Hoss, Elika

BACKGROUND Skin laxity of the upper knee and lower thigh is a common complaint among patients. OBJECTIVE This is a randomized, double-blinded, split-body, placebo-controlled study to evaluate the safety and efficacy of poly- l -lactic acid (PLLA) for treatment of upper knee skin laxity. MATERIALS AND METHODS Twenty female subjects between the ages of 30 and 65 years with upper knee laxity were enrolled. The patients were randomized to receive 3 treatments of PLLA in 1 knee, whereas the other knee received 3 treatments of bacteriostatic water. RESULTS Statistically significant improvement as rated on the physician global aesthetic improvement scale was seen at Day 56 after final treatment in the active knee when compared with the placebo knee. This improvement was sustained at Day 84 and Day 168 after final treatment visits. No statistically significant difference was seen between the active and placebo knees on the subject global aesthetic score or the subject satisfaction scale. CONCLUSION Based on our study, PLLA may be a safe and effective modality in addressing upper knee skin laxity. Larger studies with longer follow-up times and a validated knee laxity scale are needed to further determine if and how much improvement can be achieved.

Introduction. The phenomenon of graft-versus-host disease, a solid organ transplant recipient, is a rare development with a very poor prognosis. Case Presentation. A 40-year-old woman with type 1 diabetes developed cutaneous graft-versus-host disease following second pancreas transplantation. Conclusion. The development of a nonspecific rash in the early posttransplant period following a pancreas transplant warrants suspicion for graft-versus-host disease.

AbstractBackgroundThough a rare tumor, sebaceous carcinoma is relatively well‐described in immunocompetent patients, in whom it often occurs in a periorbital distribution where it has an overall poor prognosis with a high metastasis rate. The effect of transplant‐related immunosuppression on the development of sebaceous carcinoma and its outcomes has not been characterized.MethodsWe collected 9 cases from a single institution of patients developing sebaceous carcinoma after solid organ transplantation. We analyzed clinicopathologic features.ResultsWe estimate the prevalence of sebaceous carcinoma post‐solid organ transplantation to be 0.09%. The mean age at diagnosis was 66.1 years (std 7.0 years). The mean time between transplantation and sebaceous carcinoma diagnosis was 7.1 years (std 5.1 years). All tumors occurred in extra‐ocular distribution. Two patients likely had Muir‐Torre syndrome, of whom 1 died from metastatic sebaceous carcinoma. No other patients developed metastatic disease or had disease‐related death. Mohs micrographic surgery and wide local excision were equally effective and there were no recurrences with either procedure.ConclusionsOur study found that sebaceous carcinoma in solid organ transplant recipients occurs in in an extraorbital distribution with only 1 patient developing metastatic disease. Both Mohs micrographic surgery and wide local excision are acceptable treatment modalities for sebaceous carcinoma in transplant recipients.

AbstractPrurigo pigmentosa (PP) is a rare inflammatory dermatosis of unknown cause characterized by a predominantly truncal eruption of pruritic erythematous papules in a reticular pattern, resolving with hyperpigmentation. PP is twice as common in girls and women, and the mean age at onset is 25 years. Diagnosis of PP is challenging and is aided by characteristic histopathologic findings. We report a case of PP in a 17‐year‐old white boy. The eruption arose during strict adherence to a ketogenic diet.