Publications by authors named "Adnan Mir"

37 Publications

Bullous drug eruption after second dose of mRNA-1273 (Moderna) COVID-19 vaccine: Case report.

J Infect Public Health 2021 Jul 8. Epub 2021 Jul 8.

Icahn School of Medicine at Mount Sinai/NYC Health + Hospitals Queens, NY, USA. Electronic address:

Background: In December 2020, Moderna released the mRNA-1273 vaccine. The most common side effects are headache, muscle pain, redness, swelling, and tenderness at the injection site. In addition, there have been dermatological adverse events, such as hypersensitivity reactions. Although rare, various bullous eruptions have been described following vaccination. Bullous pemphigoid has been reported to occur most often after receipt of influenza and the diphtheria-tetanus-pertussis vaccine. To the best of our knowledge, there have been no reports of bullous drug eruptions resulting from mRNA vaccines.

Case Summary: A 66-years-old obese Guyanese male presented with a bullous rash following receipt of a commercial COVID-19 mRNA vaccine. He received the first dose uneventfully. However, within 24 h of receiving the second dose, he developed fever, myalgias, and malaise accompanied by a painful blistering rash of his torso, arms, and legs. His fever and myalgias improved after 24 h, but his painful rash did not, and five days after the initial symptoms, he presented to the hospital. There were many violaceous, poorly demarcated patches on his trunk, arms, and thighs on examination, many of which had large flaccid bullae within, and a few areas on his buttocks, posterior shoulder, and scrotum were eroded. The exam was also significant for lower extremity muscle tenderness, stiffness with preserved strength. A skin biopsy showed epidermal necrosis and sparse perivascular dermatitis concerning Stevens-Johnson syndrome or erythema multiforme. However, in the absence of mucous membrane involvement or targetoid lesions, the diagnosis of an extensive bullous fixed drug eruption was made.

Conclusion: This case illustrates that the bullae eruption occurred as a result of receiving the Moderna vaccination.
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http://dx.doi.org/10.1016/j.jiph.2021.06.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264280PMC
July 2021

Assessing comfort level with pediatric skin specimens among dermatopathologists and pediatric pathologists: A national cross-sectional survey.

J Cutan Pathol 2021 Sep 14;48(9):1109-1114. Epub 2021 Mar 14.

Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Background: Cutaneous histopathologic diagnoses in children often differ from those in adults. Depending on practice setting, these specimens may be evaluated by dermatopathologists or pediatric pathologists. We sought to determine whether comfort level with pediatric dermatopathology is associated with prior training, pediatric dermatopathology exposure during fellowship, career duration, or specimen subtype.

Methods: We surveyed dermatopathologists and pediatric pathologists practicing in the United States. Training and practice variables were evaluated by multivariable regression for association with comfort level.

Results: Of the 156 respondents, 72% were dermatopathologists (response rate 11.6%) and 28% were pediatric pathologists (response rate 9.3%). Dermatopathologists reported higher comfort overall (P < .001); this was also true for inflammatory dermatoses and melanocytic neoplasms (P < .001). Thirty-four percent and 75% of dermatopathologists and pediatric pathologists, respectively, reported lower comfort with pediatric skin specimens than their usual cases. Pediatric pathologists were 28% more likely to refer these cases to colleagues. Among dermatopathologists, dermatology-trained were more comfortable than pathology-trained colleagues interpreting inflammatory dermatoses (P < .001).

Conclusions: Pathologists' comfort with pediatric dermatopathology varied significantly based upon prior training, career duration, and specimen subtype. These results suggest opportunities for improving education in this domain.
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http://dx.doi.org/10.1111/cup.13997DOI Listing
September 2021

New Onset Granulomatosis with Polyangiitis Associated with COVID-19.

Case Rep Dermatol Med 2021 13;2021:8877292. Epub 2021 Jan 13.

Jamaica Hospital, Department of Internal Medicine, Dermatology, New York, NY, USA.

