Necrolytic migratory erythema associated with a metastatic neuroendocrine tumor.

Necrolytic migratory erythema (NME) is a skin condition historically associated with pancreatic glucagonomas. Rarely it occurs in the absence of a pancreatic tumor, which has been described as pseudoglucagonoma syndrome. We describe a woman with a metastatic neuroendocrine tumor who developed NME 6 years after diagnosis of the tumor. Her laboratory data revealed essential fatty acid deficiency and a high level of glucagon. Although the pathogenesis of NME is not completely understood, zinc, essential amino acid, and fatty acid deficiencies have all been postulated as possible causative factors.

Prurigo pigmentosa: report of two cases in the United States and review of the literature.

Prurigo pigmentosa is a rare inflammatory skin disease of unknown etiology presenting as a pruritic truncal eruption of reticulated and symmetric macules and papules with the predilection for young Japanese females. Although cases of PP are increasingly reported in the non-Japanese literature, dermatologists may be unfamiliar with this entity. Here we report a Caucasian American female and a Chinese American female with PP and a discussion of the literature. The treatments of choice for prurigo pigmentosa are tetracyclines such as doxycycline and minocycline, as well as dapsone. The prognosis is excellent.

Acanthosis nigricans in a plaque of scleredema on the back of a diabetic patient: a case report.

Acanthosis nigricans (AN) and scleredema are two skin conditions that have been reported in association with diabetes mellitus. Few cases associating scleredema and AN have been reported. A literature search did not reveal any reports of diabetic patients developing AN on top of a scleredema plaque. Here we report a patient with diabetes mellitus who developed AN within the same indurated scleredema plaque.

Cutaneous adiaspiromycosis: a distinct dermatologic entity associated with Chrysosporium species.

Primary cutaneous infection with Chrysosporium, a saprophytic fungus commonly found in soil, is believed to be very rare, with only two previously reported cases. We present a case of localized cutaneous Chrysosporium in an immunocompromised heart transplant patient. Considering that the histology of the skin in this case is superimposable on that seen in pulmonary Chrysosporium known as adiaspiromycosis, we regard the cutaneous variant in the absence of pulmonary disease as a distinct dermatologic entity. The low frequency of reports of primary cutaneous Chrysosporium infection suggests either underreporting of this diagnosis in the literature, or misidentification of this fungus as another more common mycotic species sharing morphologic similarities. By amplifying our understanding of Chrysosporium infection in the skin, this disorder will be easier to identify and treat.

Clinical, histologic, and ultrastructural changes after nonablative treatment with a 595-nm flashlamp-pumped pulsed dye laser: comparison of varying settings.

BACKGROUND: The flashlamp-pulsed dye laser has been used for nonablative dermal remodeling. OBJECTIVE: We conducted a study analyzing the clinical, histologic, and electron microscopic findings after treatment with different flashlamp-pulsed dye laser settingss in the same subject. RESULTS: Most subjects showed mild to moderate improvement after flashlamp-pulsed dye laser laser treatment. There was no statistical difference in the clinical, histologic, or electron microscopic findings with a variety of laser treatment settings. CONCLUSION: Nonablative dermal remodeling can be accomplished with not only a variety of different technologies, but also with the same laser using markedly different settings.