<b><i>Introduction:</i></b> Keratoacanthoma (KA) is a group of tumors of epidermal origin with controversial nature. Subungual keratoacanthoma (SUKA) is a rare and destructive variant with more aggressive behavior. SUKA appears as a rapidly growing, painful tumor beneath the nail plate that rapidly progresses to a mass that can measure up to 2 cm. The toe location is unusual. The diagnosis must be made based on the correlation of clinical, radiological, and histopathological findings. <b><i>Case Presentation:</i></b> We present two cases of patients diagnosed with SUKAs with different clinical presentations which ranged from very typical to uncommon one. Both cases were treated with simple excision without recurrences. <b><i>Conclusion:</i></b> SUKA is a rare subungual tumor. Nail bed location represents a more difficult diagnostic challenge. SUKA should be suspected in the context of persistent and progressive pain on a finger or toe, once more frequent painful tumors have been ruled out.
Confluent ulcerated lesions that demonstrate an edematous and indurated border, surrounded by erythema. (c, d) Pansy flowers exhibit different colours.
Purpose of Review To review recent literature on Malassezia folliculitis and explore its association with COVID-19. Recent Findings Reports of Malassezia folliculitis in the setting of COVID-19 are scarce. Shared characteristics between affected individuals include male sex, obesity, intensive care, and administration of systemic antibiotics and systemic steroids. Dexamethasone can potentially stimulate sebum production and therefore lead to Malassezia proliferation. The clinical picture of Malassezia folliculitis accompanying COVID-19 is similar to classic descriptions but tends to spare the face and predominates in occlusion sites. Summary Malassezia folliculitis is under-recognized. Fever, sweating, occlusion, immobility, antibiotics, and dexamethasone contribute to COVID-19 patients developing Malassezia folliculitis. Antifungal therapy, together with correcting predisposing factors, is the mainstay of management. Future research should explore the relationship between systemic steroids and other acneiform reactions.
A metastatic tuberculous abscess is a rare condition that should be considered in the differential diagnoses of subcutaneous nodules in immunosuppressed patients. A 71-year-old woman with rheumatoid arthritis developed disseminated tuberculosis due to Mycobacterium bovis. After taking a vertebral biopsy, subcutaneous nodules appeared on the extremities. Initial histopathological and microbiological studies performed on the skin biopsy did not identify the mycobacterium. An aspirate obtained from a cold abscess was cultured and studied with a positive polymerase chain reaction; cultures grew M. bovis and treatment for disseminated tuberculosis was initiated. Two months later, the fevers recurred, and new skin nodules appeared. A repeated skin biopsy failed to identify the agent, yet it again grew from the material obtained from an aspirated abscess. Diagnostic tests should be exhausted in order to identify the organism successfully. This case suggested that recurrent hematogenous dissemination may originate after the manipulation of deep foci and present as a metastatic tuberculous abscess. Key words: Mycobacterium bovis; Cutaneous tuberculosis; Vertebral tuberculosis; Metastatic tuberculous abscess; Immunosuppression
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