Erythema toxicum neonatorum

History

          A 3-day-old neonate presented with small follicular papules and pustules on an erythematous base. The lesions involved the face, trunk, and proximal extremities.The eruption has disappeared  by the 10th day. Erythema toxicum neonatorum occurs in the majority of healthy full-term newborns, usually on the second or third day. Because it is so common dermatologists are usually consulted only for the most florid or atypical cases.

Disseminated DLE

History

          A 47-year-old woman complained of an itchy rash on her back and forehead of 2 years duration. On examination multiple, well-demarcated, erythematous plaques with irregular hyperpigmented borders and hypopigmented and even depigmented scarred centers with some adherent scales and excoriations were found. ANF and Anti-dsDNA antibodies were negative.

Rhinophyma

History

          A 68-year-old man presented with a hypertophied, red nose with prominent pilosebacous openings of more than 10 years duration. He was disappointed by poor response to many medical conservative therapies used for long periods.

KA in xeroderma pigmentosum

History

          A 10-year-old boy who is a known case of xeroderma pigmentosum with positive family history of similar condition and early onset skin tumors. He presented with an asymptomatic, dome-shaped nodule with a central keratinous plug of 10 months duration. Excisional biopsy showed KA.

Paget’s disease of the breast

History

          A 63-year-old lady complained of > one-year history of persistent, moderately pruritic, unilateral, slightly infiltrative red plaque involved the left nipple and surrounding areolar region. The patient claimed partial improvement on topical steroid treatment which had been prescribed from time to time. O/E many left axillary lymph nodes were palpable. Skin biopsy confirmed the diagnosis of Paget’s disease of the breast and immunohistochemical assessment revealed positive CEA, EMA and negative S-100 protein. The patient had been referred to surgery.

Common, interesting and rare dermatoses presented in simple way by Dr. Nameer Al-Sudany