days his clinical and radiological status improved significantly.
  • 7.

    【2hr】Pilomatrixoma with Atypical Features: A Case Report

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    机译 Pilomatrixoma具有非典型特点：案例报告
    摘要：Pilomatrixoma is an uncommon, benign tumor with differentiation towards both the hair matrix and cells arising in the cortex, most frequently appearing in the first or second decade of life. In rare instances, pilomatrixomas can show malignant transformation. Pilomatrix carcinoma is extremely uncommon and has traditionally been considered a tumor of low malignant potential; however, a high local recurrence rate has been reported. There is a paucity of literature on these lesions, with only a few reports describing the spectrum of malignant changes seen in these lesions. In this case report, we present a case of pilomatrixoma in an adult patient showing atypical features. While the tumor is small, there are focal features that suggest progression to malignancy, but do not fulfill the criteria for pilomatrix carcinoma. These focal atypical features include a focal infiltrative pattern at the periphery, with a variable cytological atypia and an increased mitotic rate, up to five mitotic events/high-power field. Irregular foci of central necrosis (comedonecrosis) were present in several lobules. Some of the features identified were similar to a subset of pilomatrixoma, known as “proliferating pilomatrixoma.” However, our case did not have the diffuse changes or larger size that has been frequently reported in “proliferating pilomatrixoma.” In conclusion, given the lack of focality of the changes, the lesion in our case is best described as a pilomatricoma with atypical features. Furthermore, our case may highlight the need to ensure close clinical follow-up for these lesions with unexpected atypical features that raise concern of recurrence and malignant transformation.
  • 8.

    【2hr】Geophilic Tinea Profunda after a Stay at a Swiss Lake: A Case Report

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    机译 Geophilic Tinea Profunda住在瑞士湖之后：案例报告
    摘要：Cutaneous infections with Nannizzia gypsea in Switzerland are very rare (only about 0.2% of all dermatophyte infections). We present the case of an impressive tinea profunda on the upper arm of a 53-year-old woman. In our patient, the source of infection was probably the sand and soil at a Swiss lake. This case report shows the importance of a correct diagnostic workup, as the infection can mimic an inflammatory dermatosis like psoriasis or eczema and thus lead to a diagnostic and therapeutic delay.
  • 9.

    【2hr】Squamous Cell Carcinoma within a Congenital Nevus Sebaceous: Case Report and Literature Review

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    机译 先天性痣中鳞状细胞癌：案例报告和文献综述
    摘要：Nevus sebaceous (NS) is a benign hamartoma that typically occurs on the head and neck area at birth. Occasionally, secondary neoplasms can develop on top of the original nevus, which usually occur in the middle age. Squamous cell carcinoma (SCC) arising in NS may occur but is very rare. We report the case of a 44-year-old female with an asymptomatic erythematous papule arising within a hairless yellowish plaque on the left parietal area of her scalp for a month. An excisional biopsy was done, and the histopathologic examination revealed SCC arising in the NS.
  • 10.

    【2hr】Primary Cutaneous Cryptococcosis due to

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    机译 由于初重皮肤细胞病
    摘要：Cryptococcus neoformans is an opportunistic germ, usually causing infections in immunocompromised patients. The main sources of infection with C. neoformans are excrement from birds, decomposing wood, fruit, and vegetables. Primary cutaneous cryptococcosis (PCC) is a clinical entity, differing from secondary cutaneous cryptococcosis and systematic infection. We report the case of an immunocompetent 60-year-old woman with PCC due to C. neoformans in her right thumb. She reported an accidental injury caused by a rose thorn while she was gardening. Clinical examination showed the presence of an erythematous ulcerated nodule with elevated borders, suppuration, and central necrosis. Skin histology examination showed cutaneous and subcutaneous fibrinoid necrosis with bleeding, abscess, neutrophil-rich cellular infiltration, and the presence of PAS-, Grocott- and mucin-positive spores. The mycological culture showed milky and creamy colonies of C. neoformans after 3 days. As there was no previous history of pulmonary cryptococcosis, we diagnosed PPC. We treated the patient surgically with accurate debridement of nonvital tissues in the right thumb. In addition, we started itraconazole treatment 100 mg twice daily for 6 months, which led to rapid clinical improvement without relapse. PCC is a rare infection that can present with quite unspecific clinical pictures including acneiform lesions, purpura, vesicles, nodules, abscesses, ulcers, granulomas, pustules, draining sinuses, and cellulitis. Prolonged systemic antifungal therapy is necessary in order to get a healing result without relapse. We summarize all the cases of PCC in immunocompetent patients published so far in the literature.
  • 11.