The coronavirus disease 2019 (COVID-19) has recently been found to cause cutaneous vasculitis in patients. Granulomatosis with polyangiitis (GPA) is a type of small and medium vessel vasculitis that is often associated with pulmonary issues and has been shown to raise diagnostic complications in COVID-19 infection. In this report, we discuss the first case of new-onset GPA in the setting of active COVID-19 infection. Symptoms often overlap between the two diseases, and while there is no current cure for COVID-19, rapid immunosuppressive initiation can be lifesaving for patients with GPA. Thus, this case is essential in expanding our current knowledge of COVID-19 and its many skin manifestations.
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http://dx.doi.org/10.1155/2021/8877292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7811565PMC
January 2021

Rapid screening of invasive fungal infections in the hospital setting using the (1,3)-β-D-glucan assay.

Cutis 2020 Jul;106(1):33-34;36

Departments of Dermatology and Medicine, University of Texas Southwestern, Dallas, USA.

Disseminated candidiasis and other invasive fungal infections are a substantial cause of morbidity and mortality in immunocompromised and critically ill patients. Diagnosis of disseminated candidiasis via blood culture and skin biopsy can be unreliable and may delay treatment. (1,3)-β-D-glucan (BDG) assay is a rapid, cost-effective, noninvasive diagnostic screening tool for the dermatology hospitalist to consider.
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http://dx.doi.org/10.12788/cutis.0051DOI Listing
July 2020

Verrucous pilar cysts infected with beta human papillomavirus.

J Cutan Pathol 2020 Apr 6;47(4):381-386. Epub 2019 Nov 6.

Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas.

Epidermoid cysts with histopathologic features of human papillomavirus (HPV) infection have been previously reported and are commonly termed verrucous cysts. We report a series of eight histopathologically distinct verrucous pilar cysts, distinguished from traditional verrucous epidermoid cysts by trichilemmal keratinization, as well as two verrucous hybrid pilar-epidermoid cysts. These lesions contain characteristic stratified epithelial linings with abrupt transitions to compact eosinophilic keratin, as well as areas of papillomatosis, coarse intracytoplasmic keratohyalin granules, and vacuolar structures suggestive of HPV-induced cytopathic change. HPV-24, a β genus HPV species, was identified by degenerate polymerase chain reaction in DNA extracted from two of the lesions, and the presence of β-HPV E4 protein was confirmed by immunohistochemistry. HPV-60, the HPV species most commonly reported in verrucous epidermoid cysts, was not detected. Verrucous pilar cysts represent histopathologically and potentially etiologically distinct lesions which may be underrecognized.
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http://dx.doi.org/10.1111/cup.13599DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386817PMC
April 2020

Therapy for anogenital verrucae in preadolescent children with topical and systemic treatment.

Pediatr Dermatol 2019 Sep 13;36(5):623-627. Epub 2019 Jun 13.

Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.

Background/objectives: Anogenital verrucae (AV) are benign, human papillomavirus (HPV)-induced tumors of the anogenital skin and mucosa. Medical therapy for AV in preadolescents has not been well studied. We explore the efficacy and safety profile of sinecatechins 15% ointment and imiquimod 5% cream in the treatment of AV, alone and in combination therapy with other commonly used medications.

Methods: A single-institution, retrospective review of children under 12 years of age with AV treated with imiquimod 5% cream and sinecatechins 15% ointment was performed. Demographic data, side effects, and outcomes of therapy were recorded for each patient, and overall efficacy was determined.

Results: A total of 37 patients met inclusion criteria. Responses were seen in 8 out of 9 patients treated with sinecatechins 15% ointment (5 full, 3 partial, and 1 no response) and 9 out of 17 patients treated with imiquimod 5% cream (4 full, 5 partial, and 8 no response). Combination therapy with one or more of the following treatments (podophyllin, cimetidine, candida antigen injection, and HPV vaccine) were evaluated, but no combination was objectively superior to the others. No significant difference was found in overall efficacy between sinecatechins and imiquimod. Side effects were mild and limited to irritation and erythema.

