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Journal of Cutaneous Pathology

O Servitje, F Climent, L Colomo, N Ruiz, A García-Herrera, F Gallardo, S Mercadal, H Pomares, C Muniesa, C Martin-Callizo, J Marcoval, R Rovira, T Estrach, R M Pujol
BACKGROUND: Primary cutaneous follicular center-cell lymphoma (PCFCL) is one of the most common types of cutaneous B-cell lymphoma. Differences in immunohistochemical expression of BCL2 and CD10 antigens along with the presence of t(14:18) translocation in neoplastic cells have been postulated as relevant clues in differentiating PCFCL from cutaneous lesions secondary to a systemic follicular lymphoma (SCFL). The aim of this study is to evaluate the significance and usefulness of these parameters in a large series of patients...
December 4, 2018: Journal of Cutaneous Pathology
Stephanie A Castillo, Anh K Pham, Dorothea T Barton, Joel A Lefferts, Shaofeng Yan, Julia A Bridge, Konstantinos Linos
Melanoma ex blue nevus (MEBN) is a rare, aggressive, and potentially lethal neoplasm. Distinguishing MEBN from an atypical cellular blue nevus can be very challenging. We report a diagnostically difficult case of MEBN with lymph node metastases, in which single nucleotide polymorphism array and fluorescence in situ hybridization were used to arrive at the correct diagnosis. It was also analyzed by the recently-introduced proprietary 23-gene expression signature test (myPath Melanoma, Myriad Genetics Inc.). To our knowledge, this is the second reported case of MEBN analyzed by the 23-gene expression signature, which provided a false negative result...
December 2, 2018: Journal of Cutaneous Pathology
Joong-Heon Suh, Soo-Kyung Lee, Ho-Young Kim, Myoung-Shin Kim, Un-Ha Lee
Multinucleate cell angiohistiocytoma (MCAH) is a rare cutaneous disease entity characterized by multiple red-to-brown or violaceous papules usually located on the acral regions such as the face and the distal arms and legs. It affects elderly women more than men and hardly occurs at a young age. The exact pathogenic mechanism of MCAH is not yet clearly understood. We report an exceptionally rare case of a 14-year old boy who presented with multiple asymptomatic erythematous papules and a single flat brownish plaque on the left chest...
November 29, 2018: Journal of Cutaneous Pathology
Eloise R Galligan, Lindsey Fix, Sameera Husain, Philip Zachariah, Darrell J Yamashiro, Christine T Lauren
We report a case of disseminated Trichosporon asahii in a patient on systemic anti-fungal therapy who presented with multiple cutaneous nodules suggestive of fungal infection. Histologic features resembled neutrophilic eccrine hidradenitis but staining with periodic acid-Schiff and Gomori methenamine silver confirmed the clinical diagnosis. This case highlights the importance of maintaining suspicion for trichosporonosis and contextualizing histologic findings within the underlying clinical picture. This article is protected by copyright...
November 22, 2018: Journal of Cutaneous Pathology
Reiko Tsutsumi, Kazunari Sugita, Yuko Abe, Yutaka Hozumi, Tamio Suzuki, Nanako Yamada, Yuichi Yoshida, Osamu Yamamoto
BACKGROUND: Rhododendrol (Rhododenol®), an inhibitor of tyrosinase activity, is used as a skin-whitening component. Many cases of leukoderma after the application have been reported, termed Rhododenol-induced leukoderma (RIL). The aim of this study was to clarify the pathogenesis of RIL morphologically through comparison with vitiligo. METHODS: We examined 14 cases of RIL and 15 cases of vitiligo using routine histopathology and immunohistochemistry. Thirteen cases of RIL, 6 cases of vitiligo and specimens of the RIL mouse model were evaluated by electron microscopy...
November 19, 2018: Journal of Cutaneous Pathology
David Cormican, Ciaran Kennedy, Sandra Murphy, Reiltin Werner, Derek G Power, Cynthia Cbb Heffron
BACKGROUND: Techniques for the accurate identification of activating mutations of BRAF in metastatic melanoma are of great clinical importance, due to the availability of targeted therapies for these tumours. There is uncertainty regarding the frequency with which BRAF status differs between primary and metastatic sites. METHODS: Between 2011 and 2016, 219 melanoma cases underwent BRAF testing in our institution. In 53 of these, paired primary and metastatic specimens were available for PCR and immunohistochemical evaluation...
