A Pinpoint Orifice on the Glans Penis of a Young Man.

A man in his 30s presents with a 14-year history of purulent penile discharge that has not responded to antibiotics or corticosteroids. A pinpoint orifice is found on the glans penis. What is your diagnosis?

[Erythema induratum of Bazin as a reactivation of latent tuberculosis infection in a patient receiving anti-tumor necrosis factor treatment]. / Eritema indurado de Bazin como una reactivación de una tuberculosis latente en una paciente con tratamiento biológico anti-factor de necrosis tumoral.

Erythema induratum of Bazin is a rare form of cutaneous tuberculosis, considered as part of the spectrum of tuberculids or hipersensitivity reactions to Mycobacterium tuberculosis. Treatment with biologic agents is a known risk factor for tuberculosis reactivation, especially in areas of high incidence like Latin America, which is why screening and treatment protocols must be followed before these therapies are initiated. We present a case of erythema induratum of Bazin as a reactivation of latent tuberculosis infection in a patient with rheumatoid arthritis treated with golimumab.

Eritema indurado de Bazin como una reactivación de una tuberculosis latente en una paciente con tratamiento biológico anti-factor de necrosis tumoral / Erythema induratum of Bazin as a reactivation of latent tuberculosis infection in a patient receiving anti-tumor necrosis factor treatment

Resumen El eritema indurado de Bazin es una tuberculosis cutánea rara, considerada una tuberculide o reacción de hipersensibilidad a Mycobacterium tuberculosis. El tratamiento con agentes biológicos es un factor de riesgo conocido para la reactivación de tuberculosis, especialmente en áreas de alta incidencia como Latinoamérica, por lo que existen protocolos de búsqueda y tratamiento antes del inicio de este tipo de terapias. Se presenta un caso clínico de eritema indurado de Bazin como reactivación de una infección tuberculosa latente en una paciente con artritis reumatoide que recibía tratamiento con golimumab.

Abstract Erythema induratum of Bazin is a rare form of cutaneous tuberculosis, considered as part of the spectrum of tuberculids or hipersensitivity reactions to Mycobacterium tuberculosis. Treatment with biologic agents is a known risk factor for tuberculosis reactivation, especially in areas of high incidence like Latin America, which is why screening and treatment protocols must be followed before these therapies are initiated. We present a case of erythema induratum of Bazin as a reactivation of latent tuberculosis infection in a patient with rheumatoid arthritis treated with golimumab.

Case for diagnosis. Hyperpigmented and excoriated papules and nodules in a diabetic patient

Abstract Reactive perforating collagenosis is a rare perforating dermatosis clinically characterized by intensely pruritic hyperpigmented papules, plaques, and nodules with a central keratotic plug. Histopathology reveals transepidermal elimination of collagen fibers. Its pathophysiology is still under investigation, but the acquired form has been linked to systemic conditions such as diabetes mellitus and chronic kidney disease. However, it has also been described as a paraneoplastic syndrome. The authors present the case of a 65-year-old diabetic patient in which a myeloproliferative neoplasm was suspected.

Case for diagnosis. Hyperpigmented and excoriated papules and nodules in a diabetic patient.

Reactive perforating collagenosis is a rare perforating dermatosis clinically characterized by intensely pruritic hyperpigmented papules, plaques, and nodules with a central keratotic plug. Histopathology reveals transepidermal elimination of collagen fibers. Its pathophysiology is still under investigation, but the acquired form has been linked to systemic conditions such as diabetes mellitus and chronic kidney disease. However, it has also been described as a paraneoplastic syndrome. The authors present the case of a 65-year-old diabetic patient in which a myeloproliferative neoplasm was suspected.

Extramammary Paget's disease of the vulva: Persistent vulvar itching requires a skin biopsy!

Our case highlights the need to perform a skin biopsy in patients presenting with persistent vulvar itching, especially if they have not responded to conventional treatment for benign conditions.

Eczema herpeticum: A medical emergency in patients with atopic dermatitis.

