Cutaneous Rosai-Dorfman disease: A case report

Pure cutaneous Rosai-Dorfman is distinguished from classic Rosai-Dorfman disease by isolated skin involvement without lymphadenopathy or systemic symptoms. Herein, we report a case of a 30 year-old-man with 16 months history of a slowly enlarging, asymptomatic, purple plaque on her left cheek following cutaneous leishmaniasis successfully treated. The histopathological examination showed dense infiltration of inflammatory cells involving the entire dermis, consisting of large macrophages with emperipolesis, S100 and CD68 positive, lymphocytes and plasma cells. The patient was treated with intralesional triamcinolone with a significant improvement. The present article aimed to emphasise the clinical, histological differential diagnosis and to share the tumoral presentation of cutaneous Rosai-Dorfman disease.

196 A Rare Case of Chemical Burn: Dithranol With Salicylic Acid

A 16-year-old female with psoriasis was admitted to our Plastic Surgery department with a significant chemical burn to the neck, upper torso, and left cheek (TBSA 6%). She applied a concoction of cream prescribed by her dermatologist in her native country, Poland when she returned to the United Kingdom. A few hours after application she developed a burn with pH of 5. A review of the cream revealed a mixture of 19% Dithranol and 5% Salicylic acid. This combination is recognized for managing psoriasis, however the strength of dithranol in the combination given is of a high concentration (normally <3%). This alone can cause a burn to the skin if left for a prolonged period of time. Salicylic acid is an enhancer which augments the stability of dithranol and increases its penetration and efficacy. The concentration of 5% is also on the higher end. Our patient was admitted for pain relief and further irrigation till normalization of the pH which was achieved after 3 days. A worrying aspect in our patients’ case is that she was given the cream to commence at home. High concentration preparation is normally commenced in a controlled setting under medical supervision.

Surgical management of an odontogenic cutaneous fistula

A patient presented to our unit with a long history of a discharging skin infection on his left cheek, which came and went. He had been seen by numerous healthcare practitioners including his general practitioner, general dental practitioner and dermatologist, with no resolution. He was eventually diagnosed with an odontogenic cutaneous fistula (OCF), for which he underwent surgical management. The purpose of the study is to describe the diagnosis and surgical management of an OCF, from initial assessment through to postoperative review and discharge. Following surgical management of the OCF and treatment of the source of infection by dental extraction, the patient is no longer experiencing purulent discharge through his left cheek. The extraoral skin site of drainage at his left cheek has resolved completely, with minimal residual scarring. OCF can be managed by a number of different treatment modalities. The treatment of an OCF by surgical excision is presented.

Case Report: Successful Treatment of Cutaneous Squamous Cell Carcinoma in Three Patients With a Combination of Acitretin and Clarithromycin

Few studies have evaluated acitretin as a primary treatment for cutaneous squamous cell carcinoma (CSCC). We report, for the first time, three cases of CSCC successfully treated with acitretin and clarithromycin. A literature review on this subject was also was performed. This case report included three patients with CSCC treated with acitretin and clarithromycin at the First Affiliated Hospital of Fujian Medical University (2008–2019). Patient 1 (83-year-old woman, ulcerated mass on the left cheek), patient 2 (97-year-old woman, painful mass on the left cheek) and patient 3 (76-year-old woman, large mass on the right ankle) received 8, 6, and 30 courses of combination therapy. All patients tolerated the adverse effects (pseudotumor cerebri and mucocutaneous dryness) and achieved complete regression within 6 months. Patients 1, 2, and 3 have not experienced recurrence during a 10-, 3-, and 6-year follow-up. Acitretin has limited efficacy as a monotherapy for CSCC. Our experience indicates that combination therapy with acitretin and clarithromycin may be an effective and well-tolerated treatment for unresectable CSCC.

Pigmented epithelioid melanocytoma: A rare tumor

Pigmented epithelioid melanocytoma is a poorly understood and rarely reported skin tumor which mimics melanoma and whose diagnosis is based on clinical, histological and immunohistochemical arguments. We report the case of a young 24-year-old patient who consulted for the sudden appearance of a plaque and then a black nodule on the left cheek, gradually increasing in size, painless and slightly infiltrated. Dermoscopy could not decide between a nodular melanoma or a blue nevus given the intensity of the pigmentation. Anatomopathological examination of the piece revealed a pigmented epithelioid melanocytoma or animal-type melanocytoma. The consequences of the complete excision were simple without recurrence after a follow-up of 9 months. It is a borderline affection, its diagnosis and treatment are necessary in order to avoid any unforeseeable malignant evolution.

Recalcitrant lymphocytoma cutis successfully treated with mycophenolate mofetil

Lymphocytoma cutis reflects an exaggerated local immunologic reaction to a stimulus presenting on the head, neck, or upper extremities as a firm 1–3 cm erythematous and/or violaceous plaque or nodule. However, lymphocytoma cutis may be difficult to treat due to the variety of causative agents and the lack of reported successful treatments and outcomes. Here, we present a case of 68-year-old female with recalcitrant lymphocytoma cutis resistant to other first-line therapies including tacrolimus ointment and steroids. The red plaque on the patient’s left cheek was eventually treated with mycophenolate mofetil. Mycophenolate mofetil was an accessible and effective therapeutic option to treat lymphocytoma cutis with minimal side effects.

Clinical, Dermoscopic and Histhopatological Findings in Diagnosis of Nevus Spilus

Introduction: Nevus spilus (NS) are seen in 0.2% to 2.3% of the population and have 0,13% to 0,2% risk for malignant transformation. Clinical, dermoscopic, and histhopatological features were describe in this case report in order to be easily recognize NS. Although NS is a benign cutaneous anomaly it has potential malignant transformation and requires regular follow up. Case Report: A case of nevus spilus in 23 years-old female was reported. There were multiple asymptomatic brownish pigmented spots over brownish patch on left cheek which gradually increased in number and size since 1 year ago. Dermatologic state: brown macules and dark brown papules in a speckled, overlying background café au lait macule. Dermoscopy revealed reticular pattern in background light brown and dark reticuloglobular pattern in dark speckled. Histopathology showed elongation of rete ridges with grouping of melanocyte cells at the tip, and proliferation of nevus cells. Conclution: Patient was planned to treat with Nd-Yag laser.

Facial Erysipelas: A Case Report

Erysipelas is a superficial cutaneous process that is usually restricted to the dermis, but with prominent lymphatic involvement commonly caused by streptococci. We present a patient who was admitted for swelling and erythema of his left cheek. We diagnosed facial erysipelas, the curative treatment was based on the prescription of effective antibiotic therapy against streptococci and bacteria producing β-lactamase (staphylococci). Removal of the remaining teeth was scheduled during medical treatment. At a 4-month follow-up after dental removal, there has been no recurrence of erysipelas.Through a clinical case of facial erysipelas, this work allows illustrating the specificities of this pathology.