Mycobacteria infection in an immunocompetent patient with no risk factors: evaluation and management of non-healing majocchi granuloma-type nodule

Atypical mycobacterial infections are more commonly described among immunocompromised patients, although there has been an increasing incidence in recent years of infections in immunocompetent hosts. Normally preceding trauma is a risk factor for infection. We describe a case of Mycobacteria chelonae infection in a healthy individual with no risk factors

Mycobacteria infection in an immunocompetent patient with no risk factors: evaluation and management of non-healing majocchi granuloma-type nodule

Atypical mycobacterial infections are more commonly described among immunocompromised patients, although there has been an increasing incidence in recent years of infections in immunocompetent hosts. Normally preceding trauma is a risk factor for infection. We describe a case of Mycobacteria chelonae infection in a healthy individual with no risk factors

Circumscribed palmoplantar hypokeratosis: a case report and review of the literature

We describe an 84-year-old man presenting with a solitary, well-circumscribed, chronic erosion of the sole. Histopathologic examination confirmed diagnosis of circumscribed palmoplantar hypokeratosis. Circumscribed palmoplantar hypokeratosis is a rare and benign condition of unknown etiology presenting as an erosion on the palms or soles. Although lesions are typically asymptomatic, the entity is important for dermatologists and providers in other specialties to recognize, especially considering a differential diagnosis that includes neoplasia

The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions

BACKGROUND: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy. OBJECTIVES: We sought to estimate the prevalence and assess the clinical significance of CS in melanocytic and nonmelanocytic lesions. METHODS: This was a prospective observational study in which dermatoscopic assessment of lesions was recorded in consecutive patients examined during a 6-month period. In addition, a data set of biopsy-proven melanomas was retrospectively analyzed. RESULTS: In all, 11,225 lesions in 881 patients were prospectively examined. Retrospectively, 229 melanomas imaged with polarized dermatoscopy were analyzed. In the prospective data set, a median of 12.7 lesions (range, 1-54) were evaluated per patient. None of clinically diagnosed Clark nevi (n = 9750, 86.8%) demonstrated CS. Overall, CS were observed in 206 (1.8%) lesions, most commonly dermatofibromas and scars among nonbiopsied lesions. A total of 265 (2.4%) lesions were biopsied, including 20 melanomas and 36 nevi. Among biopsied malignant lesions, CS were most commonly observed in basal cell carcinoma (47.6%) and invasive melanomas (84.6%). Melanomas were more likely to have CS than biopsied nevi (odds ratio = 9.7, 95% confidence interval 2.7-34.1). In the retrospective data set, CS were more commonly observed among invasive melanomas (41%) compared with in situ melanomas (17%) (odds ratio = 3.4, 95% confidence interval 1.9-6.3, P < .001). The prevalence of CS correlated with increased melanoma thickness (P = .001). LIMITATIONS: Biopsied lesions represent a small percentage of the total number of lesions evaluated. CONCLUSION: Among biopsied malignant lesions, CS are most commonly observed in basal cell carcinoma and invasive melanomas and rarely seen in nevi. In melanoma, CS may reflect increased tumor thickness and progression

Accuracy in melanoma detection: a 10-year multicenter survey

Early excision is the only strategy to reduce melanoma mortality, but unnecessary excision of benign lesions increases morbidity and healthcare costs