BerEP4-Negative Basal Cell Carcinoma: An Immunophenotype Not to Forget.

Basal cell carcinoma (BCC) is the most common cancer worldwide. Although not typically metastatic, BCC can be locally destructive. BerEP4 is an antibody against CD326, an epithelial cell adhesion molecule (EpCAM) that is expressed on epithelial progenitor cells and carcinomas.

A Comparison of Preoperative Telephone Call Versus Mailed Educational Materials on Patient-Reported Outcomes in Mohs Micrographic Surgery.

Background: Preoperative education has uncertain benefits on the preparedness and satisfaction of patients undergoing Mohs micrographic surgery (MMS).

Objective: We sought to determine the effect of a preoperative telephone call on preparedness and satisfaction in patients undergoing same-day office consultation and MMS.

Materials And Methods: All new patients ( N = 208) scheduled for same-day office consultation and MMS were mailed a standardized preoperative packet.

Lenalidomide-induced symmetrical drug-related intertriginous and flexural exanthema.

Symmetric drug-related intertriginous and flexural exanthema (SDRIFE) is a cutaneous drug reaction that presents with symmetrical erythema in the flexures. The reaction typically appears hours-to-days after drug exposure but has been reported to occur months after drug initiation. Diagnostic criteria include cutaneous reaction after exposure to a systemic drug, erythema of the gluteal region and/or V-shaped erythema of the inguinal areas, involvement of an additional intertriginous site, symmetry, and absence of systemic involvement.

Radiation-Induced Eccrine Squamous Syringometaplasia With Perineural Invasion.

Eccrine squamous syringometaplasia (ESS) is a benign metaplastic reaction of eccrine ducts that occurs in response to injury and can be a histologic mimic of squamous cell carcinoma (SCC). Reported is an 82-year-old man undergoing Mohs surgery for presumed SCC diagnosed in a field of radiation dermatitis. After 3 Mohs stages, the peculiar squamous proliferation was recognized as ESS and the procedure was aborted.

Assessment of Pain, Healing Time, and Wound Contraction in Postoperative Auricular Defects Healing Secondarily With and Without the Use of a Porcine Xenograft, a Pilot Study.

Background: Postoperative auricular defects heal well with secondary intention healing (SIH); however, potential complications include postoperative pain, perichondritis, and chondritis.

Objective: To compare postoperative pain and wound healing in auricular defects healing by secondary intention with and without the placement of a porcine xenograft.

Materials And Methods: Twenty-one subjects were enrolled in the study.

Systemic Targeted Treatments for Basal Cell Carcinoma.

The sonic hedgehog (SHH) inhibitors vismodegib and sonidegib are the only 2 first-line systemic medications approved for the treatment of locally aggressive basal cell carcinoma (BCC). Vismodegib is the only SHH inhibitor approved for metastatic BCC. Cemiplimab, an immune checkpoint inhibitor (ICI), is now an approved second-line therapy for locally advanced or metastatic BCC.

Kaposi sarcoma: What to do with a negative human herpesvirus 8 immunohistochemical stain?

Kaposi sarcoma (KS) is an intermediate vascular sarcoma that can cause significant morbidity and mortality in patients if left untreated. It is associated with human herpesvirus 8 (HHV-8) infection. Definitive diagnosis is supported by classic histopathology including slit-like vascular spaces, spindle cells, lymphocyte infiltration, and extravasated red blood cells on H&E stain and positive immunohistochemical (IHC) staining for HHV-8.

Management of surgical soft tissue defects of the lower extremities.

Management of post-operative soft-tissue defects on the lower legs is challenging owing to arterial and venous insufficiency, poor skin quality including epidermal and dermal atrophy, insufficient tissue laxity, and increased risk of infection. This paper highlights the management of post-operative soft-tissue defects on the lower extremity that cannot be closed primarily or by reconstruction with a local flap. A systematic review of the literature was performed using the National Library of Medicine (NLM) PubMed online database.

Squamoid Eccrine Ductal Carcinoma.

Squamoid eccrine ductal carcinoma (SEDC) is a rare and under-recognized primary cutaneous tumor with a high risk for local recurrence and metastasis. The tumor has a biphasic histologic appearance consisting of a superficial portion indistinguishable from squamous cell carcinoma (SCC) and a deeper component demonstrating eccrine ductal differentiation. Because of superficial sampling, SEDC often is misdiagnosed as SCC during the initial biopsy.

Postoperative Pain After Mohs Surgery: Physician Perceptions and How Those Perceptions Influence Opioid Prescribing Practices.

Background: Little is known about dermatologists' perceptions of postoperative pain and how those perceptions correlate with patient-reported pain and opioid prescribing.

Objective: To determine dermatologists' accuracy in predicting postoperative pain compared with patient-reported pain and how physicians' perceptions affect opioid prescribing practices.

Methods And Materials: A prospective observational study in which patients undergoing Mohs surgery rated pain on the Numerical Rating Scale (0-10).

Systemic medications linked to an increased risk for skin malignancy.

Over the last several decades, many new drugs that target molecular pathways in carcinogenesis and the inflammatory immune system have been developed, resulting in substantial improvements in the treatment of many malignancies and inflammatory conditions. However, an increasingly widespread deployment of these new drugs has revealed an increased tendency for patients to develop skin malignancy in some instances and questions of possible association between their use and skin cancer. Specifically, increased skin cancer risk has been reported in association with BRAF inhibitors, sonic hedgehog-inhibiting agents, Janus kinase (JAK) inhibitors, and phosphodiesterase 5 (PDE-5) inhibitors.

New Treatments for Hereditary Angioedema.

Hereditary angioedema is characterized by severe, episodic edema of the subcutaneous and mucosal tissue. The disease carries significant morbidity and mortality due to involvement of the gastrointestinal tract and upper airway. Recent advances in the treatment of hereditary angioedema include new techniques used to isolate and purify human-derived C1 inhibitor, the production of a recombinant form of C1 inhibitor, and the development of drugs that target the kallikrein-kinin pathway.

Alopecia areata presenting in 2 kidney-pancreas transplant recipients taking cyclosporine.

Alopecia areata (AA) is an autoimmune disease of uncertain pathogenesis, typically treated with immunomodulators. We report the paradoxical development of AA in two kidney-pancreas transplant recipients receiving immunosuppressive therapy, which included cyclosporine. Review of the literature revealed only 7 other cases of AA occurring in solid organ transplant recipients; all occurred during long-term cyclosporine therapy.