Calcinosis Cutis Secondary to Trauma in a Patient with Systemic Lupus Erythematosus and Ovarian Cancer

Summary@#Calcinosis cutis is characterized by the accumulation of insoluble calcium salts in the cutaneous and subcutaneous tissue. This condition is classified into four subtypes of calcification: dystrophic, metastatic, idiopathic and iatrogenic. Here, we describe a case of calcinosis cutis in a patient with systemic lupus erythematosus (SLE) who was recently diagnosed with ovarian cancer. Following total hysterectomy with bilateral salphingo-oophorectomy, she developed a painful erythematous plaque over the anterior aspect of the left forearm which turned into single thin yellowish plaque over the following days. Multiple attempts of intravenous cannulation for intravenous fluids occurred at the site. Skin biopsy revealed calcification in the dermis and subcutaneous fat associated with altered dermal collagen. Von Kossa stain demonstrated the presence of calcium deposition. She responded to topical calcineurin inhibitor which resulted in a complete resolution of the skin lesion.

Adult Onset Still’s Disease: A Case Report in Hospital Kuala Lumpur

@#Adult onset Still’s disease (AOSD) is a sporadic complex autoinflammatory syndrome first described in 1971.1 It is characterised by high spiking fever, polyarthritis, sore throat, lymphadenopathy, hepatosplenomegaly, serositis, and evanescent skin eruptions.1,2 It is associated with life-threatening complications too. Diagnosis of AOSD is laborious as it requires extensive investigations to exclude infections, autoimmune diseases and malignancy. Here we illustrate a young female who exhibited a turbulent presentation of ASOD.

Jessner’s Lymphocytic Infiltration of the Skin – A Case Report and Discussion of Current Literature

@#Jessner’s lymphocytic infiltration of skin is an uncommon disorder characterised by benign accumulations of lymph cells in the skin. It is of unknown aetiology and presents as erythematous papules and plaques on the face, neck and/or back, with possible itching of the skin surrounding the lesions. The lesions may remain unchanged for many years and then spontaneously disappear, without residual scarring. Current literature on this topic are limited and numerous treatments have been tried with limited success. We report a recent case of Jessner’s lymphocytic infiltration seen in our practice and discuss the histology and our approach to management.

Rhabdomyosarcoma Arising in A Giant Congenital Melanocytic Nevus

A variety of malignancies have been documented to arise within congenital melanocytic nevi (CMNs).Although the most frequent malignancy arising within a CMN is melanoma, the association betweenrhabdomyosarcoma and CMN has rarely been documented. We report a 4-month-old girl presentedwith ulcerated nodule overlying a giant CMN at the posterior back that exhibited rapid growth.Biopsy of the nodule revealed embryonal rhabdomyosarcoma in association with CMN. She receivedchemotherapy with vincristine and actinomycin D. This the first case of rhabdomyosarcoma associatedwith giant CMN reported in our local setting. Clinicians must consider rhabdomyosarcoma as one ofthe differential diagnosis in patients presenting with ulcerated nodules on giant CMN.

From Red Herring to Malignancy

Angiosarcoma is a rare but aggressive malignant tumor of vascular endothelial cells accounting for1-2% of soft tissue sarcoma. Due to its rarity and heterogeneity in clinical presentation, delay indiagnosis and treatment is not uncommon. Hence, prognosis is usually guarded. Here we report acase of primary cutaneous angiosarcoma arising from the right cheek which progressed rapidly andresulted in perforation of buccal mucosa despite combination therapy of paclitaxel and propranolol.