Background and Design: There are few reports on the in vivo reflectance confocal microscopy (RCM) features of clear cell acanthoma (CCA). This study aimed to evaluate the diagnostic ability of RCM in CCAs that are difficult to diagnose clinically and to compare the RCM findings with those observed in squamous cell carcinoma in situ (SCCIS) lesions, which exhibit similar clinical morphology.
Materials and Methods: We searched our database and identified three cases of CCA with atypical features and three cases of SCCIS with common morphological features. We described the clinical, dermoscopic, RCM, and histopathological characteristics of these cases.
Results: Both lesion groups showed prominent epidermal hyperplasia on RCM; however, atypia in epidermal cells in CCAs was not as pronounced as that in SCCISs. The general architecture was preserved in the CCAs. In SCCISs, epidermal basal cells were increased in size, and prominent pleomorphism and atypia were observed in the full-thickness epidermis, whereas basal cells in CCAs were normal in pattern and appearance.
Conclusion: We suggest that differentiating CCA from SCCIS on RCM is possible, even in atypical cases, by careful evaluation of the general architecture of the tumor and determination of the degree of epidermal disarray, nuclear features of the epidermal cells, presence of uniformity or pleomorphism of the epidermal cells, and features of the basal cells. A comparison of normal skin and tumor areas may also help in better evaluation.

Background and Design: Dermatologic issues constitute a considerable portion of primary care visits, with a steadily increasing demand for cutaneous and cosmetic procedures. Family physicians (FPs) play a pivotal role in addressing these patients and directing them to the appropriate specialties. However, studies on FPs’ perceptions and referral practices for cutaneous and cosmetic procedures are limited.
Materials and Methods: An online survey was created and distributed to FPs working in Türkiye. Participants were asked to provide demographic and professional information and identify the specialists to whom they primarily referred their patients for various procedures. Additionally, participants were asked to indicate whether they had educational needs regarding these procedures and to specify their preferred methods for receiving such training. Results: A total of 387 FPs completed the survey. Dermatologists were the preferred specialists for procedures such as biopsies for suspicious skin and nail lesions (91.7% and 89.4%, respectively), facial and non-facial skin cancer treatments (78.6% and 81.5%, respectively), laser treatments (77.5%), platelet-rich plasma (PRP)/mesotherapy injections (74.9%), botulinum toxin injections (72.9%), hair transplantation (54.8%), and ingrown toenail treatment (35.4%). General and orthopedic surgeons were also favored for the treatment of ingrown toenails (28.9% and 24.5%). Plastic surgeons were predominantly preferred for liposuction (84.5%) and thread application (45%). There were significant differences in the preferences of FPs for certain procedures according to their workplace and level of prior dermatology education. FPs expressed notable educational demands for botulinum toxin injections (62.5%), PRP/mesotherapy (61%), and ingrown toenail treatment (57.6%). Practical training programs were the most preferred method of education (89.6%). Conclusion: This study emphasizes that FPs in Türkiye primarily refer patients to dermatologists for various cutaneous and cosmetic procedures, with other surgical specialists involved in certain cases. Interdisciplinary collaboration and the development of structured training programs are important to ensure patient safety and optimize the referral practices.

Eosinophilic cellulitis, also known as Wells syndrome, is a rare inflammatory skin disorder of unknown etiology. The disease has no known racial or sexual predisposition. It usually affects adults, although it can also be observed in children. Typically, it begins as a solitary burning or pruritic erythematous, edematous, and urticarial plaque, which usually has an acute cellulitis-like appearance. Nodules, blisters, or bullae may develop later in the initial lesion. The disease follows a pattern of spontaneous relapse and remission. The extremities and trunk are the most commonly involved localizations, but only a few cases of solely orbital involvement have been reported. Herein, we present a case of unilateral orbital eosinophilic cellulitis that remained undiagnosed for a long period.

Eczema herpeticum (EH), also known as Kaposi‘s varicelliform eruption, is a viral skin infection caused by the herpes simplex virus in the setting of compromised skin, most often associated with atopic dermatitis (AD). An eighteen-year-old female patient with a longstanding history of AD presented with EH, confirmed by viral testing, and was treated with intravenous acyclovir and topical antibiotics. A potent topical corticosteroid, clobetasol propionate, was applied to manage the underlying AD. Within five days, significant improvement was observed in both the viral and eczematous lesions with no adverse effects. This case highlights the effectiveness of combining antiviral therapy with topical corticosteroids in EH and the role of corticosteroids in supporting skin recovery in patients with AD at risk of EH.