Congenital Smooth Muscle Hamartoma of the Skin

Abstract: Three cases of circumscribed congenital smooth muscle hamartoma (CSMH) in the neonate are described, including typical characteristics and differential diagnosis. This condition is a clearly defined, distinct entity, separate from simitar lesions that are considered in the differential diagnosis. It is possibly more common than is evident from the literature.     

Congenital Smooth Muscle Hamartoma of the Skin

Abstract: : A 2-month-old white girl had a congenital, tan-colored, slightly elevated, 3 × 2-cm plaque on the left midback. Clinically, the lesion was suspected to be a solitary masiocytoma. Rubbing the lesion produced a transient erythema and edema that was similar to Darier sign seen in mastocytoma. Analysis of a skin biopsy specimen revealed a smooth muscle hamartoma; special stains did not show evidence of increased numbers of mast cells. This relatively uncommon condition can be confused with a variety of other cutaneous diseases. Light microscopic examination of a skin biopsy specimen establishes the diagnosis. A review of the approximately 50 cases reported in the literature showed that there is no known associated systemic involvement or malignant transformation. The clinical lesions usually become less prominent with time.     

Hemophagocytic Lymphohistiocytosis in a Newborn Presenting as “Blueberry Muffin Baby”

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life‐threatening hyperinflammatory syndrome characterized by uncontrolled activation and proliferation of proinflammatory cytokines. Initial presentation commonly includes fever, hepatosplenomegaly, and pancytopenia; 6 to 65% of cases also have a concurrent cutaneous eruption. We present the case of a 6‐day‐old premature infant boy with congenital severe thrombocytopenia, anemia, and hepatosplenomegaly who presented with several cutaneous violaceous papules and nodules and was found to have HLH.     

面部先天性皮肤平滑肌错构瘤1例

患者女,15岁。颏部淡粉色包块15年,缓慢增大。皮损组织病理：表皮大致正常,真皮全层可见增生的平滑肌纤维束,增粗的平滑肌束边界清楚,纵行分布。免疫组化：平滑肌肌动蛋白SMA（＋）,高倍镜下可见清晰的阳性表达横纹肌结构。诊断：先天性皮肤平滑肌错构瘤。     

Congenital Smooth Muscle Hamartoma on the Face Treated Using Vascular Laser

Abstract: A congenital smooth muscle hamartoma is a rare, benign proliferation of smooth muscle bundles in the dermis that is usually diagnosed in the neonatal period or infancy. Surgical excision is the first‐line therapeutic option, but in certain areas such as the face, surgery may be too aggressive, and different treatments should be considered. We present the case of a congenital smooth muscle hamartoma on the face treated using pulsed dye laser with good response.     

The “gauntlet” of pellagra

A 48-year-old alcoholic Filipino man presented to the outpatient department with a 2-year history of an eruption in a photosensitive distribution and episodes of mild diarrhea. He was otherwise in good health. Dermatologic examination revealed a browny-red coloration, with a sharply demarcated erythematous border, affecting both hands and lower forearms, where it was striking in its symmetry ( Fig. 1 ). Around the neck, it was typical of a casal's necklace. The fronts and backs of the legs and the dorsa of the feet were also erythematous. The patient showed no evidence of mental confusion.

Figure 1 Open in figure viewer PowerPoint “Gauntlet” of pellagra, showing browny-red discoloration with sharply demarcated erythematous border     

False “Highlighting” with Wood’s Lamp

Abstract: Wood's lamp evaluation is used to diagnose pigmentary disorders. For example, vitiligio typically demonstrates lesional enhancement under Wood's lamp evaluation. Numerous false positive enhancing lesions can be noted in the skin. We describe a 5‐year‐old Hispanic boy who had painted his face with highlighter, producing enhancing lesions under Wood's lamp. Physicians who use Wood's lamp should be aware that the appearance of markers and highlighter can mimic that of true clinical illnesses.