Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Acquired dermal melanocytosis, characterized by the presence of melanocytes in the dermis, varies in the timing and location of occurrence. While congenital cases, such as Mongolian spots, nevus of Ota, nevus of Ito, and blue nevus, are common, acquired cases also occur. Acquired bilateral nevus of Ota-like macules is relatively common in Asians;however, extrafacial cases, particularly those involving both the face and extremities, are extremely rare. We report the case of a 66-year-old man with symmetric pigmented patches on the scalp, face, shoulders, and dorsa of the hands for 9 months, following the onset of spots on the forehead and nose that progressively spread. Notably, nasal ala pigmentation was confirmed. Histopathological examination revealed scattered melanin-containing dendritic cells in the upper dermis. Based on the clinicopathological findings, he was diagnosed with acquired dermal melanocytosis of the face and extremities, representing a rare case.

Dermatomyositis (DM) is a rare systemic autoimmune disorder characterized by distinct skin rash and muscle weakness. Approximately 15%∼30% DM cases present as a paraneoplastic syndrome often associated with an underlying malignancy. Herein, we report the case of a 60-year-old male recently diagnosed with esophageal cancer and exhibited symptoms of DM. The patient presented with generalized muscle weakness and a characteristic skin rash persisting for 3 months. Muscle weakness initially manifested in the proximal arms and later progressed to the proximal legs. In addition, the patient experienced difficulty in swallowing food. Clinical, laboratory, histological, and imaging assessments confirmed the diagnosis of DM associated with esophageal cancer. Notably, both DM and esophageal cancer can cause dysphagia. Therefore, accurate differentiation of dysphagia resulting from malignancy from that resulting from DM is pivotal in the diagnostic process.

Background: Laugier-Hunziker syndrome (LHS) is a rare, benign, acquired disorder that is usually characterized by hyperpigmentation of the oral cavity and lips, along with longitudinal melanonychia. Till date, its characteristics have not been investigated in a large number of patients in a single-center study. Objective: This study aimed to investigate the clinical, dermoscopic, and histological characteristics of LHS. Methods: We retrospectively reviewed the medical records, biopsy specimens, and clinical and dermoscopic photographs of 21 patients diagnosed with LHS at Pusan National University Hospital (Busan and Yangsan) over a period of 15 years (2008∼2022). Results: Among the 21 patients, 20 patients (95.2%) were female and one patient (4.8%) was male, and the mean age was 56.0 years (range: 18∼75 years). The lower lip (95.2%) was the most frequently affected oral mucosa, followed by the upper lip (81.0%), buccal mucosa (66.7%), tongue (57.1%), gingiva (42.9%), and palate (14.3%). The nails were the most commonly affected extraoral site, and in our study, eight of 21 patients (38.1%) presented with periungual lesions. Based on the dermoscopic findings, a globular pattern was the most common. Histologically, the lesions showed epithelial acanthosis and increased basal keratinocyte melanin without an increase in the number of melanocytes. Conclusion This is the first study to investigate the clinical, dermoscopic, and histological characteristics of patients with LHS. The results of this study could be helpful in understanding LHS.