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Journal of Cutaneous Pathology

Emilie Jacobsen, Erica Shantha Tarabadkar, Michi M Shinohara
We present a case of a widespread fixed drug eruption histologically mimicking CD8 positive cutaneous T cell lymphoma (CTCL). CTCL has several potential histological and clinical mimics, and accurate diagnosis relies on a combination of clinicopathologic correlation and molecular studies. We add generalized fixed drug eruption to the list of possible CTCL mimics. This article is protected by copyright. All rights reserved.
October 16, 2018: Journal of Cutaneous Pathology
Shyam S Raghavan, Eric K Hong, Youn H Kim, Jinah Kim
INTRODUCTION: Mycosis fungoides (MF) with large cell transformation (LCT) is an advanced stage of cutaneous lymphoma with a poor prognosis. Identification of LCT is critical and especially challenging when the number of large abnormal lymphocytes is near but below 25%. We propose that Ki67 and p53 may be useful in making this diagnosis. MATERIALS AND METHODS: We identified 17 patients with advanced stage (T3 or T4) MF without LCT and 38 patients with a biopsy-confirmed new diagnosis of MF with LCT treated at our institution's cutaneous lymphoma clinic from 2012-2016...
October 16, 2018: Journal of Cutaneous Pathology
I U Perkins
I am a second year dermatopathology fellow at the University of California San Francisco. As I begin my last year of training, I find myself increasingly considering questions that go beyond the usual "What is the most likely diagnosis or the most helpful immunostain?" Once I enter practice, what sort of pathologist, dermatopathologist, and physician colleague do I aspire to be? How will I do my best for the patient represented by each glass slide that crosses my stage? What should I do if I recognize that an error has been made, especially, if the error is my own? Very recently, we deliberated a particularly challenging case of a poorly differentiated malignant neoplasm in our division consensus conference; I wondered how much is truly "enough" in the work-up of such a case, particularly in an under-insured patient...
October 15, 2018: Journal of Cutaneous Pathology
Benjamin Johansson, Helka Sahi, Virve Koljonen, Tom Böhling
BACKGROUND: Merkel cell carcinoma (MCC) tumor samples frequently express B-lymphoid lineage markers. However, the reasons for expression of specific B-lymphoid lineage markers are still unclear. We studied in a large pool of tissue microarray MCC samples, validate in a larger cohort the expression of TdT and Pax-5, which are two B-lymphoid lineage markers. METHODS: Immunoexpression and staining intensities of TdT and Pax-5 were statistically correlated with patient, tumor, Merkel cell polyoma virus (MCV), and disease-specific parameters...
October 12, 2018: Journal of Cutaneous Pathology
Dawn Z Eichenfield, David Cotter, John Thorson, Brian Hinds, Bryan K Sun
Agminated blue nevi are dermal melanocytic proliferations that classically present as dark blue macules or papules in a grouped, linear, or blaschkoid distribution. In their more common sporadic form, blue nevi manifest in young adulthood as solitary blue papules or macules on the scalp, face, hands, or feet. By contrast, agminated blue nevi tend to manifest earlier in life, and are distributed more evenly across anatomic sites. Recent studies have identified mutations in sporadic blue nevi in the genes encoding the guanine nucleotide-binding proteins, GNAQ and GNA11...
October 12, 2018: Journal of Cutaneous Pathology
Maria C Ferrufino-Schmidt, Francisco Bravo Puccio, Braulio M Valencia, Alejandro Llanos-Cuentas, Andrea K Boggild, Philip E LeBoit
We read with great interest the article by Sundharkrishnan and North1 in which they compare the expression of CD1a between Old World and New World Leishmania species, and we would like to share our experience and thoughts. This article is protected by copyright. All rights reserved.
October 12, 2018: Journal of Cutaneous Pathology
Fang-Ying Wang, Chau Yee Ng, Jennifer Wu, Kang-Ling Kuo, Yao-Yu Chang, Tseng-Tong Kuo
Acquired perforating calcific collagenosis (APCC), which is characterized by the calcification of dermal collagen fibers with subsequent transepidermal elimination and perforation, is an extremely rare entity. Thus far, it has only been reported in a patient with direct contact exposure to calcium chloride. Here we report a unique case of APCC occurring in a drug addict admitted for rhabdomyolysis. The present case is a 20-year-old male patient hospitalized for drug-related rhabdomyolysis and multiple organ damage...
