Melanoacanthoma is a benign epithelial tumor composed of melanocytes and keratinocytes that can morphologically mimic malignant neoplasms. Two patients with melanoacanthoma that clinically masqueraded as melanoma are described: a 65-year-old African-American woman with a pigmented nodule on the right preauricular area and an 85-year-old Haitian-Creole man with a large exophytic nodule on his left lower abdomen. Melanoma was clinically suspected in both patients. Biopsies were performed, which established the diagnosis of melanoacanthoma. Complete removal of a melanoacanthoma should be considered since partial excision may result in recurrence.
Solitary cutaneous focal mucinosis is a unique condition defined by the presence of mucin, a hyaluronic acid complex, in the dermis. The lesion typically presents as an isolated, asymptomatic papule or nodule on the extremities or back and is not associated with any systemic condition. Conversely, multiple cutaneous focal mucinosis present with numerous skin lesions has been found to be associated with systemic diseases such as scleromyxedema, systemic lupus erythematous, and thyroid disease. Therefore, additional laboratory investigation should be considered when multiple cutaneous focal mucinosis is discovered. The case of a 37year-old man with solitary cutaneous focal mucinosis is discussed. The skin lesion presented as an asymptomatic nodule on his right upper shoulder; microscopic evaluation established the diagnosis, and laboratory investigation was negative for any associated conditions. Similar to previous reports of solitary cutaneous focal mucinosis, our patient provides additional supporting evidence that laboratory studies for mucin-associated systemic disease are not required for individuals who present with cutaneous focal mucinosis consisting of only a solitary skin lesion.
Vitiligo is a cutaneous condition that causes loss of pigmentation; it can be associated with other autoimmune conditions. Sjogren’s syndrome is a chronic inflammatory autoimmune condition that classically presents with xerophthalmia and xerostomia. Rarely, vitiligo has occurred in individuals with Sjogren’s syndrome. A 51-year-old Hispanic woman presented with vitiligo. Her laboratory investigation was consistent with Sjogren’s syndrome; she subsequentially developed xerophthalmia and arthritis. The association between vitiligo and other autoimmune conditions is reviewed and the association of vitiligo and Sjogren’s syndrome is discussed.
Hidradenitis suppurativa is a chronic, recurrent follicular-based inflammatory condition classically occurring in apocrine-rich areas; commonly affected areas include the anogenital, axillary, inframammary, and inguinal regions. Infrequently, hidradenitis suppurativa can occur in locations where apocrine glands are scant or absent; in this setting, it has been referred to as ectopic hidradenitis suppurativa. The case of a 59-year-old man with ectopic hidradenitis suppurativa on his right posterior thigh is described. The postulated pathogenesis, treatment modalities, and various reported locations of ectopic hidradenitis suppurativa are reviewed.
Dermatofibromas are benign skin tumors with several variants, including the rare, uncommonly described atrophic dermatofibroma. To the best of our knowledge, there are currently 105 reported cases of atrophic dermatofibromas in the literature. This variant typically presents as a flat or depressed macule whose color can range from brown to white to red; in contrast to classic dermatofibromas that typically occur on the legs, atrophic dermatofibromas have a tendency to occur on the upper back and arms. An atrophic dermatofibroma can be clinically diagnosed; however, given the broad spectrum of clinical features of this lesion, a biopsy may be required. Characteristic pathologic features include epidermal acanthosis, basilar hyperpigmentation, fibroblast hyperplasia, and decreased or absent elastic fibers within the lesion. The pathogenesis of this lesion is not yet fully understood; however, it has been postulated that the loss of elastic fibers plays a key role in its development and characteristic atrophic appearance. We present the cases of two men with biopsy-confirmed atrophic dermatofibromas: a 47-year-old man with a pigmented macule on the right upper back and a 68-year-old man with an erythematous patch on the left posterolateral shoulder. The clinical and pathologic features of atrophic dermatofibromas are also summarized.
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