No abstract

No abstract

No abstract

These cases demonstrate that calciphylaxis may be clinically misdiagnosed due to ill-defined presentations, particularly in the early stages without the characteristic features of livedo racemosa and ulceration. However, recognition in the early stages is critical to implement timely treatment. As such, definitively diagnostic skin biopsy should be considered early in suspected cases to confirm the diagnosis of calciphylaxis and ensure prompt management of this lethal disease.

No abstract

The incidence and diagnosis of cutaneous malignancies are steadily rising. In addition, with the aging population and increasing use of organ transplant and immunosuppressive medications, subsets of patients are now more susceptible to skin cancer. Mohs micrographic surgery (MMS) has become the standard of care for the treatment of high-risk nonmelanoma skin cancers and is increasingly used to treat melanoma. Mohs micrographic surgery has the highest cure rates, spares the maximal amount of normal tissue, and is cost-effective for the treatment of cutaneous malignancies. As in other medical fields, appropriate use criteria were developed for MMS and have become an evolving guideline for determining which patients and tumors are appropriate for referral to MMS. Patients with cutaneous malignancies often require multidisciplinary care. With the changing landscape of medicine and the rapidly increasing incidence of skin cancer, primary care providers and specialists who do not commonly manage cutaneous malignancies will need to have an understanding of MMS and its role in patient care. This review better familiarizes the medical community with the practice of MMS, its utilization and capabilities, differences from wide excision and vertical section pathology, and cost-effectiveness, and it guides practitioners in the process of appropriately evaluating and determining when patients with skin cancer might be appropriate candidates for MMS.

Psoriasis is an autoimmune inflammatory disease that has recently been treated with a novel treatment, ustekinumab, a human monoclonal antibody that targets the Th17 pathway. Discoid lupus is a subset of chronic cutaneous lupus erythematosus. Recent studies have suggested the Th17 pathway may be involved in cutaneous lupus. We present a case of a 41-year-old man with both severe psoriasis and hypertrophic discoid lupus treated with ustekinumab. After three doses of 45 mg subcutaneous injections at day 1, week 4, and week 16, his psoriasis plaques cleared and his hypertrophic discoid lupus plaques showed moderate improvement. Following a fourth dose of 90 mg his lupus plaques showed marked improvement. Ustekinumab may be a promising therapy for this and other forms of cutaneous lupus.

No abstract