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Melanoma, with its diverse histopathologic characteristics, can mimic both benign nevi and neoplasms of various cell lineages. Immunohistochemistry (IHC) can play a vital role in melanoma diagnosis, particularly when the cell lineage is unclear on hematoxylin and eosin sections. Commonly utilized IHC stains for melanoma diagnosis include SOX10, Melan‐A, and S100. A relatively novel stain, PReferentially expressed Antigen in MElanoma (PRAME), is also proving useful in accurate melanoma diagnosis. However, none of these stains are completely specific to melanocytes or melanoma, and misinterpretation can lead to incorrect diagnoses. This report presents a unique case of triple‐negative breast carcinoma (TNBC) metastatic to the skin exhibiting histopathologic characteristics similar to melanoma, including positivity for SOX10 and PRAME. Our aim is to highlight TNBC metastatic to the skin as a potential diagnostic pitfall. [ABSTRACT FROM AUTHOR]

Introduction: Safeguarding the integrity of the donor site during the initial suspension phase of an interpolation flap is difficult. There are a variety of approaches and no consensus on post‐operative management of the donor site or pedicle following the creation of the flap. The use of xenografts at the donor site of postauricular interpolation flaps simplifies post‐operative wound care and prevents infection, desiccation of tissue, reduces pain, and assists with hemostasis. Methods: A porcine acellular dermal skin substitute can be utilized for the purpose of care‐free interpolation flap wound care. First, the flap is designed and raised using standard surgical technique. The porcine xenograft is then sutured into the donor site and to the exposed subcutaneous side of the flap pedicle using nylon suture material. The flap then is interpolated and sutured into the surgical defect of the auricle. Silicone gel is applied to the surface of the xenograft. A pressure dressing is then placed over the surgical site. Results: A total of 4 patients had postauricular interpolation flaps to the ipsilateral helix. All four patients had a xenograft placed at the donor site and flap pedicle at the time of the flap creation and suspension. No infections and no incidence of post‐operative bleeding requiring intervention were noted. Conclusion: Utilizing a dermal skin substitute as a biological dressing for an interpolation flap prior to division and inset of the flap provides a useful alternative to traditional wound care during this interim period. [ABSTRACT FROM AUTHOR]

The development of periungual pyogenic granulomas while taking the oral acne drug isotretinoin is a known yet uncommon and potentially severe side effect of the oral vitamin A derivative. Previous reports have detailed the development of pyogenic granulomas most commonly arising at sites of previous acne lesions as well as both subungual and periungual locations, with associated paronychia, bleeding, and discomfort. This is thought to arise as a result of the nail bed's fragility and propensity toward spicule formation brought on by the proliferative action of isotretinoin. Here, we report a case of periungual pyogenic granuloma with associated paronychia in a patient taking oral isotretinoin. A review of the pathogenesis and available treatment modalities based on the current literature is provided. [ABSTRACT FROM AUTHOR]