Basal cell carcinoma (BCC) is typically found on sun-exposed skin and is the most common form of skin cancer. Risk factors include male sex, fair skin, increased ultraviolet radiation exposure, prior history of BCC, chronic arsenic exposure, genetic predisposition, and immunosuppression. BCC is a slow-growing tumor that typically presents as a shiny and pink papule or nodule with telangiectasias. However, its presentation varies depending on the histological type, which can be confirmed by biopsy. First-line therapies for low-risk BCC include standard surgical excision and curettage and electrodesiccation, whereas the gold standard for high-risk BCC is Mohs microscopic surgery. This review summarizes the current guidelines for BCC treatment and discusses the mechanism of action and clinical implications of alternative rare, experimental, and anecdotal treatments in the literature.

Necrobiotic xanthogranuloma (NXG) is a rare, chronic non-Langerhans cell histiocytosis that clinically manifests as yellow to orange papules or nodules, most commonly involving the periorbital region. Histopathologic features include necrobiotic collagen, multinucleated giant cells (including Touton and Langhans types), granulomatous inflammation with xanthomatous histiocytes, extracellular lipid, and occasionally lymphoid follicles and plasma cells. NXG has a well-documented association with monoclonal gammopathies and extracutaneous malignancies, although the underlying pathogenic mechanisms remain poorly understood. We report the case of a 72-year-old woman presenting with erythematous plaques on the abdomen and extremities. Despite the absence of classic facial involvement and an initial nondiagnostic skin biopsy, further evaluation revealed a clonal plasma cell disorder classified as borderline between monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. A subsequent biopsy demonstrated diagnostic features of NXG. This case underscores the importance of integrating clinical findings with histopathologic evaluation to achieve an accurate diagnosis.

Introduction Scabies, caused by Sarcoptes scabiei var. hominis, is a highly prevalent ectoparasitic infestation and a recognized neglected tropical disease. Increasing incidence, persistent post-treatment symptoms, and emerging resistance to conventional therapies such as permethrin necessitate effective alternative treatments. Spinosad 0.9% lotion, with known ovicidal and antiparasitic properties, has recently gained attention. This study evaluates its therapeutic efficacy using clinical and dermoscopic parameters, including polarized and ultraviolet-induced fluorescence (UVF) imaging. Materials and methods A hospital-based interventional case series was conducted at a tertiary care center from December 2025 to January 2026. Forty clinically and dermoscopically confirmed scabies patients were enrolled. Baseline demographic, clinical, and dermoscopic findings were recorded. Dermoscopy was performed using polarized and UVF modes to detect mites and burrows. Patients were treated with a single overnight application of spinosad 0.9% lotion. Follow-up assessment at three weeks included evaluation of clinical lesions (papules, nodules, pustules, excoriations) and dermoscopic signs (triangular jet sign, curvilinear tracks, and fluorescence). Statistical analysis was performed using SPSS, with p<0.05 considered significant. Results The study population had a mean age of 22±13.33 years, with a male predominance. Papules were the commonest lesions. Significant reduction was observed in papules (from 37, 92.5%, to five, 20%) with p<0.05; nodules (from 16, 40%, to one, 2.5%) with p<0.01; and pustules (from five, 12.5%, to none) with p<0.05 after treatment. Excoriations showed no significant change. Dermoscopic detection of mites decreased from 29 (72.5%) at baseline to nine (22.5%) at follow-up (p<0.05). Both polarized and UVF dermoscopy effectively demonstrated a reduction in mite-related features. No adverse effects were reported. Discussion Spinosad demonstrated significant clinical and dermoscopic efficacy, consistent with previous studies, and offers advantages such as single application and ovicidal activity. Persistent excoriations likely reflect ongoing post-scabetic pruritus rather than treatment failure. Dermoscopy proved to be a valuable objective tool for monitoring therapeutic response. Conclusion Spinosad 0.9% lotion is an effective, safe, and convenient alternative for scabies treatment, particularly in settings of resistance or poor compliance. Dermoscopic evaluation enhances diagnostic accuracy and treatment monitoring.

