51
|
Castilla C, Kim RH, Meehan SA, Pomerantz R. White fibrous papulosis of the neck. Dermatol Online J 2016; 22:13030/qt0dk217nv. [PMID: 28329544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
White fibrous papulosis of the neck is a rare diagnosisthat typically presents with white, 2-to-3-mmpapules on the posterior aspect of the neck. Wepresent an elderly woman with diffuse involvementon her abdomen and back.
Collapse
|
52
|
White F, Callahan S, Kim RH, Meehan SA, Stein J. Frontal fibrosing alopecia in a 46-year-old man. Dermatol Online J 2016; 22:13030/qt82h822bg. [PMID: 28329549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Frontal fibrosing alopecia is a scarring alopecia thatis characterized by recession of the frontotemporalhairline with the frequent loss of eyebrows. Itpredominantly affects postmenopausal womenand only rarely affects men. We report the caseof a 46-year-old man with a ten-year history of anerythematous patch with perifollicular erythemaat the superior aspect of the forehead andfrontotemporal hairline. A skin biopsy specimenshowed a perivascular, lymphocytic infiltrate withperiinfundibular fibrosis. These findings establisheda diagnosis of frontal fibrosing alopecia. Thepathogenesis of this condition is poorly understoodbut may be hormonally-mediated.
Collapse
|
53
|
Mu EW, Terushkin V, Meehan SA, Leger M, Femia A. A case of perniosis. Dermatol Online J 2016; 22:13030/qt9m573346. [PMID: 28329550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Perniosis is a localized, inflammatory reaction that ischaracterized by erythematous papules and nodulesthat often are located on the acral surfaces in youngwomen. The lesions of perniosis are thought to bedue to cold-induced vasoconstriction that leadsto hypoxemia and inflammation of the vessel wall.Histopathologic and laboratory studies are indicatedfor patients with suspected perniosis to distinguishbetween idiopathic perniosis and secondaryperniosis. Treatment includes adequate heating andclothing, proper food intake, nifedipine, ultravioletA1 phototherapy, topical glucocorticoids, andvasodilators.
Collapse
|
54
|
Callahan S, Mu E, Kim RH, Meehan SA, Possick P. Herpes simplex virus in erythrokeratoderma variabilis. Dermatol Online J 2016; 22:13030/qt2fh71152. [PMID: 28329543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
We report a 48 -year-old woman witherythrokeratoderma variabilis, which is a rarehereditary disorder of keratinization, who developednew, painful, blisters within her skin lesions. Thediagnosis of herpes simplex virus infection was madebased on the clinical history and histopathologicfeatures. She was successfully treated withprophylactic valacyclovir, and her herpetic outbreakshave halted. This case serves as a reminder thateven among the most rare skin disorders, commonsecondary complications may be easily overlooked.
Collapse
|
55
|
Rosenstein R, Martires K, Christman M, Terushkin V, Meehan SA, Seminara N, Golden BD, Franks AG. Dermatomyositis, clinically presenting with cutaneous ulcers, with histopathologic evidence of perforating collagenosis. Dermatol Online J 2016; 22:13030/qt6qd0q51w. [PMID: 28329555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Dermatomyositis is a systemic, autoimmune diseasewith a variety of clinical features that often includemyositis and characteristic cutaneous findings. Asubset of patients with dermatomyositis developcutaneous ulcers, often in the setting of vasculitis orvasculopathy. We present a case of dermatomyositiswith cutaneous ulcers that show perforatingcollagenosis on histopathologic examination.Acquired reactive perforating collagenosistypically occurs in the setting of diabetes mellitus,chronic renal failure, and other pruritic conditions,and this case represents a rare association withdermatomyositis, which may ultimately be helpful inelucidating the pathophysiology of this perforatingdisorder.
Collapse
|
56
|
Yagerman S, Callahan S, Terushkin V, Meehan SA, Pomeranz MK, Friedman-Kien A. Cutis verticis gyrata. Dermatol Online J 2016; 22:13030/qt3781b1n4. [PMID: 28329551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Cutis verticis gyrata that involves only the face isa rare presentation of this even rarer cutaneousanomaly. We present a 61-year-old man, whodeveloped primary essential progressive cutis verticisgyrata of the face.