Conclusions: Both imiquimod 5% cream and sinecatechins 15% ointment are moderately effective in the treatment of AV in preadolescent children, with a trend toward greater effectiveness of sinecatechins. Combination therapy with other treatments did not significantly increase the effectiveness of topical therapies. Each modality has a tolerable side effect profile with a low risk of serious complications.
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http://dx.doi.org/10.1111/pde.13881DOI Listing
September 2019

Giant Congenital Melanocytic Nevus Treated With Trametinib.

Pediatrics 2019 03;143(3)

Division of Pediatric Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, Texas

Giant congenital nevi are melanocytic proliferations of the skin that may be complicated by melanoma, neurocutaneous melanocytosis, pain, pruritus, and disfigurement. Current treatment options include surgical resection and medical management of associated symptoms. There is limited efficacy in these modalities. No effective pharmacologic treatments are available for the treatment of these lesions. We present the case of a 7-year-old girl with a giant congenital melanocytic nevus that had an fusion and was treated with trametinib, which resulted in rapid resolution of the patient's lifelong, intractable pain and pruritus as well as dramatic improvement in the extent of her nevus.
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http://dx.doi.org/10.1542/peds.2018-2469DOI Listing
March 2019

High-risk human papillomavirus in a child with digital pigmented Bowen's disease: Case report and dermoscopic findings.

Pediatr Dermatol 2018 Sep 22;35(5):e265-e267. Epub 2018 Jun 22.

Department of Dermatology, Texas Tech Health Science Center (HSC), Lubbock, TX, USA.

Squamous cell carcinoma in situ, also known as Bowen's disease (BD), is a skin malignancy most commonly seen in middle-aged and elderly adults. Pediatric BD is rare and can be a diagnostic challenge for physicians. Digital BD has largely been associated with human papilloma virus. We report an immunocompetent 11-year-old girl with periungual pigmented BD induced by high-risk human papilloma virus.
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http://dx.doi.org/10.1111/pde.13552DOI Listing
September 2018

Spiradenocarcinoma Treated With Mohs Micrographic Surgery.

Dermatol Surg 2019 01;45(1):152-154

Tufts University School of Medicine, Boston, Massachusetts Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.

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http://dx.doi.org/10.1097/DSS.0000000000001534DOI Listing
January 2019

Pernio as the presenting sign of blast crisis in acute lymphoblastic leukemia.

Pediatr Dermatol 2018 Jan 12;35(1):e74-e75. Epub 2017 Dec 12.

Division of Dermatology, Loyola University Medical Center, Maywood, IL, USA.

A previously healthy 5-year-old girl presented with acute onset of blue toes and red spots on the nose and fingers. The striking nature of these lesions, along with the finding of submandibular lymphadenopathy, prompted further evaluation. Laboratory findings were remarkable for anemia, high transaminase levels, and high blast count. Histopathologic findings were consistent with early pernio. Further examination revealed acute B-cell lymphoblastic leukemia. Treatment of the leukemia led to resolution of the pernio.
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http://dx.doi.org/10.1111/pde.13366DOI Listing
January 2018

Vulvar Nodules: A Rare Presentation of Mastocytosis.

J Pediatr Adolesc Gynecol 2018 Apr 21;31(2):156-157. Epub 2017 Nov 21.

Department of Obstetrics and Gynecology, Division of Pediatric and Adolescent Gynecology, UT Southwestern Medical Center, Children's Health, Dallas, Texas.

Background: Mastocytosis is a rare benign disorder characterized by the finding of mast cells in the skin and other organs, occurring in adult as well as pediatric age groups. The cutaneous form is the most common presentation in childhood and is rarely located on the vulva.

