Connective tissue nevus masquerading as a localized linear epidermal nevus.

A 22-year-old black female patient presented to the dermatology clinic with an eruption on her left arm. The eruption consisted of hyperpigmented grouped papules with a verrucous appearance. Because the lesions were soft on palpation, the eruption was diagnosed clinically as an atypical localized linear epidermal nevus. Examination of a biopsy specimen of the lesion, however, revealed marked fibroblastic proliferation and pronounced dermal fibrosis, along with epidermal changes of hyperkeratosis, focal hypergranulosis, and papillomatosis. These findings are consistent with connective tissue nevus with epidermal changes suggestive of epidermal nevus. Therefore a deep biopsy is strongly suggested to rule out the possibility of connective tissue nevus in suspected cases of atypical linear epidermal nevus.

Leukemic macrocheilitis associated with hairy-cell leukemia and the Melkersson-Rosenthal syndrome.

Specific cutaneous infiltrates in hairy-cell leukemia have distinctive histopathologic and histochemical findings. The true incidence of leukemia cutis in hairy-cell leukemia is uncertain, however, because reports often fail to document these distinctive features. A case of leukemic macrocheilitis associated with hairy-cell leukemia and the Melkersson-Rosenthal syndrome is presented. The Melkersson-Rosenthal syndrome is a clinically defined entity composed of Bell's palsy, macrocheilitis, and lingua plicata. Granulomatous cheilitis is often seen on histopathologic examination of the swollen lip tissue; in some cases, however, the findings may be nonspecific. Neoplastic macrocheilitis has not been reported in Melkersson-Rosenthal syndrome. Furthermore, leukemic macrocheilitis has not been reported in hairy-cell leukemia. A possible relationship between these entities is proposed.

A surgical approach for dermatosis papulosa nigra.

Dermatosis papulosa nigra (DPN) is a disorder commonly encountered in the adult black population. We describe 20 cases of clinicopathologically confirmed DPN cases treated with light abrasive curettage without local anesthesia. We found this procedure to be an effective therapy, which did not cause postoperative scarring or significant postoperative pigmentary change.

Periorbital granuloma annulare.

A 40-year-old woman had erythematous, papular lesions on both periorbital areas. Histologic examination disclosed the presence of palisading granulomatous lesions. To our knowledge, periorbital granuloma annulare is extremely rare. Our experience demonstrates the importance of obtaining biopsy specimens from periorbital papules and considering granuloma annulare in the differential diagnosis of such lesions.

Pseudoatrophoderma colli. A familial case.

A case of familial pseudoatrophoderma colli was found in a 22-year-old Indian woman whose sister and father had similar eruptions. Pseudoatrophoderma colli is an unusual papillary dermatosis in which the lesions appear atrophic. The condition responded very well to treatment with 5% lactic acid ointment. It is likely that pseudoatrophoderma colli is more common than has been reported. It should be considered in the differential diagnosis, along with acanthosis nigricans and confluent and reticulated papillomatosis of Gougerot and Carteaud when a pigmented and papillary dermatosis is present around the neck and upper part of the thorax.

Malignant proliferating angioendotheliomatosis.

A 48-year-old man had fever and generalized asymptomatic erythematous telangiectatic plaques and patches. Skin biopsy specimens confirmed the diagnosis of malignant angioendotheliomatosis. Local irradiation therapy induced a temporary remission. Chemotherapy was administered without altering the course of the disorder. Limited autopsy revealed visceral as well as cutaneous involvement.

Sarcoidosis associated with mycosis fungoides.

In November 1966, a 47-year-old black woman had a skin eruption and an abnormal chest roentgenogram that were found to be due to sarcoidosis. In September 1974, nodular lesions and subsequently generalized exfoliative dermatitis developed that were found to be due to mycosis fungoides. The concurrence of sarcoidosis and mycosis fungoides has been recorded only once in the literature. The depression of cell-mediated immunity found in this patient and other sarcoid patients suggests that impairment of the host's immunosurveillance system may predispose to the development of T-cell lymphomas.

Ichthyosiform sarcoidosis.

A 31-year-old black woman had acquired ichthyosis. Histologic examination of her skin revealed a sarcoidal reaction in the dermis. The diagnosis of sarcoidosis was supported by negative tuberculin (intermediate strength purified protein derivative) and Candida albicans extract intradermal skin tests; by a positive Kveim test; and by roentgenographic evidence of bilateral hilar adenopathy, paratracheal node enlargement, and diffuse pulmonary parenchymal changes. Sarcoidosis must be considered when acquired ichthyosis develops in a patient.

Acquired cutis laxa associated with multiple myeloma.

Acquired cutis laxa, or generalized elastolysis, is a rare disease. One patient was found to have not only cutis laxa but also multiple myeloma.