Granulomatous Rosacea (GR), first described in 19701, is thought to be a peculiar variant of rosacea thanks to the presence of granulomas at histopathological examination, although some authors sustain that it is a distinct histological variant found among most of the clinical spectrum of rosacea2 . GR is mostly reported in middle aged women and may present centro-facial localization3. Its histology is similar to that of Periorificial Granulomatous Dermatitis (PGD), although the latter is more common in the pediatric population4.

We present a peculiar case of a unilateral periorbital GR. A 22-year-old male in good health conditions had a dermatological consultation, complaining of a periorbital non-itching rash on the left side of his face that had been present for a few weeks. He denied any medical history or having used any topical or oral medication prior to the eruption’s onset. At clinical examination (Figure 1) papules and pustules on an erythematous background were found on the left periorbital area, whereas the contralateral side was unaffected. Mucous membranes were uninvolved and there was no palpable lymphadenopathy. Dermoscopy examination (Figure 2) showed widespread linear vessels arranged in a polygonal network and follicular opening containing whitish-grey plugs.  

Histology revealed moderate acanthosis with dilation of the hair follicles infundibula with some keratin plugs. Telangiectatic vessels were visible in the dermis, together with prominent perivascular lymphoplasmacytic infiltrate and perifollicular epithelioid granulomas (Figure 3). Stains for acid-fast bacilli (i.e. Ziehl-Neelsen) were negative. No abnormalities emerged at the serological routine exams.

Background: Herpes zoster (HZ) is often accompanied by severe neuropathic pain, known as herpes zoster–related pain (ZAP), which greatly impairs patients’ quality of life. Hyaluronic acid (HA) possesses anti-inflammatory and neuroprotective properties. Previous studies have shown that subcutaneous injection of 35 kDa HA fragments can rapidly relieve various types of pain, including ZAP. This study aimed to evaluate the analgesic efficacy of a 10% high-concentration 35 kDa HA fragment (HA35) gel applied topically in patients with ZAP. Methods: Four patients with ZAP (aged 57–77 years) were included. All received topical application of 10% HA35 gel; one patient additionally used a skin protective film to prevent gel drying. Pain intensity was assessed using the Numeric Rating Scale (NRS, 0–10) before and after treatment. Results: In three patients with acute ZAP, the mean NRS score decreased by approximately 55% within 2 minutes after application and dropped to 1–2 after 20 minutes, with analgesic effects lasting about 4 hours. In one patient with postherpetic neuralgia (PHN), the combination of HA35 gel and skin protective film extended the analgesic duration beyond 8 hours and significantly reduced erythema and swelling. Conclusions: The 10% high-concentration HA35 gel provided rapid and safe analgesia in ZAP, and the addition of a skin protective film further prolonged the duration of pain relief. This non-invasive, simple, and well-tolerated method offers a promising new topical approach for managing ZAP.

The life-history characteristics and disease-transmission capacity of adult mosquitoes can be significantly influenced by the growing temperature during their immature stages. This review evaluated available data on how temperature affects life-history features, pesticide susceptibility, immature stages, and enzyme expression in adult Anopheles mosquitoes. The review found that compared to An. adult funestus and An. quadriannulatus, embryonic stages of An. arabiensis, however, were more resistant (in terms of their survivability) to a higher temperature. Increased temperatures led to smaller larvae and shorter hatching and pupation times. At higher temperatures than at lower ones, An. stephensi's growing rate and survival rate were considerably lower. Anopheles mosquito lifetime, body size, gonotrophic cycle duration, and fecundity all reduced with rising temperatures. Females injected with the species An. arabiensis SENN instead of DDT strain showed greater resistance to pyrethroids, while the An. arabiensis SENN variant showed increased tolerance to pyrethroids. Additionally, the level of Nitric Oxide synthesized (NOS) expression was markedly elevated and pesticide toxicity was reduced by rising temperatures. The species of mosquito generation and survival are impacted by both extremely high and low temperatures. Anopheles mosquitoes may be impacted by climate change in a number of ways. Anopeheles mosquito species vary in how sensitive they are to temperature, even within the same complex. Nevertheless, it appears that little research has been done on how temperature affects the adult life-history characteristics of Anopheles mosquitoes; further research is required to fully understand this relationship. Some of the most serious infections that affect humans are spread by mosquitoes, such as malaria, which kills between 0.6 and 1.2 million people annually, mostly children in nations with a low income. There is growing recognition that a multifaceted strategy, including vector control, is required to prevent malaria since a single measure is likely to do so. Although there are now very efficient vector control methods, the majority of which include insecticides, they is evidence of increasing issues with the emergence of resistance. Numerous innovative genetic strategies for vector control are being developed. Large investments in molecular resources, such as the availability of many full-genome sequences, have substantially aided research on mosquito targeting. I contend that in order to advance vector control—which is an application of population biology—mosquito ecology must receive the same level of attention as mosquito molecular biology.

