A rare case of cutaneous myxoma with trichofolliculoma-like features.

Carney complex is a rare genetic disorder associated with a number of cutaneous lesions, especially cutaneous myxomas. We present a rare case of cutaneous myxoma (superficial angiomyxoma) with trichofolliculoma-like features in a patient with Carney complex, and explore how the associated histopathology provides critical context for elucidating the etiology of this benign neoplasm.

Treatment of Steroid-Induced Lipoatrophy Following Transverse Abdominis Plane Block With Serial Intralesional Isotonic Saline Injections: A Case Report.

A transverse abdominis plane (TAP) block is one option in the management of chronic groin pain after inguinal hernia repair. Steroid-induced lipoatrophy following local injection is an infrequent complication of this procedure, but can be distressing to patients when it does occur. A 36-year-old male patient of ours sustained this rare procedural complication and underwent successful reversal of the lipoatrophy through serial intralesional isotonic saline injections. The serial intralesional injection of isotonic saline is technically simple and may be an effective means of treating lipoatrophy. Pain specialists may opt to treat this procedural complication rather than refer to dermatology.

Ros-NET: A deep convolutional neural network for automatic identification of rosacea lesions.

BACKGROUND: Rosacea is one of the most common cutaneous disorder characterized primarily by facial flushing, erythema, papules, pustules, telangiectases, and nasal swelling. Diagnosis of rosacea is principally done by a physical examination and a consistent patient history. However, qualitative human assessment is often subjective and suffers from a relatively high intra- and inter-observer variability in evaluating patient outcomes. MATERIALS AND METHODS: To overcome these problems, we propose a quantitative and reproducible computer-aided diagnosis system, Ros-NET, which integrates information from different image scales and resolutions in order to identify rosacea lesions. This involves adaption of Inception-ResNet-v2 and ResNet-101 to extract rosacea features from facial images. Additionally, we propose to refine the detection results by means of facial-landmarks-based zones (ie, anthropometric landmarks) as regions of interest (ROI), which focus on typical areas of rosacea occurrence on a face. RESULTS: Using a leave-one-patient-out cross-validation scheme, the weighted average Dice coefficients, in percentages, across all patients (N = 41) with 256 × 256 image patches are 89.8 ± 2.6% and 87.8 ± 2.4% with Inception-ResNet-v2 and ResNet-101, respectively. CONCLUSION: The findings from this study support that pre-trained networks trained via transfer learning can be beneficial in identifying rosacea lesions. Our future work will involve expanding the work to a larger database of cases with varying degrees of disease characteristics.

Porphyria cutanea tarda in a child following multi-agent chemotherapy.

Porphyria cutanea tarda (PCT) is a blistering skin disorder that occurs most commonly in middle-aged individuals. It is caused by decreased uroporphyrinogen decarboxylase (UROD) activity, which results in elevated levels of uroporphyrinogen. Occurrence remains very rare in children with some sources quoting as few as 50 reports of childhood cases.1 The literature reports occasional cases of PCT onset with various drugs, including barbiturates, estrogens, griseofulvin, rifampicin, sulfonamides, imatinib, methotrexate, tamoxifen, and cyclophosphamide, however its incidence in childhood is uncommon.2-6 We present a case of new-onset PCT in an eight year-old following treatment of pre-B cell acute lymphoblastic leukemia with multi-agent chemotherapy.

Warfarin-induced Venous Limb Gangrene.

Warfarin is a commonly used anticoagulant that has been associated with several significant cutaneous side effects, most notably warfarin-induced skin necrosis. A lesser known adverse reaction to warfarin is warfarin-induced venous limb gangrene. Both cutaneous adverse effects share the same pathophysiology, but are clinically quite different. The majority of cases of warfarin-induced venous limb gangrene has been in patients with cancer or heparin-induced thrombocytopenia. However, other hypercoagulable disease states, such as the antiphospholipid antibody syndrome, can be associated with venous limb gangrene. In order to increase recognition of this important condition, the authors report a case of warfarin-induced venous limb gangrene in a patient with presumed antiphospholipid antibody syndrome and review the literature on warfarin-induced venous limb gangrene.

Acrodermatitis continua of hallopeau successfully treated with adalimumab.

Acrodermatitis continua of Hallopeau, first described by Hallopeau in 1890, is an uncommon variant of pustular psoriasis. Acrodermatitis continua of Hallopeau presents as sterile pustules on the hands and feet. It has a relapsing course. Although acrodermatitis continua of Hallopeau is a pustular psoriasis variant, the condition is not easily treated with antipsoriatic medications. In the following case, the authors report a case of acrodermatitis continua of Hallopeau successfully treated with adalimumab. In addition, the cases of acrodermatitis continua of Hallopeau treated with tumor necrosis-alpha inhibitors are summarized.