November 14, 2018: Journal of Cutaneous Pathology
Sepehr Hamidi, Neil S Prose, M Angelica Selim
Neutrophilic figurate erythema of infancy (NFEI) is a rare variant of annular erythema of infancy. It is characterized by annular erythematous plaques, occasionally with a polycyclic configuration. The main challenge is to differentiate this rare entity from other figurate erythemas associated with serious diseases such as neonatal lupus erythematosus. We present the case of a 9-month-old female admitted with a skin rash of unclear etiology. The rash started on her face at the age of 3 months and gradually spread to her extremities...
November 14, 2018: Journal of Cutaneous Pathology
A Roda, A R Travassos, L Soares-de-Almeida, H Kutzner
Mycosis fungoides (MF) is a primary cutaneous lymphoma, characterized by a clonal proliferation of T cell helper memory cells in the skin [1]. Various benign conditions, such as chronic inflammatory dermatoses, may mimic MF, either clinically or histologically. Distinguishing MF from dermatologic conditions mimicking MF may be challenging. Clinicopathological correlation is fundamental to support the diagnosis, which is essential to ensure proper treatment and to provide an accurate prognosis [2]. This article is protected by copyright...
November 14, 2018: Journal of Cutaneous Pathology
John H Pyne, Esther Myint, Simon P Clark, Elizabeth M Barr, Ruihang Hou
BACKGROUND: Invasive squamous cell carcinoma (SCC) is typically treated by surgical excision. METHOD: Consecutive SCC excisions were reviewed prospectively in a single Australian center from 2009-2017. Cases were examined for recurrence by histopathologic margins, microscopic tumor surface diameter, invasion depth, grade of differentiation and anatomic site. RESULTS: Over 9 years 1,296 cases were collected. By grade of differentiation maximum average microscopic surface diameters ranged from 8...
November 13, 2018: Journal of Cutaneous Pathology
Angel Fernandez-Flores, Marcela Saeb-Lima, David S Cassarino
Schwannoma involving the blood vessels is a rare phenomenon. So far, only three cases of intravascular schwannoma have been described (all of which were intraluminal), and the origin of the schwannoma in such cases is not yet completely understood. Here we describe a very rare intramural venous schwannoma in the subcutaneous right prepatellar area of a 31-year-old man. The schwannoma grew by enlarging and thickening the blood vessel wall, between two preserved layers of the vein. In some areas, there was erosion of the luminal layer, with fibrin apposed to the tumor...
November 12, 2018: Journal of Cutaneous Pathology
Faysal Fedda, Michael R Migden, Jonathan L Curry, Carlos A Torres-Cabala, Michael T Tetzlaff, Phyu P Aung, Victor G Prieto, Doina Ivan, Jeffrey N Myers, Priyadharsini Nagarajan
Extravascular migratory metastasis is a form of cancer metastasis in which tumor cells spread by tracking along the abluminal aspect of vessel walls without breaking the vascular endothelial lining or intraluminal invasion. This phenomenon has been extensively described in melanoma and is being increasingly recognized in other neoplasms. Various modalities of treatment, including radiation-, chemo-, targeted- and immune- therapies may potentially induce angiotropic behavior in neoplastic cells. Although there is a risk for tumor recurrence and metastasis, angiotropism may be under-recognized and is rarely reported...
November 9, 2018: Journal of Cutaneous Pathology
Katrina Lee, Delila Pouldar, Jessica Shiu, Ashley Elsensohn, Sébastien de Feraudy
We read with interest the case series by Everett et al. (1) describing chronic granulomatous dermatitis at sites of Talimogene laherparepvec (TVEC) injections for advanced melanoma. This article is protected by copyright. All rights reserved.
November 9, 2018: Journal of Cutaneous Pathology
Frank Meiss, Kristin Technau-Hafsi, Johannes S Kern, Annette M May
BACKGROUND: Skin diseases are frequent in patients with chronic lymphocytic leukemia and other hematological neoplasias. Eosinophilic dermatosis of hematologic malignancy (ED) has long been considered a nonspecific cutaneous reaction pattern. Recently neoplastic cells have been shown to be present in ED thus challenging the classification as a nonspecific dermatosis. METHODS: We report 5 patients with ED in association with chronic lymphocytic leukemia (CLL). We further investigated the presence of neoplastic B-cells in the skin infiltrate by immunohistochemistry and immunoglobulin heavy chain rearrangement and compared these to extracutaneous manifestations of CLL...