Kaposiform hemangioendothelioma is a rare vascular tumor of endothelial origin that occurs during the first decade of life. It is locally aggressive, with a tendency for local invasion and spread to regional lymph nodes. It presents as tender, expanding plaques, nodules, papules, or telangiectasias and is most commonly located in the retroperitoneum and skin; however, involvement of the head and neck region is uncommon. Herein, we report an unusual case of kaposiform hemangioendothelioma in a 59-year-old woman who presented with a several-month history of right-sided nasal obstruction and epistaxis. Contrast-enhanced computed tomography revealed an enhancing mass originating from the right inferior turbinate. The patient underwent endoscopic excision of the endonasal mass with any postoperative complications.

Cutaneous metastases are rare but clinically relevant manifestations of internal malignancies, occurring in fewer than 10% of cases and in only a small fraction of gynecologic cancers. They most commonly arise from ovarian carcinoma, while tubal carcinoma rarely produces such lesions. Their occurrence on a surgical scar is particularly unusual and may result from intraoperative tumor seeding or the permissive microenvironment of scar tissue, characterized by neoangiogenesis, impaired barrier function, and reduced local immunity. We present the case of a woman with high-grade serous tubal carcinoma whose recurrence began as a painful nodule and papules on the hysterectomy scar, later extending into infiltrated nodules across the lower abdomen and thigh roots. Dermoscopy revealed a diffuse erythematous background with polymorphic vascular structures, including serpentine vessels. Biopsy confirmed cutaneous metastasis. This case emphasizes dermoscopy's diagnostic role in rare scar-associated cutaneous metastases.

Indeterminate dendritic cell tumour (IDCT) is a rare form of non-Langerhans cell histiocytosis which typically presents with skin lesions. The histological appearances resemble Langerhans cell histiocytosis, although the cells are negative for CD207 (langerin) and lack Birbeck granules. The molecular mechanisms are diverse and include a subset of cases associated with ETV3::NCOA2 fusion. A significant minority of cases are associated with underlying haematological neoplasms, which require clinical exclusion.

Syringofibroadenoma is a benign proliferation of the eccrine ducts which is thought to originate as a reactive hyperplasia to other skin conditions. It usually presents as a solitary, hyperkeratotic or verrucous plaque or nodule on the extremities in elderly patients. We report the case of a 32-year-old male who presents with a pink papule on the left chest for several years. The histopathological manifestation was consistent with the diagnosis of syringofibroadenoma. We focus on the atypical clinical presentation and dermoscopic findings, given that despite there being multiple cases reported in the international literature, its dermoscopic characteristics have not been described.

