Alberto Saponaro

Necrotizing gangrene of the genitalia and perineum.

Background  Necrotizing gangrene of the genitalia and perineum is a fulminant, life‐threatening condition. This infection is usually polymicrobial and may be idiopathic or secondary to local trauma or surgery. Histologically, it is characterized by obliterative endarteritis and thrombosis of the subcutaneous vessels, fascial necrosis, and leukocytic infiltration. Mortality rates of 25–75% have been reported. Most cases of necrotizing gangrene begin insidiously, with scrotal discomfort and malaise. Later, erythema, increasing pain, and swelling, associated with fever and chills, develop. A biopsy is useful to confirm the clinical diagnosis and to obtain culture samples. Ultrasound imaging may reveal gas or testicular involvement and may help to distinguish this infection from other causes of scrotal pathology.

Eruptive lesions in a patient with bone marrow transplantation

A 41‐year‐old man with a diagnosis of chronic myeloid leukemia presented with several elevated, small, soft, yellow papules, disseminated over the face and upper trunk. The cutaneous lesions had developed 5 years after transplantation ( Fig. 1 ).

Congenital atrophic dermatofibrosarcoma protuberans

A 16‐year‐old girl presented with a congenital atrophic plaque on the anterior aspect of her right leg. The lesion had slowly enlarged until she was 9 years of age; subsequently, several tumors appeared on the surface and later became reddish, hot, and mildly painful. Within a few months, all the tumors flattened and involuted. A previous biopsy showed a congenital fibroma. The patient was in good health; the physical examination, chest X‐ray films, and laboratory studies were normal. No history of personal or familial diseases was recorded.

Multiple basal cell carcinomas in a patient with myotonic dystrophy type 1

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