Vascular stains and hair collar sign associated with congenital anomalies of the scalp

We reported a series of three meningothelial hamartomas, one benign fibrous tumor, and one aplasia cutis congenita presenting with the hair collar sign and a coexistent vascular stain. Our series highlighted the importance of coexisting cutaneous markers found in the newborn period. The presence of a vascular stain and hair collar sign with or without a congenital scalp nodule should increase suspicion of an associated cranial dysraphism.     

Leser-Trélat sign associated with Sézary syndrome

The Leser-Trélat sign is a rare but well known cutaneous indicator of internal malignancy, most commonly adenocarcinoma of the stomach. There have been only a few cases associated with lymphoproliferative malignancies. Sézary syndrome is a chronic leukemia/lymphoma characterized by generalized erythroderma and circulating Sézary cells. We describe a rare case of the Leser-Trélat sign associated with the Sézary syndrome. The skin sign was alleviated through combination chemotherapy.     

The sign of Leser-Trélat associated with malignant melanoma

A case of the sudden appearance of multiple pruritic seborrheic keratoses (Leser-Trélat sign) associated with cutaneous malignant melanoma is reported. To the authors' knowledge, this association has not been previously reported.     

Trichotillomania and trichophagia leading to trichobezoar

A 14-year-old female presented with the complaints of loss of hair, scalp pruritus, and pain in the abdomen. On careful work-up, she was found to have trichotillomania as well as trichophagia. Investigations also revealed a trichobezoar which completely filled the stomach. Hemogram showed moderate hypochromic anemia. Her detailed psychiatric profile showed a few additional features like obsessive hand washing, knuckle cracking, nose picking and body rocking. Her trichobezoar was removed surgically, and she had an uneventful post-operative recovery. She is being maintained on fluoxetine and is doing well. The role of a multi-disciplinary approach to trichotillomania patients is highlighted.     

Dispelling the myth of the "benign hair sign" for melanoma

The vast majority of melanocytic lesions with hair, such as congenital melanocytic nevi, are benign. However, there is a notion that the presence of one or more hairs in a melanocytic lesion is confirmatory for the benign nature of the lesion. To dispel this notion, we present 3 examples of melanocytic lesions that showed terminal hairs on clinical and dermoscopic evaluation, but in which the final diagnosis was invasive melanoma. Thus, integrating all clinical and dermoscopic findings, rather than relying on a single criterion for the lesion at hand should guide clinicians to the correct diagnosis.     

Trichotillomania: a review and case report

Although patients with trichotillomania typically present to dermatologists, the diagnosis and treatment lie in the field of psychiatry. We report an unusual case of a 33-year-old woman with severe trichotillomania. We review common clinical and pathologic findings of this often chronic and socially debilitating disorder. In addition, we discuss treatment options for dermatologists and how collaboration with psychiatrists is the most effective management for these difficult-to-treat patients.     

Squamous cell carcinoma and keratoacanthoma of the lower lip associated with "Goza" and "Shisha" smoking

BACKGROUND: A positive correlation between lip and buccal cancers and pipe smoking has been suggested. Various types of crude and manufactured tobacco products are consumed by smoking, chewing, and snuff dipping habits. 'Shisha" and 'Goza' smoking are widely practiced in the Middle East. The 'hubble-bubble' method and apparatus are used. These smoking habits are hazardous to health, causing obstructive lung disease, and may be important predisposing factors for the development of oral cancers. CASE REPORTS: Two cases of squamous cell carcinoma and a case of keratoacanthoma localized to the lower lip are presented in well-known 'Shisha' and 'Goza" smokers. CONCLUSIONS: "Shisha" and 'Goza' smoking have adverse effects on general health and may predispose to oral cancer. An extensive epidemiological study should be performed to determine whether this type of smoking habit is associated with a statistically increased incidence of squamous cell carcinoma and keratoacanthoma of the lips.     

Reactions at silicone-injected sites on the face associated with silicone breast implant "inflammation" or "rejection"

Although complications in various parts of the body have been suggested as being produced when silicone mammary implants are "rejected" or produce inflammation, there have apparently been no reports describing "flares" at previous sites of facial silicone injections as complications of mammary silicone implants. Such reactions appear to be comparable to so-called "systemic contact dermatitis." However, in the absence of results of skin testing, the mechanism of such "ectopic" flares remains in doubt.