Cryptococcus neoformans is an encapsulated opportunistic yeast widely distributed in the environment and classified as critical-priority fungal pathogen by the World Health Organisation due to its high mortality and limited access to timely diagnosis and effective treatment. Infection is typically acquired via inhalation, with the primary pulmonary focus often remaining asymptomatic. Particularly in individuals with impaired cell-mediated immunity, it may disseminate hematogenously to central nervous system (CNS), skin and other organs. Cutaneous cryptococcosis is a rare clinical manifestation and in most cases, represents secondary involvement of disseminated disease. Its clinical presentation is highly variable and may mimic cellulitis, abscesses, ulcers or necrotizing soft-tissue infections, posing significant diagnostic challenges. Ruxolitinib is a Janus-kinase inhibitor used to treat myelofibrosis and polycythemia vera. By suppressing interferon-γ and interleukin-12-mediated immune responses, it impairs macrophage activation, reduces T-helper-1 cell responses, suppresses natural-killer cell function, and regulates hematopoietic activity. However, these immunomodulatory effects predispose patients to invasive opportunistic infections, particularly fungal infections. In the literature, cryptococcal infections associated with ruxolitinib have been reported in a limited number of case reports, most commonly involving the pulmonary and/or central nervous system. Cutaneous involvement is exceedingly rare, and to date, no cases from Türkiye have been reported. In this case report, a 67-year-old woman with myelofibrosis who had been receiving ruxolitinib therapy for three-years and developed cutaneous cryptococcosis infection mimicking necrotizing fasciitis, accompanied by asymptomatic pulmonary involvement was presented. Despite broad-spectrum antibacterials, a small papule on the medial thigh rapidly progressed over 25 days, with severe disproportionate pain raising suspicion of necrotizing fasciitis. On admission, physical examination revealed an 8×8 cm ulcerative tissue defect on the left thigh, with surrounding erythema, ecchymosis, desquamation and hemopurulent discharge. Magnetic resonance imaging demonstrated findings suggestive of necrotising soft-tissue infection, prompting urgent surgical intervention. Intraoperatively, diffuse inflammation and patchy necrotic areas were observed and surgical debridement followed by vacuum-assisted wound closure was performed. Microbiological cultures of deep-tissue specimens yielded C.neoformans and the pathogen was confirmed by matrix-assisted laser desorption/ ionisation-time-of-flight-mass spectrometry (MALDI-TOF-MS). Antifungal susceptibility testing showed minimum inhibitory concentrations of 0.5 µg/mL for amphotericin B and 4 µg/mL for fluconazole. Histopathological examination demonstrated yeast cells within a background of suppurative inflammation and focal necrosis. Although the patient had no respiratory symptoms, chest computed tomography revealed a cavitary pulmonary nodule consistent with fungal infection. Bronchoalveolar lavage cultures showed no microbial growth. Evaluation for central nervous system involvement resulted negative for India-ink staining and cerebrospinal fluid multiplex polymerase chain reaction (PCR) test. These findings were considered consistent with systemic cryptococcosis involving the skin and lungs. Antibacterials were discontinued and intravenous liposomal amphotericin-B plus fluconazole was initiated. After central netvous system involvement was excluded, sequential therapy with fluconazole was planned. Ruxolitinib dose was adjusted by haematology. Significant clinical improvement was observed in the early phase of treatment and pain however, the patient died due to acute pulmonary embolism. This case highlights a rare cutaneous presentation of ruxolitinib-associated cryptococcosis and emphasizes the importance of clinical awareness for opportunistic fungal infections in immunosuppressed patients.

A 55-year-old female patient exhibited erythematous nodular plaques on the right side of her face for more than 1 year. The dermatological examination identified mildly infiltrated erythematous patches, papules, and nodules varying in size from a wide bean to a coin on the right side of her face and nasal alae. Several nodules exhibited a yellow hue and coalesced, while the erythema presented a mildly annular configuration. The patient was diagnosed with sinus histiocytosis (Rosai-Dorfman disease) based on dermoscopy, reflectance confocal microscopy, and histopathological examination. The patient had previously had treatment at another hospital with thalidomide, methotrexate, hydroxychloroquine, and localized betamethasone injections, yielding disappointing outcomes. Subsequently, they pursued medical care at our hospital. Due to the inadequate response to the initial immunosuppressant treatment (thalidomide and methotrexate) over 2 weeks, fire needling was incorporated for an additional 2 weeks, leading to a modest improvement in the skin lesions. These treatments were then discontinued and replaced with oral tofacitinib monotherapy (5 mg twice daily), which resulted in marked regression of the skin lesions. Over a 4-month follow-up period, the skin lesions demonstrated significant flattening and fading, with no notable adverse effects observed. This case is the first report of the JAK inhibitor tofacitinib in the treatment of cutaneous Rosai-Dorfman disease, in conjunction with local fire needling intervention, providing a novel integrated therapeutic strategy combining traditional Chinese and Western medicine for refractory cases.

Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma, composed of follicular, sebaceous and mesenchymal elements, that usually presents as a small papule or nodule on the central face. We report the case of a man in his early 30s with a 10-year history of a large, reddish to violaceous scalp mass measuring 4.5 cm in greatest dimension. The initial clinical impression was a cylindroma. Histological examination revealed a dermal lesion with multiple sebaceous lobules clustered around a central infundibular structure within a fibrovascular stroma separated by cleft-like spaces. This case highlights an unusual clinical presentation and the importance of considering FSCH in the differential diagnosis of scalp masses.