Catherine Reid

A broad spectrum of human papillomavirus types is present in the skin of Australian patients with non-melanoma skin cancers and solar keratosis.

Summary Background Human papillomavirus (HPV) may play a role in the pathogenesis of non‐melanoma skin cancer (NMSC) in epidermodysplasia verruciformis (EV) patients, but in the general population no specific HPV types have been associated with these lesions.

Drug‐induced linear IgA bullous disease following antibiotics

A 69‐year‐old woman presented with pneumonia and subacute bacterial endocarditis. Nine days after intravenous vancomycin and ciprofloxacin were commenced, the patient developed a bullous mucocutaneous eruption. Clinical presentation and histopathology were consistent with drug‐induced linear IgA bullous disease (LABD). The patient’s lesions resolved with cessation of antibiotics. A review of the features of drug‐induced LABD and the drugs that have been implicated are presented.

Frontal fibrosing alopecia associated with generalized hair loss

We present six cases of frontal fibrosing alopecia, in which generalized hair loss is a feature. Although this variant of lichen planopilaris has been reported clinically in a number of patients, there is very little histological evidence that the condition exists in peripheral sites. We believe this pattern of involvement may be more common than is reported, and have provided histological evidence of lichen planopilaris being present at sites beyond the scalp and eyebrows.

Giant keratoacanthoma arising in hypertrophic lichen planus

A 45‐year‐old man presented with a rapidly enlarging tumour in an area of long‐standing hypertrophic lichen planus of the lower leg. Histological examination of the resected specimen showed it to be a giant keratoacanthoma measuring 37 × 57 mm. Neoplastic change is a rarely reported complication of chronic variants of cutaneous lichen planus. To date there have been only two reports of keratoacanthoma development in association with lichen planus.

CASE REPORT Bullous pemphigoid induced by cephalexin

Two young men developed severe bullous eruptions with a distinctive clinical picture of severe flexural involvement and extensive mucosal ulceration. Biopsies showed subepidermal bullae and associated inflammation consisted of predominantly neutrophils. Both had IgG and C3 staining of the dermal‐epidermal junction on direct immunofluorescence. Bullous pemphigoid was diagnosed on the basis of clinical, histopathological and immunofluorescence findings. Both cases occurred after recent ingestion of cephalexin. We believe they represent the first reported cases of bullous pemphigoid induced by cephalexin.

Molluscum contagiosum in atopic dermatitis treated with 0.1% tacrolimus ointment

SUMMARY A case of molluscum contagiosum arising on the face and neck of a woman using topical tacrolimus over a period of 6 weeks for the treatment of atopic dermatitis is presented. Of particular note, these lesions remained confined to areas treated with tacrolimus and did not extend to adjacent regions treated with topical corticosteroids.

Benign familial pemphigus: little benefit from superficial radiotherapy.

Benign familial pemphigus (Hailey–Hailey disease) is a rare relapsing–remitting epidermal blistering disease palliated by a multitude of medical and surgical treatments. There are limited reports of benefit from low‐penetration X‐rays. We describe two resistant cases that appeared to respond initially to superficial radiotherapy, a 66‐year‐old man who had multiple courses to the groins (4 × 2.00 Gy/5 × 3.00 Gy) and to the axillae and low back (10 × 2.00 Gy) and a 53‐year‐old man treated twice to the groins and perineum (5 × 3.00 Gy/10 × 2.00 Gy). However, on longer follow up, benefit was found to be questionable. We conclude that while superficial radiotherapy may offer temporary relief, there is little evidence that it alters the natural history of this disease.

Drug Treatment of Cutaneous Lupus

Cutaneous lesions of systemic and discoid lupus may be clinically and histologically indistinguishable. Patients with systemic lupus erythematosus (SLE) may have classic discoid lesions. Similar haematological and immunologic abnormalities can be seen in both discoid lupus erythematosus (DLE) and SLE. Abnormal laboratory findings such as leucopenia, raised erythrocyte sedimentation rate (ESR) and mild anaemia are present intermittently in 30-50% of patients with DLE. Patients with DLE occasionally develop SLE; the conversion rate is about 6%. (author abstract)

A 30-year history of CD4+ vesiculo-bullous mycosis fungoides and multiple visceral malignancies

An 83‐year‐old Caucasian woman presented with a 25‐year history of an itchy, eczematous blistering eruption affecting her trunk and acral sites. She had a past history of adenocarcinoma of the lung, colorectal carcinoma and bladder carcinoma. Several skin biopsies consistently showed features of a spongiotic process. Direct and indirect immunofluorescence studies were repeatedly negative, excluding the possibility of an autoimmune blistering disorder. A skin biopsy several years later, however, showed histological and immunophenotypic features of mycosis fungoides. The literature on this rare phenotype of cutaneous T‐cell lymphoma generally portrays a negative prognosis. Our case illustrates an excellent prognosis with stable disease 30 years after onset.

Sentinel node biopsy: Not the standard of care for melanoma

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