Lichen planus (LP) is a common T-cell-mediated autoimmune skin disease, and its exact etiology is unknown. Typically, it affects the trunk, flexural surfaces, and the mucosa.We report a rare finding of LP involving both eyelids in a 67-year-old female. A 67-year-old Saudi female with a medical history of diabetes mellitus, hypothyroidism and rheumatoid arthritis presented with a three-month history of pruritic skin eruptions in both eyelids. She had no associated musculoskeletal symptoms or fatigue and no medical or family history of atopy. The patient had violaceous, thin, scaly plaques confined to both eyelids. Oral mucosa, genitalia, scalp, and nails were not affected. Histopathology from the right lower eyelid confirmed the diagnosis of LP. Hepatitis C virus serology was negative. Patient was examined by ophthalmology to rule out conjunctival involvement of LP. She had dry eyes only. She was initially managed by topical tacrolimus 0.1% ointment and didn\'t tolerate it due to severe reaction. She tolerated mometasone propionate 0.1% cream, which relieved the itch and partially improved the lesions. Although rare, LP of the eyelids must be considered among differential diagnoses of eyelid dermatitis. It can be confined, or it may concomitantly involve other parts of the body. LP of the eyelid may also extend to the conjunctiva, so it\'s important to screen patients by ophthalmology to rule out possible ocular involvement. This is the first case report of a Saudi patient with LP confined to the eyelid. The management of LP involving the eyelids is challenging. Treatment options include topical steroids, tacrolimus ointment, phototherapy and oral retinoids (etretinate).

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Abstract  A case report of an 8-month-old ferret with severe ulcerative dermatitis of the ventral abdomen and medial thigh regions is presented. Cutaneous biopsies of the periphery of the ulcerative lesions revealed large, confluent, superficial epidermal pustules containing inflammatory cellular debris and Gram-positive cocci, as well as perifollicular dermal necrosis. These histological findings are consistent with superficial spreading pyoderma in conjunction with dermal coagulative necrosis. Résumé- Un furet mâle de 8 mois est présenté pour une dermite ulcérative sévère du ventre et des faces internes des cuisses. Des biopsies cutanées réalisées à la périphérie des lésions ulcératives montrent la présence d\'importantes pustules épidermiques contenant des débris cellulaires inflammatoires et des bactéries cocci Gram positif, ainsi qu\'une nécrose dermique périfolliculaire. Ces éléments histopathologiques sont en faveur d\'une pyodermite superficielle extensive associée à une nécrose de coagulation du derme. [King, W. W., Lemarié, S. L., Veazey, R. S., Hodin, E. C. Superficial spreading pyoderma and ulcerative dermatitis in a ferret (Pyodermite extensive superficielle et dermite ulcérative chez un furet). Veterinary Dermatology 1996; 7: 43-47.] Resumen  Presentamos el caso clínico de un hurón de 8 meses con una dermatitis ulcerativa grave en abdomen ventral y muslo medial. El estudio de biopsias de la periferia de las zonas ulceradas reveló la presencia de grandes pústulas superficiales epidérmicas confluentes que contenían restos celulares inflamatorios y cocos Gram-positivo, así como necrosis perifolicular en la dermis. Estos hallazgos histológicos son compatibles con una pioderma de extensióin superficial en conjunción con necrosis dérmica coagulativa. [King, W. W., Lemarié, S. L., Veazey, R. S., Hodin, E. C. Superficial spreading pyoderma and ulcerative dermatitis in a ferret (Pioderma de extension superficial y dermatitis ulcerativa en un huron). Veterinary Dermatology 1996; 7: 43-47.] Zusammenfassung- Es wird ein Fallbericht vorgestellt, bei dem ein 8 Monate altes Frettchen an schwerer ulzerativer Dermatitis des ventralen Abdomens und der medialen Schenkelregionen leidet. Hautbiopsien aus der Peripherie der ulzerativen Veränderungen zeigten große, konfluierende, oberflächliche epidermale Pusteln, die entzündlichen Zelldebris und Gram-positive Kokken enthielten, sowie eine perifollikuläre dermale Nekrose. Diese histologischen Befunde stimmen mit der oberflächlich ausgebreiteten Pyodermie in Verbindung mit einer dermalen Koagulationsnekrose überein. [King, W. W., Lemarié, S. L., Veazey, R. S., Hodin, E. C. Superficial spreading pyoderma and ulcerative dermatitis in a ferret (Oberflächlich ausgebreitete Pyodermie und ulzerative Dermatitis bei einem Frettchen). Veterinary Dermatology 1996; 7: 43-47.].

Plaque-like myofibroblastic tumour (PLMT) is a rare skin condition which presents in childhood and infancy as a nodular fibrous plaque. Including our case, there are currently only 14 cases reported in the literature. Although it represents a well-defined clinicopathological diagnosis, there is significant under-reporting of this condition secondary to under-recognition and potential misdiagnosis as dermatofibroma.

