rosive pustular dermatosis (EPD) is characterized by itchy or painful erythematous plaques with erosions, sterile pustules, and yellow crusts. The etiology of EPD is unknown as laboratory tests, microbiological cultures, and histopathological studies are nondiagnostic. Cuts and bruises, cryotherapy, and other trauma to actinically damaged skin, usually a bald scalp, are inciting factors. [1][2][3][4] Here, we present 3 cases of facial EPD occurring after cosmetic resurfacing procedures. We evaluated these cases between between September 10, 2010, and May 6, 2016.

Juvenile xanthogranuloma is a benign histiocytic tumor predominantly occurring in children as yellowish papules on the head and trunk. Presentations on the volar surfaces are rare and may cause diagnostic confusion with pyogenic granuloma, eccrine poroma and digital fibrokeratoma. We report two patients with unusual presentations of solitary juvenile xanthogranuloma on the palm or sole. Both had lesions lacking the classic yellowish color and demonstrating a well-defined, peripheral hyperkeratotic rim. Histopathological evaluation revealed prominent orthokeratosis corresponding to the rim. Additional histological features, including dermal histiocytes and Touton giant cells, were consistent with the diagnosis of juvenile xanthogranuloma. Given the unusual locations and colors of the lesions, we conclude that histopathological evaluation is central to diagnosing volar juvenile xanthogranuloma. We additionally suggest that juvenile xanthogranuloma should be included in the differential diagnoses of volar lesions displaying a peripheral hyperkeratotic rim.

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Basal cell carcinoma is the most common malignancy in the United States. However, metastasis of basal cell carcinoma is exceedingly rare, with incidence estimates of 0.0028–0.055%. When it does metastasize, basal cell carcinoma most commonly spreads to regional lymph nodes and lungs, although other sites of disease can occur. This case report presents multi-modality imaging of a 54-year-old male who developed multifocal metastatic basal cell carcinoma approximately three years after initial presentation with an ulcerated groin lesion. Ultimately, metastases included many common and uncommon sites, including lymph nodes, lung, duodenum, spleen, and adrenal glands. This case provides an interesting example of an uncommon pattern of spread and associated symptoms of treatment-resistant metastatic basal cell carcinoma.

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