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Zoon's balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon's vulvitis). It is not a sexually transmitted disease but can still cause anxiety to the patients because of its chronic nature. Hence, proper diagnosis and early management are necessary. It is a clinical mimicker of other commoner genital dermatoses and is mostly a diagnosis of exclusion when other diseases have been ruled out. It is characterised by a well-demarcated shiny erythematous patch or plaque over the genital mucosa. Histopathological examination becomes necessary when we are unable to differentiate it from premalignant lesions. It reveals lozenge-shaped keratinocytes with siderophages, haemorrhages and variable plasma cell infiltrate in the dermis. Dermoscopy shows spermatozoa-like, convoluted vessels with structureless red orange areas. Response to topical therapy alone is not always satisfactory. However, lasers and surgical management can provide long-term remission. [ABSTRACT FROM AUTHOR]

Cutaneous pili migrans (CPM) is an uncommon condition in which a hair fragment penetrates the skin and produces a creeping lesion similarly of cutaneous larva migrans associated with local pain. There are few reports of CPM in the literature, and none visually describes the migration of the hair shaft in the epidermis associated with pain. Herein, we showed the first report describing a case of an in situ sequential migration of CPM in an adult patient. [ABSTRACT FROM AUTHOR]

The ridged skin of the palms and soles has several unique features: (i) presence of dermatoglyphics created by alternating ridges and grooves forming a unique pattern, (ii) presence of the highest density of eccrine sweat glands and absence of pilosebaceous units, and (iii) differential expression of keratins compared to the glabrous skin. These features explain the preferential localization of palmoplantar keratoderma (PPK) and several of its characteristic clinical features. PPK develops as a compensatory hyperproliferation of the epidermis and excessive production of stratum corneum in response to altered cornification of the palmoplantar skin due to mutations in the genes encoding several of the proteins involved in it. PPK can manifest as diffuse, focal, striate, or punctate forms per se or as a feature of several dermatological or systemic diseases. There is a wide genetic and phenotypic heterogeneity in hereditary PPK, due to which reaching an accurate diagnosis only on the basis of clinical features may be sometimes challenging for the clinicians in the absence of molecular studies. Nevertheless, recognizing the clinical patterns of keratoderma, extent of involvement, degree of mutilation, and associated appendageal and systemic involvement may help in delineating different forms. Molecular studies, despite high cost, are imperative for accurate classification, recognizing clinical patterns in resource poor settings is important for appropriate diagnosis, genetic counseling, and management. This review intends to develop a practical approach for clinical diagnosis of different types of hereditary PPK with reasonable accuracy. [ABSTRACT FROM AUTHOR]

Background: Alopecia areata (AA) describes a sudden localized patchy alopecia. The cause of AA is not completely clear and its incidence may be related to genetic, autoimmune, and environmental factors. Aim: To explore the possible mechanisms of AA and to provide a basis for the early diagnosis and treatment of AA. Methods: Gene microarray data from 122 scalp skin biopsy tissue samples from patients with AA or healthy controls from the Gene-Cloud of Biotechnology Information database were analyzed using bioinformatics analysis methods. Molecular network analysis of the differentially expressed genes (DEGs) was conducted by Cytocluster using the Molecular Complex Detection (MCODE) algorithm. Results: The gene expression profile of skin lesions from patients with AA was significantly altered, with 111 DEGs found in the skin lesions of AA, compared with that of the healthy skin. The DEGs were mainly related to biological processes such as the development of the epidermis and inflammatory reaction. The protein–protein interaction network analysis of DEGs revealed bone morphogenetic protein 2 (BMP2) as a core protein interaction network. BMP2 acted not only via the inflammatory response but also via the signaling pathways in epithelial cell development and epidermal cell differentiation to affect the epidermal development. MCODE analysis further showed that keratins (KRTs) and keratin-associated proteins (KRTAPs) can affect the epidermal development via the epidermal development pathway. Conclusions: The abnormal development of the epidermis and inflammatory reactions in skin tissue play important roles in the pathogenesis of AA and are closely related to BMP2, KRTs, and KRTAPs genes. Limitations: Our study was limited by experimental verification. [ABSTRACT FROM AUTHOR]

An 18-year-old male presented with an erythematous plaque on the left side of face and neck since 4 years. The lesion was devoid of hair, had follicular prominences, and showed increased localized sweating. Histopathology revealed an increased number of eccrine glands in the myxoid stroma with multiple vascular elements in the dermis, favoring the diagnosis of eccrine angiomatous hamartoma. This case illustrates a relatively uncommon clinical presentation of eccrine angiomatous hamartoma as a hairless, hyperhidrotic plaque in the head and neck region. [ABSTRACT FROM AUTHOR]

