Resolved Peristomal Erosive Papulonodular Dermatitis Mimicking Nevoid Hyperkeratosis of the Nipple and Areola.

Introduction: Nevoid hyperkeratosis of the nipple and areola (NHKNA) is a rare cutaneous entity with a distinct clinical and histological presentation. The type II form of this condition can result from various dermatoses, such as irritant contact dermatitis. Erosive papulonodular dermatitis is a chronic irritant dermatitis that often occurs in areas of occlusion and maceration, such as peristomal skin. Pseudoverrucous papules and nodules are a variant of erosive papulonodular dermatitis and have a non-specific histologic pattern of reactive hyperplasia. Case Presentation: We present a case of a patient with resolved peristomal erosive papulonodular dermatitis who presented status-post ileostomy reversal with clinical and histologic findings classically seen in NHKNA. Conclusion: In type II NHKNA, treatment of the primary dermatosis typically leads to resolutions. In the case of our patient, removal of the offending agent via colostomy reversal and barrier protection led to the resolution of the lesions.

Eyebrow restoration: the approach, considerations, and technique in follicular unit transplantation.

BACKGROUND: Eyebrows serve a key role in eye protection, communication, and self-expression. Trends in eyebrow grooming are constantly evolving, often requiring plucking, waxing, or laser hair removal to style. When combined with the natural thinning of the brow with aging, the result can be a sparse or even absent eyebrow hair over time. Follicular unit transplantation provides a means of restoring eyebrow fullness and architecture. With careful attention and augmentation of follicle transfer techniques, a natural end result is possible.

Differential vasodilatory responses to local heating in facial, glabrous and hairy skin.

BACKGROUND AND AIMS: Local heating induces biphasic cutaneous vasodilation in non-glabrous skin of the forearm. However, little data exist in other skin regions, despite the prevalence of facial flushing disorders. We hypothesized that facial skin will have greater initial peak responses to local heating than forearm skin because of neural differences between sites and, furthermore, axon reflex vasodilation will be eliminated in facial sites with sensory blockade. METHODS: Skin blood flow (laser-Doppler flowmetry) responses of healthy, non-obese subjects to local heating (32-42°C in ~5 min, held 40 min) in the forehead (n = 22), cheek (n = 22), forearm (n = 22) and palm (n = 13) were expressed as percentage of maximum cutaneous vascular conductance (CVC; flux/mean arterial pressure). In an additional group (n = 7), sensation was blocked (topical prilocaine-lidocaine) prior to the local heating protocol. RESULTS: Prior to heating, CVC differences were noted (forearm = 10 ± 3, cheek = 19 ± 3, forehead = 16 ± 1 and palm = 65 ± 11%CVC; P<0·05). Initial peak CVC was similar between forehead, cheek and forearm (85 ± 3, 92 ± 2, and 91 ± 6%CVC, respectively), but elevated in the palm (120 ± 8%CVC; P<0·05). Compared to facial control sites, sensory blockade delayed increases in both cheek and forehead (P<0·05) CVC but did not change magnitude of the biphasic response (P>0·05). CONCLUSIONS: These data indicate that facial skin initial CVC peaks to local heating are similar to non-glabrous skin. In contrast to forearm responses, facial topical sensory blockade does not abate axon reflex responses to local heating. Palm skin data indicate that maximal skin blood flow is not obtained during local heating as it is in non-glabrous skin.