November 8, 2018: Journal of Cutaneous Pathology
Christina Mitteldorf, Heidi Plumbaum, Markus Zutt, Michael P Schön, Kjell M Kaune
A 42-year-old Caucasian man suffered from disseminated plaques and ulcerated nodules for six weeks. He had weight loss and generalized lymphadenopathy. Underlying diseases were not known up till then. Based on a skin biopsy the diagnosis of CD8-positive cutaneous T-cell lymphoma, type mycosis fungoides was made in a pathological reference center for lymphoma. A reproducible TCR-beta rearrangement was detectable. Before starting therapy, a new biopsy was taken and the previous diagnosis was re-evaluated taking clinical images and symptoms into account...
November 8, 2018: Journal of Cutaneous Pathology
Koya Obara, Sumiyuki Mii, Yasuyuki Amoh
Primary cutaneous peripheral T cell lymphoma, not otherwise specified (pcPTCL-NOS) is a rare, aggressive, fatal type of cutaneous T-cell lymphoma. The clinical presentation of pcPTCL-NOS is characterized by generalized plaques, nodules or tumours but ulcers are uncommon. We report an atypical case of pcPTCL-NOS with cytotoxic protein expression, presenting as multiple ulcers on the entire body. A 48-year-old man first presented with pruritic papules on the trunk. The papules gradually increased in number and became ulcerated...
November 8, 2018: Journal of Cutaneous Pathology
G Broggi, F Lacarrubba, A E Verzì, G Micali, R Caltabiano
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma with a predilection for males (2:1) and dark skin individuals (2:1). As regards the pathogenesis, it has been well demonstrated that monoclonal T-cell receptor (TCR) gene rearrangements lead to neoplastic expansion of CD4+ lymphocytes of the skin [1]. This article is protected by copyright. All rights reserved.
November 1, 2018: Journal of Cutaneous Pathology
Vanessa Szablewski, Olivier Dereure, Céline René, Ariane Tempier, Luc Durand, Melissa Alame, Valère Cacheux, Valérie Costes-Martineau
BACKGROUND: We report the cases of 3 patients presenting skin lesions whose biopsies showed nodular polymorphic infiltrate consisting of lymphocytes, plasma cells, histiocytes, eosinophils, B blasts and Hodgkin Reed-Sternberg (HRS)-like cells. Two of them were initially diagnosed as classical Hodgkin lymphoma (cHL) whereas the last one as a B cell lymphoma. All patients have been treated for angioimmunoblastic T-cell lymphoma (AITL). METHODS AND RESULTS: We performed a second review of the skin biopsies with further immunophenotypic molecular analyses...
October 28, 2018: Journal of Cutaneous Pathology
Arthur Marka, Molly C E Cowdrey, Joi B Carter, Frederick Lansigan, Shaofeng Yan, Robert E LeBlanc
A relationship between Kimura disease (KD) and angiolymphoid hyperplasia with eosinophilia (ALHE) has been debated. Given substantial clinical and histologic overlap, these entities were once considered to represent a disease spectrum; however, they are now widely considered to be etiologically distinct. A diagnosis of either condition is further complicated by resemblance to various malignancies, which must be carefully excluded. Coexistence of ALHE and KD in a patient is extremely rare, with only 4 cases reported in the English literature...
October 25, 2018: Journal of Cutaneous Pathology
Angel Fernandez-Flores, David S Cassarino
INTRODUCTION: Mature sebaceous glands do not contain Merkel cells. Neither do sebaceous tumors in the vast majority of cases. Recently, however, it was demonstrated that rare sebaceous adenomas with a carcinoid-like or labyrinthine pattern can contain intratumoral Merkel cells. Our purpose in this study is to examine for the presence of Merkel cells in extraocular sebaceous carcinomas. MATERIALS AND METHODS: Nineteen cases of extraocular sebaceous carcinoma were retrospectively studied with cytokeratin (CK) 20...
October 25, 2018: Journal of Cutaneous Pathology
L A Sardiña, G Jour, M Piliang, W F Bergfeld
BACKGROUND: Erythema elevatum diutinum (EED) is a rare vasculitis with variable clinical presentation which diagnosis can be challenging. Herein we want to describe the clinicopathological spectrum of findings in 5 cases of EED. PATIENTS AND METHODS: We retrospectively analyzed 5 cases in a single institution collected over a period of 27 years. The clinical history was collected and all the slides were examined in order to determine the histopathological characteristics of the lesions...
October 25, 2018: Journal of Cutaneous Pathology
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