Tinea Capitis Masquerading as Basal Cell Carcinoma.

A 52-year-old white man with alcoholic cirrhosis presented to the Mohs surgery clinic with a 1-month history of tender "bumps" located diffusely on his scalp. Two biopsies performed at an outside institution were read as "basal cell carcinoma" and "actinic keratosis." The patient was scheduled for a large excision of the scalp for presumed multiple nodules of basal cell carcinoma and desired a second opinion from our Mohs surgery clinic.

Magnification for the dermatologic surgeon.

Ergonomic practice increases the productivity, quality, and longevity of the dermatologic surgeon. When used properly, magnification devices can be ergonomic and beneficial additions to the dermatologic surgeon's practice. Herein, we review the available magnification options for the dermatologic surgeon and evaluate the options based on cost, design, and functional advantages and disadvantages. Magnification for the dermatologic surgeon may be a useful tool for a healthier, more efficient, and higher-quality practice.

Ramsay Hunt syndrome revisited.

Varicella-zoster infections commonly are seen in clinical practice; however, Ramsay Hunt syndrome caused by reactivation of latent varicella-zoster virus in the geniculate ganglion is rare. We report the case of a 30-year-old woman who developed Ramsay Hunt syndrome and also review the characteristic features of this disease.

A lupus-like reaction to subcutaneous interferon-α at injection sites.

Interferon-α has been associated with a wide range of adverse events (AEs). A lupus-like reaction at the injection site of subcutaneous (SC) interferon-α is exceptionally rare. A 60-year-old woman with recurrent metastatic melanoma repeatedly developed cutaneous lupus-like reactions at the SC interferon-α-2b injection sites on her thighs. Known features of lupus-like reactions at SC interferon-α injection sites are reviewed, and cutaneous injection site reactions to SC interferon-α are summarized.

Paraneoplastic erythema annulare centrifugum eruption: PEACE.

Erythema annulare centrifugum is a reactive erythema of various possible etiologies including, although less often, an associated cancer. Cancer-related erythema annulare centrifugum is most commonly associated with lymphoproliferative malignancies, specifically lymphoma and leukemia. Malignancy-associated erythema annulare centrifugum is more frequently seen in women than men and the presence of skin lesions usually precedes the clinical diagnosis of the underlying malignancy. Neoplasm-derived erythema annulare centrifugum lesions often resolve following treatment of the cancer. Recurrence of erythema annulare centrifugum may occur along with the relapse of the underlying malignancy. Paraneoplastic erythema annulare centrifugum eruption (PEACE) is speculated to be a result of a cytokine or other tumor-associated factors.

Radiation port erythema multiforme: erythema multiforme localized to the radiation port in a patient with non-small cell lung cancer.

A 75-year-old man was treated with stereotactic radiation to 50 gray units in 4 fractions for stage IB non-small cell lung cancer. Radiotherapy was directed at the right lower lobe segment of the lung and lasted 4 days. He developed radiodermatitis, which completely resolved within a few weeks after radiotherapy was finished. Three months after completing radiation therapy, he developed a pruritic red lesion within his radiation port on his right mid back with the formation of blisters a week later. Two weeks after the onset of the patient's blisters, cutaneous examination showed individual and convergent erythematous papules and plaques with superficial scaling at sites of resolving vesicles located within the radiated area (Figures 1 and 2). The patient had neither symptoms of mycoplasma pneumoniae, nor lesions or history of present or past herpetic infection. Also, he had not recently been placed on any new medications, and he did not have any other erythema multiforme-associated risk factors. A biopsy from the erythematous lesions showed a band-like infiltrate of lymphocytes in the dermis. The overlying epidermis contained necrotic keratinocytes and there was alteration of the basal layer. Correlation of the clinical presentation and pathologic changes established a diagnosis of erythema multiforme localized to the radiation port. The patient was treated with topical triamcinolone acetonide 0.1% cream twice daily for 10 days and once daily for 4 days. His lesions resolved and there was mild hyperpigmentation of the affected area.

Systemic mastocytosis-associated leonine facies and eyebrow loss.

Leonine facies or loss of eyebrows, or both, occurring concurrently or in succession, can be associated with numerous etiologies. A 62-year-old woman with systemic mastocytosis who developed both leonine facies and eyebrow loss is described. The differential diagnosis of neoplasms that may present with leonine facies is summarized and conditions characterized by concurrent or sequential eyebrow loss and leonine facies are reviewed.