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Neutrophilic figurate erythema (NFE) is a rarely reported figurate erythema that clinically presents similarly to erythema annulare centrifugum (EAC) with neutrophil-predominant perivascular and interstitial infiltrate in the dermis on histopathology. We present the case of a 32-year-old active-duty military male who presented with a chronic treatment-resistant skin rash. The rash began on his thighs five years previously and was treated with topical and oral antifungals repeatedly without improvement. The patient was deployed overseas during the rash onset, but the rash persisted upon his return stateside. No triggers were identified. His persistent skin eruption consisted of erythematous polycyclic annular plaques with a "trailing edge" scale. Histologic examination revealed perivascular neutrophils and perivascular and interstitial eosinophils without signs of vasculitis or infection. With only 15 reported cases, it can be difficult to recognize leading to long delays in diagnosis and treatment. Despite having a clinical course similar to EAC, NFE may require anti-neutrophil therapy to resolve completely.

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This article discusses the rare neutrophilic dermatosis pustular pyoderma gangrenosum (PG), characterized by necrotizing skin lesions. It highlights the importance of thorough histological examination in diagnosing this variation, which resembles other pustular dermatoses. The case study of a 54-year-old female highlights the unique histological aspects of PG, including epidermal erosion, neutrophilic infiltration, sterile abscesses, and no vasculitis. The article emphasizes the need for differential diagnosis and clinical correlation, emphasizing the importance of collaboration between physicians and pathologists for accurate diagnosis.

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Better mechanistic understanding of desmosome disruption and acantholysis in Grover's disease (GD) may improve management of this disease. Recent molecular studies highlighted promising pathways to be explored by directly comparing GD and selected features of associated skin diseases. The association between GD and cutaneous keratinocyte carcinomas, the most prevalent non-melanoma skin cancers (NMSC), is not completely characterized. To review the medical literature regarding GD-associated cutaneous keratinocyte cancers, focusing on molecular features, pathophysiological mechanisms, and disease associations, to help guide future research and patient management. GD has been associated with a variety of skin conditions, but its association with skin cancers has been rarely reported. Between 1983 and 2024, only nine scientific papers presented data supporting this association. Interestingly, we found that GD may mimic multiple NMSCs, as few authors reported GD cases misdiagnosed as multiple cutaneous squamous cell carcinomas for more than 4 years or the presence of superficial basal cell carcinoma-like areas associated with focal acantholysis. In conclusion: (a) GD may be an imitator of multiple NMSCs, and (b) the relationship between GD and NMSCs may reveal promising pathways for the mechanistic understanding of desmosome disruption and acantholysis in GD and may even lead to its reclassification as a distinctive syndrome.

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Key Clinical Message: Pulsed dye laser (PDL) has proven effective in resolving lupus miliaris disseminatus faciei (LMDF) where drug therapies have failed with a lack of treatment consensus for LMDF, considering early PDL intervention is crucial to achieve resolution without scarring, prevent relapse, and enhance overall treatment outcomes. Abstract: Lupus miliaris disseminatus faciei (LMDF) is a rare inflammatory and granulomatous dermatologic disease that primarily affects the face. The optimal treatment for LMDF remains controversial, and there is a lack of consensus on the most effective therapy. This case report highlights the successful use of a 595 nm pulsed dye laser (PDL) in the treatment of LMDF following unsuccessful drug therapy. A 28-year-old male presented with reddish-brown eruptions on his face that had persisted for several months. Clinical examination revealed discrete dome-shaped eruptions in clusters on the central area of the face. Histopathological examination confirmed the diagnosis of LMDF, based on the presence of epithelioid granulomas with central caseous necrosis. Previous treatment with an oral isotretinoin and methotrexate combination also failed to yield satisfactory results. After discontinuing drug therapy, the patient underwent five sessions of PDL treatment. Ten days after the first session, the eruptions began to regress without scarring. Subsequent PDL sessions led to the complete resolution of the eruptions. The patient experienced no relapse during the follow-up period. This case report suggests that PDL treatment may be an effective option for LMDF, particularly in cases where drug therapy has failed. Early initiation of laser treatment may prevent scarring, minimize the adverse effects associated with drug therapy, and reduce the risk of disease relapse. Further research and controlled trials are needed to establish the efficacy of laser therapy in the treatment of LMDF.

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Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare chronic skin condition commonly affecting individuals with underlying hematologic malignancies, most notably chronic lymphocytic leukemia (CLL). EDHM presents as pruritic, insect-like bites, but without patient-reported contact/bites of insects. We present a case of a 44-year-old male who presented to Elkhorn Dermatology with a scaly rash and serpiginous borders on the nasal tip and right cutaneous upper lip. The patient was diagnosed with CLL one year prior and had been on zanubrutinib for 10 days since presenting to the dermatology clinic. Initial treatment with antifungal and antibiotic therapies showed no improvement, leading to a punch biopsy that revealed perivascular and periadnexal lymphocytic dermatitis with eosinophils. This finding, along with the patient's underlying CLL, led to a diagnosis of EDHM. This case highlights the diagnostic challenges and therapeutic complexities associated with EDHM in patients with hematologic malignancies.

