Dermatology articles: The New England Journal of Medicine

Images in Clinical MedicineFeb 25, 2021Gum Hypertrophy from Cyclosporine
Menon B.S. and Teh K.-H.|N Engl J Med 2021; 384:744A 7-year-old boy with aplastic anemia received treatment with cyclosporine. While receiving cyclosporine, severe gum hypertrophy, a known side effect of this medication, developed.

Original ArticleFeb 11, 2021Phase 3 Trials of Tirbanibulin Ointment for Actinic Keratosis
Blauvelt A., Kempers S., Lain E., et al.|N Engl J Med 2021; 384:512-520The tubulin polymerization and Src kinase inhibitor tirbanibulin was superior to placebo ointment in clearing actinic keratoses on the face and scalp at 2 months. As is typical of the disorder, lesions recurred in 47% of patients at 1 year. Adverse events were related to local irritation.

Images in Clinical MedicineFeb 11, 2021Mechanic’s Hands
Chatterjee S.|N Engl J Med 2021; 384:e16A 37-year-old man presented with painful, thickened, and cracked skin on his fingertips, which was associated with weakness of the proximal hip and shoulder muscles. The dermatologic finding was consistent with “mechanic’s hands,” and a diagnosis of antisynthetase syndrome was made.

Images in Clinical MedicineJan 28, 2021A Pulsating Leg
Gal M.S. and Greenberger S.|N Engl J Med 2021; 384:e8A 21-month-old boy presented with a pruritic rash on his left leg that was thought to be at the site of a recent insect bite. A video shows a pulsating erythematous plaque, referred to as Quincke’s sign, that was found on his leg.

Images in Clinical MedicineJan 21, 2021Pathergy in Neutrophilic Dermatosis
Moon J.-H. and Huynh J.|N Engl J Med 2021; 384:271A 7-year-old girl presented with fever and painful blisters on her arms, legs, and face. On hospital day 5, a new skin ulcer developed at an intravenous cannula site. Biopsy results were consistent with a neutrophilic dermatosis.

Sounding BoardJan 07, 2021The Rapid Rise in Cutaneous Melanoma Diagnoses
Welch H.G., Mazer B.L., and Adamson A.S.|N Engl J Med 2021; 384:72-79The incidence of melanoma of the skin is 6 times as high as it was 40 years ago; mortality has stayed low. UV light exposure is the strongest environmental risk factor, but its magnitude gives a relative risk of about 2. The most likely factors influencing the increase are changing thresholds to biopsy pigmented lesions and to label the morphologic change as melanoma.

Images in Clinical MedicineDec 31, 2020Acquired Hypertrichosis Lanuginosa
Kovitwanichkanont T. and Darling M.|N Engl J Med 2020; 383:e144A 51-year-old woman presented with rapidly progressing hair growth on her face, neck, and upper body, findings consistent with acquired hypertrichosis lanuginosa. PET-CT was performed, and a diagnosis of lung adenocarcinoma was made.

CorrespondenceDec 17, 2020Racial Bias in Pulse Oximetry Measurement
N Engl J Med 2020; 383:2477-2478The question of whether pulse oximetry measurements vary according to race has not been adequately studied, despite the wide use of this measure in clinical care. In this analysis, Black patients who had hypoxemia were more likely to have a normal pulse oximetry reading than were White patients.

Images in Clinical MedicineNov 26, 2020Blastic Plasmacytoid Dendritic-Cell Neoplasm
Gonzaga Y. and Fontes M.|N Engl J Med 2020; 383:2158A 29-year-old man presented with progressive skin lesions on the face, back, trunk, and limbs. Biopsy was performed, and a diagnosis of blastic plasmacytoid dendritic-cell neoplasm was made.

Images in Clinical MedicineOct 29, 2020Zinc Deficiency–Associated Dermatitis
Schröder S.D. and Griebl S.-W.|N Engl J Med 2020; 383:e103A 4-month-old boy presented with a progressively worsening rash on his abdomen, diaper area, limbs, face, and scalp. A biopsy was performed, and a diagnosis of zinc deficiency–associated dermatitis was made.

