Myxoid tumors are a heterogeneous group of lesions characterized by a marked abundance of extra cellular mucoid (myxoid) matrix.[1] The term aggressive emphasizes the often infiltrative nature of the tumor and its frequent association with recurrence.[2] A case of aggressive angiomyxoma arising from the vagina in a 55-year-old woman is reported for its rarity.

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Disabling pansclerotic morphea is a rare atrophying and sclerosing disorder of the subcutaneous tissue, muscle and bone. It is characterized by atrophy of the skin, subcutaneous fat, muscle and bone involving half of the face. In some patients the atrophic lesions extend to involve the ipsilateral or contralateral upper and lower limbs with radiological evidence of hemiatrophy. The patients may present with arthralgia, convulsions or cramps. We report a case of a woman with deformity of face, and left upper and lower limbs that had started as an indurated plaque on the left half of forehead at the age of 5 years and had gradually enlarged, followed by the development of atrophic changes in left eye. The case is being reported in view of its rare occurrence.

An in-transit metastasis is one that is located between the primary tumor and the closest lymph node region and results from tumor emboli getting trapped in the lymphatic channels. A 65-year-old male patient who had undergone partial amputation of the penis and bilateral inguinal lymph node resection for squamous cell carcinoma of the penis 4 months earlier developed multiple cutaneous metastatic lesions in the pubic region and scrotum. The case is reported for the uncommon presentation of in-transit metastases.

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Case 1 A 9‐year‐old girl born to second‐degree consanguineous parents was brought to the outpatient department with a history of pain in the feet and pigmentary changes on the skin of 4 years’ duration. Cutaneous examination revealed large symmetrical areas of mottled pigmentation (both hypo and hyper) with atrophy over the face, flexures, hands, and feet. There were multiple, small, keratotic papules (Fig. 1) over the back, joints, palms, and soles. Scalp examination revealed widened suture lines and multiple, soft, nodular swellings on the occipital region with sparse and short hair. There was also a small nodule on the scalp which discharged cheesy material and was suggestive of calcinosis cutis. The right index finger showed a broad terminal phalanx. Gynecologic examination revealed a small infantile uterus. The patient had normal dentition. 1 Keratotic papules on the buttocks Cases 2 and 3 Two brothers, aged 6 and 3 years, who were brought to the clinic for screening, also revealed similar skeletal and cutaneous changes, but with less intense pigmentation. Both had normal development of the genitalia. Case 4 After 4 years, another girl of 15 years of age was referred to us with complaints of inability to walk due to pain in the feet. The patient was born to second‐degree consanguineous parents and showed the same clinical features as those of Case 1, except for short stature (height, 138 cm) and a broad terminal phalanx on the left middle finger. This female patient also had an infantile uterus. All four patients were subjected to routine investigations, which were found to be within normal limits. Examination of the hair under potassium hydroxide mount did not reveal any abnormality. Skeletal surveys were performed for all patients. In Case 1, an X‐ray of the skull—anteroposterior (AP) and lateral view (Fig. 2) revealed frontal bossing of the cranial vault. Coronal, lambdoid, and sagittal sutures were widened, measuring 5, 5, and 7 mm, respectively. The cranial vault had a ground glass appearance and did not show outer and inner table differentiation. The metopic and mendosal sutures were seen. The sutures were seen as straight lines instead of serrated interdigitations. The occipital area showed only a sea of membranes with islands of ossified bones (Wormian bones). Platybasia was seen. The mandible was hypoplastic. A chest X‐ray revealed a narrow chest cavity with normal clavicles. An X‐ray of the spine was normal. An X‐ray of the pelvis showed increased acetabular angles, collapsed head of femur, and reduced shaft neck angle. An X‐ray of the hand showed popcorn calcification in the soft tissues. There was hypoplasia of the distal part of the terminal phalanx of the left index finger. An X‐ray of the foot also showed similar soft tissue calcification of the left big and little toes. 2 Lateral view of X‐ray of the skull showing multiple Wormian bones in the occipital region Skeletal surveys of the two other siblings revealed Wormian bones and widened suture lines, but were otherwise normal. A skel...

Lichen sclerosus (LS) is a chronic inflammatory disorder of an unknown aetiology most commonly affecting the anogenital area. However, extragenital involvement also occurs uncommonly. A case of extra-genital LS involving the areolae of both breasts, in a 15-year-old boy, is reported for its rarity.