Dermatology Commons^™

Blaschko-Linear Lupus Erythematosus In A Pediatric Patient, Marshall Hall, Olivia Mayer, Henry Lim, Dustin V. Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

The lines of Blaschko represent epithelial cell migration during embryonic development. Rare forms of cutaneous lupus erythematosus may manifest along these lines, and lesions are termed Blaschko-linear lupus erythematosus (BLE). The purpose of this case study is to present a rare manifestation of linear cutaneous lupus erythematosus following the lines of Blaschko in a pediatric patient. To date, there are very few reports of BLE. We present a 17-year-old female with a 2-month history of a mildly tender growing lesion along the right nasofacial sulcus. The patient denied lesions elsewhere and any systemic, joint, or mucosal symptoms. A biopsy of …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Hidradenitis Suppurativa, Jamie Y. Choe, Henry Lim, Marshall Hall, Christian Scheufele, Dustin V. Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent deep-seated nodules and painful abscesses with scars, fistulae, and sinus tracts that predominately affect the intertriginous sites. Onset typically occurs soon after puberty. Depending on disease severity, HS can lead to varying levels of pain, disability, and disfiguration with significant impacts on quality of life. Hidradenitis suppurativa is diagnosed clinically, and no diagnostic tests are specific to the disease. Therefore, clinicians must have the knowledge and competence to identify the clinical features of HS accurately. The purpose of this report is to provide descriptions of characteristic clinical presentations …

Using Mohs Micrographic Surgery To Treat A Large, Pedunculated Trichoblastoma On The Upper Cutaneous Lip, Richard G. Bindernagel Jr., Addie Walker, Richard Miller

HCA Healthcare Journal of Medicine

Trichoblastomas are uncommon adnexal tumors that usually occur on the face. We report a case of a 62-year-old White man with a large, asymptomatic, slow-growing lesion that had been on his right upper cutaneous lip for 15 years. A 2 cm pink, pedunculated nodule with telangiectasia was seen on examination. A shave biopsy was consistent with trichoblastoma: a circumscribed-appearing dermal tumor of basaloid cells arranged in cords and islands within a cellular stroma, focal epidermal connection, and papillary mesenchymal bodies. The patient elected for treatment with Mohs micrographic surgery (MMS) given the length of time that the tumor had been …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Braden Van Alfen, Navya Peddireddy, Marshall Hall, Henry Lim, Christian Scheufele, Garrett Furth, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Tinea corporis is a common superficial fungal infection caused by dermatophytes. It typically presents as well-defined, pruritic, annular papules and plaques with central hypopigmentation. The differential diagnosis includes pityriasis rosea, nummular dermatitis, plaque psoriasis, tinea versicolor, granuloma annulare, and discoid lupus. This article compares different presentations of tinea corporis in various skin types as classified by the Fitzpatrick scale. Recognizing varying presentations of tinea in patients of different skin tones will aid in early and appropriate diagnosis and treatment.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keratosis Pilaris, Henry Lim, Reem Ayoub, Madelyn Richards, Marshall Hall, Christian Scheufele, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Keratosis pilaris (KP) is a common benign disorder involving hyperkeratosis of the skin. It is associated with other common dry skin disorders such as atopic dermatitis and ichthyosis vulgaris. Lesions are clinically characterized as symmetrically distributed, monomorphic, folliculocentric, hyperkeratotic papules with a variable degree of perifollicular erythema. The appearance can be likened to spikey bumps that are commonly located on the arms, legs, and buttocks. Awareness of KP is important as every primary care clinician will see patients with this disorder. Identification can support the diagnosis of other associated skin diseases. Education about KP and its treatment may alleviate psychological …

The Efficacy Of The Fitzpatrick Scale In Clinical Practice, Dana Olsen, Cecilia Nguyen, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Many skin diseases can manifest differently depending on the pigment of one’s skin. The Fitzpatrick scale is a classification of phototypes (I-VI) that categorizes patients' skin based on its ability to tan and burn. Even though it is a simple questionnaire, the Fitzpatrick scale has numerous criticisms due to its dependence on patients’ self-perception, variability in how questions are asked, limited range, and the underestimation of the risk of skin cancers. Alternatives to the Fitzpatrick scale include the melanin index, pigment protection factor, a visual color scale, and using artificial intelligence along with existing or new scales. Having a more …

Advancements In Treating Stretch Marks In People Of Color: A Comprehensive Review Of Therapeutic Modalities, Hannah Chaudhury, Nicole York, Helen Chen, Michelle Tarbox

Gulf Coast Division GME Research Day 2026

No abstract provided.