Case Records of the Massachusetts General HospitalOct 22, 2020Case 33-2020: A 55-Year-Old Man with Abdominal Pain, Joint Swelling, and Skin Lesions
Yasuda M.R., Roller L.A., Fagenholz P.J., and Hoang M.P.|N Engl J Med 2020; 383:1664-1671A 55-year-old-man with a history of neurofibromatosis and chronic necrotizing pancreatitis presented with abdominal pain and recurrent painful skin lesions. Three months before presentation, polyarticular joint swelling had developed and a central fluctuant nodule on an erythematous base had been noted on the left lower leg. A diagnostic test was performed.

Images in Clinical MedicineOct 15, 2020Trichomegaly Associated with Panitumumab
Goyal A. and Blaes A.|N Engl J Med 2020; 383:e94A 53-year-old woman with appendiceal cancer who was receiving treatment with panitumumab was found to have marked eyelash trichomegaly, a side effect of EGFR inhibitors.

Images in Clinical MedicineOct 15, 2020Vancomycin-Induced Linear IgA Bullous Dermatosis
Go J.R. and Abu Saleh O.M.|N Engl J Med 2020; 383:1577A 67-year-old man presented with a diffuse bullous eruption while receiving treatment with vancomycin. Direct immunofluorescence revealed linear deposition of IgA along the basement membrane zone, a finding consistent with linear IgA bullous dermatosis.

Images in Clinical MedicineOct 01, 2020Secondary Syphilis
Bhugra P. and Maiti A.|N Engl J Med 2020; 383:1375A 62-year-old man presented with a rash on his hands, feet, trunk, and genitals. A rapid plasma reagin test was conducted, and a diagnosis of secondary syphilis was made.

CorrespondenceOct 01, 2020Benralizumab for Chronic Spontaneous Urticaria
N Engl J Med 2020; 383:1389-1391Benralizumab, an anti–interleukin-5-receptor antibody, was evaluated in a 24-week study involving 12 patients with chronic spontaneous urticaria. The disease was assessed on the basis of urticaria activity scores. After three monthly injections and 2 months without benralizumab, 5 patients had a complete response and 2 had a partial response.

Original ArticleSep 24, 2020Brief Report: Antisense Inhibition of Prekallikrein to Control Hereditary Angioedema
Cohn D.M., Viney N.J., Fijen L.M., et al.|N Engl J Med 2020; 383:1242-1247Two patients with severe bradykinin-mediated angioedema received weekly subcutaneous injections of antisense oligonucleotides targeting prekallikrein messenger RNA. Subsequent to drug administration, they had reduced attack rates.

Original ArticleSep 17, 2020Five-Year Analysis of Adjuvant Dabrafenib plus Trametinib in Stage III Melanoma
Dummer R., Hauschild A., Santinami M., et al.|N Engl J Med 2020; 383:1139-1148At 5 years of follow-up, the 12-month use of adjuvant therapy with dabrafenib (a BRAF inhibitor) plus trametinib (a MEK inhibitor) in patients with stage III melanoma with BRAF V600 mutations resulted in relapse-free survival of 52%, as compared with 36% with placebo.

Images in Clinical MedicineAug 27, 2020Pemphigoid Gestationis
Agostinis P. and Antonello R.M.|N Engl J Med 2020; 383:e61A 30-year-old pregnant woman presented to the ED at 34 weeks of gestation with an itchy rash. A biopsy was performed, and a diagnosis of pemphigoid gestationis was made.

Images in Clinical MedicineAug 20, 2020Poststreptococcal Pustulosis
Goldberger T. and Molho-Pessach V.|N Engl J Med 2020; 383:e55A 47-year-old man presented with a pustular rash that had developed on both hands 1 week after he had received a diagnosis of group A β-hemolytic streptococcus pharyngitis. A diagnosis of poststreptococcal pustulosis was made.

Original ArticleAug 13, 2020Compression Therapy to Prevent Recurrent Cellulitis of the Leg
Webb E., Neeman T., Bowden F.J., et al.|N Engl J Med 2020; 383:630-639In a single-center, randomized, unblinded trial involving 84 participants with chronic edema of the leg and recurrent cellulitis, the incidences of cellulitis and hospitalizations among participants who received compression therapy were lower than those among participants who received only education about preventing cellulitis.

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