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Journal of Cutaneous Pathology

Larisa Lehmer, Sama Kassira Carly, Sebastien de Feraudy
Matrical carcinoma with melanocytic hyperplasia (MCMH), previously referred to as malignant melanocytic matricoma, is a rare variant of the uncommon pilomatrical carcinoma, which occurs most often on the head/neck and upper backs of middle-aged men. Nodular lesions may resemble pigmented basal cell carcinoma or melanoma clinically. We present a case of MCMH in a Hispanic patient with history of melanoma. Histopathologic clues to appropriate diagnosis include basaloid cells, numerous atypical mitoses, matrical differentiation, shadow cells, strong diffuse nuclear and cytoplasmic expression of beta catenin, and interspersed pigmented dendritic melanocytes...
February 20, 2019: Journal of Cutaneous Pathology
Matteo Provasi, Filippo Bagnoli, Daniele Fanoni, Silvia Alberti-Violetti, Dario Tomasini, Emilio Berti
Intravascular large B-cell lymphoma (IVLBCL) is one of the rarest B-cell non Hodgkin lymphomas (NHL), with an aggressive clinical behavior and a poor prognosis; in fact, its treatment is still an unmet clinical need, with a 3-year overall survival (OS) rate of 60-81%, and a central nervous system relapse rate of 25%. It usually presents as a widespread disease at diagnosis with multi-organ involvement. Previously considered as a diffuse large B-cell lymphoma variant, it now represents a different extranodal large B-cell lymphoma entity in the last WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues...
February 18, 2019: Journal of Cutaneous Pathology
Patricia M Richey, Nkanyezi N Ferguson, Mary S Stone
A 68-year-old man presented for excision of a nodule on his right sub-mandibular neck that had grown quickly over a three-month period. Initially, it looked like an "ingrown hair," and he admitted to expressing blood-tinged fluid from the nodule multiple times. This article is protected by copyright. All rights reserved.
February 17, 2019: Journal of Cutaneous Pathology
Omar Bushara, Daniel Miller, Alessio Giubellino, Matthew Schomaker, Bharat Thyagarajan, Andrew C Nelson
Epidermodysplasia Verruciformis (EV) is a rare skin disease characterized by the development of multiple flat warts with the potential for malignant transformation. Patients are susceptible to Human Papilloma Virus (HPV) infection that develops in a background of either a genetic or acquired immunodeficiency predisposing patients to infection with specific HPV types that are ubiquitous but generally non-pathogenic in healthy individuals. There is no standard clinical methodology for determining the causative HPV from patients with suspected EV...
February 17, 2019: Journal of Cutaneous Pathology
Annalucia Virdi, Carlotta Baraldi, Alessia Barisani, Barbara Corti, Francesco Savoia, Annalisa Patrizi, Iria Neri
Plaque-like myofibroblastic tumor is a rare and benign pediatric soft tissue tumor. It presents as a slowly growing plaque reaching several centimeters in diameter, made up of multiple nodules. The clinical and histological features of this benign entity are similar to other fibrohistiocytic or myofibroblastic tumors occuring in childhood, so the diagnosis can be difficult. The correlation between clinical data, histopathology and immunohistochemistry is necessary for the correct diagnosis. This article is protected by copyright...
February 9, 2019: Journal of Cutaneous Pathology
P W Wolstencroft, K E Rieger, H W Leatham, D F Fiorentino
BACKGROUND: Common histopathologic findings in cutaneous dermatomyositis include vacuolar interface with dyskeratosis, mucin, and perivascular inflammation. Data examining the relationships between these and other histologic abnormalities, or their dependence on biopsy site, and medications is limited. METHODS: Using 228 dermatomyositis skin biopsies and statistical analyses including Chi-squared analyses, calculations of relative risk, and adjusted GEE regressions we investigated relationships between 14 histopathologic findings and the impact of clinical factors on these findings...
February 9, 2019: Journal of Cutaneous Pathology
Kate J Johnstone, Geoffrey M Strutton
BRAF mutation status is a critical predictive and prognostic biomarker in guiding management of unresectable and metastatic melanoma.1 We recently observed a case of BRAF V600E-mutated chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) intermixed with BRAF V600E wild-type melanoma reported to harbor BRAF V600E mutation on molecular testing. Our observation underscores the importance of appropriate tumor selection for molecular studies and knowledge of mutational status of co-existing tumors. This article is protected by copyright...
