A 33-year-old man with recessive dystrophic epidermolysis bullosa presented with a 3-month history of an enlarging mass within scarring on the posterior aspect of the right shoulder. The clinical appearance of the mass with an almost cobbled, verrucous surface, and its rapid evolution suggested the development of a squamous cell carcinoma (SCC) in a chronically scarred site. Histopathological examination of a biopsy taken from the lesion subsequently revealed it to be a verruciform xanthoma. This case shows that benign phenomena can mimic SCC and underlines the need for a biopsy to be taken promptly.
An 80-year-old woman presented with a slowly enlarging, intermittently painful lesion on the upper part of her right ear. It had been present for 2 years. On examination, there was a discrete, firm, translucent papule, 7 · 4 mm in size, on the posterior aspect of the upper crus of the antihelix of the right ear. A single prominent blood vessel was visible on the surface of the lesion and it was tender to palpation ( Fig. 1).
Treatment of trigeminal trophic syndrome is challenging and often unsatisfactory, particularly in patients with cognitive impairment. We report the novel use of a thermoplastic dressing in two patients with trigeminal trophic syndrome. Use of the dressing resulted in successful healing of ulceration in both patients, which has been maintained in the short term, representing a simple and economical therapeutic option in the management of this difficult condition.
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