Subject(s)
Coloring Agents/adverse effects , Tattooing/adverse effects , Xanthomatosis/chemically induced , Arm , Biopsy, Needle , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Diagnosis, Differential , Exanthema/diagnosis , Exanthema/etiology , Humans , Immunohistochemistry , Risk Assessment , Xanthomatosis/pathologyABSTRACT
Melanoma is a common, potentially deadly disease but is curable if caught early. A specimen of a pigmented lesion must capture the entire width and depth of the lesion to evaluate the lesion's size, symmetry, and circumscription. Saucerization shaving, punching, and excision biopsy are 3 techniques that can be used to achieve a satisfactory specimen. Physicians should have a low threshold to biopsy a suspicious atypical pigmented lesion, but acceptable specimens are key in following through with an accurate diagnosis.
Subject(s)
Biopsy/methods , Melanoma/pathology , Skin Neoplasms/pathology , Diagnosis, Differential , Humans , Nevus/pathologyABSTRACT
IMPORTANCE: Cold panniculitis is a self-limited condition, manifesting as erythematous plaques or nodules after cold exposure, that typically affects infants and children. Recently, a variant involving the lateral thighs of equestrians has been described. Since the original report of this variant, some confusion has arisen in the literature in which the terms equestrian cold panniculitis and equestrian perniosis are both used. Outside of this presentation, cold panniculitis in adults is exceedingly rare. OBSERVATIONS: We describe 2 adult patients using ice-pack therapy for chronic back pain who developed erythematous, purpuric plaques at the site of ice-pack application. Histopathologic findings from both patients were similar and showed overlapping features of perniosis and cold panniculitis that closely resembled the pattern seen in cutaneous lupus erythematosus. CONCLUSIONS AND RELEVANCE: Ice-pack dermatosis is an uncommon cold-induced process that occurs in adults using long-term ice-pack therapy. The clinical manifestations include erythematous to purpuric plaques with a livedolike appearance and superficial ulceration. The histopathologic features resemble those seen in cutaneous lupus erythematosus with a superficial and deep perivascular and periadnexal dermatitis with increased dermal mucin and a superficial lobular panniculitis.
Subject(s)
Back Pain/therapy , Chilblains/diagnosis , Dermatitis/etiology , Hypothermia, Induced/adverse effects , Ice/adverse effects , Lupus Erythematosus, Cutaneous/pathology , Panniculitis/diagnosis , Adult , Antigens, CD20/metabolism , B-Lymphocytes/immunology , CD3 Complex/metabolism , Dermatitis/diagnosis , Diagnosis, Differential , Female , Humans , Male , Middle Aged , T-Lymphocytes/immunologyABSTRACT
Incidence rates of melanoma continue to rise, especially in young women, despite the enormous body of evidence that identifies ultraviolet radiation as a skin carcinogen. It is time for a change in societal norms, an increase in counseling of young adults about the risks of indoor tanning facilities, and to prevent young adults from tanning by introducing new legislation.
