THE CUTTING EDGE: CHALLENGES IN MEDICAL AND SURGICAL THERAPIES SECTION EDITOR: EDWARD W. COWEN, MD, MHSc; ASSISTANT SECTION EDITORS: MURAD ALAM, MD; RUTH ANN VLEUGELS, MD Treatment of Acquired Perforating Dermatosis With Cantharidin Jessica Wong, BMedSci; Robert Phelps, MD; Jacob Levitt, MD; Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia (Ms Wong); and Departments of Pathology (Dr Phelps) and Dermatology (Dr Levitt), The Mount Sinai Medical Center, New York, New York Many treatments have been proposed for acquired per- dialysis, a 30-year history of insulin-dependent diabetes forating dermatosis (APD), with varying success. In gen- mellitus, hypercholesterolemia, hypertension, coronary eral, treatment is unsatisfactory and definitive resolu- artery bypass, hypothyroidism, and hyperparathyroid- tion of existing lesions is difficult to achieve. ism. There was no family history of similar skin lesions. A biopsy specimen from a lesion on the left leg revealed keratotic plugs filled with laminated orthokeratotic and REPORT OF A CASE parakeratotic keratin and debris. Beneath the plug, the epidermis was thinned and the dermis showed a neutro- A 65-year-old woman presented with a 6-month history philic infiltrate and foci of fibrosis (Figure 2A). Tri- of pruritic, hyperpigmented papules with central, hyper- chrome stain showed rare focal collagen extruding
JAMA Dermatology – American Medical Association
Published: Feb 1, 2012
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