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American Journal of Dermatopathology

Ferdinand Toberer, Wolfgang Hartschuh, Katharina Wiedemeyer
Necrolytic migratory erythema (NEM) is associated with glucagonoma, an endocrine malignancy of the pancreas. It is a rare and a likely underrecognized paraneoplastic dermatitis. A 38-year-old woman presented to our clinic with a 3-year history of reocurring pruritic skin rashes with increasing intensity. The skin lesions presented with active annular borders, central scaling, and postinflammatory hyperpigmentation, but also with erosions, pustules, and crusted lesions. Multiple skin biopsies were taken. The workup of the patient revealed a tumor localized in the head of the pancreas, and glucagon serum levels were elevated...
September 17, 2018: American Journal of Dermatopathology
Debajyoti Chatterjee, Vikarn Vishwajeet, Uma Nahar Saikia, Bishan Radotra, Dipankar De, Deepak Bansal
Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder characterized by clonal proliferation of neoplastic Langerhans cells (LCs). LC proliferation can also be seen in different reactive dermatosis. CyclinD1 is a downstream marker of mitogen-activated protein (MAP) kinase pathway, which is often activated in LCH. This study aimed to evaluate the role of cyclinD1 to differentiate reactive LC proliferation from LCH. All cases of cutaneous LCH diagnosed by biopsy in the past 3 years (n = 13) were immunostained with CD1a, p53, CD31, and cyclinD1...
September 17, 2018: American Journal of Dermatopathology
Abul Ala Syed Rifat Mannan, Binny Khandakar, Songyang Yuan
Cutaneous angiomyolipoma is a rare mesenchymal tumor, distinct from its renal counterpart. Only few cases have been reported in English language literature to date. Here, we report a case in a 36-year-old man who presented with a painless swelling on his right ear. Microscopy revealed a well-circumscribed tumor, composed of an admixture of mature adipocytes, blood vessels, and bundles of smooth muscles. The tumor cells were positive for desmin and calponin but negative for HMB45, melan-A, SOX10, tyrosinase, and CD10...
September 17, 2018: American Journal of Dermatopathology
Lavleen Singh, Mamta Sengar, Surbhi Goyal, Meha Mansi, Nita Khurana, Anup Mohta
INTRODUCTION: The accurate histopathological diagnosis of the phimotic prepuce is indispensable because early diagnosis, treatment, and close follow-up are crucial in genital dermatosis such as lichen sclerosus (LS). This study analyzes the histopathological spectrum of childhood phimosis with special emphasis on LS. We also highlight a peculiar pattern of histopathological evolution in LS, prepuce. MATERIAL AND METHODS: The histopathology slides of all the pediatric preputial circumcision specimens performed for the indication of pathological phimosis (n = 43) during the study period (2012-2017) were analyzed...
September 17, 2018: American Journal of Dermatopathology
Jessica G Labadie, Aleksandra G Florek, Timothy VandenBoom, Pedram Yazdan, Aleksandar L Krunic
We present a 25-year-old male patient with a primary cutaneous primitive neuroectodermal tumor (cPNET) with unusual immunohistochemistry and lack of fusion oncogene generation. The lesion expressed CD99 and WT-1, and the histological features were consistent with cPNET. Differential diagnoses such as rhabdomyosarcoma, desmoplastic small round blue cell tumor, hematolymphoid neoplasm, neuroblastoma, and CIC-DUX round cell sarcoma were ruled out based on immunohistochemistry, genetic studies, and histology. Previous cPNET cases have been published detailing abnormal immunochemistry and genetic expression...
September 17, 2018: American Journal of Dermatopathology
Almut Böer-Auer, Dieter Metze
BACKGROUND: Hand-foot-mouth disease (HFMD) is a common contagious viral infection usually affecting infants and children. Recently, literature on HFMD in adults is increasing. It has been reported that adults often present with unusual exanthems with similarities to erythema multiforme (EM). No study has so far compared the histologic features of HFMD with those of EM. METHODS: Histopathologic features in 7 biopsies of 6 adult patients with HFMD are compared with biopsies from 9 patients with EM to identify the best criteria for differentiation...
September 11, 2018: American Journal of Dermatopathology
Nagwa Mohammad Elwan, Yomna Mazid El-Hamd Neinaa
No abstract text is available yet for this article.
September 11, 2018: American Journal of Dermatopathology
Hiba Zaaroura, Reuven Bergman, Mariela J Nevet
Pigmented contact dermatitis (PCD) is a noneczematous variant of allergic contact dermatitis, and benzyl salicylate is one of its causes. This type of PCD shows nonlichenoid interface dermatitis with pigment incontinence. We aimed to characterize the earliest histopathological changes of this reaction. A 51-year-old man presented with persistent facial eruption composed of hyperpigmented and hypopigmented macules due to exposure to benzyl salicylate present in his aftershave. The biopsies obtained from hyperpigmented and hypopigmented macules, and from the positive patch test site to benzyl salicylate, showed a nonlichenoid focal vacuolar interface dermatitis with mononuclear cells in the papillary dermis and around the pilosebaceous units, along with melanophages...
