Primary Dermal Melanoma: A Rare Clinicopathological Variant Mimicking Metastatic Melanoma

none6Primary dermal melanoma (PDM) is a rare distinct variant of cutaneous melanoma, predominantly occurring on the extremities of young or middle-aged adults. In comparison to conventional melanoma, PDM is characterized by unexpectedly prolonged survival and long-term survival. Thus, correct identification of this variant is crucial to avoid potential misdiagnosis and establish correct treatment and follow-up. In addition, no consensus and specific guidelines exist on the management of this peculiar subtype of cutaneous melanoma.noneSimonetti, Oriana; Molinelli, Elisa; Brisigotti, Valerio; Brancorsini, Donatella; Talevi, Davide; Offidani, AnnamariaSimonetti, Oriana; Molinelli, Elisa; Brisigotti, Valerio; Brancorsini, Donatella; Talevi, Davide; Offidani, Annamari

A peculiar case of large primary cutaneous Ewing’s sarcoma of the foot: Case report and review of the literature

Introduction: Primary cutaneous extraskeletal Ewing’s sarcomas (ESs) are extremely rare tumors, limited to the skin and generally appear as a single small lesion, circumscribed mid-to-deep dermis or involving subcutis. Due to their rarity and morphological similarity to other cutaneous tumors, ESs are subject to being clinically and pathologically subdiagnosed. Presentation of case: A 37-year-old man presented a large rapidly growing mass of the first toe measuring 9.5 × 8 cm with no radiological evidence of bone involvement. The patient underwent wide surgical tumor resection; histological, immunohistochemical and molecular evaluation confirmed the diagnosis of ESs. Postoperative examinations revealed no metastasis and after 11 months follow-up no recurrences were detected. Discussion: Current literature reports only a few isolated cases or small series. ESs are generally described as small masses with a favorable clinical behavior. Despite lower extremity is a relatively frequent site, only rare and small ESs of the foot have been reported. To our knowledge the present case is the largest ES of the foot. Despite its large size, the patient did not report any metastases confirming the hypothesis of treating superficial ES with surgery alone, thus avoiding adjuvant radiotherapy and/or chemotherapy and their related side-effects. Conclusion: ESs still remain exceedingly rare tumors and they could not be taken in consideration into differential diagnosis. This case represents a peculiar example of large ES in an uncommon site as the foot successfully treated with surgery alone, and may serve as an alert for those physicians who approach such rapidly growing superficial lesions

Pyoderma gangrenosum succesfully treated with golimumab: Case report and review of the literature

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis frequently related to chronic inflammatory bowel disease often associated with exacerbation of intestinal disease and/or loss of treatment efficacy. However, in patients with comorbidities, such as diabetes, the diagnosis may be a challenge. Here we report the case of DA, a 68-year-old man with a history of ulcerative recto-colitis (URC), type II diabetes and arterial hypertension, who had been treated with Infliximab and Adalimumab in the past. In September 2017, patient developed an erythematous, infiltrated and painful lesion of the third distal part of his left leg, with ulcerative evolution, rapidly worsened despite a broad.-spectrum antibiotc treatment had been introducted. A worsening of rectocolitis occurred simultaneously. In agreement with the gastroenterologists, patient started a new biological therapy with Golimumab, and oral prednisone with slow tapering of steroid dosage following the improvement of both cutaneous and intestinal symptoms. Dermatologists should be aware about the risk of PG in patient suffering from inflammatory bowel diseases, and consider this diagnosis in all patients affected by URC developing rapidly extending ulcerative skin lesion. Moreover therapeutic choice should take into consideration the effectiveness of golimumab on the inflammatory background which sustains both intestinal and skin disease in this type of patients. This article is protected by copyright. All rights reserved