Case: A 9-year-old prepubertal girl presented with bilateral vulvar nodules found incidentally by her pediatrician. Biopsy and histopathologic review confirmed mastocytosis. Her lesions significantly diminished over the following year.

Summary And Conclusion: Mastocytosis should be on the differential for lesions on the vulva in children, in addition to the more common disorders such as condyloma acuminata and molluscum contagiosum. It is a benign condition in children, and conservative, symptomatic management is recommended.
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http://dx.doi.org/10.1016/j.jpag.2017.11.006DOI Listing
April 2018

Acral Plexiform Palisaded Encapsulated Neuromas as the Initial Cutaneous Manifestation of Cowden Syndrome.

Pediatr Dermatol 2017 Jul 23;34(4):e219-e220. Epub 2017 May 23.

Department of Dermatology, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas.

Cowden syndrome (CS) is an autosomal dominant genodermatosis associated with characteristic mucocutaneous findings of facial trichilemmomas, palmoplantar keratoses, sclerotic fibromas, and oral papillomas. Mucocutaneous neuromas have also been reported in association with CS. We describe a patient with CS whose sole cutaneous finding was palisaded encapsulated neuromas (PENs) with a plexiform growth pattern in an acral location. Along with previous reports, this case suggests that acral plexiform PENs may be an early, highly specific finding in CS and highlights the importance of screening these patients for PTEN mutation.
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http://dx.doi.org/10.1111/pde.13161DOI Listing
July 2017

Abrupt Onset of Pustules in a Child.

JAMA Pediatr 2017 07;171(7):703-704

Department of Dermatology, University of Texas Southwestern Medical Center, Dallas.

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http://dx.doi.org/10.1001/jamapediatrics.2017.0357DOI Listing
July 2017

Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands.

Lupus Sci Med 2017 13;4(1):e000207. Epub 2017 Mar 13.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA; Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, New York, USA.

Subacute cutaneous lupus erythematosus (SCLE) is a well-defined subtype of lupus erythematosus, characterised by photosensitivity, annular and/or psoriasiform lesions, variable systemic involvement and presence of circulating SSA/anti-Ro antibodies. SCLE may be idiopathic or drug-induced. Both the idiopathic and drug-induced forms of SCLE are analogous in their clinical, serological and histological features. Drug-induced SCLE has been reported with various oral agents, but to our knowledge this is the first reported case due to a topical medication. A 34-year-old female foot masseuse presented with a 2-month history of scaly, erythematous lesions isolated to the dorsal hands and interdigital spaces. She had used topical terbinafine, a topical antifungal cream, to her clients' feet for a number of years. ANA and anti-SSA/Ro antibodies were positive. Physical examination, serology and histopathology were consistent with SCLE. We propose that our patient's unique presentation of SCLE may be explained by a prolonged occupational exposure to topical terbinafine as a foot masseuse. While oral terbinafine is a drug known to cause drug-induced SCLE, to our knowledge, this is the first topically induced form of the disease.
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http://dx.doi.org/10.1136/lupus-2017-000207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353283PMC
March 2017

Congenital infantile fibrosarcoma mimicking a cutaneous vascular lesion: a case report and review of the literature.

J Cutan Pathol 2017 Feb 2;44(2):193-200. Epub 2016 Dec 2.

Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, USA.

Congenital infantile fibrosarcoma (CIFS) is a rare neoplasm of infancy that occurs most frequently in the extremities, and when presenting in the skin, may sometimes resemble infantile hemangiomas or other vascular lesions. Clinically, these tumors differ from hemangiomas in the time of onset, morphology, and growth pattern and must be evaluated histologically for definitive diagnosis. We describe an infant with a neoplasm involving the distal left forearm initially presumed to be a vascular lesion after evaluation by two separate ultrasound studies. He presented at seven weeks of life with a multinodular lesion that had enlarged significantly since birth, and the skin biopsy revealed a fibrosarcoma. This case highlights an unusual cutaneous presentation of CIFS, which varies in appearance from the previous 12 cases reported in the literature. We review the clinical manifestations of these congenital masses and emphasize early diagnosis for conservative therapy and improved prognosis.
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http://dx.doi.org/10.1111/cup.12854DOI Listing
February 2017

Nodal signalling in Xenopus: the role of Xnr5 in left/right asymmetry and heart development.