October 12, 2018: Journal of Cutaneous Pathology
Graziana Gallo, Heinz Kutzner, Thomas Mentzel, Anna Maria Cesinaro
Cellular neurothekeoma (CNT) is a dermal lesion with still unknown histogenesis, characterized by immunohistochemical staining for NKI/C3, NSE, MiTF, CD10, and CD68, whereas S100 protein, desmin and cytokeratins are negative. Particularly, in several studies NKI/C3 has been reported as a strong marker of CNT. We describe herein the clinical, histopathological and immunohistochemical features of two cases morphologically consistent with myxoid CNT, one of which showing some atypical features, both characterized by negative immunohistochemical staining for NKI/C3...
October 12, 2018: Journal of Cutaneous Pathology
Allison J Good, Alexandra L Snodgrass, Anna De Benedetto, Kiran Motaparthi
Collagenous and elastotic marginal plaques of the hand is a rare, chronic keratoderma characterized by hyperkeratotic linear plaques located along the radial and ulnar aspects of the hands bilaterally. As an isolated finding, collagenous and elastotic marginal plaques of the hand occurs secondarily to chronic trauma and photodamage. Herein, collagenous and elastotic marginal plaques of the hand is described as a manifestation of alkaptonuria. In addition to keloidal collagen, ochronotic fibers and fragmented, thickened elastic fibers were observed...
October 7, 2018: Journal of Cutaneous Pathology
Michela Venturi, Luca Pilloni
MCC is an aggressive rare neuroendocrine primary tumour of the skin, with an increasing incidence mainly because of the higher reporting rate and the improvements in diagnostic techniques. Because of its non-specific clinical and histopathological picture, immunohistochemistry (IHC) is essential in distinguishing MCC from other morphologically similar mimics(1). This article is protected by copyright. All rights reserved.
October 5, 2018: Journal of Cutaneous Pathology
Anna-Marie Hosking, Ashley Elsensohn, Joy Makdisi, Sergei Grando, Sebastien de Feraudy
Keratosis pilaris (KP) is a benign cutaneous disorder characterized by folliculocentric hyperkeratotic papules most often occurring on the proximal extremities. Erythema is usually limited to perifollicular skin, but when keratosis pilaris presents on a background of confluent erythema, the term keratosis pilaris rubra (KPR) is used. The histological findings associated with KPR have not been well described in the literature. Herein, we present a case of a 14-year-old male with a 7-year history of erythema and follicular-based papules over his bilateral cheeks, consistent with KPR...
October 2, 2018: Journal of Cutaneous Pathology
Erik A Williams, Andrea P Moy, Nicole A Cipriani, Sagar U Nigwekar, Rosalynn M Nazarian
BACKGROUND: Calciphylaxis is a rare, painful and debilitating disorder of vascular calcification and skin necrosis that typically affects patients with advanced kidney disease. During our routine pathology practice, we noted several missed diagnoses on calciphylaxis consultation cases originating from outside institutions and sought to explore factors associated with false negative pathologic diagnosis of calciphylaxis. METHODS: The pathology database of a large tertiary academic medical center was retrospectively searched for "calciphylaxis" in inside reports on outside surgical consultation cases between 2007-2017...
October 2, 2018: Journal of Cutaneous Pathology
Pavandeep Gill, Marie Abi Daoud
Cellular neurothekeoma is a benign cutaneous neoplasm that typically occurs on the head, neck, and upper body of young adults with a slight female predominance. It is a rare lesion to diagnose and multiple neurothekeomas in one patient is an even more uncommon finding. We present a case of multiple neurothekeomas in a middle-aged woman with lower extremity involvement and summarize the current literature on multiple neurothekeoma patients. A 46-year-old female presented with nearly one dozen skin-coloured papules on the head, upper limb, and lower limb...
