Blog

Aquagenic Wrinkling: It burns…

A 16 year-old female presented with a two month history of painful, burning wrinkling of her palms after taking a pottery class.  Within 5 minutes of water exposure she noted the onset of wrinkling with sharp pains like paper cuts.  The pain would resolve within 5-10 minutes after drying her hands.  She denied taking any… Read more »

Merkel Cell Carcinoma: Murky Cell Carcinoma…

An ode to Jimmy Buffett…I have been getting a lot of questions from patients about this extremely rare malignancy.  In my entire career I have only had 3 to 4 cases.  Merkel Cell Carcinoma (MCC) was originally described by Toker in 1972.  The cell of origin is the Merkel cell, which is a slow-acting mechanoreceptor… Read more »

Mycosis Fungoides: Cutaneous T-cell Lymphoma…

Mycosis Fungoides (MF) is a malignant neoplasm of T-lymphoytes, particularly of T-helper (Th) cells.  The incidence is around 1 in 300,000 each year, but this number is rising.  MF affects all races, however, in the United States black persons are more often affected than Caucasians. The clinical features are variable depending on the various stages… Read more »

Bot Fly Myiasis: What’s eating me…

Case of the Month:  A 70 year gentleman spends his time between Las Vegas and Costa Rica, where he has a home.  He was at his house in Costa Rica one day when he decided to walk into the surrounding wooded area near his home.  He notes that he experienced a number of insect bites… Read more »

Pyoderma Gangrenosum: It’s not an infection…

Pyoderma Gangrenosum (PG) was initially described by Brunsting in 1930.  Classic PG begins as an inflammatory pustule with a surrounding halo that enlarges and subsequently ulcerates.  A primary lesion may not be seen and most of these patients present with frank ulcerations.  Satellite violaceous papules may be found peripheral to the border of the ulceration. … Read more »

Leukocytoclastic Vasculitis: Small-Vessel Vasculitis…

Vasculitis is a direct result of inflamed blood vessels.  The vast majority of cases of cutaneous Leukocytoclastic Vasculitis, also referred to as Small-Vessel Vasculitis (LCV) follow an acute infection or exposure to a new medication.  Palpable Purpura is the hallmark of LCV, the lesions ranging from pinpoint to several centimeters in diameter. Annular, vesicular, bullous… Read more »

Silicone Granulomas: Body Contouring Disasters…

Liquid injectable Silicone (LIS) has been used for decades as a permanent filler for soft tissue augmentation in many locations to include the face, lips, eyelids, buttocks, hips and penis.  LIS has a chemical composition of dimethyl polysiloxane.  Pure LIS is nontoxic, noncarcinogenic, chemically inert and does not support the growth of microorganisms.  It has… Read more »

Keloids: Beyond the Margins…

Keloids are benign dermal fibroproliferative tumors with no malignant potential.  The first description of abnormal scar formation in the form of Keloids was recorded in the Smith Papyrus regarding surgical techniques in Egypt around 1700 B.C.  The actual term Keloid, means “crab claw” and was first coined by Alibert in 1806 in an attempt to… Read more »

Kaposi Sarcoma: The Old & The New…

Kaposi Sarcoma (KS) was originally described by Moritz Kaposi in 1872 when he called it “multiple benign pigmented idiopathic hemorrhagic sarcoma.”  Since those initial descriptions there have been three clinical presentations that have been referred to as “Classic form” or Old World KS:  Initially KS was an indolent disease seen chiefly in middle-age men of… Read more »