Cutaneous Lymphoid Hyperplasia With T-Cell Clonality and Monotypic Plasma Cells Secondary to a Tick Bite: A Hidden Critter and the Power of Deeper Levels.

Cutaneous lymphoid hyperplasia (CLH) is a benign reactive process with T-cell or B-cell lymphocytic infiltration in the skin, which can simulate cutaneous lymphomas both clinically and histologically. Various antigenic stimuli have been implicated in the development of CLH, including tick bites. Finding histologic evidence of such triggering factors, however, is often difficult.

Acral verruca-like presentation of chronic graft-vs.-host disease.

Background: Chronic graft-vs.-host disease (GVHD) is a severe and potentially fatal complication in patients after undergoing allogeneic stem cell transplant. This disease may be hard to diagnose as it has numerous cutaneous presentations.

Cluster of Cryptococcus neoformans Infections in Intensive Care Unit, Arkansas, USA, 2013.

We investigated an unusual cluster of 6 patients with infection at a community hospital in Arkansas during April–December 2013, to determine source of infection. Four patients had bloodstream infection and 2 had respiratory infection; 3 infections occurred within a 10-day period. Five patients had been admitted to the intensive care unit (ICU) with diagnoses other than cryptococcosis; none had HIV infection, and 1 patient had a history of organ transplantation.

JAK2-positive cutaneous myelofibrosis presenting as sclerosing extramedullary hematopoietic tumors on the scalp: case presentation and review of the literature.

We report the second case of cutaneous myelofibrosis with a documented JAK2 activating mutation involving the scalp of a 67-year-old woman with primary myelofibrosis in her marrow. In contrast to the previous case, the biopsy revealed extensive lesional collagen deposition and closely mimicked a fibrohistiocytic proliferation. Similar rare lesions occurring in the setting of myeloproliferative neoplasms have been called sclerosing extramedullary hematopoietic tumors.

Influenza a outbreak in an ambulatory stem cell transplant center.

Background: In the era of cost-consciousness regarding healthcare , provision of medical services in an outpatient setting has become increasingly attractive. We report an influenza outbreak in an ambulatory stem cell transplant center in 2013 that highlights unique identification and infection control challenges in this setting.

Methods: Nasopharyngeal swabs were performed on patients with suspected influenza-like illnesses (ILI), defined by subjective fever or measured temperature of ≥37.

Efficacy and safety of 12 weeks versus 18 weeks of treatment with grazoprevir (MK-5172) and elbasvir (MK-8742) with or without ribavirin for hepatitis C virus genotype 1 infection in previously untreated patients with cirrhosis and patients with previous null response with or without cirrhosis (C-WORTHY): a randomised, open-label phase 2 trial.

Background: There is a high medical need for an interferon-free, all-oral, short-duration therapy for hepatitis C virus (HCV) that is highly effective across diverse patient populations, including patients with cirrhosis or previous null response to pegylated interferon (peginterferon) plus ribavirin (PR-null responders). We aimed to assess the efficacy, safety, and effective treatment duration of grazoprevir (an HCV NS3/4A protease inhibitor) combined with elbasvir (an HCV NS5A inhibitor) with or without ribavirin in patients with HCV genotype 1 infection with baseline characteristics of poor response.

Methods: The C-WORTHY trial is a randomised, open-label phase 2 trial of grazoprevir plus elbasvir with or without ribavirin; here we report findings for two cohorts of previously untreated patients with cirrhosis (cohort 1) and those with previous PR-null response with or without cirrhosis (cohort 2) enrolled in part B of the study.

Systemic panniculitis-like T-cell lymphoma with involvement of mesenteric fat and subcutis.

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is an uncommon non-Hodgkins primary cutaneous lymphoma that typically presents as subcutaneous nodules on the extremities or trunk. Here, we report an unusual case of systemic panniculitic T-cell lymphoma with predominantly mesenteric extra-cutaneous involvement and an aggressive clinical course with histopathologic and immunophenotypic features that mimic SPTCL. This case serves to expand the body of literature regarding systemic SPTCL-like disorders with prominent extra-cutaneous involvement.

Recognizing BRCA gene mutation risk subsequent to breast cancer diagnosis in southwestern Ontario.

Objective: To describe the population of women in southwestern Ontario who were diagnosed with potentially preventable BRCA mutation-related breast cancer.

Design: Retrospective chart review.

Setting: The Cancer Genetics Clinic of the London Regional Cancer Program in London, Ont.

Dermatologic manifestations of colonic disorders.

Purpose Of Review: The skin is often a mirror for matters of internal diseases including disorders of the gastrointestinal tract. Here we enumerate many cutaneous and gastrointestinal associations and focus closely on three of the lesser known cutaneous manifestations of colonic disorders.

Recent Findings: Muir-Torre syndrome involves cutaneous sebaceous adenomas and internal malignancy; screening of cutaneous lesions for microsatellite instability, and absence of mismatch repair genes provides an opportunity for diagnosis of the syndrome.

Severe cutaneous adverse drug reaction due to fluconazole.

Fluconazole is a rare cause of severe cutaneous adverse drug reactions. A case of a diffuse, exfoliative eruption due to fluconazole is presented. Convincing arguments for a diagnosis of both widespread bullous fixed drug eruption and toxic epidermal necrolysis are made.

Liver transplant and hepatitis C in methadone maintenance therapy: a case report.

Methadone maintenance therapy for the treatment of opioid dependence continues to carry a social stigma. Until recently, patients on methadone were not considered for liver transplantation. We describe the first case of a patient on methadone who received a liver transplant for end stage liver disease and was successfully treated for recurrent hepatitis C.

Coping with sports injuries: an examination of the adolescent athlete.

Forty-eight injured adolescent athletes completed questionnaires over 3 months after injury to assess psychosocial outcomes. Depressive symptoms decreased over time, and the lack of positive stress and high athletic identity were associated with early depressive symptoms after accounting for injury severity. Increased social support was associated with lower initial depressive symptoms.