No abstract

Epstein-Barr virus (EBV)-positive mucocutaneous ulcer was recently described as a clinicopathologic entity occurring secondary to iatrogenic or age-related immune suppression. The histopathology of EBV-positive mucocutaneous ulcer reveals a polymorphous infiltrate including atypical large B-cells and Reed-Sternberg-like cells which are CD20-positive, CD30-positive and EBV-positive. The disorder follows an indolent and self-limited course. We report a case of EBV-positive mucocutaneous ulcer secondary to prolonged use of azathioprine for the treatment of pemphigoid and highlight the need for recognition of this disorder by dermatopathologists and dermatologists.

The patient incorrectly identified 45 of 271 surgical sites (16.6%), and the physician incorrectly identified 16 of 271 surgical sites (5.9%). The surgeon and the patient both incorrectly identified 12 of 271 sites (4.4%). All surgical sites were correctly identified with preoperative biopsy-site photography.

Variations in MMS reflects the diverse training and creativity among Mohs surgeons. Unless potential errors are addressed, however, false negatives will occur and undermine the superior cure rate of MMS.

We present a novel method for repairing adjacent surgical defects with a rotation flap. Surgeons are presented with adjacent surgical defects and challenged to find the repair option that will give the most optimal cosmetic result. The options for closing small adjacent surgical defects include making the defects a single large defect for primary closure, full-thickness skin grafting, primary closure of each defect separately, flap coverage, secondary intention healing, or any combination of these. The use of a single rotation flap to cover two adjacent surgical defects provides the surgeon with a convenient and cosmetically acceptable option that avoids unacceptable wound tension and does not distort neighboring structures.