Hydroavacciniforme on a dark skin with mucosal involvement

Hydroa vacciniforme is a rare idiopathic photodermatosis uncommon in dark skinned patients, which usually begins in childhood before the age of 10 years old and disappear in adolescence , it begins symmetrically in photo exposed areas as a sensation of skin burning in less than 24 hours of sun exposition , and then a vesicular rash develops , become umbilicated and secondarily crusted. Within weeks, the scars heal and leave a residual varioliform scar appearance, the condition generally improves with regular use of high protection sunscreens and resolves during adolescence. In patients who do not respond to conservative treatment, use of systemic agents has been reported like psoralen with exposure to ultraviolet A [PUVA], ultraviolet B TL-01phototherapy, antimalarial agents and ismmunosuppressive medication. Our patient is a 10-year-old child -without pathological antecedents- who consulted for atrophic depressed scars after a vesicular rash, which begin with a sensation of skin burning a day after intense sun exposure. These scars are covered by hemorrhagic crusts in some areas and appear on exposed areas: face, ear, hands and forearms with erosive lesions of the lower lip. The Child reports that this is the second episode with an interval of 6 months between the 2 episodes.Pan African Medical Journal 2016; 2

A rare case of dermatomyositis revealed during pregnancy with good outcome

There are only few case reports in the literature documenting outcome of pregnancy in patients with DM in contrast with those of other connective tissue diseases especially when dermatomyositis is revealed during pregnancy , most of the publications reported a poor prognosis for both the mother and the fetus , yet, in our case we confirmed the results of the rare recent cases that have tended to show a good outcome, after the treatment with glucocorticoid and immunosuppressant therapy.Pan African Medical Journal 2016; 2

Dermoscopy of Infectious Dermatoses (Infectiouscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Dermoscopy has been showed to facilitate the non-invasive recognition of several infectious disorders (infectiouscopy) thanks to the detection of peculiar clues. Although most of the knowledge on this topic comes from studies involving light-skinned patients, there is growing evidence about its use also in dark phototypes. This systematic literature review summarizes published data on dermoscopy of parasitic, bacterial, viral and fungal dermatoses (dermoscopic findings, used setting, pathological correlation, and level of evidence of studies) and provides a homogeneous terminology of reported dermoscopic features according to a standardized methodology. A total of 66 papers addressing 41 different dermatoses (14 bacterial, 5 viral, 11 fungal infections, and 11 parasitoses/bites and stings) and involving a total of 1096 instances were included in the analysis. The majority of them displayed a level of evidence of V (44 single case reports and 21 case series), with only 1 study showing a level of evidence of IV (case-control analysis). Moreover, our analysis also highlighted a high variability in the terminology used in the retrieved studies. Thus, although promising, further studies designed according to a systematic and standardized approach are needed for better characterization of dermoscopy of infectious skin infections

Dermoscopy of Hair and Scalp Disorders (Trichoscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Hair and scalp disorders are of significant interest for physicians dealing with dark phototypes due to their prevalence and potential aesthetic impact resulting from a higher tendency for scarring. In order to facilitate their non-invasive diagnosis, several dermoscopic studies have been published, yet data are sparse and no systematic analysis of the literature has been performed so far. This systematic literature review summarizes published data on trichoscopy of hair and scalp diseases (trichoscopic findings, used setting, pathological correlation, and level of evidence of studies). A total of 60 papers addressing 19 different disorders (eight non-cicatricial alopecias, nine cicatricial alopecias, and two hair shaft disorders) were assessed, for a total of 2636 instances. They included one cross-sectional analysis, 20 case-control studies, 25 case-series, and 14 single case-reports, so the level of evidence was V and IV in 65% and 33% of cases, respectively, with only one study showing a level of evidence of III. Notably, although there is a considerable body of literature on trichoscopy of hair/scalp diseases, our review underlined that potentially significant variables (e.g., disease stage or hair texture) are often not taken into account in published analyses, with possible biases on trichoscopic patterns, especially when it comes to hair shaft changes. Further analyses considering all such issues are therefore needed