Interstitial granulomatous dermatitis (IGD) was first described in 1993 by Ackerman as a cutaneous reactive disease in patients with arthritis. Since then, numerous cases associated with different hematological and rheumatic disorders have been reported. IGD is a polymorphic entity that usually involves the upper part of the trunk. Histologically, it is defined as a diffuse dermal histiocytic infiltrate of different densities surrounded by fragmented collagen. We report the case of a 56-year-old man with pruritic papules affecting neck, proximal arms and thorax associated with weight loss and chronic fatigue for six months. Two punch biopsies were taken and the specimens showed lymphohistiocytic interstitial infiltrates with fragmented collagen and elastic fibers in dermis. IGD was diagnosed as first manifestation of a rare chronic myeloproliferative hematologic disorder (cMPD) with rearrangement of beta-receptor for platelet-derived growth factor (PDGFRB). After two months of imatinib, lesions regressed completely. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 73-year-old man who was diagnosed with hepatocellular carcinom and was admitted to the hospital for sorafenib therapy. It talks about the patient having a history of psoriasis which was treated with vitamin D3 ointment and topical corticosteroids. It tells about the patient experiencing lesions and pustules after receiving the sorafenib therapy. It speaks about the patient being given topical corticosteroids for the lesions.

Loricrin is a terminally differentiating structural protein comprising more than 70% of the cornified envelope. It contributes to the protective barrier function of the stratum corneum. In vivo, loricrin is expressed in all mammalian stratified epithelia with the highest levels of expression in humid tissues such as newborn epidermis, the epithelia of oral and anal mucosa, esophagus, foreskin, vagina and the epidermal parts of sweat ducts. Loricrin is not expressed in non keratinizing epithelia and its expression at these sites actually represents a defensive or protective mechanism of the body. An insight into this protein- "Loricrin" can shed light to its potential as a marker in the early stages of potentially malignant disorders like oral sub mucous fibrosis and leukoplakia. This compilation has been done by taking into account the existing literature, reviews and original studies on loricrin, a major component of the cornified cell envelope, its structure and the alterations that result due to its absence or presence of both the epidermis and the oral mucosa. [ABSTRACT FROM AUTHOR]

A case study is presented of a 60‑year‑old female reported with a gradually progressive asymptomatic swelling over the lower half of face for the past 20 years. It informs that she was diagnosed with subcutaneous zygomycosis. It further mentions that hematoxylin and eosin-stained section of biopsy specimen showed granulomatous inflammation in the lower dermis. It mentions that the patient was treated with saturated solution of potassium iodine in gradually increasing doses.

Background: Direct immunofluorescence examination is an important technique in the diagnosis of cutaneous inflammatory disorders including lichen planus, especially in clinically and histopathological doubtful cases. Objective: To study the diagnostic utility of intensity, number, and subtypes of positive immuno-reactants found in lichen planus. Materials and Methods: A detailed analysis of clinical as well as immuno-histological features of lichen planus cases was carried out. Results: The male to female ratio was 1:1.1. The largest number of patients was in 31-50 year age group. Itching was the most common presenting symptom. Papular lesions were seen in 53% cases. Remaining had hypertrophic (6), follicular (3) and mucosal (9) variants. Clinico-pathological discrepancies were observed in 3 patients. The characteristic histopathological changes including basal cell vacuolization, band-like lymphocytic infiltrate at dermo-epidermal junction were seen in all the biopsies while Civatte bodies were detected in 29% cases. The overall positive yield of direct immunofluorescence microscopy was 55%. Immune deposits at Civatte bodies and dermo-epidermal junction were detected in 47% and 8% of cases, respectively. Immunoglobulin M was the most common immunoreactant followed by immunoglobulin G. Conclusions: There was no correlation found between the number and intensity of Civatte bodies with clinical variants of disease and also between the number of positive immunoreactants and clinical severity of the disease. The frequency, number, and arrangement of Civatte bodies in clusters in the papillary dermis as well as multiple immunoglobulins deposition at the Civatte bodies on direct immunofluorescence of skin biopsies are important features distinguishing lichen planus from other interface dermatitis. [ABSTRACT FROM AUTHOR]

Background: Epidermal inclusion cyst in the breast (EICB) is very rare. It presents as breast lump mainly in peri-areolar region and needs to be differentiated from other breast lesions with predominance of squamous cells. Aim: To analyze the role of fine needle aspiration cytology (FNAC) in patients presenting with breast lump. Materials and Methods: The present study is a retrospective study over the period of past 2 years, where the patients presented with firm breast lumps. Six of these cases were diagnosed as EICB on FNAC. Smears from these cases were reviewed for cytomorphological findings and correlated with clinico-radiological details. Results: Patients ranged in age from 25 to 60 years, and female to male sex ratio was 2:1 (female 4, male 2). Mammography was done in women (4), which showed solid, well-defined mass lesions in peri-areolar region and were suggestive of benign breast lesions (3) and infective lesion (1). FNA was performed; Giemsa-stained smears showed predominantly mature benign squamous cell and anucleated squames in all cases, thus one of the cytological diagnoses was EICB. Five of these cases had histological confirmation. Conclusion: EIC of breast is not that rare lesion as considered. The patients may not seek medical attention because of small painless swelling; unless the lump increases in size or becomes painful. FNAC is confirmatory in the presence of a typical pultaceous aspirate and cytomorphological features of EIC. Thus, FNAC plays a crucial role in its diagnosis and management. Symptomatic cases should be readily excised and need histological correlation to rule out any potential complications that can arise in these cysts. [ABSTRACT FROM AUTHOR]