We describe the case of a 13-year-old girl with atopic dermatitis (AD) and severe asthma that presented to the Dermatology clinic with a pruritic skin rash, which appeared concomitantly to common cold symptoms. On examination, there are erythematous, umbilicated papules and vesicles, some with erosions and crusting, surrounding the mouth and areolas; a few lesions are visible on the forearms. The mucous membranes were unaffected, the patient was afebrile, and no lymphadenopathies were present. A diagnosis of eczema herpeticum (HE) was suspected, and a direct fluorescent antibody test was positive for herpes simplex virus. Even when the clinical presentation is characteristic, the eruption might be confused with other infections like impetigo and primary varicella infection. Misdiagnosis can lead to severe complications, including bacteremia and death. EH is considered a medical emergency, and the index of suspicion for this infection should be high among clinicians. Prompt treatment with oral acyclovir should be initiated; in cases of severe disease or immunocompromised patients, hospitalization for systemic antivirals is required. If EH is recognized early it is easily and effectively treated. Any patient with pre-existing skin disease and acute "blistering" should be examined to rule out EH.

A novel treatment for idiopathic knuckle pads with cantharidin-podophylotoxin-salicylic acid.

Knuckle pads are benign subcutaneous nodules that appear most frequently on the small joints of the hands. In children, they are often idiopathic, and no universally effective treatment has been reported. We present the case of an adolescent successfully treated with a combination of topical cantharidin -podophylotoxin -salicylic acid.

Hemangioma microvenular: reporte de caso / Microvenular hemangioma: case report

El hemangioma microvenular corresponde a una neoplasia infrecuente de origen vascular y estirpe benigno. Su etiología es desconocida; sin embargo, se han reportado casos asociados a la inmunosupresión y factores hormonales. Suele aparecer en adultos jóvenes con ligera predominancia en mujeres y en la mayoría de los casos se presenta como un nódulo asintomático en extremidades. Clínicamente, puede imitar lesiones vasculares benignas y malignas. Dentro de su diagnóstico diferencial debe considerarse el Sarcoma de Kaposi y otros tipos de hemangiomas. Debido a su inespecificidad clínica, el diagnóstico debe ser realizado histológicamente. Se han descrito múltiples alternativas terapéuticas además del seguimiento periódico. Algunos casos han sido tratados con una escisión completa sin recurrencias a 5 años de seguimiento y otros tratados con láser pulsado con excelente respuesta. Se presenta el caso de una mujer de 44 años con una placa eritematoviolácea asintomática de aproximadamente 8 centímetros en su antebrazo derecho de 1 mes de evolución, con biopsia compatible y control clínico a 10 meses sin cambios significativos.

Microvenular hemangioma is a rare neoplasm of vascular origin and benign lineage. Its etiology is unknown; however, there are some cases associated with immunosuppression and hormonal factors. It usually appears in young adults with a slight predominance in women and in most cases, it presents as an asymptomatic nodule on the extremities. Clinically, it can mimic benign and malignant vascular lesions. Its differential diagnosis includes Kaposi's sarcoma and other types of hemangiomas. The diagnosis must be made histologically. Multiple therapeutic alternatives have been described. Some cases have been treated with complete excision without recurrence at 5 years, and others with pulsed laser with excellent response. We present the case of a 44 year old woman with a 1 month history of an asymptomatic erythematous plaque of approximately 8 centimeters in her right forearm with compatible biopsy. The lesion had no significant changes at 10 months followup.

Pilomatrixoma quístico con verruga vulgar intraquística: reporte de un caso / Cystic pilomatrixoma with intracystic vulgar wart: case report

El pilomatrixoma es una neoplasia anexial benigna, que habitualmente se presenta como pápula o nódulo subcutáneo, de crecimiento lento y asintomático. Es más frecuente en niños. El diagnóstico se basa en hallazgos clínicos, y la ecografía es útil como examen complementario. El tratamiento es su resección quirúrgica. Se presenta un caso infrecuente de pilomatrixoma quístico con verruga vulgar intraquística en un paciente adulto.

Pilomatricoma is a benign adnexal tumor, usually presenting as a slow growing asymptomatic subcutaneous papule or nodule. It is more common in children. The diagnosis is based on clinical findings, and ultrasound is useful as a complementary workup tool. Its treatment is surgical excision. We present a rare case of a cystic pilomatricoma with an intracystic verruca vulgaris in an adult patient.