Milia-like idiopathic calcinosis cutis is a rare entity. Only 19 cases have been reported so far, the majority of them developed in children with Down's syndrome. The mean age of the patients is 10.3 years, with a sex ratio of nine girls to ten boys. Hands are most commonly affected.We report a case of a 69-year-old, otherwise healthy woman, who developed milia-like idiopathic calcinosis cutis on her forehead.To our knowledge, we report the seventh case occurring in a patient without Down's syndrome, and the first case occurring in an elderly person.

Brooke-Spiegler syndrome is a rare condition with a predisposition to develop cutaneous adnexal neoplasms, especially cylindromas, trichoepitheliomas and spiradenomas. Malignant transformation of cylindromas is rare. In such cases usually cylindrocarcinomas develop within these lesions. We present an unusual case of basal cell carcinoma developing within a preexisting cylindroma.58-year-old woman with a 30-year history of multiple dermal cylindromas extensively involving her scalp was referred for dermatological treatment. The patient reported that one of the long-lasting lesions, 5.5 cm in size, ulcerated within the foregoing few weeks. Histopathology confirmed cylindromas and basal cell carcinoma within the ulcerating tumor. Surgical excision of largest cylindroma tumors led to cosmetic and functional improvement. Magnetic resonance and computed tomography showed tumor infiltration into the skull lamina externa. Metastases were excluded by chest radiography and abdominal ultrasound examination.Patients with Brooke-Spiegler syndrome should be followed-up for malignant transformation of skin tumors to prevent deep penetration and possible metastases.

We report a retrospective case-control study to investigate whether the rotundiform variant of pityriasis versicolor (PV) is significantly associated with the first episodes of PV. Our setting was a dermatology clinic run by a consultant dermatologist. We retrieved medical records of all patients with PV between April 1, 2002 and March 31, 2005. We identified patients with lesions forming closed round circles. We excluded patients with uncertain diagnosis or diagnosis not substantiated by Wood's light examination or skin scrapings for potassium hydroxide examination. For each patient, we retrieved the medical record of the next patient of the same sex and similar age (± three years) with documented non-rotundiform PV and diagnosis substantiated by investigations as the control subject.80 patients were diagnosed as having PV during the record retrieval period. 18 had clinical descriptions or clinical photographs documenting rotundiform PV. Five were excluded owing to uncertain diagnosis, unclear clinical descriptions, or diagnoses unsubstantiated by examination under Wood's light or skin scrapings for potassium hydroxide examination. 13 had definite diagnosis of rotundiform PV. Ten agreed to attend clinic. The response rate was 76.9%. Ten age-and-sex pair-matched control subjects with non-rotundiform PV were recruited. Nine patients with rotundiform PV and two controls with non-rotundiform PV had their episode of PV representing their first episode of PV (p = 0.01; OR = 36.0, 95% CI: 2.2 - 866.9). We conclude that rotundiform PV is significantly associated with the first episode of PV. This phenomenon might be analogous to the herald patch being the primary lesion in pityriasis rosea.