Cristián Vera-Kellet

Topical sodium metabisulfite for the treatment of calcinosis cutis: a promising new therapy

Calcinosis cutis is a chronic calcium‐mediated disease that causes significant morbidity. Multiple treatments have been tried, with varying results; indeed, to date, no standard treatment has been generally accepted. Sodium metabisulfite is an inorganic compound that, when it reacts with oxygen, becomes sodium sulfate, a metabolite of sodium thiosulfate that has a similar ability to inhibit calcium oxalate agglomeration. Four women diagnosed with calcinosis cutis, secondary to dermatomyositis, systemic sclerosis and radiodermatitis after breast cancer, were evaluated for their response to topical 25% sodium metabisulfite. In all patients a decrease in lesion size, erythema and pain from injuries was shown, with complete resolution of the associated ulcers. One patient had a complete response. None experienced adverse effects. Topical sodium metabisulfite is a promising emerging therapy that should be considered as a valid alternative treatment in calcinosis cutis. Randomized prospective studies are required to evaluate its true efficacy.

Eosinophilic annular erythema: complete clinical response with dapsone

dominant pattern have also been reported, and such cases are difficult to differentiate from HBT. The bilateral clinical presentation, presence of telangiectasias, absence of previous trauma, and appearance of the lesions in both twins makes HBT a more likely diagnosis in our two patients. We have found only two reports in the literature of HBT in patients with no family history and none in monochorionic twins.

Intralesional methotrexate as an adjuvant treatment for pyoderma gangrenosum: A case report.

A 35‐year‐old man presented with an eighteen‐month history of painful ulcers on both calves. Three ulcers with erythematous‐violaceous undermined borders were noticed on his right leg and one on the left leg [Figure 1]. A detailed laboratory evaluation was done including complete blood counts, erythrocyte sedimentation rate, antinuclear antibodies, chest radiograph, quantiferon gold assay for tuberculosis and human immunodeficiency virus (HIV) serology all of which were unremarkable. Bacterial, fungal and mycobacterial cultures from the ulcer were negative. A skin biopsy showed ulceration surrounded by granulation tissue with a scant, diffuse infiltrate of lymphocytes, neutrophils and plasmacytes and fibrosis but without any signs of vasculitis [Figure 2] and a negative periodic acid‐Schiff stain, all suggestive of pyoderma gangrenosum. Associated systemic diseases were ruled out with normal blood and urine protein electrophoresis, sacroiliac radiography, rheumatoid factor and gastroenterology evaluation including colonoscopy.

Brimonidine gel for the treatment of persistent heliotrope rash in a patient with amyopathic dermatomyositis: a case report

tance confocal microscopy for in vivo skin imaging. Photochem Photobiol 2008; 84: 1421–1430. 6 Scope A, Mahmood U, Gareau DS et al. In vivo reflectance confocal microscopy of shave biopsy wounds: feasibility of intraoperative mapping of cancer margins. Br J Dermatol 2010; 163: 1218–1228. 7 Chen CSJ, Elias M, Busam K, Rajadhyaksha M, Marghoobb A. Multimodal in vivo optical imaging, including confocal microscopy, facilitates presurgical margin mapping for clinically complex lentigo maligna melanoma. Br J Dermatol 2005; 153: 1031–1036. 8 Tannous Z, Torres A, Gonz alez S. In vivo real-time confocal reflectance microscopy: a noninvasive guide for Mohs micrographic surgery facilitated by aluminum chloride, an excellent contrast enhancer. Dermatol Surg 2003; 29: 839–846. 9 Patel YG, Aranda I, Haipern AC, Li H, Halpern AC, Rajadhyaksa M. Confocal reflectance mosaicing of basal cell carcinomas in Mohs surgical skin excisions. J Biomed Opt 2007; 12: 034027.

Brimonidine gel for the treatment of recalcitrant facial erythema in diseases other than rosacea: a novel tool for clinicians.

Background Clinicians have recognized the impact of cutaneous signs and symptoms in patients quality of life over the years. Often, systemic response to a certain therapy is faster than the cutaneous response, leading to patient frustration and treatment discontinuation. Brimonidine gel is an alpha-2 adrenergic agonist recently approved by the FDA for the treatment of persistent facial erythema of rosacea. Objectives and methods We describe 3 patients with recalcitrant facial erythema secondary to dermatomyositis, pityriasis rubra pilaris and systemic lupus. Their main complaint was facial erythema that was persistent even though they were under systemic treatment. Empirically, we decided to try topical Brimonidine gel for the treatment of their facial erythema as a rescue measure. Results 30 minutes after we applied 0.5% Brimonidine gel in the office, we achieved an excellent clinical response, without adverse effects in all of these patients. Conclusion Topical Brimonidine gel may be a complementary therapy for the management of recalcitrant facial erythema in patients with systemic lupus, dermatomyositis and pityriasis rubra pilaris.

Nifedipine cream versus sildenafil cream for patients with secondary Raynaud phenomenon: A randomized, double-blind, controlled pilot study

3. Ouyang H. The delivery of sunscreen aerosol sprays [abstract]. J Am Acad Dermatol. 2014;70:AB157. 4. Ou-Yang H, Stanfield J, Cole C, Appa Y, Rigel D. High-SPF sunscreens (SPF

Pilocarpine and artificial saliva for the treatment of xerostomia and xerophthalmia in Sjögren syndrome: a double-blind randomized controlled trial

70) may provide ultraviolet protection above minimal recommended levels by adequately compensating for lower sunscreen user application amounts. J Am Acad Dermatol. 2012;67:1220-1227. 5. American Academy of Dermatology website. Sunscreen FAQs. Available at: https://www.aad.org/media-resources/stats-andfacts/prevention-and-care/sunscreens. Accessed June 13, 2017. 6. O’Connor A. Is sunscreen flammable? New York Times. June 6, 2012.

Oral Amalgam Tattoo Mimicking Melanoma

Sjögren syndrome (SS) is associated with xerostomia and xerophthalmia. Pilocarpine has been shown to stimulate the secretion of saliva.

Labial ulcer: oral manifestation of syphilis.

A 49-year-old woman without a personal or family history of melanoma presented with an asymptomatic pigmented lesion on her tongue that was suggestive of oral melanoma. The patient reported that she had undergone a dental procedure 3 months before the appearance of the lesion.

Black Hairy Tongue

A 39-year-old woman presented with a 6-week history of anulcerated and indurated lesion in the upper lip (Fig. 1). Thehistological study showed an ulcer with dense lymphoplas-macytic infiltrate and the immunohistochemistry (IHC) waspositive for spirochetes. Both, the rapid plasma reagin test(RPR) andthemicrohemaglutinationofthe