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Background: Extramammary Paget disease (EMPD) is a rare malignant neoplasm arising from apocrine gland-bearing skin. The surgical management of EMPD is often coupled with noninvasive techniques including cryotherapy, ablative lasers, topical chemotherapies, and photodynamic therapy (PDT). The specificity and preservation of tissue that PDT with photosensitizers 5-aminolevulinic acid or 5-methyl aminolevulinate allows makes it a potential treatment of EMPD., Methods: The authors present a review of 13 studies, from 2002 to 2019, examining the reported efficacy of PDT alone and adjunctive PDT in EMPD treatment., Results: In the 52 patients with 56 lesions who received stand-alone PDT, 20 lesions (35.7%, n = 20/56) experienced complete resolution, 31 lesions (55.4%, n = 31/56) experienced partial resolution, 5 lesions (8.9%, n = 5/56) failed to demonstrate response to treatment, and 23 lesions (41.1%, n = 23/56) had recurrence. In the 56 patients with 66 lesions that received adjunctive PDT paired with surgery ( n = 55/66), imiquimod ( n = 4/66), holmium laser and surgery ( n = 1/66), Mohs surgery ( n = 2/66), and combined surgery, imiquimod, and 5-fluorouracil ( n = 1/66), 34 lesions (51.5%) experienced complete resolution, 27 lesions (40.9%) experienced partial resolution, 5 lesions (7.6%) failed to demonstrate any response to treatment, and 16 lesions (24.2%) had EMPD recurrence., Conclusion: Further studies with larger sample size are needed to consolidate these findings and inform clinical decisions., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Hypothyroidism is associated with many characteristic cutaneous manifestations; however, to the best of our knowledge, it has not previously been linked to psoriasiform lesions or multiple abscesses. We describe a previously healthy 15-year-old girl with psoriasiform lesions, abscesses, and extremely severe hypothyroidism, all presenting simultaneously. The pathophysiology of the connection is unclear, but several hypotheses are discussed. The temporal relationship of these conditions and the significant improvement of the skin lesions upon normalization of T4 levels following initiation of thyroid supplementation illustrate a direct association. It is probable that the extreme severity of hypothyroidism in our patient is implicated in the etiology of these skin lesions. This unique case illustrates that novel cutaneous manifestations may sometimes act as an early presenting sign of hypothyroidism and may be associated with more severe forms of the disorder.

Background: Bowen's disease is a common skin cancer. There are many different therapeutic approaches to treatment. Topical 5-Fluorouracil (5-FU) cream has been used for many years and there are many published papers attesting to its effectiveness. However, no papers have presented long-term followup results with biopsy confirmation of cure., Objectives: The purpose of this article is to present the long-term findings following the use of this cream in the treatment of Bowen's disease., Methods: Twenty-four patients with 26 biopsy-confirmed lesions of Bowen's disease were treated with topical 5-Fluorouracil cream and were followed for periods of up to 10 years. Posttreatment biopsies were performed in most cases., Results: Two of the 26 lesions treated topically recurred at some point. The rest were apparently cured., Conclusion: The results presented in this article confirm that treatment of Bowen's disease with topical 5-Fluorouracil cream is safe and effective treatment.

Background: Tinea capitis is a worldwide problem and occurs most commonly in young children. Certain common fungal types are most often recognized as the responsible infecting organism., Objective: This article presents the case of an elderly woman with tinea capitis caused by a fungal organism that rarely infects hair. A review of the world literature provides evidence of only a few other similar cases., Conclusions: Trichophyton rubrum causing tinea capitis in adults is a rare but now increasingly recognized entity. This possibility should be kept in mind when caring for adults with nonhealing scalp conditions.

A twenty-four year old white man with Ehlers-Danlos syndrome (Type IV) is presented herein. He demonstrates, or has demonstrated, spontaneous bowel perforation, club feet, cryptorchidism, spontaneous vascular rupture, prominent veins, and distal joint hypermobility. In addition, laparotomy for an acute abdominal condition at four years of age revealed a persisting and gangrenous vitelline duct cyst. We believe this is the first report of this congenital anomaly associated with this syndrome.

We present a case of solitary fibrofolliculoma. Histopathologic findings of this entity are characteristic: in the dermis a central hair follicle is surrounded by a thick mantle of fibrotic and mucinous stroma, and numerous thin, anastomosing bands of follicular epithelium extend into this stroma. This entity has been described as occurring only multiply; to our knowledge, this is the first case report of a solitary fibrofolliculoma.

A middle-aged man developed multiple dermatofibromas on the legs and arms. The lesions were about sixty in number and were unusual in their rapid onset, their larger-than-average size, and their appearance in large numbers on the arms and trunk. They started approximately 4 months after the patient had begun a regimen of prednisone and cyclophosphamide for myasthenia gravis. This appears to be the second report of the development of multiple dermatofibromas in patients with an autoimmune disease that was being treated with immunosuppressive medications.

Congenital temporal triangular alopecia is a form of nonscarring alopecia that, as its name suggests, is present at birth. Four cases are reported. One patient underwent hair transplantation, which was successful and might be useful in other patients. Cases occurring in a father and his son suggest for the first time a genetic link.

A case of pseudoepitheliomatous, keratotic, and micaceous balanitis in a 69-year-old white man is presented. This report supports the notion that this condition is a localized form of verrucous carcinoma which tends to be resistant to treatment and to recur locally. Treatment with topical fluorouracil cream was partially effective but follow-up studies were not available because the patient died of lung cancer. This appears to be only the third reported case of this condition in the English literature.