Open Biol 2016 08;6(8)

Cincinnati Children's Research Foundation, 3333 Burnet Avenue, Cincinnati, OH 45229, USA

Nodal class TGF-β signalling molecules play essential roles in establishing the vertebrate body plan. In all vertebrates, nodal family members have specific waves of expression required for tissue specification and axis formation. In Xenopus laevis, six nodal genes are expressed before gastrulation, raising the question of whether they have specific roles or act redundantly with each other. Here, we examine the role of Xnr5. We find it acts at the late blastula stage as a mesoderm inducer and repressor of ectodermal gene expression, a role it shares with Vg1. However, unlike Vg1, Xnr5 depletion reduces the expression of the nodal family member xnr1 at the gastrula stage. It is also required for left/right laterality by controlling the expression of the laterality genes xnr1, antivin (lefty) and pitx2 at the tailbud stage. In Xnr5-depleted embryos, the heart field is established normally, but symmetrical reduction in Xnr5 levels causes a severely stunted midline heart, first evidenced by a reduction in cardiac troponin mRNA levels, while left-sided reduction leads to randomization of the left/right axis. This work identifies Xnr5 as the earliest step in the signalling pathway establishing normal heart laterality in Xenopus.
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http://dx.doi.org/10.1098/rsob.150187DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008007PMC
August 2016

Segmental stiff skin syndrome (SSS): A distinct clinical entity.

J Am Acad Dermatol 2016 Jul 2;75(1):163-8. Epub 2016 Mar 2.

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. Electronic address:

Background: Stiff skin syndrome (SSS) is a noninflammatory, fibrosing condition of the skin, often affecting the limb girdles.

Objective: We present 4 new patients with SSS with largely unilateral, segmental distribution. To date, reported cases of SSS have been grouped based on generally accepted clinical and histopathologic findings. The purpose of this study was to analyze differences in clinical and histopathologic findings between previously reported SSS cases.

Methods: This is a retrospective review of 4 new cases and 48 previously published cases of SSS obtained from PubMed search.

Results: Of 52 total cases, 18 (35%) were segmentally distributed and 34 (65%) were widespread. The average age of onset was 4.1 years versus 1.6 years for segmental versus widespread SSS, respectively. Limitation in joint mobility affected 44% of patients with segmental SSS and 97% of patients with widespread SSS. Histopathologic findings were common between the 2 groups.

Limitations: This was a retrospective study of previously published cases limited by the completeness and accuracy of the reviewed cases.

Conclusions: We propose a distinct clinical entity, segmental SSS, characterized by a segmental distribution, later age of onset, and less severe functional limitation. Both segmental SSS and widespread SSS share common diagnostic histopathologic features.
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http://dx.doi.org/10.1016/j.jaad.2016.01.038DOI Listing
July 2016

Vesicular erythema migrans: an atypical and easily misdiagnosed form of Lyme disease.

Dermatol Online J 2015 Aug 15;21(8). Epub 2015 Aug 15.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine.

Erythema migrans is the initial sign in the majority of patients infected with Borrelia, the genus of spirochetes that causes Lyme disease. Early identification and treatment decrease the risk of progression to later stages of disease. Although a "bull's eye" appearance owing to lesional clearing is considered classic for erythema migrans, this feature is surprisingly often lacking among patients in the United States. Furthermore, cutaneous Lyme disease can exhibit a wide range of morphologic variability in a minority of patients. Herein, we describe the case of a patient with Lyme disease in which the presence of atypical vesicular features, in conjunction with the initial absence of clearing, resulted in multiple misdiagnoses and delayed treatment. We also review the literature on the epidemiology and management of erythema migrans for cases in which the diagnosis may pose a challenge.
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August 2015

Photodistributed granuloma annulare.

