Rapidly Enlarging Malignant Proliferating Trichilemmal Tumor
Malignant proliferating trichilemmal tumors are rare adnexal neoplasms that most commonly occur on the scalp in elderly women. These tumors are associated with recurrence and even nodal or distant metastatic spread. Here, JDD authors describe a 38-year-old patient who presented with a scalp nodule that was diagnosed as a high-grade malignant proliferating trichilemmal tumor.
Introduction
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Malignant proliferating trichilemmal tumors are rare adnexal neoplasms that most commonly occur on the scalp in elderly women. These tumors are associated with recurrence and even nodal or distant metastatic spread. Here, JDD authors describe a 38-year-old patient who presented with a scalp nodule that was diagnosed as a high-grade malignant proliferating trichilemmal tumor.
Introduction
Th … Continue reading "Rapidly Enlarging Malignant Proliferating Trichilemmal Tumor"
CASE REPORT
A 71-year-old Fitzpatrick phototype IV man with a history of hyperlipidemia and extensive travel to the Middle East presented with a mildly painful vegetative growth on his right lower leg for 1.5 months (Figure 1). In 2014, the patient reported a pruritic “rash” in the same location, which was treated with fluocinonide .05% ointment with resolution.
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While performing Mohs micrographic surgery for this squamous cell carcinoma (shown in picture), you sever a nerve that lies superficially in the temple, just beneath the thin dermis and subcutaneous fat. The patient would have trouble performing which of the following?
A. Raising his eyebrows
B. Grimacing
C. Smiling
D. Closing his eyes
E. Chewing food
To find out the correct an … 
Have you ever come across a patient with a skin cancer that you are not 100% sure should be treated with Mohs surgery or an alternative modality? Or a patient who comes back for a follow-up after skin cancer surgery with an undesirable scar and you wonder if you should have opted for a less invasive option? I certainly have. Some of these nagging questions were answered by a thoughtful, case-based … 
JDD Authors Rachel Fayne BA, Sonali Nanda MS, Anna Nichols MD PhD, and John Shen MD report a case of biopsy-proven invasive SCC in an 86-year-old Caucasian male with history of multiple actinic keratoses and no previous skin cancers. The patient declined surgical treatment due to concerns about cosmetic outcomes. A combination of topical 5% imiquimod cream, 2% 5-FU solution, and 0.1% tretinoin cre …