An Update on Current Clinical Management and Emerging Treatments in Hidradenitis Suppurativa.

Hidradenitis suppurativa (HS) is a severe, debilitating, chronic inflammatory skin disease characterized by recurrent painful nodules, abscesses and draining sinus tracts in intertriginous areas. While this condition appears to stem from follicular unit dysfunction, its cause is multifactorial and the exact pathogenesis has yet to be fully elucidated. These factors make treatment selection challenging and contribute to variable therapeutic response among affected patients. Typical regimens consist of a combination of medical and surgical modalities, tailored to individual responses. However, HS is often refractory to traditional treatments, prompting the need for newer and more effective therapies. Herein, we review current and emerging HS therapies.

A Rare Presentation of Dermatofibrosarcoma Protuberans of the Scalp Treated with "Slow-Mohs" Micrographic Surgery.

Dermatofibrosarcoma protuberans (DFSP) is a rare, fibrohistiocytic tumor with intermediate malignancy.1 While these tumors are slow-growing and only metastasize in 6% of cases,2 they are often locally destructive, with relatively high local recurrence rates after initial excision. Overall annual incidence rates in the US are 0.8-4.1 per million person-years,2 though incidence among African Americans is nearly double that of Caucasians.3 DFSP is most commonly seen on the trunk (42-50%), followed by the extremities (30-42%) and, rarely, on the head and neck (10-15%).2,4 Other studies report that DFSP of the scalp accounts for under 5% of total cases.5 However, the head and neck region is reported to have the highest tendency to recur locally, roughly 50-75% of cases.4 Further, DFSP tumors on the scalp have the potential to metastases to the brain,4 thus highlighting the importance for these tumors to be correctly diagnosed and treated early on. Partly due to its rarity and also its tendency to mimic other mainly benign lesions clinically, DFSP is often misdiagnosed, leading to years of delay in proper treatment and otherwise likely avoidable sequelae.6 We describe a rare presentation of DFSP on the scalp of a 45-year-old African American woman successfully treated with "slow-Mohs" micrographic surgery. We also discuss the most common misdiagnoses for DFSP and scenarios when this tumor should be included in the differential and subsequent work-up.J Drugs Dermatol. 2022;21(5):534-535. doi:10.36849/JDD.6719.