February 7, 2019: Journal of Cutaneous Pathology
Angela Wipf, Heidi Wipf, Daniel Miller
Pseudocarcinomatous (pseudoepitheliomatous) hyperplasia represents reactive epidermal change mimicking squamous cell carcinoma (SCC), owing to a variety of inflammatory and neoplastic phenomena, including deep fungal infections, CD30-positive lymphomas, and others. We report a case of Sweet syndrome (SS) arising in a patient with acute myelogenous leukemia, with persistent orolabial involvement which mimicked SCC both clinically and microscopically, but resolved entirely with adequate corticosteroid treatment...
February 7, 2019: Journal of Cutaneous Pathology
Angel Fernandez-Flores, David S Cassarino
INTRODUCTION: Granulomatous mycosis fungoides (MF) is a rare variant in which granulomas are associated with other typical signs of MF. Its prognosis is worse than that of classical MF. Plasmacytoid dendritic cells (PDC) are a subset of Interferon (IFN) producing dendritic cells that link the innate and the adaptative immune responses. They have also been related to tolerance to certain tumors such as melanoma. MATERIALS AND METHODS: In this paper, we examined for the presence of CD123+ PDC in six cases of granulomatous MF from our archives...
February 7, 2019: Journal of Cutaneous Pathology
Maria Fernanda Dias, Hudson Dutra, Ralph Trüeb, Enoí Vilar, Mayra Rochael, Ada Quattrino, Amanda Cury
Ichthyosis is a heterogeneous group of inherited skin disorders characterized by a defect of keratinization. Patients diagnosed with lamellar ichthyosis (LI) and some ichthyosiform syndromes, such as the Conradi-Hünermann-Happle syndrome (CHHS), usually present with hair loss. Even though only few dermatologic complaints carry as many emotional overtones as hair loss, there is extremely little data available in the literature regarding scalp histopathologic features on ichthyosis. A better understanding of scalp changes in such context may result in new therapeutic strategies that in turn would enhance patients' self-steem and quality of life...
February 7, 2019: Journal of Cutaneous Pathology
Ryan DeCoste, Phillip Moss, Robert Boutilier, Noreen M G Walsh
Bowen Disease (BD) with divergent adnexal differentiation is a rare composite cutaneous tumor featuring different phenotypic elements. Sebaceous, poroid and trichilemmal invasive components have been described in this setting and very infrequent reports of mucinous glandular differentiation are extant. Clinically these tumors are not sufficiently distinctive to enable recognition without histopathological evaluation. From a microscopic perspective, care must be taken to exclude a collision tumor as well as other combined cutaneous neoplasms featuring squamous and glandular differentiation...
February 7, 2019: Journal of Cutaneous Pathology
Min Young Lee, Suna Jin, Kyung-Hwa Lee, Min Ho Park, Sung Taek Jung, Adam Rubin, Sook Jung Yun
A 36-year-old man presented with a subcutaneous nodule on the right upper arm. A small nodule had developed 8 years earlier, and grew in size, accompanied by a tingling sensation and numbness. In addition, he had a bluish irregular patch on the right hand since birth, which crossed from the palm to the dorsal hand. Skin biopsies from the hand showed heavily pigmented melanocyte proliferation in the dermis with perieccrine, perivascular, and perineural involvement, and a diagnosis of congenital plaque-type blue nevus was made...
February 4, 2019: Journal of Cutaneous Pathology
Danielle Leavitt, Michael Wells, Phammela Abarzua, George F Murphy, Christine G Lian
BACKGROUND: Hair follicle cycling is dependent upon activation and differentiation of an epithelial subpopulation of cells with stem-like characteristics. These cells express cytokeratin 15 (CK15) and are sequestered within a specialized niche termed the follicular bulge. The pathways that mediate bulge activation are poorly understood, although growing evidence suggests a role for epigenetic events. METHODS: Here we investigated murine and human hair follicles to determine whether a recently described epigenetic hydroxymethylation marker, 5-hmC, known to mediate cell growth and differentiation, may play a role in bulge activation...
February 4, 2019: Journal of Cutaneous Pathology
Ashok Singh, Rupinderkaur Brar, Biswajit Dey, Jitendra Nigam, Archana Deshpande
Myxofibrosarcomas (MFS) are sarcomas most commonly seen in older patients. These are tumors of deep soft tissue seen in subcutaneous tissue, deep fascia with frequent muscle involvement. These sarcomas are notorious for recurrences, progression to a higher grade with notable metastatic potential. It is very often under-diagnosed owing to its inherent morphological variability. A case of MFS is presented as a cutaneous, exophytic, polypoidal mass because of its rarity and importance of timely diagnosis, as under diagnosis may lead to inadequate clearance of tumor, recurrences, metastases and increased mortality...
