Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that may occur after surgery and mimic wound infection. We report the case of a 30-year-old woman who developed painful progressive ulceration 7 days after caesarean section. Initial treatment with broad-spectrum antibiotics for presumed surgical site infection was ineffective. Clinical examination showed a large hypogastric ulcer with an erythematous base and undermined inflammatory borders. Histopathological examination of a biopsy taken from the ulcer edge demonstrated a dense dermal neutrophilic infiltrate, supporting the diagnosis of PG. Oral prednisolone at 1 mg/kg/day was started, with progressive improvement and complete re-epithelialization after 4 months. This case highlights the importance of considering PG in postoperative wounds that worsen despite adequate antimicrobial treatment, in order to avoid unnecessary surgical procedures and initiate timely immunosuppressive therapy.

Morphea as a side effect of tumor necrosis factor-α (TNF-α) inhibitors is a rare phenomenon. Disabling pansclerotic morphea (DPM) is an exceptionally rare and severe subtype characterized by extensive full-thickness skin involvement with potential extension to deeper tissues. We report the case of a 9-year-old boy with polyarticular juvenile idiopathic arthritis (JIA) who developed rapidly progressive pansclerotic morphea eight months after initiation of etanercept therapy. The sclerosis began at the injection site and spread to involve the four limbs, trunk, neck, and face within six months, sparing only the fingertips and toes. Histopathological examination confirmed pansclerotic morphea. Etanercept was discontinued, and treatment with methotrexate and corticosteroids was initiated. At two-year follow-up, the sclerosis has significantly decreased, although hand contracture deformities persist. To our knowledge, this is the first documented case of juvenile pansclerotic morphea induced by etanercept, and only the second case of pansclerotic morphea induced by any TNF-α inhibitor.

Carcinoma en cuirasse is a rare form of cutaneous metastasis associated with advanced breast cancer, characterized by diffuse sclerodermoid induration of the skin. We report the case of a 50-year-old woman treated for invasive ductal carcinoma of the left breast, who presented seven years later with pulmonary metastases and a progressively evolving erythematous, indurated plaque of the anterior chest wall, associated with infiltrated papules and a peau d'orange appearance. Skin biopsy showed infiltration of the dermis and hypodermis by malignant epithelial cells arranged in cords and trabeculae within a fibrous stroma. Immunohistochemistry confirmed metastatic invasive ductal carcinoma, with strong positivity for GATA3, E-cadherin, and estrogen receptors in approximately 90% of tumor cells, consistent with a grade II invasive ductal carcinoma (Elston and Ellis classification). Carcinoma en cuirasse is a rare but characteristic manifestation of breast cancer progression that frequently mimics benign dermatoses or post-radiotherapy changes, and its diagnosis relies on histopathological examination. This case underscores the importance of recognizing cutaneous metastases in patients with a history of breast cancer, since their presence signals advanced disease and carries significant implications for management.

Lichen planus (LP) is an inflammatory disorder that can involve the skin, nails, hair follicles, and mucous membranes and may present with diverse clinical morphologies that mimic other dermatologic conditions. Hypertrophic (verrucous) LP is a chronic variant characterized by hyperkeratotic lesions that most often affect the lower extremities, which makes isolated hand involvement diagnostically challenging. We report a 65-year-old man with skin-colored, dermally embedded verrucous papules confined to the right hand with extension to the wrist, evolving for more than 40 years. He denied pruritus, pain, and functional limitation. Mild nail atrophy was noted, and there was no mucosal involvement. Skin biopsy revealed pseudoepitheliomatous acanthosis consistent with cicatricial-stage verrucous LP. Treatment with a very potent topical corticosteroid (clobetasol propionate) under occlusion was initiated, though adherence was poor, and weekly trichloroacetic acid sessions were planned. Clinicopathologic correlation supported the diagnosis in this atypical unilateral presentation and guided management and follow-up.

Acquired hypertrichosis lanuginosa is a rare cutaneous disorder most commonly recognized as a paraneoplastic phenomenon. Non-malignant associations have been documented, with a severe catabolic state proposed as the common pathophysiologic denominator. We report the first case of diffuse acquired hypertrichosis occurring in the context of dermatomyositis complicated by pulmonary tuberculosis, in the absence of malignancy. A 44-year-old woman with newly diagnosed anti-NXP2-positive dermatomyositis developed diffuse hypertrichosis during a severe catabolic state, with a 22% loss of initial body weight and declining serum protein levels, driven by the convergence of active myositis and pulmonary tuberculosis unmasked by immunosuppressive therapy. The diagnosis of tuberculosis proved particularly challenging, as initial chest CT, three consecutive sputum cultures, sputum PCR, and PCR on cold abscess aspirates were all negative for Mycobacterium tuberculosis. Diagnosis was ultimately established through bronchoscopy with bronchoalveolar lavage PCR. A comprehensive paraneoplastic workup including whole-body ¹⁸F-FDG PET/CT excluded an underlying malignancy. The hypertrichosis resolved spontaneously upon initiation of anti-tuberculous therapy and nutritional recovery. This observation expands the spectrum of non-malignant conditions associated with acquired hypertrichosis lanuginosa and highlights the diagnostic challenges of tuberculosis reactivation in immunosuppressed patients with inflammatory myopathies.

