Besides being an uncommon clinicopathological entity, interstitial granulomatous
dermatitis, also described as interstitial granulomatous dermatitis with arthritis
(IGDA), has shown a wide spectrum of clinical manifestations, such as linear and
erythematous lesions, papules, plaques and nodules. Histological features include
dense dermal histiocytic infiltrate, usually in a palisade configuration, and
scattered neutrophils and eosinophils. We describe a middle aged woman with
rheumatoid arthritis of difficult management and cutaneous lesions compatible with
IGDA.
Squamoid eccrine ductal carcinoma is an eccrine carcinoma subtype, and only
twelve cases have been reported until now. It is a rare tumor and its
histopathological diagnosis is difficult. Almost half of patients are
misdiagnosed as squamous cell carcinoma by the incisional biopsy. We report the
thirteenth case of squamoid eccrine ductal carcinoma. Female patient, 72 years
old, in the last 6 months presenting erythematous, keratotic and ulcerated
papules on the nose. The incisional biopsy diagnosed squamoid eccrine ductal
carcinoma. After excision, histopathology revealed positive margins. A
wideningmargins surgery and grafting were performed, which again resulted in
positive margins. The patient was then referred for radiotherapy. After 25
sessions, the injury reappeared. After another surgery, although the
intraoperative biopsy showed free surgical margins, the product of resection
revealed persistent lesion. Distinction between squamoid eccrine ductal
carcinoma and squamous cell carcinoma is important because of the more
aggressive nature of the first, which requires wider margins surgery to avoid
recurrence.
Frontal fibrosing alopecia is a distinctive form of scarring alopecia considered
to be a clinical variant of lichen planopilaris. It predominantly occurs in
postmenopausal women and has a slowly progressive course. It was first described
by Kossard in 1994. Since then the number of reported cases has increased
significantly. Coexistence of frontal fibrosing alopecia and autoimmune
disorders - such as discoid erythematosus lupus and Sjögren's syndrome -
may suggest a common pathogenic background among the diseases.
Tyrosine kinase inhibitors are effective as a target therapy for malignant
neoplasms. Imatinib was the first tyrosine kinase inhibitor used. After its
introduction, several other drugs have appeared with a similar mechanism of
action, but less prone to causing resistance. Even though these drugs are
selective, their toxicity does not exclusively target cancer cells, and skin
toxicity is the most common non-hematologic adverse effect. We report an
eruption similar to lichen planopilaris that developed during therapy with
nilotinib, a second generation tyrosine kinase inhibitor, in a patient with
chronic myeloid leukemia resistant to imatinib. In a literature review, we found
only one report of non-scarring alopecia due to the use of nilotinib.
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