Background: Phakomatosis pigmentovascularis (PPV) is a rare congenital neurocutaneous disorder defined by the coexistence of pigmentary lesions and vascular malformations. PPV type II (phakomatosis cesioflammea) is the most common subtype and is characterized by dermal melanocytosis and capillary malformations. Early recognition is important due to potential ocular, neurologic, and systemic involvement.

Case Presentation: We report a newborn female presenting with extensive slate-gray to blue dermal melanocytosis involving the back, extremities, and abdomen, along with bilateral facial violaceous capillary malformations. Systemic evaluation, including abdominal ultrasonography and brain MRI with angiography, revealed no visceral or intracranial vascular anomalies. Laboratory studies were unremarkable aside from hemoglobin S trait. The cutaneous findings were consistent with PPV type II. Pediatric neurology, dermatology, and ophthalmology referrals were arranged to evaluate for associated glaucoma, neurologic abnormalities, and to initiate long-term surveillance. Future pulsed-dye and Nd:YAG laser therapy was recommended for lesion management.

Discussion: PPV is extremely rare, with fewer than 200 cases documented. The condition may phenotypically overlap with Sturge–Weber syndrome, Klippel–Trenaunay syndrome, and other vascular anomalies, necessitating careful systemic evaluation. Although the pathogenesis is linked to somatic mosaic mutations affecting RAS/MAPK signaling, clinical diagnosis remains paramount. Early multidisciplinary management is essential to monitor for ocular and neurologic complications and to optimize cosmetic outcomes.

Conclusion: This case highlights the characteristic presentation of PPV type II and reinforces the importance of comprehensive systemic evaluation and multidisciplinary follow-up. Awareness of this rare entity aids in distinguishing it from other neurocutaneous syndromes with overlapping features.

Palmoplantar lichen planus is a rare variant of lichen planus that predominantly affects the palms and soles and often lacks classical clinical features. Due to its variable morphology and resemblance to other palmoplantar dermatoses, diagnosis is frequently delayed or missed. We report a case of a 23-year-old female presenting with violaceous papules over the palms and soles associated with oral mucosal involvement. Dermoscopic examination revealed fine white linear streaks, and histopathological analysis demonstrated features consistent with lichen planus. The patient showed significant clinical improvement following treatment with oral acitretin. This case highlights the importance of clinicopathological correlation in diagnosing atypical palmoplantar eruptions and emphasizes early recognition to avoid misdiagnosis and delayed treatment.

Melanoma, a malignant tumor arising from melanocytes, is known for its aggressive behaviour and propensity for metastasis. While commonly associated with the skin, melanoma can disseminate to various organs, including the digestive tract, leading to significant clinical challenges. The gastrointestinal tract, particularly the stomach and intestines, is an uncommon site for melanoma metastasis, yet its occurrence poses unique diagnostic and therapeutic complexities.

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but serious condition characterized by a heterogenous rash, eosinophilia, and end organ involvement. Non-steroidal anti-inflammatory drugs (NSAIDs) are among the rarer medications that may induce this severe adverse hypersensitivity reaction.   

Case Presentation: We present a case of a 50-year-old male with extensive trauma history complicated by chronic pain and an unvaccinated status who presented with acute onset fevers and dynamic morbilliform rash covering greater than 50 percent of his body surface area (BSA). A clinical diagnosis of NSAID-induced DRESS was made based on the temporal relationship with the patient’s ibuprofen use, eosinophilia, and organ involvement. Treatment with systemic corticosteroids (1 mg/kg/day) resulted in significant symptom improvement. The patient was discharged on an oral and topical steroid regimen after nine days of admission, with close outpatient dermatology follow-up. 

Conclusion: This case highlights the importance of keeping rare drug-induced hypersensitivity reactions like NSAID-induced DRESS on the differential, particularly in patients with complex medical histories and during a time when there is a rising concern for measles infection, which may initially present with a very similar clinical syndrome.