Discoid lupus is an autoimmune disorder with primarily cutaneous manifestations. Carcinomatous changes in discoid lupus can lead to the development of squamous cell carcinoma. While this most often occurs in Caucasians, the presented patient is an African American. She developed numerous squamous cell carcinomas in areas of scarring from discoid lupus. This case illustrates the need for careful observation of discoid lupus for the development of squamous cell carcinoma in the African American patient.

Subcorneal pustular dermatosis (SPD) is a rare pustular neutrophilic dermatosis in which groups of sterile pustules appear in the superficial (subcorneal) skin. This chronic condition can be associated with significant morbidity and decreased quality of life. Dapsone is the first‐line therapy for SPD, but some patients fail to respond or cannot tolerate it. In these instances, patients may be treated with second‐line therapies such as phototherapy, topical corticosteroids, or systemic agents including glucocorticoids, acitretin, immunosuppressive, or biologic medications. These therapies may not always be efficacious and can be associated with intolerable adverse effects. Here, we report a case of a patient who sustained long‐term remission and no side effects with the novel use of pentoxifylline, a tumor necrosis factor‐alpha inhibitor, as monotherapy. Pentoxifylline should be considered as a possible therapy in patients with SPD intolerant to dapsone.

A 14-year-old African American girl with a history of mild atopic dermatitis presented to the outpatient dermatology clinic for evaluation of light spots on her arms and legs. The lesions had been present for approximately 3 months and were asymptomatic. She was otherwise healthy without a history of fevers or weight loss.Physical examination revealed numerous 1 to 1.5 centimeter hypopigmented macules and patches on the extremities, with sparing of the face and trunk (Fig. 1). No lymphadenopathy was appreciated. Initially, the lesions were felt to be potentially consistent with postinflammatory hypopigmentation; however, the patient denied any preceding skin eruption or flare of her atopic dermatitis. She was instructed to moisturize her skin with white petrolatum daily and use sunscreen.The lesions remained unchanged when she returned for follow-up; therefore, a skin biopsy was performed (Fig. 2).