Anthony C. Soldano

Perforating granulomatous dermatitis reaction to exogenous tattoo pigment: a case report and review of the literature.

Abstract:The majority of cutaneous hypersensitivity reactions to exogenous tattoo pigments can be histologically classified as lichenoid or granulomatous. The etiology is still uncertain but is generally accepted to be a delayed-type hypersensitivity reaction to either the pigment itself or its carrier solution. In this report, we review the literature concerning adverse reactions to tattoos. In addition, we describe the second case of a localized granulomatous dermatitis to the red dye within a tattoo that histologically resembled granuloma annulare. This is the first reported example of a perforating granuloma annulare–like reaction.

Eosinophilic neuritis and eosinophilic panniculitis in a patient with advanced acquired immunodeficiency syndrome

The pruritic, papular eruption of human immunodeficiency virus with associated peripheral eosinophilia is well documented. We describe a 32-year-old African American man with advanced acquired immunodeficiency syndrome; a generalized painful, pruritic, papular rash; peripheral blood eosinophilia; and perineural eosinophilic infiltrates with eosinophilic panniculitis. To our knowledge, the latter 2 features have not been previously described in the literature on human immunodeficiency virus dermatoses. We propose that eosinophilic neuritis and eosinophilic panniculitis may represent additional findings in the spectrum of cutaneous disease seen in patients with advanced acquired immunodeficiency syndrome.

Primary cutaneous CD4-positive small/medium-sized pleomorphic T-cell lymphoproliferative disorder: Report of a case and review of the literature

Primary cutaneous small/medium‐sized T‐cell lymphoma (PCSM‐TCL), which was included in the World Health Organization ‐ European Organization for Research and Treatment of Cancer (WHO‐EORTC) classification for cutaneous lymphomas as a provisional entity in 2008, has recently been reclassified as primary cutaneous small/medium‐sized T‐cell lymphoproliferative disorder (PCSM‐TCLPD) because of its indolent behavior and uncertain malignant potential. Treatment with local therapies is usually curative, although there have been reports of aggressive, systemic disease. This spectrum of disease behavior evokes the consideration that this entity may actually be multiple diseases with a shared clinicopathologic features rather than a singular disease process with a variety of behaviors. PCSM‐TCLPD retained its designation as a provisional entity under the updated WHO‐EORTC guidelines; however, additional cases of PCSM‐TCLPD are needed to shed more light on this rare disorder.

Koenen's tumor and facial angiofibromas in a case of Birt-Hogg-Dubé syndrome: A cutaneous contribution to growing evidence of a relationship with tuberous sclerosis complex

Birt-Hogg-Dube syndrome (BHD) is an uncommon autosomal dominant genodermatosis characterized by fibrofolliculomas and trichodiscomas on the face and neck with acrochordons in flexural areas. These skin signs serve as markers for internal disease, most importantly spontaneous pneumothoraces and renal cancers. BHD is caused by a mutation in a tumor suppressor gene. This gene encodes the protein folliculin (FLCN), important for normal functioning of the mammalian target of rapamycin (mTOR) signaling pathway.1

Adnexal Carcinoma: Microcystic Adnexal Carcinoma and Sebaceous Carcinoma

Microcystic adnexal carcinoma (MAC) and sebaceous carcinoma (SC) are rare adnexal neoplasms. MAC most commonly presents as a poorly defined, firm, skin-colored papule, nodule, or plaque on the head and neck. Although locally destructive, MAC does not typically metastasize. Rates of misdiagnosis are high, due to incomplete, superficial sampling. Resection techniques with meticulous margin control, including Mohs micrographic surgery (MMS), are recommended in the management of MAC.

Basal cell carcinoma and malignant melanoma cutaneous collision tumor

ABSTRACT Malignant tumors composed of both epithelial and melanocytic populations are exceedingly rare. Because the etiology of these malignant tumors is not yet defined, several authors have argued for the continued cataloging of these lesions. We present a 67-year-old man with a suspicious-appearing lesion on the right forearm; initial biopsy was consistent with a pigmented basal cell carcinoma. On re-excision, a collision of malignant melanoma and basal cell was identified.