Sonia Chavez-Alvarez

Disseminated fusariosis with endophthalmitis after skin trauma in acute lymphoblastic leukaemia

PETT schedule, to successfully control both, metastatic growth in cutaneous and uveal melanoma by simultaneously targeting multiple hallmarks of melanoma: Communicative reprogramming may overcome (molecular-)genetic heterogeneity among melanomas of quite different origin as well as at different metastatic sites. PETT schedule provides a modest toxicity profile and omits maximal tolerable dosages of single drugs by concertedly modulating melanoma plus adjacent stroma cell functions. These promising data with PETT combination therapy are currently studied in a randomized phase II trial in second-line. A.R., C.H. designed the research, analysed the data and wrote the paper; C.H., M.V., Ch.H., M.L., M.B., S.H. and A.R. treated the patients; W.H. critically reviewed the manuscript.

Balloon Cell Melanoma and Its Metastasis, a Rare Entity

Balloon cell melanoma (BCM) with metastasis is a rarely occurring neoplasia. The incidence of BCM is low, and hence, the frequency of these lesions presenting metastasis is even less frequent. This review exposes the balloon cell metastasis cases that have been published and a new case. These cases share the histopathological features but the location of initial melanoma, age and sex vary. It is relevant for the dermatologist and dermatopathologist to keep in mind the diagnosis of BCM and consider the possibility of it metastasizing as nonpigmented skin lesions.

Hair That Is Difficult to Manage in a Hispanic Girl

physical examination, her hair was light brown, with discrete glistening in some areas, along with a dry and unruly appearance ( Fig. 1 ). No other morphological defects were found upon physical examination. Dermoscopy did not reveal any relevant features, nor did examination under a light microscope. Scanning electron microscopy was not available; therefore, we decided to send some hair strands for pathology examination ( Fig. 2 ). What is your diagnosis? Question

Positive Jacquet's sign in traction alopecia

A 32-year-old previous healthy woman was observed with a 3-year history of hair loss. On physical examination, she had decreased hair density and smooth padded alopecic patches on the occipital and parietal scalp. The fronto/temporal hair rim was preserved. A positive Jacquets sign was present with easy formation of several folds in the occipito/parietal scalp; the pull test was negative. This article is protected by copyright. All rights reserved.

Noodle pattern: a new dermoscopic pattern for crusted scabies (Norwegian scabies)

1 Brunner PM, Silverberg JI, Guttman-Yassky E et al., Councilors of the International Eczema Council. Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Invest Dermatol 2017; 137: 18–25. 2 Radtke MA, Sch€afer I, Glaeske G, Jacobi A, Augustin M. Prevalence and comorbidities in adults with psoriasis compared to atopic eczema. J Eur Acad Dermatol Venereol 2017; 31: 151–157. 3 Egeberg A, Andersen YM, Gislason GH, Skov L, Thyssen JP. Prevalence of comorbidity and associated risk factors in adults with atopic dermatitis. Allergy 2017; 72: 783–791. 4 Egeberg A, Skov L, Andersen YM et al. Ten-year mortality is increased after hospitalization for atopic dermatitis compared with the general population, but reduced compared with psoriasis. J Am Acad Dermatol 2017; 76: 98–105. 5 Silverberg JI, Greenland P. Eczema and cardiovascular risk factors in 2 US adult population studies. J Allergy Clin Immunol 2015; 135:721.e6– 728.e6. https://doi.org/10.1016/j.jaci.2014.11.023. Epub 2015 Jan 8. 6 Loeffler M, Engel C, Ahnert P et al. The LIFE-Adult-Study: objectives and design of a population-based cohort study with 10.000 deeply phenotyped adults in Germany. BMC Public Health 2015; 15: 691. 7 Schmitt J, Schwarz K, Baurecht H et al. Atopic dermatitis is associated with an increased risk for rheumatoid arthritis and inflammatory bowel disease, and a decreased risk for type 1 diabetes. J Allergy Clin Immunol 2016; 137: 130–136. 8 Wu LC, Hwang CY, Chung PI et al. Autoimmune disease comorbidities in patients with atopic dermatitis: a nationwide case-control study in Taiwan. Pediatr Allergy Immunol 2014; 25: 586–592. 9 Mohan GC, Silverberg JI. Association of vitiligo and alopecia areata with atopic dermatitis: a systematic review and meta-analysis. JAMA Dermatol 2015; 151: 522–528. 10 Standl M, Tesch F, Baurecht H et al. Association of atopic dermatitis with cardiovascular risk factors and diseases. J Invest Dermatol 2017; 137: 1074–1081. 11 Silverberg JI. Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies. Allergy 2015; 70: 1300–1308.