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Linear immunoglobulin A bullous dermatosis (LABD) is a rare immune-mediated vesiculobullous disease that is reported to be induced by infections or medications. Atezolizumab is a monoclonal antibody that targets programmed cell death ligand-1 and has been used to treat multiple cancers. Here, we report a case of drug induced LABD following the administration of Atezolizumab.

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Althought Malassezia spp. have been involved in various pathologies, they are integral part of the cutaneous, gut, oral, ears, nose and throat (ENT) mycobiota. Since Malassezia are difficult to grow in culture, unexhaustive molecular biology methods have been developed to detect them. The aim of the study was to evaluate an in-house pan-Malassezia quantitative PCR (panM-qPCR) on various clinical human samples and determine Malassezia burden in various human mycobiota. The panM-qPCR was designed to target the repeated 28S rDNA gene from all Malassezia species. We used the assay to quantify the Malassezia burden on 361 samples from 161 subjects (80 skin swabs from 10 healthy volunteers (HV), 13 samples from 2 seborrheic dermatitis patients (SD), 90 skin samples from 19 burned patients, 119 stools samples from 89 immunocompromised patients, 59 ENT samples from 41 patients). For HV, the amount of Malassezia was different according to the swabbed areas. Cq in SD are lower than in HV. In burned patients, Cq was significantly lower compared to HV. In stool samples, 6.7% were positive for Malassezia spp. with a high Cq. For the ENT area, a higher proportion of positive specimens were detected in ears samples than in nose samples. Our findings emphasized the importance of qPCR, confirming elevated Malassezia spp. levels on individuals' faces and scapls, increased burden in SD patients and in severely burnt patients than in HV. The pan-MqPCR appears to be a promising tool for studying Malassezia in various human mycobiota.

Malassezia species are ubiquitous members of various human mycobiomes, including cutaneous and mucosal sites. While these fungi have been implicated in several pathologies, their presence as commensals complicates their study, especially due to difficulties in culturing them in vitro. This has necessitated the development of molecular techniques to detect and quantify Malassezia species directly from clinical samples.

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This clinical case series presents descriptions of 3 patients with familial Mediterranean fever (FMF) who have atypical manifestations and abnormal inheritance mechanisms in terms of Gregor Mendel's laws. Although molecular genetic testing can help with disease diagnosis, it is not always conclusive. The primary need for genetic testing in atypical cases is to explain the mechanism of inflammation and to select the optimal therapy. These clinical observations demonstrate the changes in the spectrum of phenotypic manifestations of FMF in the context of the widespread introduction of molecular genetic methods.

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Familial Reactive Perforating Collagenosis (FRPC) is a very rare form of benign dermatosis frequently presented during early childhood and not associated with systemic diseases. Less than 50 FRPC patients have been reported in the literature. Due to the limited number of cases, the pathophysiology of this unique entity remains elusive; moreover, no standard treatment has been agreed upon. Here, we report a case of FRPC in a 20-year-old male who was presented with generalized multiple discrete papules covered with central keratotic plugs in all regions of his body, particularly in the facial area, neck, abdominal, and extensor region of the extremities for more than 7 years. Similar symptoms were acknowledged in the patient's family members. Histopathological analyses identified the crateriform shape invagination in the epidermis filled with inflammatory lymphocytes and basophilic debris and perforated by basophilic collagen bundles from the underlying dermis. Based on the clinical and histopathological findings, the patient was diagnosed with FRPC. He was treated with topical desoximetasone 0.25% cream applied 2-3 times daily. A follow-up evaluation after 4 weeks revealed a near-complete resolution of skin papules. To our knowledge, this is the first report of FRPC case from Indonesia. Unlike the majority of FRPC patients who had their disease onsets during infancy or early childhood, FRPC skin manifestations in our patient started during the adolescence period. The resolution of skin manifestations after daily application of topical desoximetasone suggests that topical corticosteroids are a potential treatment option for FRPC patients.

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Linear IgA bullous dermatosis (LABD) is an acquired autoimmune subepidermal blistering disorder. Diagnosis always relies on skin pathology and direct immunofluorescence (DIF), with typical linear deposits of IgA along the basement membrane zone (BMZ). The typical clinical manifestation is tense bullae arranged like the "string of pearls" companied with severe pruritus. Dapsone is often considered first-line therapy for LABD, and it is necessary to test the HLA-B*1301 gene to prevent the occurrence of dapsone-induced hypersensitivity syndrome (DHS). Here we report a case of LABD resistant to corticosteroid and sulfasalazine, while waiting for HLA-B*1301 gene test results, dupilumab was used to control severe pruritus.

