Search

Combination topical corticosteroids and vitamin D analog treatments for nail psoriasis are widely used in cream and ointment vehicles, but patients may prefer a foam vehicle due to ease of application and favorable cosmetic appearance. Calcipotriene 0.005%/betamethasone dipropionate 0.064% (Cal/BD) aerosol foam is an FDA approved therapy for plaque psoriasis, but may also be an effective treatment for nail psoriasis in a novel aerosol foam. We present a case series of 3 patients with mild to moderate nail psoriasis who responded positively to treatment with Cal/BD aerosol foam applied 1-2 times daily to affected nails for at least 6 weeks. Reduction of nail plate surface abnormalities and a decrease in inflammation of the nail folds were assessed with clinical evaluation and dermoscopy, and documented with serial photography. While further research on the efficacy and safety of Cal/BD aerosol foam as a treatment for nail psoriasis is needed, this report suggests its potential as a combination topical vitamin D analogue and high potency steroid in a foam vehicle.

Nevus sebaceous is a congenital epidermal hamartoma characterized by hyperplastic changes to the epidermis and adnexa. Nevus sebaceous is associated with an elevated risk of cutaneous neoplasms, most often benign; however, malignant neoplasms, most notably basal cell carcinoma, can also present in these patients. Although a rare occurrence, more often affecting adult patients, squamous cell carcinomas have also been reported to arise at the site of pre-existing nevus sebaceous. Herein we report a unique case of a patient with basal cell carcinoma and squamous cell carcinoma arising concurrently in the same nevus sebaceous.

A 51-year-old female with a history of rheumatoid arthritis was admitted for progressive fevers, chills and malaise. Five weeks prior, she started minocycline for an RA exacerbation. Two weeks after starting minocycline she developed an abscess on her right ankle that was treated at an urgent care facility with ceftriaxone and trimethoprim-sulfamethoxazole. She had minimal improvement so was switched to clindamycin. She developed additional abscesses on her right ankle and right axilla and spiking fevers so she was treated with incision and drainage under general anesthesia. Routine blood work obtained prior to surgery revealed severe neutropenia (0.74 103/ul) and the patient was urgently referred to the emergency department. Skin biopsy was obtained on admission and revealed ulceration, necrosis, acute and chronic inflammation, vasculitis with vascular thrombosis and rod-shaped bacteria in blood vessel walls and lumina consistent with ecthyma gangrenosum. The following day tissue and blood cultures confirmed the growth of Pseudomonas aureginosa. Bone-marrow biopsy showed decreased granulopoiesis and hematopoiesis, and a diagnosis of minocycline-induced agranulocytosis presenting as ecthyma gangrenosum was made. The patient had dramatic improvement with appropriate antibiotic therapy, discontinuation of minocycline and initiation of filgrastrim. She has remained healthy without recurrence for 17 months.

not available.

Hypergranulation is the extension of granulation tissue beyond the required amount to close a tissue defect. We report our experience using aluminum chloride to treat a series of two patients with hypergranulation tissue. Both patients had lengthy treatment courses after Mohs surgery with growth of hypergranulation tissue that resolved once aluminum chloride was placed on the wound. Aluminum chloride is a useful hemostatic agent frequently employed in dermatology. It is a readily available and low-cost option for management of hypergranulation after dermatologic procedures. Chronic wounds are a common treatment challenge for clinicians. Due to its affordability and availability, clinicians may consider topical aluminum chloride when managing post-surgical hypergranulation tissue.

not available.