Clinicopathologic Self-assessment

Dr. Yadir Hurley, Chair of Dermatology at Saint Louis University, presents intriguing clinical cases focusing on dermatological conditions. The session covers two key cases starting with a 25-year-old male exhibiting dyschromia characterized by deep pigment deposition. Various stains are discussed leading to a diagnosis of dermal Fontana-Masson positive pigment deposition, with a significant consideration of Minocycline-induced hyperpigmentation. After further investigation and lab tests, the discussion turns to potential associations with Kratom, a substance gaining popularity for its stimulant effects but with possible side effects including hyperpigmentation and toxicity. The legality of Kratom varies by state, complicating patient disclosure about its use.



The second case is a 59-year-old female with an ulcerated mass, leading to a discussion on histological findings and differential diagnoses involving mycosis fungoides. The histological evaluation indicated granulomatous changes, ultimately diagnosing granulomatous mycosis fungoides, a rare variant requiring both clinical and histological correlation. Overall, Dr. Hurley emphasizes the need for thorough patient questioning to uncover underlying issues that may not be initially disclosed, particularly concerning medications and supplements.