IgG4-related disease (IgG4-RD) is characterized by masses at multiple sites, a dense lymphoplasmacytic infiltrate containing numerous IgG4+ plasma cells, storiform fibrosis, and often elevated serum IgG4 concentrations. We present a third case of alopecia (in this instance, cicatricial) caused by IgG4-RD. Based on our findings combined with those seen in two other cases, the histopathologic features of IgG4-RD alopecia include: sparing of the epidermis, cicatricial (scarring) alopecia with a markedly decreased number of hairs, miniaturization of residual hairs, and total loss of the sebaceous glands. Groups of follicles with their associated sebaceous glands (follicular units) are replaced by an extremely dense infiltrate of lymphocytes and especially plasma cells. Histiocytic aggregates, both foamy and non-foamy, may also be present. Variable degrees of fibroplasia may be present but are not an important feature in this type of alopecia.
Low-grade cutaneous carcinoma with squamous and trichoblastic features is an uncommon cutaneous malignancy with follicular differentiation. Alopecia areata (AA) is an autoimmune folliculocentric skin disease. We present an uncommon case of a 50-year-old woman in whom AA developed on the scalp surrounding a low-grade cutaneous carcinoma with squamous and trichoblastic features. Our case study reviews the limited relevant literature and hypothesizes that the CD8+ T lymphocytic infiltrate within our patient's tumor likely instigated the AA.
Abstract The ongoing North American epidemic of intravenous opioid and methamphetamine use increases the occurrence of bacteremia from environmental organisms. In this study, we report a case of Mycobacterium mucogenicum bacteremia and associated nodular soft tissue infection in a person who uses tap water to inject drugs.
A 48-year-old woman was given a diagnosis of infiltrating ductal breast carcinoma (T2N1M0; grade I; positive for estrogen receptors, progesterone receptors and human epidermal receptor-2 [HER2] status; with 3/31 positive nodes). Treatment at that time involved left lumpectomy with axillary node
