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Amicrobial pustulosis of the folds (APF) is a rare neutrophilic dermatosis found in association with autoimmune diseases. We present a 49‐year‐old woman with a history of systemic lupus erythematosus and a recurrent pustular eruption in the cutaneous folds. Histologic examination revealed spongiform pustulosis and dermal neutrophilic infiltrate. The Gram and periodic acid–Schiff stains were negative for bacteria and fungi. A diagnosis of amicrobial pustulosis of the folds was given. While there is no standard treatment, our patient's symptoms resolved following an oral prednisone taper and have not recurred since starting colchicine. The presence of pustules and erosive plaques in skin folds in young women with autoimmune conditions should raise suspicion for APF. The combination of localized neutrophilic spongiosis with intraepidermal or subcorneal pustules in conjunction with dermal changes of a neutrophilic dermatosis is a helpful clue to the diagnosis. If the patient does not already have a diagnosis of an underlying autoimmune condition, a presentation of APF should prompt further screening consisting of a relevant review of symptoms and appropriate assessment for autoimmune antibodies, since APF may precede the diagnosis of autoimmune disorders. [ABSTRACT FROM AUTHOR]

Localized argyria with pseudo-ochronosis: A report of two cases highlighting involvement of elastic fibers Pseudo-ochronosis in localized argyria was first reported in 2002,[1] when they described ochre-colored swollen homogenized collagen bundles seen on biopsy of localized argyria in the absence of the typical causes of ochronosis. Keywords: argyria; elastic fibers; localized argyria; pseudo-ochronosis EN argyria elastic fibers localized argyria pseudo-ochronosis 815 818 4 08/16/23 20230901 NES 230901 INTRODUCTION Argyria, either localized or generalized, is a rare dermatologic condition where the deposition of silver within skin or mucous membranes results in grayish-blue pigmentation that can be appreciated clinically. [Extracted from the article]

Reactive infectious mucocutaneous eruption (RIME) is a recently described entity in which there is prominent mucositis, most commonly involving the oral and urogenital mucosa, secondary to a variety of pathogens. There is typically minimal cutaneous involvement in RIME. This contrasts with erythema multiforme (EM) in which characteristic targetoid lesions predominate, usually in isolation (EM minor), but in a subset of cases, with severe mucositis (EM major). While the histopathologic features of RIME have not been as well defined, those of EM are characterized by epidermal apoptosis and interface dermatitis with lymphocytes making up the predominant cell type. We report a unique case of RIME in a 16‐year‐old male with COVID‐19 characterized by significant mucositis involving the oral and genital mucosa, as well as numerous targetoid lesions on the trunk and extremities. Histopathologically, there was an inflammatory infiltrate obscuring and disrupting the epidermal interface, associated with epidermal necrosis, and blister formation. The infiltrate was composed of cells with irregular, non‐segmented and elongate nuclei, with myeloid and histiocytoid cytomorphology. The cells were positive for myeloperoxidase, CD68, and CD163 (subset) suggesting myeloid lineage. RIME is a rarely reported COVID‐19‐related eruption, and targetoid lesions and myeloid interface reactions have not been described with RIME. [ABSTRACT FROM AUTHOR]

HER2 protein over-expression was investigated in seventeen cases of primary cutaneous and metastatic malignant melanoma using the semi-quantitative Dako Hercep Test[sup TM] immunohistochemical assay. Formalin fixed, paraffin embedded tissue was employed; membrane staining was scored on a scale of 0 to 3+. Control cell lines were stained concurrently in all cases, and performed within prescribed criteria. All cases were negative for HER2 protein over-expression. Fifteen cases had a score of 0, one case showed focal areas of 1+ and another case was 1+ overall, with foci approaching 2+. (A score of 0 or 1+ is negative, 2+ is weak positive and 3+ is strong positive.) Over-expression of HER2 protein is best known in breast cancer. The incidence of HER2 over expression in other malignancies is not known. The value of testing for HER2 over-expression lies in the existence of anti HER2 therapy, namely Herceptin (Trastuzumab) – a monoclonal antibody that targets the HER2 protein, inhibiting tumor cell proliferation. The presence of HER2 protein over-expression in melanoma cells would suggest possible benefit of Herceptin therapy. This study, although limited, suggests that HER2 protein over-expression is, at best, infrequent in melanoma; therefore Herceptin therapy is unlikely to be useful. Since its initial description, it has continued to be a matter of debate whether actinic granuloma (AG) should be considered a specific condition or simply granuloma annulare (GA) with incidental elastophagocytosis because of its location on sun-damaged skin. We conducted a case control study to clarify this issue. Twenty cases diagnosed as AG between 1991 and 2001 were retrieved from our archives. Fourteen met our inclusion criteria: sufficient tissue for elastic and mucin stains; loss of the elastic tissue in or at the side of the granuloma; and elastophagocytosis. Sixteen cases of GA, 8 involving sun-exposed and 8 involving non-sun-exposed body sites, were randomly sel... [ABSTRACT FROM AUTHOR]