Severe Acute Systemic Reaction After the First Injections of Ixekizumab.

We report the case of a 39-year-old woman who presented with generalized malaise; lymphadenopathy; arthritis; dactylitis; ecchymosis; acute onycholysis; and a red, nonpruritic, nonscaly, mottled rash on the right breast 24 hours after the first injections of ixekizumab for psoriasis and psoriatic arthritis. Ixekizumab is a humanized IgG4 monoclonal antibody that binds to IL-17A. Adverse events of ixeki-zumab include infection, inflammatory bowel disease, candidiasis and tinea infections, severe injection-site reactions, arthralgia, headache, infections, neutropenia, and thrombocytopenia.

Systemic amyloidosis: unusual presentation mistaken for a recurrent scabies infection.

We report the case of a 63-year-old woman with a history of undifferentiated connective-tissue disease, polyarthritis, and bilateral carpal tunnel syndrome who presented with generalized pruritus and erythematous and excoriated papules on the trunk and extremities. Empiric scabies treatment was unsuccessful. Patch testing and T-cell receptor gene rearrangement studies were unremarkable.

Disseminated verruciform xanthoma: a case report.

Verruciform xanthomas (VXs) are rare mucocutaneous lesions that can appear in isolation or in association with chronic inflammation, systemic diseases, or metabolic abnormalities. We report the case of a patient who presented with disseminated VX with oral, cutaneous, and genital involvement without an obvious underlying cause. Treatments including salicylic acid 40%, high-potency topical corticosteroids, antibiotics, and chlorhexidine failed to improve the lesions; however, the patient was satisfied with the cosmetic results of serial shave excisions.

Necrolytic acral erythema: an expanding spectrum.

Hepatitis C virus (HCV) infection is the most common chronic blood-borne viral infection in the United States. Well-described cutaneous manifestations of HCV infection include polyarteritis nodosa, porphyria cutanea tarda, type II cryoglobulinemia-associated vasculitis, pruritus, erythema nodosum, urticaria and urticarial vasculitis, lichen planus, and erythema multiforme. First described in 1996, necrolytic acral erythema (NAE) is now recognized as a cutaneous acral eruption uniquely associated with HCV infection.

Unilateral volar annular syringomata.

We report a case of a 71-year-old woman with an atypical unilateral and focally annular distribution of asymptomatic syringomata on the volar surface of the left forearm. We are unaware of previous reports of isolated unilateral syringomata presenting with an annular pattern on the volar distal extremity.