Allergic Contact Dermatitis To Medihoney Gel After Mastectomy: Role Of Alkyl Glucoside Sensitization In Chronic Wounds, Madison M. Taylor, Jordan L. Jafarnia, Austin Black, Kelly C. Nelson, Megan N. Rogge

Gulf Coast Division GME Research Day 2026

No abstract provided.

Panacos Procedure For Treatment Of Uncooperative Warts, Val Haddon, Joel Santana, Andra Achim

West Florida Division GME Research Day 2026

No abstract provided.

Inhaled Nitrous Oxide Use In Dermatologic Laser Surgery: A Four-Year Retrospective Safety Review, Sophia Anagnostis, Chelsea Kesty, Katarina Kesty

West Florida Division GME Research Day 2026

No abstract provided.

A Case Of Median Raphe Cysts In 8-Year-Old Male, Christina Guo, Marshall Hall, Garrett Furth, Henry Lim, Olivia Gruver, Dustin Wilkes, Stephen E. Weis

North Texas GME Research Forum 2026

Background: The median raphe cyst is a rare, benign, congenital condition characterized by small, fluid-filled cysts that develop along the ventral midline of male external genitalia. These cysts are usually asymptomatic during infancy and childhood but tend to grow in size as the patient grows. These can become cosmetically concerning or symptomatic due to swelling, irritation, and discomfort. They may also present social and psychological stress to patients and families. We present a case of median raphe cysts in an 8-year-old male.

Case Presentation: An 8-year-old male without a prior medical history who presented to dermatology for penile lesions. He …

Evaluating The Alt-70 Model For Cellulitis Management In The Emergency Department, Marshall Hall, Paige Loux, Henry Lim, Jeffrey Durbin, Garrett Furth, Olivia Gruver, Christina Guo, Dustin Wilkes, Michael Carletti, Stephen E. Weis

North Texas GME Research Forum 2026

Background: Cellulitis is a common skin infection that classically presents with unilateral lower extremity erythema, swelling, and pain. The diagnosis is made clinically. Many conditions may mimic cellulitis that are collectively referred to as “pseudocellulitis.” These include stasis dermatitis, deep vein thrombosis, atopic dermatitis, psoriasis, and gout. The Alt-70 model is a validated clinical prediction tool for differentiating cellulitis from pseudocellulitis. It is unclear if it is utilized or if it has changed clinical practice in the emergency department setting.

Methods: This was a retrospective chart review study utilizing the HCA Healthcare Data Warehouse. The Alt-70 model was applied using …

Excision Followed By Standing Cone Deformity Repair Is Tissue Conservative, Henry Lim, Christian Scheufele, Marshall Hall, Stephen Weis, Dustin Wilkes

North Texas GME Research Forum 2026

Introduction Elliptical excisions are the most common method to treat benign and malignant tumors in dermatologic surgery. This standardized design is traditionally 3 to 4.5 times longer than the excisional width to prevent unsightly protrusions of skin after primary closure, known as “standing cone,” “Burow’s triangles” or “dog ear” deformities. This results in a scar significantly longer than the original tumor that may be less easily concealed.

Objective To compare the final repair length of a tissue conservative method to remove skin tumors and close resultant defects against predicted repair length of traditional elliptical excision.

