Rare biopsy of erythema ab igne

    68 year old female was referred for a biopsy by a rheumatologist to rule out connetive tissue. She presented with reticulated erythematous rash on her left flank. Clinical history revealed use of heat pads in this area. Biopsy was performed to confirm "erythema ab igne"


    Another example of macular arteritis: emerging entity not to be confused with polyarteritis nodosa

    68 year old female with asymptomatic pigmented erythematous macules on both lower legs. Biopsy was submitted with clinical differential diagnosis of mast cell disorder and hypersensitivity reaction


    28 year old female with l anterior ankle patch and erythematous papules

    28 year old otherwise healthy female presents with a 3x4.5cm patch with a few erythematous-pink 2-3mm papules over the left anterior ankle. The lesions were present since birth and have not changed in size. They were soft, non-tender associated with occasional pruritus. The patient never received treatment for the lesion and has no past medical history of skin cancer or melanoma.  A shave biopsy was performed and was consistent with trichilemmoma. Etiology was deemed not consistent with Cowden syndrome (trichilemmomas on the face). Patient is not currently interested in treatment.

    Eccrine gland necrosis allowing presumptive diagnosis of thrombotic vasculopathy in a patient with acute lupus erythematosus, pulmonary alveolar hemorrhage, antiphospholipid antibodies and livedo reticularis with purpura

    Pt was is a 43 year female with a history of hypothyroidism, Raynaud's, Barrett's esophagus, DVT (while on OCPs), recent admission for diffuse alveolar hemorrhage and diagnosed with systemic lupus erythematosus /MCTD overlap characterized by raynaud's, alopecia, puffy hands, GERD, lymphopenia, Smith +, RNP +, chromatin+, low titer anti DNA +, low C4, lupus anticoagulant positive.


    6yo f with pruritic red lichenified erythematous papules on bilateral upper and lower extremities, and trunk

    56yo f who presents with 30 years of pruritic red scattered lichenified erythematous papules, with crust and erosions on bilateral upper and lower extremities, and trunk. Patient has noted minimal improvement with NBUVB, PUVA and clobetasol ointment. Patient is currently on sertraline, occasionally takes benadryl 25mg po qhs for sleep, but denies other medications. Biopsy consistent with spongiotic dermatitis. 

    A subcutaneous nodule in the scalp in a 65 years old man

    A 65 year-old male presented with a subcutaneous calp mass.  Except a deep vein thrombosis, his previous medical and family histories are unremarkable.


    24 year old female patient with severe nail psoriasis

    24 year old female patient with longstanding history of severe nail psoriasis characterized by dystrophic nails, subungual hyperkeratosis, and onycholysis in the absence of skin or joint involvement. Nails have improved with Stelara 45mg for the past two years. Patient previously failed Humira with significant injection site reactions and burning sensations from injection.  Patient's nails are sensitive and do bleed with trauma. Patient took 4 months of fluconazole every week for a nail clipping significant for rare yeast. 

    A 52 year old male with a lesion on 4th left toe

    Long standing lesion on the left 4th toe treated as unusual wart/FEP polyp for a period of six months.


    Persistent plaque after nitrogen mustard treatment of mycosis fungoides

    The patient was a 56 year old male with known mycosis fugoides. He was treated with nitrogen mustard. A biopsy of a persistent plaque was performed.


    26 year old female with painful lesions on fingers and toes

    26 year old female referred for a complex 2 year history of painful red bumps on her fingertips and toes following an episode of abdominal pain 2 years ago. The patient reports that the lesions are very sensitive and painful to the touch and that they worsen with exposure to the cold. The patient has been worked up with numerous labs which have all been normal (SPEP neg, CBC, BMP, SSA, SSB, Rf, ANA, CRP, ESR, antiSCL070 Ab). She has been afebrile since her symptoms started. Of note, a biopsy done at an outside hospital showed interface dermatitis with necrotic keratinocytes.

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