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Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a rare autosomal dominant disorder that is characterized by multiple basal cell carcinomas developing at a young age, keratocystic odontogenic tumors of the jaw, palmar or plantar pits, calcification of the falx cerebri, and skeletal abnormalities. Nevoid basal cell carcinoma syndrome is caused by mutations in the PTCH1 or SUFU genes. Our patient with Fitzpatrick skin type VI was diagnosed with Gorlin syndrome based on the presentation of multiple major diagnostic characteristics. Although he is 33 years old, he has not developed any multiple basal cell carcinomas to date.

Tufted angioma is a rare, benign vascular tumor of uncertain pathogenesis, characterized histopathologically by "tufts" of capillaries within the dermis. A life-threatening coagulopathy, Kasabach-Merritt phenomenon, occurs in approximately 10% of cases of tufted angioma and is characterized by profound thrombocytopenia and fibrinogen consumption. We present an asymptomatic 10-month-old boy who presented with an erythematous patch of the right upper extremity and subsequently was diagnosed by biopsy with tufted angioma. Baseline laboratory workup of our patient revealed mildly decreased fibrinogen and elevated D-dimer levels without thrombocytopenia or elevated partial thromboplastin time. This suggests that asymptomatic patients with tufted angioma may present with coagulopathy in the absence of Kasabach-Merritt phenomenon. This also highlights the importance of obtaining baseline laboratory workup in patients presenting with tufted angioma.

Although 90% of dermatologists discourage the use of tanning beds, about half of psoriasis patients report using tanning beds and most of these note improvement. The purpose of this investigation was to determine if dermatology residents are advocating the tanning bed use to their patients.

Background: Though psoriasis is chronic and recurring, current options can help many patients achieve good disease control. New treatments could provide greater improvement in objective disease, but it is not clear that there is room for improving subjective outcomes, particularly for patients who are already "well-controlled.", Objective: To analyze treatment satisfaction of well-controlled patients with psoriasis in two patient populations of very different disease severity., Methods: Patients with well-controlled psoriasis on topicals (mild psoriasis) only or on biologics (moderate-to-severe psoriasis) were queried by telephone about perceptions of disease control, improvement level, overall treatment satisfaction, and consideration for trying new treatments. Satisfaction scores and feedback were analyzed to assess treatment type and satisfaction level associations., Results: The majority of patients, regardless of disease severity, would consider trying new treatments for psoriasis, though patients with mild psoriasis were less satisfied with their disease control, level of improvement, and overall treatment. Patient feedback revealed widespread treatment dissatisfaction, non-adherence, and inconvenience., Limitations: The patient population was from one university setting., Conclusion: 16% of patients with psoriasis meet study definition for "well-controlled" disease. Less than 20% of these well- controlled patients with psoriasis are satisfied with their current level of control and clearance and would not consider trying new treatments, suggesting the majority of well-controlled patients, regardless of disease severity, still have unmet needs. Stronger patient-physician communication may contribute to patient-based, comprehensive care in concordance with a health system that is headed towards financial incentives for better patient satisfaction.