Basal cell carcinoma invasion of an ear piercing.

Basal cell carcinoma (BCC) development in the context of a piercing is a rare phenomenon, reported in the literature in only six instances. We present a 55-year-old woman with nodular BCC involving her auricular piercing and extending clinically onto the posteroinferior right ear lobule and right post-auricular crease. Histological analysis revealed spread of the BCC through the piercing onto the anterior lobule, with evidence that the cancer utilized the piercing as a low resistance pathway for this microscopic invasion. This case is, to our knowledge, the first report of microscopic BCC present within an auricular piercing itself. Chronic inflammation related to repeated trauma from the embedded jewelry may have played a role in its formation. A piercing may provide a path of least resistance for BCC tumor cells to invade, providing a nidus for recurrence. Careful histological examination with possible complete excision of the piercing is prudent to prevent cancer return.

Unilateral Breast Skin Changes in Patient With Hidradenitis Suppurativa: Malignancy Versus Lymphedema.

Hidradenitis suppurativa (HS) is an inflammatory skin disorder typically affecting the groin, inframammary folds, and axillae. HS is characterized by the development of boils, abscesses, fistulas, and sinus tracts. Due to the inflammatory destruction of lymph vessels, patients with long-standing HS may develop lymphedema. Most commonly reported in the literature is lymphedema involvement of the genital and anal regions. In this case report, we describe unilateral breast skin changes in a patient with HS. The patient was extensively worked up for inflammatory breast cancer, and eventually underwent stereotactic biopsies. Subsequently, these biopsies were consistent with lymphedema due to her chronic HS. Although rare, there is a paucity of literature describing breast lymphedema associated with HS. As breast lymphedema due to HS may mimic inflammatory breast cancer, it is important for providers to firstly rule out malignancy and place lymphedema high on the differential when examining and treating these patients.

Extreme winter weather: A force to be remembered in dermatopathology.

It is important for the dermatopathologist to be adept in differentiating tissue artifacts from normal tissue variants and pathologies. Numerous tissue artifacts have been described to date; however, once we are familiar with the common artifacts that appear in our practice, we may not immediately recognize other confounders. For example, dermatopathologists in more temperate regions of the country may not be familiar with freezing artifact. In this case series, we present three common diagnoses in dermatopathology that were obscured by the extreme winter weather that severely impacted the Southern United States in February 2021 and discuss methods to prevent these artifacts.