We report the case of a 40-year-old African-American female with biopsy-proven pulmonary sarcoidosis who developed atrophic plaques on her shins, trunk, and scalp that were clinically and histologically consistent with necrobiosis lipoidica (NL). The lesions appeared 3 years after her diagnosis of sarcoidosis, and progressed despite chronic prednisone. Sarcoidosis and NL are granulomatous skin disorders reported to coexist in the same patient only 10 times in the literature. Including the current case, patients have been exclusively females around middle age, and have greater tendencies to develop typical cutaneous sarcoidosis. The incidence of diabetes is rare in this group. Like typical NL, NL associated with sarcoidosis tends to ulcerate, and is difficult to treat. Interestingly, there are six similar cases reported in the literature of patients with sarcoidosis who developed lesions clinically and behaviorally consistent with NL, but received a final histological diagnosis of sarcoidosis. These cases share very similar demographics and clinical features with cases of true NL associated with sarcoidosis, and often have more ambiguous histology containing features of both cutaneous sarcoidosis and NL. Comparing the two sets of cases raises the possibility of a final common disease pathway shared by these two granulomatous skin disorders.

No abstract

Background-Wide local excision of primary cutaneous melanoma usually provides clear margins and excellent local control. Nonclassical presentations of cutaneous melanoma, however, can challenge this treatment algorithm. Specifically, persistent melanoma-in-situ (MIS) at the margin not suspected clinically makes planning definitive wide local excision more difficult. We hypothesized that the use of punch biopsies as a mapping tool would allow us to obtain clear margins in these challenging cases.

Background Crowdfunding for medical costs is becoming increasingly popular. Few previous studies have described the fundraising characteristics and qualities associated with success. Objective This study aimed to characterize and investigate the qualities associated with successful dermatological fundraisers. Methods This cross-sectional study of dermatological GoFundMe campaigns collected data, including demographic variables, thematic variables using an inductive qualitative method, and quantitative information. Linear regression examined the qualities associated with success, which are defined based on funds raised when controlling for campaign goals. Logistic regression was used to examine qualities associated with extremely successful campaigns, defined as those raising >1.5 times the IQR. Statistical significance was set at P<.05. Results A total of 2008 publicly available campaigns at the time of data collection were evaluated. Nonmodifiable factors associated with greater success included male gender, age 20-40 years, and White race. Modifiable factors associated with success included more updates posted to the campaign page, non–self-identity of the campaign creator, mention of a chronic condition, and smiling in campaign profile photographs. Conclusions Understanding the modifiable factors of medical crowdfunding may inform future campaigns, and nonmodifiable factors may have policy implications for improving health care equity and financing. Crowdfunding for medical disease treatment may have potential implications for medical privacy and exacerbation of existing health care disparities. This study was limited to publicly available GoFundMe campaigns. Potential limitations for this study include intercoder variability, misclassification bias because of the data abstraction process, and prioritization of campaigns based on the proprietary GoFundMe algorithm.

Background Pemphigus erythematosus (PE) is a rare autoimmune skin condition with clinical, histopathological, and serological features that show overlap between lupus erythematosus and pemphigus foliaceus. It typically presents with erythematous, scaly plaques and has a female predominance. Methods After Institutional Review Board (IRB) approval, we searched the internal pathology database for “pemphigus erythematosus” in the diagnostic line between 1 January 2000 and 30 July 2020. A comprehensive chart review was performed to collect patient demographics, clinical presentation, and treatment course. We performed a review of the literature and clinical, histopathological, and serological features were collected for comparison to our case series. Results Five patients in the case series and 87 patients in the literature were diagnosed with PE. Clinical, histopathological, and serological features were consistent with what has been reported in the literature, although our cohort demonstrated a younger age at presentation, along with a higher proportion (80%) of Black patients. Of the 25 patients in the literature whose race was reported, only five patients (20%) were reported to be Black. Conclusion This is the first case series of PE that has shown an increased prevalence among middle‐aged Black patients. No specific trend in regards to race was seen in the review of the literature.