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We report a 48-year-old woman who presented with waxing and waning papulovesicles of 4 years' duration. Histologic examination revealed a folliculotropic, small cell dominant, T cell lymphocytic infiltrate unaccompanied by follicular mucin deposition and with scattered intrafollicular and perifollicular CD30+ cells. A diagnosis of type B follicular lymphomatoid papulosis (LyP), rather than mycosis fungoides (MF), was made on the basis of her clinical presentation, which included spontaneously resolving, waxing and waning papules that healed with scarring. Type B follicular LyP is a rare form of LyP.

Long-term in vitro compatibility of desoximetasone and tacrolimus ointments prompted the current trial in humans. We aimed to evaluate the efficacy of twice-daily simultaneous application of desoximetasone and tacrolimus in the treatment of atopic dermatitis versus tacrolimus monotherapy. Eighty-two subjects were treated in this multicenter, single-group, double-blinded, paired, 3-week follow-up clinical study of desoximetasone 0.25% and tacrolimus 0. 1% ointments versus tacrolimus 0.1% ointment and vehicle. Subjects were treated twice daily for 21 days or until clearing. Safety and efficacy were assessed at days 3, 7, 14, and 21. The combination of desoximetasone and tacrolimus ointment was superior to tacrolimus alone (P=.0002) in treating atopic dermatitis as measured by the summary of the scores for erythema, lichenification, pruritus, scaling/dryness, and oozing/crusting. Of note, pruritus at the application site was diminished in subjects treated with desoximetasone and tacrolimus together compared with tacrolimus alone (P=.04). Combination treatment with desoximetasone and tacrolimus offered increased efficacy and tolerability over tacrolimus alone in patients with atopic dermatitis.

Scurvy, a disease rarely seen in modern times, results from dietary deficiency of vitamin C and is characterized in adults by hemorrhagic diathesis, hair follicle abnormalities, and osteopenia. We present a 59-year-old man with perifollicular petechiae of the extremities, a painful lower extremity hematoma, and sacral osteopenia, who was repeatedly misdiagnosed with leukocytoclastic vasculitis. The patient's dietary history revealed several months of virtually no vitamin C intake. The patient rapidly improved with vitamin C replacement. We review the biochemical basis and pathophysiology of scurvy, clinical scenarios in which it occurs, clinical signs and radiologic features of the condition, and recommendations for its diagnosis and treatment.