Collapse
|
57
|
Ng E, Terushkin V, Meehan SA, Ho R, Pomeranz MK. Cowden syndrome presenting with trichilemmomas. Dermatol Online J 2016; 22:13030/qt2743j3qs. [PMID: 28329541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Cowden syndrome (CS) is a genetic cancerpredisposition syndrome that is associated withgermline mutations in the phosphate and tensinhomologue deleted on chromosome ten (PTEN)tumor suppressor gene. It is characterizedby the formation of benign and malignanttumors. Characteristic benign tumors includetrichilemmommas, acral keratoses, mucocutaneousneuromas, and oral papillomas. The most commonmalignant condition include breast, thyroid, andendometrial cancers. We present a case of a30-year-old woman with CS, who initially presentedwith trichilemmomas that were misdiagnosed ascomedonal acne. Recognition of the presentingfeatures of CS is important to ensure proper referral,management, and treatment for these patients.
Collapse
|
58
|
Park JH, Yagerman S, Feng H, Kim RH, Meehan SA, Lewin J. Gardner-Diamond syndrome. Dermatol Online J 2016; 22:13030/qt15f65047. [PMID: 28329546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Gardner-Diamond syndrome, which also is knownas autoerythrocyte sensitization disorder, is a raresyndrome of inflammatory, edematous papulesthat evolve into painful ecchymoses on the trunkand lower legs after a period of stress with no priorhistory of trauma. This syndrome usually occurs inwomen with a history of psychiatric disorders, themost common one being depression. Although theexact mechanism of injury is not well understood,it is hypothesized that these patients haveautoantibodies to phosphatidylserine, which is aphospholipid membrane component in erythrocytes.Treatment for this disorder includes symptomatictherapies and psychotropic medications to treat theunderlying psychiatric disorder.
Collapse
|
59
|
Farhadian J, Terushkin V, Meehan SA, Latkowski JA. Primary cutaneous marginal-zone lymphoma. Dermatol Online J 2016; 22:13030/qt9r97c4fd. [PMID: 28329553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Primary cutaneous B cell lymphomas (PCBCL) are thesecond most common type of primary cutaneouslymphoma. The three main types of PCBCL areprimary cutaneous marginal-zone lymphoma(PCMZL), primary cutaneous follicle-centerlymphoma, and primary cutaneous diffuse largeB-cell lymphoma, leg type. PCMZL has an indolentcourse with a five-year survival rate approaching99%. Lesions most often present on the trunk or armas erythematous-to-violaceous papules, plaques, ornodules. Approximately one-half of patients havesolitary skin lesions. Treatment options includesurgery, radiation, and topical, intralesional orsystemic therapy. We present the case of a 33-yearoldHispanic woman with firm, pruritic, pink papuleson the forehead and cheeks, who was diagnosedwith PCMZL.
Collapse
|
60
|
Rosenstein R, Orme C, Kim RH, Meehan SA, Femia A. Sarcoidosis with prominent necrosis on histopathology. Dermatol Online J 2016; 22:13030/qt0t5336w4. [PMID: 28329548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Sarcoidosis is a multiorgan inflammatory diseasewith variable clinical presentations and the commonhistopathologic finding of noncaseating granulomas.The etiology of the disease is not known, butevidence suggests both environmental and geneticcontributions to the pathogenesis. Depending onthe severity of cutaneous disease and extent ofextracutaneous involvement, therapies range fromtopical and intralesional glucocorticoids to systemicimmunomodulatory and immunosuppressiveagents. We present the case of a patient withcutaneous sarcoidosis with prominent necrosis onhistopathologic examination in the setting of severepulmonary sarcoidosis.
