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When an active patient has a mass on the Achilles tendon, fibroma of the tendon sheath should be in the differential diagnosis along with other tumors and benign conditions like inflammation or rupture. A case report demonstrates how the clinical characteristics of fibromas resemble other common tendon tumors, such as giant cell tumor of the tendon sheath. A histologic exam is needed to distinguish a fibroma of the tendon sheath from other tumors. Plain films should be considered to rule out bony involvement. Surgical excision is required. Patients should know that fibromas recur in 25% of those who have them removed. [ABSTRACT FROM AUTHOR]

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

Background: Regulatory T cells (Tregs) are reduced in the peripheral blood and skin lesions of patients with bullous pemphigoid (BP). Low-dose interleukin 2 (IL-2) therapy can stimulate Tregs specifically, suggesting potential for the treatment of BP., Objective: To evaluate the response to low-dose IL-2 therapy in the treatment of moderate-to-severe BP., Methods: Forty-three patients with moderate-to-severe BP were included. The therapy included systemic corticosteroids with an initial dose of 0.5 mg/kg/d for moderate and 1.0 mg/kg/d for severe disease, respectively, combined with allowed immunosuppressants for the control group, whereas in addition to the same corticosteroid therapy, IL-2 (half million IU) was administered subcutaneously every other day for the treatment group for 8 weeks. The primary outcome was the number of days required to achieve disease control. Secondary outcomes included other clinical responses., Results: The number of days required to achieve disease control with the treatment group was (7.60 ± 3.00), which was shorter than in the control group (10.43 ± 3.06) (P = .008). The total amount of systemic corticosteroids was less, and no serious infections were detected in the treatment group., Limitations: Single center, open-label study with short duration and small size., Conclusion: Our trial supports the potential of low-dose IL-2 therapy for patients with moderate-to-severe BP, which showed earlier treatment responses., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Erythema nodosum (EN) is a form of septal panniculitis that can occur secondary to multiple etiologies including inflammatory disorders, infections, or medications. We describe a 42-year-old woman who developed tender, erythematous, subcutaneous nodules persisting for 4 months following a copperhead snakebite. The diagnosis of EN was confirmed via histopathology, and the patient was treated with colchicine. Physicians should be aware of possible etiologies of EN to evaluate patients who present with new-onset tender subcutaneous nodules. Additionally, physicians should understand the various complications that can result from snakebites, with the potential for lingering cutaneous manifestations weeks to months following the initial bite.

A generalized fixed drug eruption (FDE) is an uncommon but potentially dangerous reaction to medication. In this case series, we present 1 patient with a generalized FDE and 2 patients with generalized bullous FDE that resolved with cyclosporine, though 1 patient required close monitoring in the intensive care unit. Immediate acceleration of care upon development and recognition of generalized bullous FDE is essential, as the mortality rate is similar to Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).

Sea urchin injuries are common following accidental contact with sharp sea urchin spines. Immediate manifestations of injury include local erythema, pain, and myalgia. Failure to remove the spines from the skin may result in delayed systemic reactions, secondary infection, granulomas, and-if joint spaces are involved-inflammatory or infectious synovitis and arthritis. The majority of severe complications can be avoided if the spines are fully removed from the skin soon after injury, which can be difficult. This article aims to bring awareness to the myriad complications from sea urchin injuries as well as the mechanisms for successful spine removal.

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

Patients presenting with a linear, erythematous, blistering eruption may experience a sudden painful sunburn that seems to get worse rather than better with time. In warm climates, exposure to the common fig tree (Ficus carica) may be the culprit. Dermatologists should recognize fig phytophotodermatitis as a possible cause and help the patient connect their symptoms with the inciting agent as well as administer proper treatment.

There is a large burden of treatable dermatologic conditions in refugee populations. Parasitic infestations are particularly common when there are barriers to basic hygiene, crowded living or travel conditions, and lack of access to health care. Body lice are associated with anemia and can transmit a variety of diseases; chronic impetigo secondary to scabies is a leading cause of chronic kidney disease globally. Dermatologists have unique skills to identify skin infections, inflammatory diseases, and infestations. Appropriate dermatologic care has the potential to improve overall outcomes.