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BACKGROUND: Pruritus is a common symptom that can significantly reduce quality of life through sleep disruption.
OBJECTIVE: To examine features of disturbed sleep in patients with chronic pruritic dermatoses and test the hypothesis that systemic inflammation may serve as a biomarker for impaired sleep in these patients.
METHODS: Cross-sectional analysis of the National Health and Nutrition Examination Survey investigating systemic inflammation using C-reactive protein (CRP) levels. Logistic regression was used to compare patients with and without sleep disturbances, adjusting for demographics (model 1) and medical comorbidities (model 2).
RESULTS: Chronic pruritic dermatoses were associated with multiple sleep disturbances, including nighttime awakenings (model 1: odds ratio [OR], 1.646; 95% confidence interval [CI], 1.031-2.627; model 2: OR, 1.329; 95% CI, 0.888-1.989) and early morning awakening (model 1: OR, 1.669, 95% CI, 1.118-2.493; model 2: OR, 1.582; 95% CI, 1.008-2.481). Mean CRP levels were 52.8% higher among patients with pruritic dermatoses reporting trouble sleeping compared with those who did not (0.663 vs 0.434 mg/dL; P = .034). Trouble sleeping was also positively correlated with CRP levels (β = 0.142, P = .025).
CONCLUSIONS: Potential recall bias among participants.
CONCLUSIONS: In addition to confirming sleep disturbances with pruritic dermatoses, we found these disturbances are more likely to present with elevated CRP levels. Clinicians should consider the potential risk for sleep-related and cardiac comorbidities in patients diagnosed with itchy skin conditions.

Introduction Bed bug infestations have risen dramatically in many industrialized nations in recent decades. Most people fed upon by bed bugs will develop a pruritic rash although the frequency with which this occurs is not definitively known and may depend on host factors including the duration of the infestation. Methods Surveys were completed from 706 emergency department (ED) patients in Cleveland, OH about their current and past exposure with bed bugs. Subjects were asked about any post-bed bug feeding rashes that developed. Results There were 24% (169/698) of subjects reporting either a current or past home bed bug infestation, with 37% (253/698) reporting they had previously been fed upon by a bed bug. Of those reporting a previous bed bug feeding, 68% (172/253) reported a pruritic post-bed bug feeding rash and 24% (57/237) reported developing a blister. Overall, 5% (37/705) of ED patients reported currently having a rash, but only 2% (14/698) of ED patients reported currently have bed bugs at home and of those, only 14% (2/14) said they currently had a rash. Conclusion While 68% of ED patients reported a pruritic post-bed bug feeding pruritic rash, almost a third of persons did not report developing the rash. Post-bed bug feeding blister reactions are less common. Asking ED patients about a rash had a low sensitivity of 14% (2-43%) and a specificity 95% (93-96%) to identify persons reporting home bed bugs.

BACKGROUND: Tinea imbricata is a chronic superficial mycosis caused mainly by Trichophyton concentricum. The condition mainly affects individuals living in primitive and isolated environment in developing countries and is rarely seen in developed countries. Physicians in nonendemic areas might not be aware of this fungal infection.
OBJECTIVE: To familiarize physicians with the clinical manifestations, diagnosis, and treatment of tinea imbricata.
METHODS: A PubMed search was completed in Clinical Queries using the key terms \"Tinea imbricata\" and \"Trichophyton concentricum\". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews, and case reports. The information retrieved from the above search was used in the compilation of the present article.
RESULTS: The typical initial lesions of tinea imbricata consist of multiple, brownish red, scaly, pruritic papules. The papules then spread centrifugally to form annular and/or concentric rings that can extend to form serpinginous or polycyclic plaques with or without erythema. With time, multiple overlapping lesions develop, and the plaques become lamellar with abundant thick scales adhering to the interior of the lesion, giving rise to the appearance of overlapping roof tiles, lace, or fish scales. Lamellar detachment of the scales is common. The diagnosis is mainly clinical, based on the characteristic skin lesions. If necessary, the diagnosis can be confirmed by potassium hydroxide wet-mount examination of skin scrapings of the active border of the lesion which typically shows short septate hyphae, numerous chlamydoconidia, and no arthroconidia. Currently, oral terbinafine is the drug of choice for the treatment of tinea imbricata. Combined therapy of an oral antifungal agent with a topical antifungal and keratolytic agent may increase the cure rate.
CONCLUSIONS: In most cases, a spot diagnosis of tinea imbricata can be made based on the characteristic skin lesions consisting of scaly, concentric annular rings and overlapping plaques that are pruritic. Due to popularity of international travel, physicians involved in patient care should be aware of this fungal infection previously restricted to limited geographical areas.