    【2hr】Intralymphatic Histiocytosis: An Unusual Presentation

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    机译 腹腔内组织细胞症：一个不寻常的呈现
    摘要：Intralymphatic histiocytosis (ILH) is a rare cutaneous condition initially described in 1994 by O'Grady et al. It often appears as a red to violaceous, livedoid patch or plaque usually on the extremities. We present a 71-year-old female with a history of psoriasis, 50 pack years smoking and recent Legionnaires disease who came to us complaining of a red to violaceous, blanching, edematous, mildly tender lesion covering the left lower lip and extending to the chin and anterior neck. After multiple biopsies, ILH was confirmed and the patient was initially started on tacrolimus 0.1% ointment b.i.d., but there was no response. Then, she was started on oral pentoxifylline and intermittent topical steroids, as well as continuing the topical tacrolimus. There was again no response, so now she is taking a TNF-ɑ inhibitor as it appears to be a granulomatous process. These ILH cases are very rare and there is limited literature that describes one treatment as a cure. Treatment of ILH is very difficult, but several different therapies have been reported with varying success. If the disease is secondary to an underlying inflammatory disease or malignancy, then treatment of the primary disorder can lead to resolution of the ILH.
  • 12.

    【2hr】Mycosis Fungoides with Dermal Mucin Deposition: An Unusual Variant of the Most Challenging Primary Cutaneous Lymphoma

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    机译 用皮肤粘蛋白沉积霉菌诱导：最具挑战性的主要皮肤淋巴瘤的异常变体
    摘要：Mycosis fungoides (MF) is defined as an epidermotropic primary cutaneous T-cell lymphoma composed of small-to-medium-sized T lymphocytes with cerebriform nuclei and with a T-helper phenotype. LeBoit first described an unusual variant of MF with dermal acid mucin deposition. Such a variant was still considered in the list of clinicopathological variants of MF by Cerroni and colleagues. We herein report a case of patch-stage MF with abundant papillary dermal mucin deposition in a clinical setting of an erythematous patch on the lower abdomen and thigh.
  • 13.

    【2hr】A Diagnostically Challenging Case of Febrile Ulceronecrotic Mucha-Habermann Disease in an Adult Female Successfully Treated with Methotrexate and Cyclosporine

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    机译 在成年女性中诊断地挑战发热性溃疡分子Mucha-habermann病的案例成功用甲氨蝶呤和环孢菌素治疗
    摘要：Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare and severe variant of pityriasis lichenoides et varioliformis acuta (PLEVA) characterized by intermittent pyrexia, acute onset of generalized ulceronecrotic lesions, and histopathology suggestive of PLEVA. Prompt diagnosis and treatment are necessary to halt the progression of this potentially fatal disease; however, the widely variable presentation of FUMHD in addition to its rarity poses a diagnostic challenge. We report the case of a previously healthy 43-year-old woman who presented to the emergency department with 1 month of generalized rash and intermittent fevers. Her only reported new exposure were elective intravenous vitamin infusions received at a medi-spa 1 week prior to onset of lesions. Initial evaluations were inconclusive, and confluent ulceronecrotic, hemorrhagic lesions appeared on approximately 90% of her body despite steroid, antibiotic, and cyclosporine therapy. Repeat histopathology was consistent with PLEVA, and in the context of her clinical presentation she was diagnosed with FUMHD. The patient rapidly attained remission with methotrexate therapy but sustained residual scarring.
  • 14.

    【2hr】A Case of Pruritic Urticarial Papules and Plaques of Pregnancy: Pathophysiology and Serum Cytokine Profile

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    机译 妊娠刺癌丘疹和妊娠斑块的病例：病理生理学和血清细胞因子剖面
    摘要：We report a case of pruritic urticarial papules and plaques of pregnancy (PUPPP) starting with target lesions on both forearms at the end of second pregnancy. The patient's target lesions became generalized itchy edematous eczema lesions especially on her abdomen extended by pregnancy, which immediately disappeared postpartum. The mechanism PUPPP has not been elucidated so far; however, the typical target lesion was the initial phenotype in the current case. To approach the pathophysiology of PUPPP, we examined the cytokine profile in the patient's serum before and after delivery. The upregulated Th2 cytokine profile including IL-9 and IL-33, and the reaction against skin-resident bacteria and fungus might be involved in PUPPP.
  • 15.