Methods Eighteen cases are presented …

Inpatient Dermatology: Dermatology Consults At Medical City Fort Worth, Olivia Gruver, Marshall Hall, Henry Lim, Christina Guo, Garrett Furth, Stephen E. Weis, Dustin Wilkes, Michael Carletti

North Texas GME Research Forum 2026

Background: Inpatient dermatology is an important yet evolving field. There has been a linear decrease in the number of dermatologists providing inpatient care and in the number of medical centers with an inpatient dermatology service. Medical centers with inpatient dermatology services are unevenly distributed geographically, with most in larger metropolitan areas. There is still a great need for dermatologic expertise in the inpatient setting. We aim to examine the utility of the dermatologic consult service, including the most common chief complaints and conditions that prompted consultation over four months at Medical City Fort Worth.

Methods: This was a retrospective chart …

Healing Times Of Mohs Defects Using Cellular, Acellular, And Matrix-Like Products Compared With Secondary Intention In A Single Patient, Benjamin R. Cooper, Anthony Concilla, Kathleen Ward, Taha Rasul, Arianne E. Chavez

South Atlantic Division GME Research Days 2026

No abstract provided.

Beneath The Pigment: An Unusual Cystic Complication Of Red Ink, Tamara Fakhoury, Erika Pulver, Karissa Lehew, Angelia Stepien

South Atlantic Division GME Research Days 2026

No abstract provided.

High-Grade Undifferentiated Sarcoma With Osteoclast-Like Giant Cells Mimicking A Pyogenic Granuloma, Shiv Patel, Tamara Fakhoury, Taha Rasul, Benjamin Cooper, Leila Parsa, Madeline Coleman, Alexandra Mathis, Karthik Krishnamurthy, Michelle Foley

South Atlantic Division GME Research Days 2026

No abstract provided.

Often Overlooked: Microbial Influence In Disease Progression Of Mycosis Fungoides, Alexis Coican, Angelia Stepien

South Atlantic Division GME Research Days 2026

No abstract provided.

Can Chatgpt Cut It? Evaluating Ai In Dermatologic Surgery Reconstruction, Anthony Concilla, Benjamin R. Cooper, Taha F. Rasul, David Ciocon, Adam Chahine

South Atlantic Division GME Research Days 2026

No abstract provided.

Afx: Small Tumor, Big Personality, Alexandra Mathis, Abigail Lowe, Juan Rosario

South Atlantic Division GME Research Days 2026

No abstract provided.

Not Your Average Nodule: The Enigmatic Chondroid Syringoma, Alexandra Mathis, Clara Barranco, Joanna Mcgetrick, Karthik Krishnamurthy

South Atlantic Division GME Research Days 2026

No abstract provided.

Cutaneous Clues To Systemic Relapse In Alk-Negative, Cd30+ Anaplastic Large Cell Lymphoma, Leila Parsa, Angelia Stepien

South Atlantic Division GME Research Days 2026

No abstract provided.

A Case Of Calciphylaxis Initially Managed As Cellulitis, Karan Rajalingam, Benjamin R. Cooper, Angelia Stepien

South Atlantic Division GME Research Days 2026

No abstract provided.

Angiolymphoid Hyperplasia With Eosinophilia Causing Conductive Hearing Loss: A Case Report, Radhika Mohan, Kulwinder Bhatnura, Harsh Bhatt, Jennifer Y. Cho, Dennis Besong

South Atlantic Division GME Research Days 2026

No abstract provided.

Staphylococcal Scalded Skin Syndrome In Melanated Skin: A Pediatric Case Report, Aleah Lafrancis-Ream, Scott Gutovitz, Hannah Chotiner

HCA Healthcare Journal of Medicine

Background

Staphylococcal scalded skin syndrome (SSSS) is a dermatologic emergency that most commonly affects young children, requiring prompt recognition and treatment to avoid severe symptoms and fatal sequelae. It is characterized by a desquamation of the skin caused by exotoxins produced by the Staphylococcus aureus species and may present differently in melanated skin.

