Background: Chronic eosinophilic leukemia (CEL) is a rare, slowly progressive hematologic malignancy characterized by clonal proliferation of eosinophils in the bone marrow due to underlying genetic mutations. Persistent eosinophilia (>1.5 x 10⁹/L) for 1–6 months is a key diagnostic criterion. The presence of the FIP1L1::PDGFRA fusion gene and increased blast or abnormal cells in the bone marrow further supports the diagnosis. Case presentation: A 63-year-old male presented with symptoms of dry skin, pruritus, skin rash, enlargement of cervical, axillary, and inguinal lymph nodes, headache, and edema. According to the medical history, the disease began 4 years earlier with pruritus in the lower legs and progressed over the past 2 years with worsening skin rash. Complete blood count revealed eosinophilia of 48.6%. Based on leukogram, myelogram, skin histopathology, and cytogenetic analysis performed in China, a diagnosis of chronic eosinophilic leukemia was established. The patient responded well to treatment with imatinib and hydroxycarbamide. Conclusion Clinical manifestations of chronic eosinophilic leukemia are often nonspecific and may be misdiagnosed as dermatological conditions. Therefore, cytogenetic analysis (including FISH), leukogram, myelogram, and skin histopathological examination play a crucial role in accurate diagnosis.

Background: Dermatomyofibroma (DMF) represents a rare and distinct benign cutaneous mesenchymal neoplasm of fibroblastic/myofibroblastic differentiation. Approximately 150 cases of DMF have been documented in the literature. Nevertheless, the occurrence of DMF on the face is exceptionally rare. Clinically, DMF is often misdiagnosed as a scar, keloid or dermatofibrosarcoma protuberans. Thus, histopathological and immunohistochemical analyses are instrumental in establishing a differential diagnosis. We present a rare case of dermatomyofibroma that occurred in the facial region. Case presentation: A 20-year-old female patient presented to Sundara Dermatology Clinic in August 2025, with a lesion that had persisted for two years on her left masseteric region. Previously, she had consulted at the National Dermatology Center, where she was diagnosed with “acne scar” and underwent an intradermal triamcinolone injection once. However, the treatment proved ineffective, and the lesion gradually increased in size. Upon physical examination, a poorly circumscribed, irregularly elevated, firm, brown plaque measuring 2.5 x 2 cm in size was observed on the left upper chin, extending to the preauricular region. Diagnosis: A skin biopsy was performed to establish the diagnosis. Histopathological examination suggested differentiating Dermatomyofibroma from Dermatofibrosarcoma protuberans. Therefore, immunohistochemical analysis utilizing CD34 and SMA markers was conducted. Based on the histological and immunohistochemical findings, the final diagnosis was confirmed as Dermatomyofibroma. Treatment: The standard treatment for DMF is complete surgical excision of the tumor. After providing the patient with an accurate diagnosis and recommending surgical excision, she underwent a surgery and the tumor was completely excised. To date, no instances of recurrence have been noted. Conclusion Dermatomyofibroma is a rare benign cutaneous neoplasm characterized by clinical features that overlap with other dermatological conditions, which increases the risk of misdiagnosis and inappropriate treatment. We emphasize the critical role of skin biopsy and immunohistochemical analysis in cases with similar clinical manifestations, thereby mitigating the risk of further misconduct.

Background: Basal cell carcinoma stands as the most prevalent cutaneous malignancy, originating from the basal cells of the epidermis. Approximately 4 million new cases are diagnosed globally annually. In contrast, schwannoma is a rare benign nerve sheath tumor arising from Schwann cells. The simultaneous occurrence of these two tumors within a single lesion is exceedingly uncommon. We present a rare case of basal cell carcinoma coexisting with cutaneous schwannoma. Case Presentation: A 68-year-old European male patient presented to Sundara Dermatology Clinic in April 2025 with a complaint of a persistent facial lesion that had not healed. The lesion initially manifested in June 2024 as a small, asymptomatic lesion, which the patient disregarded, attributing it to minor trauma during shaving. Recently, the lesion has exhibited an increase in size and occasional bleeding. Upon the physical examination, a round to oval-shaped, elevated papular lesion with central ulceration and crusting was observed on the right nasolabial fold. Diagnosis: A skin biopsy was conducted to ascertain the diagnosis. Histopathological examination indicated the presence of basal cell carcinoma in conjunction with schwannoma or neuroma, necessitating a differential diagnosis. Immunohistochemical analysis employing markers such as S100, BCL2, P63, CD10, and actin was performed. Upon analyzing the histological and immunohistochemical findings, the final diagnosis was confirmed as Basal cell carcinoma coexisting with schwannoma. Treatment: Surgical excision is the standard treatment for both basal cell carcinoma and schwannoma. The patient was advised accordingly and underwent complete surgical removal of the tumor. No recurrence has been observed during postoperative follow-up. Conclusion The coexistence of basal cell carcinoma and cutaneous schwannoma within a single lesion is exceedingly rare. Clinically, basal cell carcinoma frequently mimics other dermatological conditions, necessitating meticulous differentiation. It is imperative to emphasize the paramount importance of skin biopsy and immunohistochemistry in the differential diagnosis and optimal treatment selection.

Background: The skin barrier serves as the primary defense against environmental factors. Mongolia’s extreme climate conditions may contribute to skin barrier impairment, increased trans-epidermal water loss (TEWL), and decreased skin moisture. Objective: To determine and compare skin moisture, TEWL, and skin pH levels in children. Methods: A cross-sectional study was conducted in June 2023 with 104 relatively healthy children selected through random sampling. Skin physiological parameters, including skin moisture, skin pH and TEWL were measured following the EEMCO (European Group on Efficacy Measurement of Cosmetics and Other Topical Products) guidelines using the Multi Skin Test MC750 device (Courage+Khazaka Electronics, Germany) at nine different sites. Data analysis was performed using Microsoft Excel and Stata-14 software. Results: Among the participants, 51.9% (n=54) reported having dry skin (p<0.0001). Additionally, 64.5% (n=67) used moisturizers, but their usage did not show a statistically significant difference in skin moisture (p=0.929), skin pH (p=0.378), or TEWL (p=0.332). 14.42% (n=15) had extremely dry skin, while 85.58% (n=89) had dry skin, with no participants falling within the normal skin moisture range. TEWL showed a moderate inverse correlation with age (r=-0.331, p=0.0006). When analyzed by age groups, skin moisture (p=0.023) and TEWL (p=0.038) differed significantly between groups. Conclusion Skin moisture and TEWL significantly differ across age groups. Given that all participants had dry skin, moisturization is crucial. Mongolia’s extreme climate is likely a key contributing factor to childhood skin dryness.

BACKGROUND. Annular elastolytic giant cell granuloma (AEGCG) is a rare skin disease, characterized by loss of elastic tissue due to elastophagocytosis by multinucleated giant cells in the upper part of dermis, which clinically presents as multiple annular plaques with raised erythematous border and central atrophy. We report a first case of AEGCG in dermatology practice in Mongolia. Its clinical and histological features, differential diagnosis and treatment modalities are described and discussed in detail.