Multiple bilateral adnexal tumours of the ear: Dermoscopic clues

1. Singh G, Miteva M. Prognosis and management of congenital hair shaft disorders with fragility: part I. Pediatr. Dermatol. 2016; 33: 473–80. 2. Jain N, Khopkar U. Monilethrix in pattern distribution in siblings: diagnosis by thrichoscopy. Int. J. Trichology 2010; 2: 56–9. 3. Shah V, Tharini GK, Manoharan K. Monilethrix with Holt-Oram syndrome: case report of a rare association. Int. J. Trichology 2015; 7: 33–5. 4. Shimomura Y. Journey towards unraveling the molecular basis of hereditary hair disorders. J. Dermatol. Sci. 2016; 84: 232–8. 5. Wang JM, Xiao YJ, Liang YH. Novel D323G mutation of DSG4 gene in a girl with localized autosomal recessive hypotrichosis clinically overlapped with monilethrix. Int. J. Dermatol. 2015; 54: 1163–8. doi: 10.1111/ajd.12790

Classic medical tools for the prevention of adverse technology-associated events: Tongue depressors and lasers

SURGICAL CHALLENGE Intense pulsed light, 810-nm diode, long pulsed 1064-nm neodymium-doped yttrium aluminium garnet, and Alexandrite are lasers that can be used for hair removal. The dermatologist should be cautious when treating patients with intense pulsed light or any laser that targets hairs or pigment in the eyebrows. Charring of hairs in eyebrows can lead to patient discomfort ranging from a few burned hairs that will eventually grow back to a thermal burn with visible consequences. A frequently encountered type of lawsuit in dermatology is related to cutaneous injuries resulting from laser application. In addition to being overly cautious, how can the dermatologist avoid applying intense pulsed light or any other laser treatment to the eyebrows or hairline?

Acute hemorrhagic edema of infancy (Finkelstein's disease): favorable outcome with systemic steroids in a female patient

Dear Editor, Acute hemorrhagic edema of infancy was initially described in 1913 by Snow. It is a benign, self-limited leukocytoclastic vasculitis that occurs most commonly in males. It evolves favorably with conservative medical management and treatment with steroids is not usually administered. We present a case of a 2-year-old girl, non-toxemic, with sudden onset of asymptomatic large purpuric non-blanching plaques, with a targetoid and annular appearance, predominantly on the limbs and trunk, sparing the genital area, and edema and tenderness of the left ankle 2 days before the initial medical evaluation. A history of diarrhea from the previous week that resolved with oral antibiotics (cephalosporin) for 5 days was the only relevant medical history. The patient’s immunizations were up to date; she had no other clinical conditions. Her temperature on arrival was 36.5°C, and she presented no other signs or symptoms. She was prescribed loratadine by a general practitioner (Figure 1).

An Atrophic Plaque with Arborizing Vessels

Dermatofibromas are a common finding in the daily clinical practice. Most lesions are found incidentally or because patients seek medical attention due to the aspect of the lesion. Rare variants of dermatofibroma such as aneurismatic or atrophic dermatofibroma can be encountered simultaneously; thus, these combined features may raise the possibility of other diagnoses to be considered. By providing diverse clinical and dermoscopic examples of dermatofibromas, we may prevent misdiagnosing these lesions. This case illustrates how two rare variants of dermatofibroma can coexist. Clinical presentation of dermatofibromas may vary greatly, and it is essential for dermatologists to recognize them clinically and dermoscopically before obtaining histopathological diagnosis.