Ectopic nail, also known as onychoheterotopia, is a rare disorder in which nail tissue develops outside the normal nail unit. Plantar involvement is particularly uncommon. We report a 60-year-old man with treated hypertension who presented with a painful, persistent lesion on the plantar surface of the left foot that had evolved for five years. Examination showed a rounded, exophytic, yellowish plaque measuring 2.2 × 1.5 cm arising within a keratotic nodule on the plantar arch. Dermoscopy revealed furrowed and transverse bands resembling wooden slats, creating a barrel-stave-like appearance. Plain radiography showed no underlying bone abnormality. An initial surgical excision was followed by recurrence at the same site four months later because the ectopic nail matrix had not been completely removed. A second excision with complete removal of the matrix was performed. Histopathological examination confirmed nail tissue with normal keratinization and no atypia. No further recurrence was reported. This case highlights the diagnostic value of clinical and dermoscopic recognition and, most importantly, the need for complete removal of the ectopic nail matrix to prevent recurrence.

Discoid lupus erythematosus (DLE) of the scalp is a rare and challenging diagnosis in pediatric patients, especially during early, non-scarring stages when it mimics common causes of hair loss such as tinea capitis or alopecia areata. This report describes a 9-year-old boy presenting with alopecic scalp lesions initially misdiagnosed and resistant to topical corticosteroids. Dermoscopic examination revealed characteristic features of scalp DLE, including follicular keratotic plugs and the “red spider on yellow dot” sign, facilitating early diagnosis. A biopsy confirmed the diagnosis, and systemic involvement was excluded. Given the poor response to topical therapies and the delayed effect of antimalarials, treatment with oral prednisone minipulse therapy was initiated, resulting in complete clinical remission and hair regrowth after 8 weeks without adverse effects. This case highlights the diagnostic value of trichoscopy in pediatric scalp alopecia and suggests corticosteroid minipulse therapy as a promising short-term option for managing scalp DLE in children, warranting further studies.

Background:Hair care beliefs and practices are influenced by cultural traditions and modern trends. Understanding these perceptions can help address common misconceptions and guide better care practices. Objective:This cross-sectional study aimed to explore widespread beliefs and routines related to hair care among a diverse population. Methods:A 40-item questionnaire was administered to 300 participants of various demographic backgrounds and hair types. It covered topics such as hair washing frequency, perceived factors affecting hair growth, use of hair care products, and the role of social media in influencing choices. Results:Findings revealed common misconceptions, including beliefs about the harmful effects of frequent washing, the importance of certain nutrients, and exaggerated expectations from specific products. Social media played a significant role in shaping participants' hair care behaviors. Limitations:The study relied on self-reported data, which may be biased. The sample may not represent the general population, and cultural nuances might be underrepresented. The cross-sectional design limits causal interpretation, and no clinical assessments were conducted. Conclusion:Dermatologists have a key role in dispelling myths and providing evidence-based advice. Educational efforts, both in clinical settings and via social media, could improve public understanding and promote healthier hair care practices.

BackgroundThe global distribution of pemphigus varies according to genetic, ethnic, socioeconomic, and cultural backgrounds. Despite the increased utilization of global health records and reporting systems, epidemiological data remain limited and poorly categorized.ObjectivesTo provide a detailed analysis of the epidemiological, clinical, and therapeutic features of pemphigus from a multicenter study in Morocco.MethodsA cross-sectional descriptive multicenter study included patients treated for pemphigus at dermatology departments across eleven different university hospitals in Morocco between January 1990 and December 2023.ResultsOur multicenter cohort consisted of 978 patients. The average annual incidence was estimated at 0.7 cases per million inhabitants per year, with a prevalence of 2.56/100,000 population. The female-to-male ratio was 1.4:1, and the median age was 55.9 years. The most common variant was pemphigus vulgaris (519 cases), followed by seborrheic pemphigus (229 cases), pemphigus foliaceous (135 cases), and pemphigus vegetans (65 cases). Treatment strategies included corticosteroids alone (27.9%) or in association with immunosuppressive agents (72.1%). The evolution was marked by remission in 60.9% of patients, relapse in 31.8%, and death in 7.2%.ConclusionsOur national multicenter study provides data on pemphigus in Morocco; it identified 978 cases over a 33-year period and highlighted the epidemiological, clinical, therapeutic and evolutionary characteristics of our population.