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Port wine birthmarks (PWB) are capillary vascular malformations within the papillary and reticular dermis, most commonly occurring on the head and neck and may darken and thicken with age. Pulsed dye laser (PDL) is the gold standard of treatment for PWB as it selectively targets involved vessels. Sirolimus is a macrolide antibiotic that selectively inhibits mammalian target of rapamycin, thereby suppressing the angiogenesis pathways that can be activated by PDL. Sirolimus and PDL may be used together to treat PWB. We present a case series describing three cases of delayed ulceration and systemic sirolimus absorption following combination therapy, highlighting a potential complication and patient safety concern. [ABSTRACT FROM AUTHOR]

16 Mentzel T, Reisshauer S, Rütten A, Hantschke M, Soares de Almeida LM, Kutzner H. Cutaneous clear cell myomelanocytic tumour: a new member of the growing family of perivascular epithelioid cell tumours (PEComas). Keywords: clear cell; mesenchymal; neoplasm; soft tissue EN clear cell mesenchymal neoplasm soft tissue 835 838 4 09/21/22 20221001 NES 221001 INTRODUCTION Distinctive dermal clear cell mesenchymal neoplasm (DDCCMN) is a very rare entity. The clinical presentation of a solitary, exophytic nodular tumor and histopathologic findings of large cells with abundant clear cytoplasm and characteristic staining pattern were compatible with distinctive dermal clear cell mesenchymal neoplasm. Primary clear cell sarcoma of the skin is rare, most often affecting tendons and aponeurosis of the limbs.7-11 Sharing similar pathologic properties, clear cell sarcoma is considered the soft tissue counterpart of malignant melanoma. [Extracted from the article]