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We describe a 3-year-old male patient with an unusual congenital lesion on the plantar surface of the left foot that had been asymptomatic until shortly before presentation. Histologic examination of the plaque revealed a thinner keratin layer, increased pigmentation, and a pilosebaceous unit with a visible vellus hair. We tentatively hypothesize from this single case that a disruption in the normal sequence of events of morphogenesis, and particularly in dorsal-to-ventral orientation, may have occurred in this patient.

Linear IgA bullous dermatosis (LABD) in adults is characterized by subepidermal bullae associated with a linear deposition of IgA at the basement membrane zone. Its cause is unclear, although it appears to have an immune-mediated basis. The development of LABD in a cancer patient undergoing immunotherapy has been described in the French literature. We describe a similar case of LABD arising in a patient while undergoing interleukin-2 immunotherapy for renal cell carcinoma.

A 72-year-old woman had a preauricular mass and several scalp nodules. Her medical history included excisions of multiple cutaneous tumors, including cylindromas, trichoepitheliomas, basal cell epitheliomas, and a trichilemmoma. The parotid mass and a scalp nodule were excised. On light microscopy, the parotid mass and scalp nodule appeared similar. Ultrastructural features revealed by electron microscopic analysis of the tumors allowed diagnosis of a cylindroma of the scalp and a parotid basal cell adenoma. The association of trichilemmoma and membranous basal cell adenoma of the parotid has not been previously described. The pathogenesis of these multiple cutaneous tumors from a common cell of origin is considered.

Seckel's syndrome consists of multiple congenital anomalies, including bird-headed dwarfism, mental deficiency, and skeletal and ophthalmic defects. We report a patient with this syndrome who demonstrated pigmentary changes, including streaks of brown pigmentation on the neck, groin, and axillae. Histologic examination revealed pigment incontinence.

A widespread pruritic papular eruption associated with human immunodeficiency virus has been previously described. Electron microscopic study of lesional skin from a patient who presented with such an eruption showed cytoplasmic tubuloreticular structures in every venular capillary endothelial cell that was studied. The significance of this finding and the possible cause of these structures are discussed. This new finding strongly suggests that this dermatosis is a dermatosis related to acquired immunodeficiency syndrome (AIDS) and may be helpful in confirming the diagnosis of the AIDS-related complex or AIDS in future patients presenting with this dermatosis.

We report a case of tinea of the face caused by Trichophyton rubrum in which the histologic changes were consistent with granuloma faciale. We recommend that local infection with dermatophytes be considered in all cases of histologic granuloma faciale, especially when the clinical presentation is atypical for this dermatosis.

We report two cases of eccrine syringofibroadenoma. Both patients had a large, solitary hyperkeratotic nodular lesion over the extremities. Histologic sections showed spongelike masses of small cuboidal acrosyringeal cells. Fibrovascular connective tissue stroma resembling premalignant fibroepithelial tumor of Pinkus filled the spaces between the masses.

Diabetics may have an increased susceptibility to cutaneous blister formation clinically manifest as the bullous eruption of diabetes. We evaluated the mechanical force necessary to induce suction blisters in fifteen insulin-dependent diabetics and twenty age-matched normal controls. The mean suction blister threshold for the diabetics was 31.9 minutes versus 68.0 minutes for the controls, a highly significant difference (p less than 0.01). Histologic appearance of suction blisters was similar in diabetic and normal skin, under both light and electron microscopic examination, with a noninflammatory subepidermal separation in the lamina lucida between the cell membrane and the basal lamina. These results demonstrate that insulin-dependent diabetics have a marked reduction in suction blister threshold as compared to age-matched controls.