Dermoscopy of Cutaneous Neoplasms in Skin of Color – A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Over the last few decades, dermoscopy has been showed to facilitate the non-invasive diagnosis of both benign and malignant skin tumors, yet literature data mainly comes from studies on light phototypes. However, there is growing evidence that skin neoplasms may benefit from dermoscopic assessment even for skin of color. This systematic literature review evaluated published data in dark-skinned patients (dermoscopic features, used setting, pathological correlation, and level of evidence of studies), also providing a standardized and homogeneous terminology for reported dermoscopic findings. A total of 20 articles describing 46 different tumors (four melanocytic neoplasms, eight keratinocytic tumors, 15 adnexal cutaneous neoplasms, seven vascular tumors, four connective tissue tumors, and eight cystic neoplasms/others) for a total of 1724 instances were included in the analysis. Most of them showed a level of evidence of V (12 single case reports and six case series), with only two studies featuring a level of evidence of IV (case-control analysis). Additionally, this review also underlined that some neoplasms and phototypes are underrepresented in published analyses as they included only small samples and mainly certain tones of “dark skin” spectrum (especially phototype IV). Therefore, further studies considering such limitations are required for a better characterization

Dermoscopy of Inflammatory Dermatoses (Inflammoscopy) in Skin of Color—A Systematic Review by the International Dermoscopy Society “Imaging in Skin of Color” Task Force

Dermoscopic patterns of inflammatory dermatoses (inflammoscopy) have been extensively studied in the recent years, though data on patients with darker phototypes (IV-VI) are sparse. The aims of this systematic review were to summarize the current state of knowledge on inflammoscopy applied to skin of color and provide a standardized nomenclature of reported findings. Besides dermoscopic features, type of setting and magnification, number of cases, and histopathological correlation were analyzed. Eighty-five papers addressing 76 different dermatoses (25 papulosquamous dermatoses, 19 hyperpigmented dermatoses, seven hypopigmented dermatoses, four granulomatous dermatoses, two sclerotic dermatoses, five facial inflammatory dermatoses, and 14 miscellaneous conditions) for a total of 2073 instances were retrieved. Only one study showed a level of evidence of III (cross-sectional study), whereas 10 and 74 displayed a level of evidence of IV (case-control studies) and V (case-series and case-reports), respectively. Moreover, our analysis also highlighted that most of papers focalized on a limited number of dermatoses, with several conditions having only single dermoscopic descriptions. Additionally, few studies compared findings among phototypes belonging to the “skin of color” spectrum. Further studies designed according to a systematic approach and considering the above-mentioned issues are therefore needed

Dermoscopy of skin metastases from breast cancer: two case reports

Abstract Background Cutaneous metastatic breast cancer is the most common cutaneous metastatic malignancy in women. The assessment of cutaneous metastatic disease can be perplexing because the clinical presentation appears similar to other skin malignancies like angiosarcoma or melanoma, or benign diseases like cellulitis and lymphedema. To date, only a limited number of dermoscopic images of cutaneous metastatic solid tumors, especially breast cancer, have been published. Case presentation The authors report two Moroccan cases highlighting dermoscopy as a quick tool to recognize skin metastasis of breast cancer in two different clinical presentations. A 51-year-old Moroccan woman presented with nodules of various sizes on and around a mastectomy scar, and a 65-year-old Moroccan woman presented with cellulitis-like lesions on her chest wall and her back. Dermoscopic features were similar in the two cases with findings of yellow central areas, polymorphic vessels, whitish bright lines, whitish structureless areas, and linear irregular fissure-like depressions on a pink-orange background. Conclusions The recognition of dermoscopic patterns of cutaneous metastasis of breast cancer is not only useful to facilitate diagnosis at an early stage and to rule out other differentials, especially in difficult presentations such as cellulitis-like lesions or lymphedema, but it may also be used by physicians in monitoring mastectomy scars

Blood eosinophilia: A poor prognostic factor for primary cutaneous T cell lymphomas? A cohort of 72 cases

Introduction: Blood eosinophilia (BE) is described as a poor prognosis marker for some T cell malignancies. Objective: to detect the presence and the prognostic significance of BE in patients with cutaneous T cell lymphoma (CTL). Methods: This was a retro prospective study of 72 patients with CTL. Patients with other factors that may increase BE were excluded. Results: We had 14 cases of BE, 10 cases were in the erythrodermic stage of the disease and 6 in the tumoral stage and we had 4 cases of death. The BE was associated with deterioration of the general condition (p=0.001); depilation of the body (p=0.04), erythroderma (p=0.008), scalp and nails involvement (p=0.000), high rate of lactate Dehydrogenase (LDH) (p=0.000) and beta 2 microglobulin (B2M), (p=0.000), the histological type of Mycosis fungoides (MF) with positive Immunohistochemistry for CD4 (p=0.014) and CD3(0.05). Conclusions: BE was significantly related to MF, to advanced stages of the disease, to pejorative clinical signs and to elevated rate of LDH and B2M which are poor prognostic factors of MF with four cases of death, which prove that BE is also a poor Prognostic factor of MF