Collapse
|
61
|
Kim RH, Nagler AR, Meehan SA. Universal immunohistochemical screening of sebaceous neoplasms for Muir-Torre syndrome: Putting the cart before the horse? J Am Acad Dermatol 2016; 75:1078-1079. [DOI: 10.1016/j.jaad.2016.07.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 11/30/2022]
|
62
|
Myers KL, Mir A, Schaffer JV, Meehan SA, Orlow SJ, Brinster NK. Segmental stiff skin syndrome (SSS): A distinct clinical entity. J Am Acad Dermatol 2016; 75:163-8. [DOI: 10.1016/j.jaad.2016.01.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/12/2016] [Accepted: 01/26/2016] [Indexed: 11/17/2022]
|
63
|
Goldman C, Akiyama MJ, Torres J, Louie E, Meehan SA. Scedosporium apiospermum infections and the role of combination antifungal therapy and GM-CSF: A case report and review of the literature. Med Mycol Case Rep 2016; 11:40-3. [PMID: 27182483 PMCID: PMC4857212 DOI: 10.1016/j.mmcr.2016.04.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 04/25/2016] [Indexed: 12/29/2022] Open
Abstract
Scedosporium apiospermum, a ubiquitous environmental mold, is increasingly reported as causing invasive fungal disease in immunocompromised hosts. It poses a therapeutic challenge due to its intrinsic resistance to traditional antifungals and ability to recur despite demonstrating susceptibility. We present an immunocompromised patient with a cutaneous S. apiospermum infection that disseminated despite treatment with voriconazole, the drug of choice. Adding echinocandins and GM-CSF provided partial recovery, indicating a potential synergistic role of dual-antifungal and immunotherapeutic agents.
Collapse
|
64
|
Milam EC, Meehan SA, Ramachandran S. Well-Demarcated, Scaly Plaques. JAMA 2016; 315:508-9. [PMID: 26836734 DOI: 10.1001/jama.2015.16068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
65
|
Hausauer AK, Hoffmann R, Terushkin V, Meehan SA, Femia AN, Pomeranz MK. Acral keratoses and squamous-cell carcinomas likely associated with arsenic exposure. Dermatol Online J 2016. [DOI: 10.5070/d32212033383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
66
|
Castilla C, Kim RH, Meehan SA, Pomerantz R. White fibrous papulosis of the neck. Dermatol Online J 2016. [DOI: 10.5070/d32212033387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
67
|
|
68
|
Farhadian JA, Terushkin V, Meehan SA, Kornreich C. Skin-limited relapse of systemic anaplastic large-cell lymphoma. Dermatol Online J 2016. [DOI: 10.5070/d32212033374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
69
|
Rosenstein R, Orme C, Kim RH, Meehan SA, Femia A. Sarcoidosis with prominent necrosis on histopathology. Dermatol Online J 2016. [DOI: 10.5070/d32212033391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
70
|
Mu EW, Terushkin V, Meehan SA, Leger M, Femia A. A case of perniosis. Dermatol Online J 2016. [DOI: 10.5070/d32212033393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
71
|
Ng E, Terushkin V, Meehan SA, Ho R, Pomeranz MK. Cowden syndrome presenting with trichilemmomas. Dermatol Online J 2016. [DOI: 10.5070/d32212033384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
72
|
Myers K, Terushkin V, Meehan SA, Cohen DE. Gyrate erythema in the setting of tinea pedis. Dermatol Online J 2016. [DOI: 10.5070/d32212033382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
73
|
Farhadian J, Terushkin V, Meehan SA, Latkowski JA. Primary cutaneous marginal-zone lymphoma. Dermatol Online J 2016. [DOI: 10.5070/d32212033397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
74
|
Park JH, Yagerman S, Feng H, Kim RH, Meehan SA, Lewin J. Gardner-Diamond syndrome. Dermatol Online J 2016. [DOI: 10.5070/d32212033389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
75
|
Rosenstein R, Martires K, Christman M, Terushkin V, Meehan SA, Seminara N, Golden BD, Franks, Jr AG. Dermatomyositis, clinically presenting with cutaneous ulcers, with histopathologic evidence of perforating collagenosis. Dermatol Online J 2016. [DOI: 10.5070/d32212033399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|