Case Presentation

Our case describes a 6-month-old Black infant girl who presented to the emergency department with SSSS that was unrecognized on 2 prior encounters. This delay in diagnosis and the misapplication of topical antibacterial agents and steroids may have contributed to the worsening of her symptoms …

A Colorful Enigma: A Case Of Orange Palpebral Spots In A 63-Year-Old Woman, Obarikanemi Nwogu, Karl Kellawan

HCA Healthcare Journal of Medicine

Background

The thin, vascularized skin of the eyelids makes them prone to irritation and discoloration, potentially revealing underlying issues, such as subcutaneous deposits, and an abundance of pigments like carotenoids and lipofuscins. First described in 2008 by Assouly et al, orange palpebral spots (OPS) present as painless orange-yellow lesions on the upper eyelids, primarily affecting White women with Fitzpatrick skin types I to III. Despite various hypotheses, the exact cause of OPS remains elusive, with no established links to malignancy or systemic illnesses.

Case Presentation

A 63-year-old woman, with a medical history including basal and squamous cell carcinoma, diabetes mellitus, …

Upper Respiratory Tract Infection Leading To A New Diagnosis Of Sweet Syndrome And Monoclonal Gammopathy Of Unknown Significance, Nidhi Rawat, Meron Gebrehiwot, Jason Raw, Jeyaprakash Ramachandran

HCA Healthcare Journal of Medicine

Background

We present a rare case of Sweet syndrome with underlying monoclonal gammopathy of unknown significance (MGUS) which initially presented as upper respiratory tract infection.

Case Presentation

A 52-year-old woman presented with a complaint of sore throat for 6 days, productive cough and fever for 5 days, and red, pruritic, circular, tender rashes on face, arms and trunk for 2 days. There was a past history of similar self-limiting rashes presenting intermittently for 1.5 years. She also reported to be taking tablet ibuprofen, as required for the past 1-2 years, for cervical spondylosis. On integumentary examination, widespread, red, tender, annular …

Clinical Images Of Cutaneous Horns In Patients Presenting To A Family Medicine Residency Practice, Julia Fashner, Tillie Schumann

HCA Healthcare Journal of Medicine

We detail 2 cases of cutaneous horn, also referred to as cornu cutaneum, which is a hard-compacted linear outgrowth of keratin that projects above the skin. We present these images to increase awareness for all medical specialties who may see a patient with this skin lesion.

Brown Umbilical Nodule: A Case Of Primary Cutaneous Endometriosis, Richard G. Bindernagel Jr., Aleia Boccardi, Taylor C. Jindia, Parth Patel, Jaimie Bryan, Addie Walker, Summer Moon, Richard Miller

HCA Healthcare Journal of Medicine

Background

Endometriosis is a common condition in which endometrial glands and stroma are implanted outside the uterine cavity. Rarely, the skin can be involved.

Case Presentation

We describe a case of a 41-year-old woman who presented to the dermatology clinic complaining of a brown umbilical nodule with slight erythema. It was occasionally painful and hemorrhagic. She denied a history of endometriosis and abdominal surgeries. A shave biopsy of the nodule was consistent with a diagnosis of cutaneous endometriosis. The patient was referred to her gynecologist for further evaluation and treatment.

Conclusion

This unique case demonstrates primary cutaneous endometriosis in the …

Persistent Lichenoid Reaction And Eruptive Keratoacanthomas Following Pd-1 Inhibitor Therapy, Paul Vance, Michael Hohnadel

HCA Healthcare Journal of Medicine

Background

Immune checkpoint inhibitors, such as nivolumab, have become integral in treating metastatic malignancies by enhancing immune responses against tumors. However, they are associated with immune-related adverse events (irAEs), including cutaneous reactions. We report a case of persistent lichenoid dermatitis during therapy and eruptive keratoacanthomas (KAs) following the cessation of nivolumab.

Case Presentation

A 77-year-old Caucasian man presented with a subcutaneous melanoma on the left lateral chest, treated with excision followed by adjuvant nivolumab. Seven weeks into therapy, he developed pruritic erythematous macules, forming patches on his forearms, later spreading to his trunk. Biopsy confirmed lichenoid dermatitis. Treatment with triamcinolone …