January 25, 2019: Journal of Cutaneous Pathology
Courtney M Chapman, Jessica Kwok, Nicole Cresce, Emily Privette, Thomas Cropley, Alejandro A Gru
The dual presentation of IgG and IgA positivity on direct immunofluorescence (DIF) constitutes a rare form of pemphigus. IgG/IgA pemphigus varies widely in clinical and pathologic presentation. Reported sites of involvement range from the trunk as the sole site of involvement to the whole body and oral mucosa as well as the conjunctiva and esophagus1 . This article is protected by copyright. All rights reserved.
January 25, 2019: Journal of Cutaneous Pathology
Andrea Montes-Torres Andrea, Mar Llamas-Velasco, Tania M Capusan, Beatriz Aguado, Magdalena Adrados
Lymphoblastic lymphomas (LBL) are uncommon malignant neoplasms derived from immature T- or B- lymphoid progenitor cells. Although cutaneous involvement may reach 33% in B-LBL, only twelve cutaneous cases of T- LBL have been published. We report the case of a 49-year-old woman with 2-month history of erythematous-violaceous plaques in the sternal region and breasts. Histopathologic examination showed a dense monomorphus infiltrate in dermis and positive immunostainings for CD3, CD99 and terminal deoxynucleotidyl transferase, thus indicating T-LBL...
January 24, 2019: Journal of Cutaneous Pathology
Carly Dunn, Harrison P Nguyen, Viraat Patel, Heather S Barker, A Hafeez Diwan, Marwan Yared, Tarek Elghetany, Alejandro Restrepo, Harry Dao
Post-transplant lymphoproliferative disorder (PTLD) is an uncommon complication after solid organ transplants and hematopoietic stem cell transplants. Isolated involvement of the skin without systemic involvement in PTLD is extremely rare. Primary cutaneous PTLD is generally categorized as either cutaneous T-cell lymphomas or cutaneous B-cell lymphomas, with variable Epstein-Barr virus (EBV) positivity. Herein, we describe an exceedingly uncommon case of a primary cutaneous Hodgkin-like polymorphic PTLD. A man in his 60s, with a history of kidney transplant, presented with a 5-week history of 2 indurated plaques...
January 22, 2019: Journal of Cutaneous Pathology
Nikki S Vyas, Ahmad Charifa, Garrett T Desman, Jennifer M McNiff
BACKGROUND: Distinguishing acute generalized exanthematous pustulosis (AGEP) and pustular psoriasis (PS) can be challenging. Staining for plasmacytoid dendritic cells, or PDCs (producer of IFN-α/β),[1] and MxA (an IFN-α/β inducible protein)[2] may help discriminate these entities. METHODS: Forty-three cases of AGEP and PS were compiled from two academic institutions. All cases were examined for CD123+ PDCs, eosinophils, acanthosis, papillomatosis, suprapapillary plate thinning, tortuous dilated capillaries, single necrotic keratinocytes, papillary dermal edema, vasculitis, eosinophil exocytosis, intraepidermal pustules, and subcorneal pustules...
January 22, 2019: Journal of Cutaneous Pathology
Kohei Ogawa, Yasuhiro Mitsui, Suzuka Miyamoto, Yuki Nakamura-Nishimura, Yukiko Nakanishi, Hiroaki Azukizawa, Hideo Asada
Pustules with facial and/or neck edema is one characteristic feature of drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) at the early stage. Although several retrospective histopathologic studies on DIHS/DRESS have been reported, the detailed histopathologic findings of facial pustules for DIHS/DRESS are unavailable. We herein report a case of DIHS/DRESS with facial pustules that was histopathologically similar to eosinophilic pustular folliculitis (EPF)...
January 22, 2019: Journal of Cutaneous Pathology
Jose Fernandez-Vazquez, Jesús Del Pozo Losada, Felipe Sacristán-Lista
A 52-year-old man presented with a rapidly growing red tumor on the central neckline. It had appeared over a congenital flat and pinkish vascular lesion that involved the shoulder and the upper anterior area of his chest. Intermingled with the pinkish stain, there were also some blue nodules several millimeters in diameter. Histopathologic examination revealed that the full lesion was a mixed venous-capillary malformation. The red tumor was excised and diagnosed as a pyogenic granuloma developing over the venous component of the vascular malformation...
January 22, 2019: Journal of Cutaneous Pathology
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