Dermatol Online J 2015 Dec 16;21(12). Epub 2015 Dec 16.

New York University School of Medicine.

Annular elastolytic giant cell granuloma (AEGCG) is a controversial entity that is considered by many to be a variant of granuloma annulare (GA). The majority of cases of AEGCG occur in Caucasian women (3:2) between the ages of 40 and 70, with the distribution of the mostly annular lesions favoring exposed areas of skin and rarely involving covered skin. The most common systemic association has been with diabetes mellitus. We present a 52-year-old woman with an asymptomatic, annular, erythematous, photodistributed eruption of two-years duration. As part of her evaluation, it was detected that she had a hemoglobin A1C of 10.3% and a diagnosis of diabetes mellitus was made. We review the literature on the clinical and histopathologic features of GA and AEGCG and the overlap between these entities.
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December 2015

Paraneoplastic erythema annulare centrifugum eruption (PEACE).

Dermatol Online J 2015 Dec 16;21(12). Epub 2015 Dec 16.

New York University School of Medicine.

Erythema annulare centrifugum (EAC) is a reactive erythema with distinct, annular, erythematous plaques with trailing scale. This condition has been associated with various etiologies, which include an associated malignant condition. EAC with cancers or paraneoplastic erythema annulare centrifugum eruptions (PEACE), is more likely to be associated with lymphoproliferative malignancies such as lymphomas and leukemias. Histopathologic features include a superficial and deep, lymphohistiocytic perivascular infiltrate. We present a patient with a history of diffuse large B cell lymphoma in remission for two years, who presented with a one-year history of EAC.
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December 2015

Eosinophilic dermatitis of hematologic malignancy.

Dermatol Online J 2015 Dec 16;21(12). Epub 2015 Dec 16.

New York University School of Medicine.

Eosinophilic dermatosis of hematologic malignancy is a rare, paraneoplastic phenomenon that presents as a pruritic papular or vesicular eruption that is clinically and histopathologically similar to insect bites. We present a 56-year-old man with multiple relapses of diffuse large B cell lymphoma with a typical presentation of pruritic papules and vesicles on the extremities that correlate with a recent relapse of his lymphoma.
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December 2015

Generalized granuloma annulare in a folliculocentric distribution.

Dermatol Online J 2015 Dec 16;21(12). Epub 2015 Dec 16.

New York University School of Medicine.

We present a 69-year-old man with type 2 diabetes mellitus and a five-year history of an eruption of follicular pustules, papules, and nodules, which was identified histopathologically as folliculocentric granuloma annulare (GA). Folliculocentric generalized GA is a rarely reported variant of GA, in which the the palisading histiocytes form focal granulomas in a follicular pattern. In this case, the GA may represent an isotopic phenomenon, with lesions developing in hair follicles that were previously affected by a suppurative folliculitis.
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December 2015

Squamous-cell carcinoma in situ.

Dermatol Online J 2015 Dec 16;21(12). Epub 2015 Dec 16.

New York University School of Medicine.

We present a 30-year-old woman with atopic dermatitis and ichthyosis vulgaris and a one-year history of an erythematous, scaly plaque on the dorsal surface of her right hand, which developed three years after an accidental exposure to prolonged ultraviolet C (UVC) radiation in a laboratory accident. The plaque, which was initially treated as eczematous dermatitis, was eventually identified histopathologically as squamous-cell carcinoma in situ. Although causation is not definitive, this case is the first to describe development of non-melanoma skin cancer (NMSC) in an area of skin known to be acutely exposed to UVC radiation. As UVC radiation becomes a more frequently used anti-microbial technology, UVC radiation may become a more commonly identified risk factor in the development of NMSC.
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December 2015

Acrokeratoelastoidosis.

