[Show abstract][Hide abstract] ABSTRACT: Introduction. Merkel cell carcinoma is a rare, aggressive neuroendocrine cell carcinoma arising in the sun-exposed skin of elderly patients. Most of these tumors are located in the dermis. An unusual clinical presentation of such a tumor in the subcutis, if not biopsied, may be easily mistaken as a benign lesion. Case Presentation. An 83-year-old white woman presented with a several-month history of a painless 7 mm subcutaneous mass that was initially thought to be a lipoma. A conservative follow-up was planned. At the insistence of the patient, an excisional biopsy of the mass was performed revealing a subcutaneous Merkel cell carcinoma. The tumor cells stained positively for CK 20, chromogranin, and synaptophysin. No other primary or metastatic tumors found after a thorough work-up. The patient was treated with local irradiation. She remains disease free at her six-month follow-up visit. Conclusion. When a new growth is encountered in the sun-exposed skin of elderly patients, a biopsy is warranted even if the lesion clinically appears benign.
[Show abstract][Hide abstract] ABSTRACT: Purpura annularis telangiectodes of Majocchi is an uncommon form of pigmented purpuric dermatosis which may present a therapeutic challenge. Given the rare nature of this condition, there is limited anecdotal information available regarding optimal therapy. Although pigmented purpuric dermatoses are generally innocuous, in some cases they may cause patients significant distress, and there is a need to exclude cutaneous T-cell lymphoma.
We reviewed the literature on the treatment of pigmented purpuric dermatoses and managed a 69-year-old woman who presented with purpuric annular patches on the legs.
Three separate biopsies demonstrated an interstitial to perivascular lymphocytic infiltrate with erythrocyte extravasation, consistent with pigmented purpuric dermatosis. The patient's condition proved refractory to many of the previously reported modes of management, but markedly improved with methotrexate. Treatment alternatives for pigmented purpuric dermatosis are reviewed, and a treatment algorithm is proposed.
This is the first reported case regarding the successful use of methotrexate for pigmented purpuric dermatosis. Methotrexate may offer a therapeutic alternative to patients with highly symptomatic pigmented purpuric dermatosis refractory to other, more conservative, treatment modalities.
International journal of dermatology 10/2009; 48(10):1129-33. · 1.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Poroma is a benign adnexal skin tumor seen in middle aged individuals with no sex predilection. The acral sites are the most commonly affected regions. Hip or buttock as a location of origin has rarely been reported. We report two cases of poroma, one located on the hip of a 75-year-old man and the other on the buttock of a 60-year-old man.
[Show abstract][Hide abstract] ABSTRACT: First described more than 30 years ago, desmoplastic trichoepithelioma is a rare but benign adnexal neoplasm. Most often identified in middle-aged individuals and females, desmoplastic trichoepithelioma usually is a solitary annular plaque. Though the tumors are benign, the possibility of malignant neoplasm may spark both clinical and histologic concern. A full-thickness skin biopsy is advisable when desmoplastic trichoepithelioma is suspected. A patient's clinical history may provide some clues to help guide diagnosis, as the tumors may be present for years and slow growth is commonly reported. We present a patient with desmoplastic trichoepithelioma that uniquely documents and supports the typical natural history of this tumor, as demonstrated by annual school photographs.
Cutis; cutaneous medicine for the practitioner 04/2008; 81(3):236-8. · 0.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A 58-year-old Caucasian woman presented with a cystic lump behind the right ear that was clinically diagnosed as an infected sebaceous cyst. The lesion was treated with incision and drainage followed by antibiotics for 3 months. Because there was no resolution, a biopsy was performed that revealed a high grade angiosarcoma. She expired 2 months later. Cutaneous angiosarcoma is an extremely aggressive tumor. Therefore early diagnosis and management is crucial in providing better patient care.
[Show abstract][Hide abstract] ABSTRACT: We are reporting two cases of perianal squamous cell carcinoma in-situ, negative for high-risk (HR) and low-risk (LR) human papilloma viruses. A brief review of anal and perianal squamous cell carcinoma and the role of HPV are presented.
[Show abstract][Hide abstract] ABSTRACT: Mycobacterium mucogenicum is a recently characterized organism that rarely may cause human infections. This rapidly growing mycobacterium is commonly identified in tap water. Both immunosuppressed and immunocompetent patients may develop infections from Mycobacterium mucogenicum. Some patients have experienced lethal disease, including sepsis. Infections occurring in the skin and soft tissues have been described only after a preceding injury. We present the first case of infection with Mycobacterium mucogenicum occurring in a patient on the TNF-alpha antagonist etanercept and without any prior soft tissue injury.
[Show abstract][Hide abstract] ABSTRACT: We report a case of a 50-year-old man who developed a possible implantation carcinoma of the scalp within the craniotomy scar 19 months after a metastatic renal cell tumor nodule was removed from the brain. The English literature on the implantation carcinoma is briefly reviewed.
[Show abstract][Hide abstract] ABSTRACT: We report a case of a Merkel cell carcinoma of the dermis with a Bowen's disease of the overlying epidermis arising in the left thigh in an 88-year-old Caucasian female. A brief review of the literature is presented.
The Internet Journal of Dermatology. 2007 Volume 5 Number 2. 01/2007; 5.