Infection in a Traveler Returning From India.

We report a case of infection in a US tourist returning from India and the Himalayas. This case highlights a need for awareness of various species endemic to India and the importance for physicians to consider rickettsial diseases in returning travelers with eschar or rash-associated febrile illnesses.

Keloid formation occurring in the distribution of a congenital vascular malformation.

A 35-year-old African American man presented with complaints of malodorous drainage from hypertrophic lesions on his occipital scalp (Figure 1, inset). The patient had no family history of keloid formation and no other keloids on his body. The hypertrophic mass on his scalp had been present for 10 years and had not been a result of any type of mechanical, surgical, or laser treatment.

Cutaneous Rosai-Dorfman disease: comprehensive review of cases reported in the medical literature since 1990 and presentation of an illustrative case.

Background: The latest comprehensive review of primary cutaneous Rosai-Dorfman disease was published as part of an exhaustive survey of sinus histiocytosis with massive lymphadenopathy in 1990. Since then, much progress has been made in the understanding of malignant lymphoma and benign disorders of lymphoid and histiocytic origin.

Objective: We reviewed cases of primary cutaneous Rosai-Dorfman disease published since 1990 and discuss their clinical and pathologic features, comparing them with cases of systemic Rosai-Dorfman disease.

Severe insulin resistance associated with subcutaneous amyloid deposition.

A 59-year-old man with type 1 diabetes mellitus presented with severe resistance to subcutaneously injected insulin. Histological analysis of the injection sites, demonstrated foreign body type granulomas surrounding areas of amyloidosis. It is suggested that the granulomas were the source of an insulin-degrading enzyme (IDE) which simultaneously degraded amyloidogenic precursors into localized amyloid deposits.

Histiocytic sarcoma with secondary involvement of the skin and expression of CD1a: evidence of indeterminate cell differentiation?

Background: Histiocytic sarcoma is an exceedingly rare malignant neoplasm composed of cells with a monocyte/macrophage phenotype. In the current nosology of histiocytic neoplasms, histiocytic sarcoma is separate from indeterminate cell histiocytosis, a generally benign disorder characterized by proliferation of a CD1a+ and S-100+ population of cells lacking Birbeck granules usually limited to the skin.

Methods: We present a case of histiocytic sarcoma in a 64-year-old man presenting as a peritonsillar mass and secondarily involving the skin.

Dyshidrotic-like spongiotic dermatitis after intravenous immunoglobulin therapy.

Intravenous immunoglobulin (IVIG) therapy has been used to treat a variety of immune mediated disorders. Cutaneous reactions to IVIG are rare and have only been anecdotally described. We describe three cases with dyshidrotic-like biopsy proven spongiotic dermatitis after administration of IVIG.

A patient with extensive stem cell factor-induced hyperpigmentation.

Stem cell factor (SCF) is a cytokine that stimulates development of erythroid precursors and, consequently, may have potential importance in the treatment of certain anemias. We report a case of a young woman with Diamond-Blackfan anemia who received SCF treatment. One effect of SCF treatment is cutaneous hyperpigmentation at the injection site.