Dermatol Online J 2015 Dec 16;21(12). Epub 2015 Dec 16.

New York University School of Medicine.

Acrokeratoelastoidosis is a rare palmoplantar keratoderma. We report the case of a 32-year old man with multiple keratotic papules and plaques on the peripheral margins of his hands and feet. Histopathologic evaluation showed compact orthokeratosis; Verhoeff van Gieson stain showed thin and fragmented elastic fibers. The differential diagnosis includes focal acral hyperkeratosis, which has a similar presentation but with normal elastic fibers. Treatment of acrokeratoelastoidosis is often disappointing, with minimal response to topical glucocorticoids, keratolytics, retinoids, cryotherapy, and lasers.
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December 2015

A 1-year-old boy with persistent, generalized eruption. Urticaria pigmentosa.

Pediatr Ann 2014 Jan;43(1):e13-5

A healthy 1-year-old boy born at full term after an uncomplicated pregnancy presented to the dermatology clinic for a widespread eruption with gradual onset since 3 months of age. He was otherwise well, afebrile, feeding well, and gaining weight appropriately. The child was overall asymptomatic, though some of his lesions occasionally became red and pruritic. His mother noticed that after mild illnesses, he was more prone to these flares. She denied flushing, vomiting, diarrhea, respiratory distress, and irritability. He was meeting all developmental milestones and started walking at 11 months of age. The remainder of his review of systems was unremarkable, and family history was noncontributory. Physical exam revealed a well-appearing, well-nourished, playful, and interactive toddler. There were innumerable discrete and coalescing pink-brown macules and papules concentrated on the trunk and extending onto the proximal upper and lower extremities bilaterally, as well as the neck and lower face. Stroking the lesions quickly led to development of erythematous edematous wheals. There was no hepatosplenomegaly, and the lymph node exam was unremarkable.
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http://dx.doi.org/10.3928/00904481-20131223-11DOI Listing
January 2014

Hydroxycholoroquine-induced hyperpigmentation.

Dermatol Online J 2013 Dec 16;19(12):20723. Epub 2013 Dec 16.

New York University School of Medicine.

A 57-year-old woman with systemic lupus erythematosus and Sjögren syndrome presented with blue-grey hyperpigmentation of the face, upper back, and dorsal aspects of the feet after seven years of therapy with hydroxychloroquine. We present an unusual case of drug-induced hyperpigmentation.
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December 2013

Cutaneous features of Crouzon syndrome with acanthosis nigricans.

JAMA Dermatol 2013 Jun;149(6):737-41

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 E 38th St, 11th Floor, New York, NY 10016, USA.

Importance: Crouzon syndrome with acanthosis nigricans is a distinct disorder caused by a mutation in the FGFR3 gene, featuring craniosynostosis, characteristic facial features, and atypical and extensive acanthosis nigricans. Other cutaneous findings have not been thoroughly described.

Observations: We report 6 cases and summarize the existing literature with regard to the cutaneous manifestations of this disorder. All patients have widespread, early-onset acanthosis nigricans. Patients often have prominent hypopigmented scars at surgical sites and nevi arising early in childhood.

Conclusions And Relevance: In addition to craniofacial malformations, Crouzon syndrome with acanthosis nigricans results in characteristic cutaneous findings.
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http://dx.doi.org/10.1001/jamadermatol.2013.3019DOI Listing
June 2013

Erythema annulare centrifugum.

Dermatol Online J 2012 Dec 15;18(12):21. Epub 2012 Dec 15.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, USA.

Erythema annulare centrifugum (EAC) is a gyrate erythema, which is typically characterized by annular, erythematous plaques with trailing scale. It is considered to be a reactive condition with a wide variety of inciting causes but unclear pathophysiology. The mean duration of the eruption is 11 months. We present a patient with a 50-year history of recurrent EAC with no known cause. Although it does follow a previously reported pattern of seasonal recurrence, this case represents the longest reported duration of EAC.
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December 2012
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