Tamoxifen-induced radiation recall dermatitis.

BACKGROUND: Radiation recall dermatitis (RRD) canpresent days to years after radiation exposure andis most commonly caused by chemotherapy drugs,with tamoxifen-induced radiation recall dermatitisbeing exceptionally rare. PURPOSE: To report a newcase of tamoxifen-induced radiation recall dermatitisafter 4.5 years of tamoxifen exposure, making this thelongest time of onset to RRD after tamoxifen initiation. MATERIALS AND METHODS: The case of a woman withtamoxifen-induced RRD is presented. Using PubMedand Google Scholar, the terms tamoxifen, radiation,recall, dermatitis were searched. Relevant citationswere utilized and discussed. RESULTS: An adult womanwith history of inflammatory breast carcinomadeveloped an erythematous, scaly, tender plaquelocalized to previously irradiated skin of the left chestafter more than four years of tamoxifen therapy. Thepatient was diagnosed with RRD and was treated withtopical triamcinolone 0.1% cream twice daily to theaffected areas. The patient experienced subsequentrapid improvement despite continuation of tamoxifentreatment. Biopsy revealed changes consistent withradiation dermatitis with no evidence of malignancy. CONCLUSION: Radiation recall dermatitis can havesignificant impact on affected patients and can posea diagnostic dilemma for clinicians who may mistakeRRD for infection or recurrence of malignancy. It isimportant to be familiar with the presenting signs andsymptoms of this entity so that affected patients canreceive timely and appropriate therapy.

Histiocytoid Sweet's syndrome in a patient with myelodsyplastic syndrome: report and review of the literature.

The neutrophilic dermatoses are a group of disorders characterized by skin lesions for which histological examination reveals intense epidermal and/or dermal inflammatory infiltrates composed primarily of neutrophils without evidence of infection. The myelodysplastic syndromes consist of a heterogeneous group of malignant hematopoietic stem cell disorders characterized by dysplastic and inadequate blood cell production with a variable risk of transformation to acute leukemia. Rarely, histiocytoid Sweet's syndrome occurring in patients with myelodysplastic syndrome has been described. We present a case of a 66-year-old woman with a history of myelodysplastic syndrome who developed histiocytoid Sweet's syndrome. We also review the literature and characterize patients with myelodysplastic syndrome who have developed histiocytoid Sweet's syndrome.

A 57-year-old man with diabetes and a toe infection.

Foot infections are common complications in the diabetic population resulting in significant associated morbidity. Several risk factors predispose these individuals to foot infections including, but not limited to, sensory neuropathy, autonomic neuropathy, motor neuropathy, atherosclerotic disease, hyperglycemia, and immune dysfunction.5 Medical work-up and treatment of diabetic foot infections depends on the extent and severity of the infection. An organized and practical approach based on an understanding of the pathophysiology and microbiology is helpful in the evaluation and treatment of these infections. 2

A patient with coexistent bullous pemphigoid and primary membranous glomerulonephropathy.

Bullous pemphigoid has been rarely described in association with renal abnormalities, including membranous glomerulonephropathy, and it has been approximately 20 years since this association was last reported. We describe a case of a male patient with a concurrent onset of bullous pemphigoid and membranous glomerulonephropathy and discuss this rare association. A definite common immunologic mechanism that links the two disorders remains elusive.