Competing Interests: Conflicts of interest None disclosed.

Scorpionfish are among the most venomous creatures found in American and Caribbean seas. Their envenomation is responsible for considerable morbidity and socioeconomic burden associated with marine animal injuries. Avoiding physical contact with scorpionfish through proper identification prevails as the chief prevention method for stings. This article discusses common features of scorpionfish as well as the clinical presentation and treatment options following exposure to its toxins.

"Leaves of three, leave it be" serves as an apt caution for avoiding poison ivy (Toxicodendron species) and its dermatitis-inducing sap. Toxicodendron contact dermatitis (TCD) poses a notable burden to the American health care system by accounting for half a million reported cases of allergic contact dermatitis (ACD) annually. Identifying and avoiding physical contact with the western poison ivy (Toxicodendron rydbergii) plant prevails as the chief method of preventing TCD. This article discusses common features of T rydbergii as well as clinical manifestations and treatment options following exposure to this allergenic plant.

Rhipicephalus ticks are vectors of disease in humans and animals. Rhipicephalus sanguineus sensu lato (the brown dog tick) is one of the most geographically widespread tick species worldwide, likely due to its ability to colonize human and canine dwellings over a range of habitats. They transmit a variety of diseases to dogs and humans, including canine babesiosis, canine monocytic ehrlichiosis, hepatozoonosis, Mediterranean spotted fever, and Rocky Mountain spotted fever. Tick bites manifest as intensely pruritic, erythematous papules at the site of tick attachment; symptomatic relief usually can be achieved with topical antipruritics. Prevention of tick bites is best achieved through a combination of veterinary and environmental control; protective clothing; repellents, such as N,N-diethyl-meta-toluamide (DEET) and permethrin; and prompt identification and removal of ticks.

Background: Cytologic atypia encompasses several features of abnormal cellular morphology. We sought to quantify these features in benign and premalignant/malignant squamous cell lesions to better characterize criteria for malignancy., Methods: We conducted a rater-blinded observational study in which histopathology slides were evaluated under light microscopy, and the presence and relative quantity of 24 distinct cytological features were recorded, along with respective diagnoses. Each slide was evaluated, and the ratings were recorded and analyzed., Results: The most helpful findings, whose presence in high numbers indicates an increased likelihood that the tissue sample is premalignant/malignant, were: (1) pleomorphic parakeratosis; (2) pleomorphic nuclei in the epithelium; (3) irregular nuclei; (4) thick refractile nuclear envelope; (5) presence of nuclear hyperchromasia (dark gray); (6) peripheral nucleoli; and (7) nucleolar stems. Higher values of round or oval nuclear shape and vesicular nuclei increase the likelihood that the tissue sample is benign., Conclusions: Certain nuclear features have a higher association with premalignancy/malignancy and may guide histologic evaluation of a given lesion. These findings can be used in combination with architectural features and clinical history to add to a complete diagnostic picture., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The sticktight flea (Echidnophaga gallinacea), a carrier of plague (Yersinia pestis), rickettsial infections, and other diseases, can be found in warm climates. The flea attaches to a host by embedding its head in the skin for days at a time. Most human infestations occur in individuals who handle infested animals. The sticktight flea can cause delayed erythema of the skin surrounding the embedded head. Common treatments include oral or topical antihistamines or a topical corticosteroid applied to the affected area.

Patients with midline cutaneous anomalies of the craniospinal axis can be indicative of underlying embryonic defects, such as neural tube defects. Lack of familiarity with these midline aberrant skin findings may lead to misdiagnosis and delayed treatment. In this review, midline cutaneous anomalies of the craniospinal axis including aplasia cutis congenita, cranial and spinal dysraphism, and other developmental anomalies are explored in detail with emphasis on cutaneous clues to the diagnosis and appropriate workup., Competing Interests: Conflicts of interest None disclosed., (Copyright © 2023 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)