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Pyoderma gangrenosum (PG) is an uncommon inflammatory disorder that exhibits a range of clinical manifestations and levels of severity. It frequently occurs alongside an underlying condition, most often inflammatory bowel disease. PG, Sweet syndrome, palisaded neutrophilic granulomatous dermatitis (PNGD), interstitial granulomatous dermatitis (IGD) and rheumatoid neutrophilic dermatitis may be associated with rheumatoid arthritis (RA). We present a case of a 65-year-old woman with disseminated dermatosis to the hands, abdomen, buttocks, and lower limbs. The dermatosis presented with numerous ulcers of varying shapes, featuring clean bases, undermined edges, and a purplish erythematous appearance. Further investigations, including imaging studies and RA factor and anti-cyclic citrullinated peptide (anti-CCP) levels, led us to the diagnosis of RA. This case indicates that RA may be frequently undiagnosed and untreated in other patients with PG, as ulcers on the lower extremities can often be the main reason for seeking medical attention.

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Facial neutrophilic dermatosis is a relatively recent and rare entity. Herein, we report an original case with a clinical appearance of crusty pyoderma gangrenosum and limited face involvement, classifying it as neutrophilic dermatosis (ND) of the face. The latter is an infrequent entity and forms part of the ND spectrum. The few reported cases in the literature are characterized by a restricted distribution on the face, as in our case. Nevertheless, this entity remains controversial: some consider it a variant of Sweet's syndrome; others see it as a truly independent entity. Matthews et al. reported an association between ND of the face, as in the case of our patient with a crusty appearance, and ulcerative colitis. Our observation and that of Matthews et al. underline the wide and varied potential for the clinical presentation of this entity.

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The aims of this study were (i) to evaluate the effect of density, lineage, age, and time of day on dorsal surface temperature and (ii) to evaluate the effect of density and lineage on performance and carcass condemnations in broiler grillers. The evaluations were carried out in barns with the Dark House system, with two densities, 17 and 19 chickens/m2 and two lineages, Cobb and Ross. The dorsal surface temperature of the chickens was measured by infrared thermography at 7, 14, 21, 23, 25 and 27 days of age, four times a day. The average daily weight gain, feed conversion, mortality, partial carcass condemnations, as well as those due to arthritis and dermatosis were also evaluated. The highest dorsal surface temperatures were observed in Cobbs housed at a density of 17 chickens/m2, and in Ross housed at a density of 19 chickens/m2. Cobbs housed at a 17 chickens/m2 density showed the lowest feed conversion compared to Ross at the same density. Ross showed higher dorsal surface temperatures when compared to Cobbs at 14, 21, and 27 days. Cobbs showed higher percentages of partial carcass condemnation and arthritis compared to Ross. The higher density of broiler grillers in the Dark House system does not influence the dorsal surface temperature, performance, dermatosis, arthritis, and partial carcass condemnations.

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Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis. Half of the cases are associated with an immune dysfunction and are frequently triggered by pathergy such as a tissular aggression via surgery or burn wounds. A patient with ulcerative colitis presented a PG at the site of an iontophoresis patch for tendinopathy. Treatment in a specialized burn center, corticosteroid therapy and adapted local care contributed to a favourable evolution. PG remains a diagnosis of exclusion and inflammatory phenomena must be differentiated from infectious causes such as necrotizing fasciitis to initiate immunosuppressive treatment. Being rare and difficult to diagnose and to treat as well as associated with potentially severe sequelae, a multidisciplinary team is required for the management of PG.

Le Pyoderma gangrenosum (PG) est une dermatose neutrophilique rare. Il est, dans la moitié des cas, associé à une maladie dysimmunitaire et il est fréquemment déclenché par un phénomène de pathergie, défini comme une agression tissulaire par une intervention chirurgicale ou encore une brûlure. Une patiente avec une rectocolite ulcéro-hémorragique a développé un PG sur le site d'application d'un patch d'ionophorèse pour une tendinopathie. Un traitement par une corticothérapie, un traitement immunosuppresseur local et des soins locaux adaptés ont permis une évolution favorable. Le PG reste un diagnostic d'exclusion et les phénomènes inflammatoires doivent être différenciés de phénomènes infectieux, comme la fasciite nécrosante, afin d'initier rapidement des immunosuppresseurs. Comme il s'agit d'une pathologie rare avec un diagnostic difficile, que des séquelles peuvent être catastrophiques et qu'un traitement immunosuppresseur complexe doit être instauré, une équipe pluridisciplinaire est requise pour la prise en charge de cette pathologie.

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Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that characteristically presents with progressive ulcerative lesions. The association of PG with hematological malignancies remains unclear due to its varied clinical presentation. Herein, we report the unusual case of PG in a 75-year-old male with stage III follicular diffuse large B-cell lymphoma. Seven days subsequent to his first dose of rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone (R-CHOP) therapy, he presented to the emergency department with generalized malaise, bilateral lower extremity edema, and ecchymoses with ulcerative wounds on the dorsal of his feet. Due to the rapid progression of the patient's dermatological manifestations and declining clinical status, he required serial surgical wound debridement and a biopsy, which revealed an occlusive vasculopathy with dermal and epidermal necrosis. These pathological findings, along with the patient's clinical presentation, led to the diagnosis of PG. The patient was treated with negative pressure wound therapy, steroids, and tacrolimus ointment, which led to a marked improvement in the appearance of the patient's dermatological features and clinical status.