October 1, 2018: Journal of Cutaneous Pathology
Wan-Chieh Shen, Nien-Feng Chang Liao, Tze-Yi Lin, Po-Yuan Wu
Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder resulting from dysregulated clonal proliferation of Langerhans cells. Reticulohistiocytosis (RH) is another rare histiocytosis caused by the proliferation of histiocytes other than Langerhans cells. Co-existence of LCH and RH in different organs and in the same skin area has not been reported. We present the case of a 20-year-old woman who initially had co-existing bone LCH and cutaneous RH. After one year of chemotherapy with cytarabine, bone LCH significantly improved but cutaneous LCH developed in the same area where cutaneous RH was, resulting in hybrid LCH and RH of the skin...
September 24, 2018: Journal of Cutaneous Pathology
Elise Grgurich, Kelly Quinn, Christian Oram, Richard McClain, Nektarios Lountzis
No abstract text is available yet for this article.
September 24, 2018: Journal of Cutaneous Pathology
Shira Ronen, Doina Ivan, Carlos A Torres-Cabala, Jonathan L Curry, Michael T Tetzlaff, Phyu P Aung, Priyadharsini Nagarajan, Saul Suster, Victor G Prieto
Post-radiation vascular lesions are a rare complication most commonly seen in patients previously treated for breast cancer. The main two entities include angiosarcoma (AS), which are malignant tumors that have a poor prognosis and atypical vascular lesions (AVL), which typically behave in a benign manner and only rarely progress to angiosarcoma. The overall incidence of these lesions is low, but it appears to be increasing. Histopathologic distinction of AVL and AS is essential due to different clinical outcomes and treatment...
September 24, 2018: Journal of Cutaneous Pathology
Christina Dai, Sandra L Snyder, Michael A Scannon, Carlos A Cerruto
Primary cutaneous mycotic cysts are uncommon dermal or subcutaneous fungal lesions. The most commonly implicated organisms are species within a heterogeneous group of pigmented fungi called dematiaceous fungi. Mycotic cysts usually present as solitary lesions and can be caused by traumatic introduction of fungal elements by foreign bodies or present as a cutaneous manifestation of systemic fungal infections, especially in immunocompromised patients. We present a case of a 63 year old immunocompetent male who developed a non-erythematous solitary nodule after doing yardwork...
September 23, 2018: Journal of Cutaneous Pathology
Shin Taek Oh, Keum Jin Yang, Yeong Ho Kim, Jung Min Bae, Hyun Jeong Park, Jin Woo Kim, Young Min Park
Transient receptor potential (TRP) channels are thought to play an important role in tumor-related functions including regulation of proliferation, differentiation, apoptosis, angiogenesis, migration, and invasion during cancer progression. TRPM8 is the most notable member of the TRPM subfamily. This article is protected by copyright. All rights reserved.
September 19, 2018: Journal of Cutaneous Pathology
Leandra A Barnes, Gordon H Bae, Matthew A Lewis, Kerri E Rieger
Pachydermodactyly is a rare, benign condition characterized by swelling and thickening of the periarticular skin, most commonly at the proximal interphalangeal joints. Diagnosis is routinely made through correlation of clinical, histopathologic, and radiographic findings. Here we report a case of pachydermodactyly in a 25 year-old male, with emphasis on the clinical and histopathologic differential diagnosis and potential diagnostic pitfalls. This article is protected by copyright. All rights reserved.
September 16, 2018: Journal of Cutaneous Pathology
Jack Lee, Richard H Flowers, Margaret M Cocks, Mary Margaret B Noland
We report the case of a 40 year-old African American female with biopsy-proven pulmonary sarcoidosis who developed atrophic plaques on her shins, trunk, and scalp that were clinically and histologically consistent with necrobiosis lipoidica (NL). The lesions appeared 3 years after her diagnosis of sarcoidosis, and progressed despite chronic prednisone. Sarcoidosis and NL are granulomatous skin disorders reported to coexist in the same patient only 10 times in the literature. Including the current case, patients have been exclusively females around middle age, and have greater tendencies to develop typical cutaneous sarcoidosis...
September 14, 2018: Journal of Cutaneous Pathology
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