Becker's nevus is a cutaneous hamartoma characterized by circumscribed hyperpigmentation with hypertrichosis. Becker's nevus syndrome is an association of Becker's nevus with unilateral breast hypoplasia and muscle, skin, and/or skeletal abnormalities. We here report a case of a 15 year‑old female who presented with bilateral Becker's nevus over her groins, thighs, vulva, and in front of the neck from the age of 5 years. She had associated mental retardation, delayed development of mile stones, delayed puberty, dwarfism, depressed nasal bridge, long slender digits, crowding of lateral toes, valgus deformity of first metatarsophalangeal joint, mitral valve prolapse, muddy conjunctiva with hypertrophic and hyperpigmented caruncle of both eyes, ichthyosis, brownish hair, and absence of axillary and pubic hair. On histopathological examination collagen hamartoma underneath the Becker's nevus was found. [ABSTRACT FROM AUTHOR]

Epidermoid cysts involving the brainstem are extremely rare, with only 18 reported cases in the literature and only five purely intrinsic epidermoid cysts within this group. "White epidermoids", a rare entity, have high protein content and show reversed signal intensity on magnetic resonance images. In contrast to the classical variety, these cysts show high signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Here, we report an interesting case of intrinsic brainstem "white epidermoid cyst" in a 15-year-old girl and discuss its clinical characteristics, radiological features, and surgical treatment. The girl presented with a one-year history of progressive quadriparesis, and features of multiple cranial nerve involvement. Because the cyst was purely intrinsic and had altered signal intensity, the diagnosis was initially unclear until definitive neuroimaging was performed using diffusion-weighted magnetic resonance imaging (DW-MRI) sequences. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 64‑year‑old male with a slow growing painless mass at the periumbilical region. It notes diagnosis of primary eccrine mucinous adenocarcinoma by histopathological evaluation. It mentions the surgical excision with wide margins for treatment due to the tendency of local recurrence of disease.

Intramedullary spinal epidermoid cysts are rare, with only few cases having been reported in the literature. We are reporting a case of a 10-year-old female child who presented with symptoms of meningitis with progressive paraparesis. Magnetic resonance imaging of the spine revealed an intramedullary epidermoid cyst from C6 to D5. Near-total excision of the tumor was performed. Histopathological report confirmed the diagnosis of epidermoid cyst. The patient showed progressive recovery. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 37‑year‑old female patient who had a skin‑colored oval nodule on a tattoo on her left thigh. Topics discussed include the punch biopsy and histology performed on the patient; the immunophenotypic date collected from the examination; and the diagnosis of dermatofibrosarcoma protuberans (DFSP). Also mentioned is the Mohs' micrographic surgery performed to excise the neoplasm.

The article presents a case study of a 66‑year‑old woman who had bullous pemphigoid (BP), which had developed on lichen sclerosus et atrophicus (LSA) lesions. Topics discussed include the tense bullae on her sclerotic LSA lesions; the skin biopsies performed on the patient; and the direct immunofluorescence study of specimens from the patient. Also mentioned is the use of oral prednisolone for the treatment of the patient.

The article presents a case study of a 15-year-old girl who presented a 1-year history of asymptomatic, symmetrical, and white lesions located on her palms. The patient underwent clinical and hispathological examination and was diagnosed with aquagenic syringeal acrokeratoderma (ASA) which is a rare disorder that is characterized by symmetrical, edematous, white and translucent papules and plaques.

The article presents a case of porokeratotic eccrine ostial and dermal duct nevus (PEODDN), a rare disorder of keratinization, with unique clinical and histopathological findings. Topics discussed include the characteristics of PEODDN, diseases reportedly associated with PEODDN, and the limited treatment options for PEODDN.

Epidermal infundibular cysts have been known to arise from implantation of epidermis in the dermis or subcutaneous tissues. The present case illustrates the theory of implantation in an epidermal inclusion cyst in a previously operated case of recurrent benign fibrous histiocytoma. [ABSTRACT FROM AUTHOR]

The article discusses the case of a man with multiple angiokeratomas on the glans penis. Topics covered include the characterization of the disease such as dilated blood vessels in the upper dermis and epidermal reactions to the condition. Also mentioned is the use of biopsy to assess the health condition.

The article discusses how fine needle aspirate cytology (FNAC) provides a simple, effective tool in diagnosing an epidermoid cyst of the breast. It refers to the case of 21-year-old unmarried female who presented with a lump in the left breast. It argues that the lesion can be mistaken for a benign or malignant lesion of the breast clinically and radiologically. It highlights the efficacy of FNAC in diagnosing the lesion, which can be treated by simple excision.

Aseptic meningitis is characterized by noninfective serous inflammation of the meninges. It can occur in a recurrent fashion when associated with dermoid and epidermoid cysts due to rupture of cyst contents into subarachnoid space resulting in aseptic chemical meningitis. Bacterial meningitis in association with these tumors is commonly related to a coexisting dermal sinus tract and the most common organism is Staphylococcus aureus. [ABSTRACT FROM AUTHOR]