Introduction. Non-Langerhans cell histiocytoses (non-LCH) are a group of rare diseases with varied clinical manifestations and overlapping features seen among the subtypes. Here, we present a case of Rosai-Dorfman disease with features of necrobiotic xanthogranuloma. Case. A 45-year-old female presented with a 10-year history of an enlarging neck mass with normal overlying skin accompanied by dysphagia and multiple asymptomatic pink to yellowish-brown papules, nodules, and plaques on the face, trunk and extremities. Biopsies of a skin nodule and plaque revealed granulomatous dermal infiltrates (lymphocytes, foamy histiocytes, and Touton giant cells), emperipolesis and areas of necrosis. CD1A and Fite-Faraco staining showed negative results while CD68 and S100 positively stained the tissues of interest. Histopathology of the neck mass paralleled these findings in addition to being negative for lymphoid markers. Patient had monoclonal gammopathy and thyromegaly with enlarged cervical lymph nodes on further tests and imaging. Intralesional and systemic steroids were given which led to flattening of skin lesions and improvement in dysphagia, respectively. Conclusion. Diagnosis and classification of a particular type of non-LCH may be difficult due to similarities across its subtypes. Hence, it is our belief that these diseases may occur on a spectrum. Treatment involves a multidisciplinary approach for the best possible care.

Porocarcinoma is a rare, cutaneous adnexal malignancy usually seen in elderly patients. We present three females with varying lesions located at the head region with a history of a sudden increase in growth. Histologically, all were composed of nests of basaloid cells showing atypia, mitotic figures and eccrine-differentiated ductal elements. One patient underwent excision (0.5 cm margin) and was recurrence-free one-month post-op. This series also brings a brief review of the current literature on porocarcinoma.

Background. Androgenetic alopecia (AGA), also known as pattern hair loss, is the most common type of hair loss in men and women. Due to very limited therapeutic options, search for other effective and safe drugs is necessary. Objectives. This review aims to evaluate the efficacy and safety of a potential treatment option, topical adenosine, for AGA in male and female adults. Methods. A search of databases (Cochrane Library, Pubmed Medline, and others) was performed with no time limitations placed. We included human interventional studies published in English involving the use of topical adenosine for AGA in healthy adult males and females. Risk bias assessment was performed using the Cochrane Collaboration criteria. Results. All four trials in this review, with a total of 260 participants, used 0.75% topical adenosine lotion twice a day for a period of 6-12 months. Comparators were placebo, topical niacinamide, and topical minoxidil. Evaluated parameters include improvement in baldness grading as assessed by dermatologists and investigators, improvement and satisfaction as assessed by participants, anagen growth, thick/thin/vellus hair ratio, and hair density. Two trials found significant improvement with thick hair ratio (>60 or >80 μm) with the use of topical adenosine while two trials showed higher overall participant satisfaction with topical adenosine. Few to no adverse effects were reported with its use. Conclusion. This is the first systematic review involving topical adenosine for AGA. Topical adenosine may be effective in increasing thick hair ratio and improving the self-perception of hair growth. With minimal to no adverse effects, it may serve as an adjunct or alternative to present treatment options. However, more studies are needed to strengthen these findings.

Introduction. Mastocytosis is a disease defined by the proliferation of mast cells in organs, most commonly the skin. It may affect any age group but is usually found in children in the first year of life. We present a case of diffuse cutaneous mastocytosis manifesting in the rare bullous form. Case. A 4-month-old Filipino male presented with multiple bullae on the head, trunk, and extremities after applying chamomile oil. Biopsy of the skin demonstrated numerous mast cells, confirming the diagnosis of bullous mastocytosis. The patient was treated with oral antihistamines and corticosteroids, which was followed by a good response. Conclusion. Diagnosis of diffuse cutaneous mastocytosis may be challenging due to its rarity. Proper management requires preventive measures, symptomatic treatment, as well as communication of prognosis with the stakeholders.