    【2hr】Multiple Keratoacanthomas after a Recent Tattoo: A Case Report

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    机译 最近纹身后多个角膜囊瘤：案例报告
    摘要：We report on a 39-year-old man who presented with seven skin lesions on the right thigh 3 weeks after receiving a large tattoo which included red and black pigments. Initially, the lesions grew fast, later their growth stabilized. Histopathology showed well-circumscribed symmetric tumors with a central keratin-filled crater along with further trademarks of a keratoacanthoma. The patient had previously had multiple tattoos with no history of similar lesions. PCR analysis of one of the lesions revealed the presence of human papillomavirus 6. All lesions were excised with a safety margin. A 3-month follow-up revealed no further lesions.
  • 16.

    【2hr】Multifocal Langerhans Cell Histiocytosis: A Unique Presentation of Eosinophilic Granuloma with Intracranial Extension Massive Lymphadenopathy and Epstein-Barr Viral Infection in an Adolescent Female

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    机译 多焦点朗格汉斯细胞组织菌症：具有颅内延伸大规模淋巴结病和青少年女性嗜酸性粒细胞粒细胞粒细胞粒细胞粒细胞瘤的独特介绍
    摘要：We report the case of an otherwise healthy 17-year-old female who presented for surgical removal of an enlarging “atypical cyst” on her scalp. During subtotal excision, only friable serosanguinous translucent ribbons of tissue were found. A histopathologic diagnosis of Langerhans cell histiocytosis (LCH) was rendered and imaging studies revealed extradural invasion of the tumor. Within weeks, the patient also developed progressive lymphadenopathy with grossly elevated levels of Epstein-Barr virus viral capsid antigen antibody levels. This report aims to highlight a unique presentation of LCH with discussion of workup, management, and avoidance of potential surgical complications.
  • 17.

    【2hr】Vitiligo-Like Depigmentation following Treatment with Imiquimod 5 Cream for Condylomata Acuminata

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    机译 用咪啶醇5％乳膏处理亚硫氨菊酯的亚硫氨菊酯的钙质肌瘤
    摘要：Imiquimod cream is an immunomodulatory agent that has been approved by the US Food and Drug Administration for use in the treatment of anogenital warts (condylomata acuminata) due to its local immune effects in activating Toll-like receptors 7 and 8 on antigen-presenting cells, resulting in reduction of the viral load of human papillomavirus with subsequent wart regression. After its application, some side effects are commonly reported, including erythema, edema, scaling, erosion, and ulceration. While pigmentary changes, including vitiligo-like depigmentation, have been mentioned as a possible side effect, they have rarely been reported in the literature. Alterations in pigmentation occur because imiquimod application causes human melanocyte apoptosis and autodestruction resulting in loss of melanocytes. Herein, we report the rare case of a 34-year-old healthy male who developed vitiligo-like depigmentation following imiquimod application for his genital warts. This case report aims to increase physicians' awareness of this possible side effect that could be irreversible and difficult for the patient to accept.
  • 18.

    【2hr】Patchy Alopecia in a Patient with Rheumatoid Arthritis: A Practical Application of Trichoscopy

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    机译 患有类风湿性关节炎的患者的斑斑症状：实际应用三相
    摘要：Trichoscopy is an efficient, convenient, and accurate diagnostic dermatological procedure which is widely used in the examination of patients with skin diseases. Herein, we report a 56-year-old woman with a long-term history of rheumatoid arthritis complaining of pruritic patchy alopecia on her scalp who was referred for biopsy to exclude cutaneous lupus erythematosus. Taking advantage of trichoscopy, we were able to quickly diagnose tinea capitis. Following administration of the proper treatment the disease resolved completely.
  • 19.

    【2hr】Embolia Cutis Medicamentosa after Subcutaneous Injection with Glatiramer Acetate

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    机译 皮下注射后的栓子栓塞药物醋酸盐
    摘要：Embolia cutis medicamentosa (ECM) is a rare and unpredictable injection site reaction, occurring after intramuscular, subcutaneous, and even after intraarticular injection of various drugs. We report a very rare case of necrotizing ECM after injection of glatiramer acetate for multiple sclerosis, include a photo documentation over the entire disease course, and discuss hypotheses as to etiology and treatment.
  • 20.

    【2hr】Subtype-Specific Off-Label Treatment of Rosacea

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    机译 Rosacea的亚型特异性偏离标签治疗
    摘要：We present 2 cases of rosacea that were successfully managed with off-label treatment. The first is a case of painful, exuding papulopustular lesions of the nose treated with rifaximin, and the other is a case of severe, debilitating and painful flushing treated with sumatriptan. The cases support previous notions that gastrointestinal comorbidities may be related to papulopustular lesions and that flushing may be related to neurogenic inflammation and migraine. The cases also imply that a new approach to rosacea management, based on endotypes and comorbidities, may be warranted.
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