The Role of Hormone Therapy in Female Aesthetic Rejuvenation.

Hormones are intricately involved in age-related aesthetic changes. Declining levels of several hormones in the postmenopausal period are associated with unwanted changes in appearance, including weight gain, fat redistribution, aged skin, and hair thinning. Hormone therapies may prevent or reverse these changes.

Metastatic eccrine porocarcinoma.

Eccrine porocarcinoma (EP) is a rare malignant tumor arising from the intraepidermal sweat duct. The lesions have a varied clinical appearance and usually are asymptomatic. In reported cases, metastasis is rare but can be devastating when it occurs.

Elastin staining patterns in primary cicatricial alopecia.

Background: Most biopsy specimens of cicatricial (scarring) alopecia can be readily subclassified as lymphocytic versus neutrophilic, but specific diagnosis remains difficult, particularly when a late stage of the disease is sampled.

Objective: We sought to document patterns of scarring highlighted by elastic tissue staining in primary cicatricial alopecia.

Methods: We documented Verhoeff elastic van Gieson staining patterns in 58 routinely embedded (vertical) biopsy specimens of cicatricial alopecia.

Shiitake mushroom-induced flagellate erythema: A striking case and review of the literature.

Ingestion of raw or undercooked shiitake mushrooms is associated with a distinctive flagellate erythema. We describe a 61-year-old Caucasian man who presented with a pruritic, erythematous eruption of multiple linear streaks on the trunk and extremities starting 1 day after eating raw shiitake mushrooms. His symptoms and skin lesions resolved with minimal hyperpigmentation within approximately 1 week after treating with topical steroids and oral antihistamines.

Surgeon error and slide quality during Mohs micrographic surgery: is there a relationship with tumor recurrence?

Background: Recurrences after Mohs micrographic surgery (MMS) have been associated in the past with aggressive tumor type, large tumor size, and location within certain anatomic subunits. These factors are beyond the control of the treating physician and not subject to quality improvement efforts.

Objective: We sought to determine the relationship between slide quality and surgeon error with tumor recurrence after MMS.

Assessment of the 'no eosinophils' rule: are eosinophils truly absent in pityriasis lichenoides, connective tissue disease, and graft-vs.-host disease?

Eosinophils are often present in the inflammatory infiltrate of an interface dermatitis, but the diagnostic specificity of eosinophils in interface dermatitis has not been formally evaluated. We retrospectively identified 97 examples of interface dermatitis with clinically confirmed diagnoses, including lupus erythematosus (LE), lichen planus, pityriasis lichenoides (PL), graft-vs.-host disease (GVHD), dermatomyositis (DM) and drug reaction.

Unilateral calciphylaxis in a patient with systemic lupus erythematosus, chronic kidney disease, and hemodialysis-associated steal syndrome.

Calciphylaxis is a rare but life-threatening disease characterized by deposition of calcium within small and medium sized vessels, with subsequent thrombosis, cutaneous ischemia, and necrosis. Because of its systemic nature, calciphylaxis is typically a symmetrical, bilaterally-distributed phenomenon. Here, we present an unusual case of unilateral leg calciphylaxis in the setting of relative chronic arterial insufficiency of the affected extremity secondary to steal syndrome.

Rare tumors through the looking glass: an examination of malignant cutaneous adnexal tumors.

Objective: To identify prognostic factors related to malignant cutaneous adnexal tumors.

Design: Population-based study using the Surveillance, Epidemiology, and End Results database from January 1, 1988, through December 31, 2006.

Setting: Seventeen population-based cancer registries.

Subcutaneous intravascular pyogenic granuloma: a case report and review of the literature.

Pyogenic granuloma (PG), also known as lobular capillary hemangioma, is a common vascular proliferation that often occurs after minor injury or infection of the skin. Typically these lesions occur in the superficial dermis; although rare, subcutaneous and intravascular lesions can occur. We present a case of PG with the unusual features of being both a deep subcutaneous and intravascular lesion localized to the forehead without antecedent trauma.

Lupus erythematosus-like imiquimod reaction: a diagnostic pitfall.

Imiquimod (AldaraTM), a Toll-like receptor 7 agonist (TLR7), is known for its unique properties of being an immune response modifier and stimulator. Upon topical application, this TLR7 agonist triggers a cell-mediated immune response predominantly expressed by dendritic cells and monocytes. Local skin irritation at the application site involving erythema, pain, crusting and erosions is common and well documented.

Pyoderma gangrenosum masquerading as necrotizing fasciitis.

Necrotizing fasciitis is a fulminant advancing soft tissue infection characterized by widespread fascial necrosis, which can result in significant morbidity and even death. This condition requires prompt diagnosis and aggressive management with extensive surgical debridement and appropriate antibiotic coverage. Pyoderma gangrenosum, in contrast, is a noninfectious inflammatory condition of the skin that typically does not require surgical management.

Nonbullous neutrophilic dermatosis: Sweet's syndrome, neonatal lupus erythematosus, or both?

We describe a 5-day-old infant who fulfilled the diagnostic criteria for Sweet's syndrome, and the concurrent histologic and autoantibody features supporting the diagnosis of neonatal lupus. To our knowledge, this is the youngest case of Sweet's syndrome reported in the literature. Importantly, our findings further support the hypothesis that lupus erythematosus should be considered in the differential diagnosis of a nonbullous neutrophilic dermatosis, as it may represent the initial manifestation of the disease.

Mycobacterium marinum infection simulating interstitial granuloma annulare: a report of two cases.

We report two cases of Mycobacterium marinum infection that histologically simulated interstitial granuloma annulare (GA). In one case, an infectious etiology was not suspected in histologic sections, but a tissue culture performed during the patient's clinic visit identified M. marinum, and a subsequent Fite stain revealed mycobacteria.