C. Lisa Kauffman

Intrafollicular mucin deposits in Pityrosporum folliculitis

11. Kuo T-t. Cutaneous extramedullary hematopoiesis presenting as leg ulcers. J AM ACAD DERMATOL 1981;4 592-6. 12. Soga N, Sakai C, Shibata A, et al. An autopsy case of primary myelofibrosis with high value of circulating immune complexes, IgG (kappa) monoclonal gammopathy and extramedullary hematopoietic subcutaneous tumors. Rinsho Ketsueki 1982;23:1713-8. 13. Takashashi F, Ikeda A, Kohgo Y, et al. Primary myelofibrosis with skin nodules terminating in leukemic transformation: an autopsy case. Rinsho Ketsueki 1983;24: 1361-6. 14. Hocking WG, Lazar GS, Lipsett JA, et al. Cutaneous extramedullary hematopoiesis following splenectomy for idiopathic myelofibrosis. Am J Med 1984;76:956-8. 15. Levine LE, Pearson MG, Baron JM, et al. Extramedullary hematopoiesis [Letter]. Arch Dermatol 1984;12@1282. 16. Roupe G. Kutane extramedullare Hamatopoese bei myelofibrose. Hautarzt 1987;38:230-1. 17. Green LK, Klima M, Burns TR. Extramedullary hematopoiesis occurring in a hemangioma of the skin [Letter]. Arch Dermatol 1988;124:1720. 18. Albeda FW, Van Der Meer J, Vellenga E. Vascular proliferation as an unusual cause of hemorrhagic diathesis in myelofibrosis. Am J Clin Path01 1991;95:564-6. 19. Beckman EN, Oehrle JS. Fibrous hematopoietic tumors arising in agnogenic myeloid metaplasia. Hum Path01 1982;13:804-10. 20. Pierard G-E. Hematopoiese cutanee et myelofibrose. Ann Path01 1987;7:73-5. 21. Puig L, Garcia MP, de Moragas JM. Cutaneous extramedullary hematopoiesis in a patient with acute myelofibrosis [Letter]. Arch Dermatol 1988;124:329-30. 22. Schofield JK, Shun JLK, Cerio R, et al. Cutaneous extramedullary hematopoiesis with a preponderance of atypical megakaryocytes in myelofibrosis. J AM ACAD DERMATOL 1990;22:334-7. 23. Mizoguchi M, Kawa Y, Minami T, et al. Cutaneous extramedullary hematopoiesis in myelofibrosis. JAM ACAD DERMATOL 199&221351-5. 24. Del Forno C, Borroni G, Caresana G, et al. Cutaneous extramedullary hematopoiesis in idiopathic myelofibrosis: description of a case. G Ital Dermatol Venereal 1990; 125:205-9. 25. Brough AJ, Jones D, Page RH, et al, Dermal erythropoiesis in neonatal infants: a manifestion of intra-uterine viral disease. Pediatrics 1967;40:627-35. 26. Schwartz JL, Maniscalco WM, Lane AT, et al. Twin transfusion syndrome causing cutaneous erythropoiesis. Pediatrics 198

Lymphomatoid contact dermatitis caused by nickel

74:527-9. 27. Argyle JC!, Zone JJ. Dermal erythropoiesis in a neonate. Arch Dermatol 198 1; I 17:492-4. 28. Vakilzadeh F, Dominick HC, Bramswig J. Kutane erythropoese bei fetaler Rh-erythroblastose-blueberry-muffinbaby. Hautarzt 1982;33:440-2. 29. Popoff L, Popoff N. L’Hemope85:157-67. 30. Sarma DP. Extramedullary hematopoiesis of the skin. Arch Dermatol 1981;117:58-9. 3 I. Demory JL, Dupriez B, Fenaux P, et al. Cytogenetic studies and their prognostic significance in agnogenic myeloid metaplasia: a report on 47 cases. Blood 1988;72:855-9.

Manual resurfacing and trichloroacetic acid for the treatment of patients with widespread actinic damage. Clinical and histologic observations.

Lymphomatoid contact dermatitis is a rarely reported entity consisting of allergic contact dermatitis that resembles mycosis fungoides pathologically. Although the histopathology has been previously described, there have been no attempts to reproduce the dermatitis for pathologic evaluation. A 68-year-old woman presented with a papular rash on her neck after exposure to a nickel-containing necklace. A biopsy specimen was suspicious for mycosis fungoides. However, the dermatitis responded quickly to topical steroids and avoidance of the necklace. A patch test to nickel was positive, and a biopsy specimen from the patch test site had no findings of mycosis fungoides. Although we were able to reproduce the contact dermatitis at a distant site, the disease was dissimilar. Lymphomatoid contact dermatitis has an excellent prognosis and resolves completely simply by avoiding the offending agent.

Teledermatology and In-Person Examinations A Comparison of Patient and Physician Perceptions and Diagnostic Agreement

BACKGROUND A facial resurfacing regimen combining manual abrasion of the skin and 25% trichloroacetic acid has been reported to produce excellent results, but the histologic depth of injury produced by this technique has not been studied. OBJECTIVE To describe our experience with this technique treating patients with extensive actinic damage and to determine the histologic depth of injury produced. METHOD We treated 40 patients using manual resurfacing and trichloroacetic acid, primarily for widespread actinic keratoses. Resurfacing tools included silicone carbide sandpaper, drywall screen, electrocautery tip cleaners, abrasive pads, scalpel blades, and curettes. Four patients underwent sequential biopsies to evaluate the depth of wounding using this technique. RESULTS Manual resurfacing combined with trichloroacetic acid consistently produced excellent cosmetic results and nearly complete eradication of actinic keratoses. Histologically, treated areas showed replacement of the dermal elastotic band by newly formed collagen, a significantly deeper level of wounding than the jessners/35% trichloroacetic acid peel, There was no evidence for foreign body granulomas clinically or histologically as a result of the abrasive materials. CONCLUSIONS The deeper level of this peel explains the improved cosmetic outcome and greater eradication of actinic keratoses. This treatment is particularly well suited for patients with extensive photodamage and widespread actinic keratoses.