September 11, 2018: American Journal of Dermatopathology
Gargi Kapatia, Tushar Pandey, Nandita Kakkar, Harsimran Kaur, Roshan Verma
Phaeohyphomycosis is a rare mycotic infection caused by heterogenous groups of dematiaceous fungi involving the skin and subcutaneous tissue. Here, we report a case of cutaneous phaeohyphomycosis presenting as cauliflower-like verrucous lesion over the face in an immunocompetent individual. Histopathology showed suppurative granulomatous inflammation replete with pigmented broad fungal hyphae which is stained with periodic acid-Schiff stain, Grocott's methanamine silver stain, Schmorl's stain, and Masson-Fontana stain...
September 11, 2018: American Journal of Dermatopathology
Nancy E Thomas, Sharon N Edmiston, Yihsuan S Tsai, Joel S Parker, Paul B Googe, Klaus J Busam, Glynis A Scott, Daniel C Zedek, Eloise A Parrish, Honglin Hao, Nathaniel A Slater, Michelle V Pearlstein, Jill S Frank, Pei Fen Kuan, David W Ollila, Kathleen Conway
Telomerase reverse transcriptase (TERT) promoter mutations are commonly found in malignant melanomas but rare in melanocytic nevi. To assess its potential diagnostic utility for the distinction of melanoma from nevus, we determined the TERT promoter mutation status of 86 primary melanomas, 72 melanocytic nevi, and 40 diagnostically problematic melanocytic proliferations. Of the 86 melanomas, 67 (77.9%) were TERT-positive, defined as harboring a hotspot TERT promoter mutation at positions -124C>T, -124_125CC>TT, -138_139CC>TT, or -146C>T...
September 11, 2018: American Journal of Dermatopathology
Silvija P Gottesman, Jason R Rosen, Jay D Geller, Benjamin B Freeman
Patients with mycosis fungoides experience considerable morbidity and mortality from secondary bacterial and viral infections. Staphylococcus aureus, β-hemolytic streptococci, herpes simplex virus, and herpes zoster virus remain the most common infectious pathogens in this group of patients. With depressed cellular immunity and diminished skin barrier as the main precipitating risk factors, immunocompromised patients can often present with an atypical presentation of a common dermatologic condition. The case herein discusses a clinically atypical nonvesicular Kaposi varicelliform eruption secondary to a varicella-zoster virus in a patient with Sézary syndrome...
September 11, 2018: American Journal of Dermatopathology
Favia Dubyk, Alejandro A Gru, Richard Flowers
No abstract text is available yet for this article.
September 4, 2018: American Journal of Dermatopathology
Randa Youssef, Doaa Mahgoub, Ola A Zeid, Dalia M Abdel-Halim, Marwa El-Hawary, Marwa F Hussein, Mary A Morcos, Dalia M Aboelfadl, Heba A Abdelkader, Yosra Abdel-Galeil, Mona R E Abdel-Halim
Hypopigmented interface T-cell dyscrasia (HITCD) is a distinct form of lymphoid dyscrasia that may progress to hypopigmented mycosis fungoides (HMF). We compared both diseases as regards their CD4/CD8 phenotype and expression of granzyme B and tumor necrosis factor-alpha (TNF-α) and how these are affected by narrow-band UVB (nb-UVB). The study included 11 patients with HITCD and 9 patients with HMF. They received nb-UVB thrice weekly until complete repigmentation or a maximum of 48 sessions. Pretreatment and posttreatment biopsies were stained using anti CD4, CD8, TNF-α, and granzyme B monoclonal antibodies...
September 4, 2018: American Journal of Dermatopathology
Andrew Kelsey, Jane M Grant-Kels, Harold Rabinovitz, Margaret Oliviero, Alon Scope
Despite the successful assignment of Current Procedural Terminology codes, there are barriers to incorporating in vivo reflectance confocal microscopy (RCM) into daily practice. Importantly, the dermatopathologist can play a key role in interpreting RCM images and can use these images to correlate with histopathology. Herein, we describe, using a case series, how RCM can be incorporated into the dermatopothalogist's practice. We also summarize the criteria for RCM diagnosis of common neoplasms.
September 4, 2018: American Journal of Dermatopathology
Lidia Ossorio-García, Irene Millán-Ortega, David Jiménez-Gallo, José María Báez-Perea, Mario Linares-Barrios
We report a case of a 65-year-old man who developed an asymptomatic bluish spot that affected the flank and left lumbar region with the onset 10 years prior. He had a history of diffuse systemic sclerosis with anti-Scl-70-positive antibodies. The appearance of the skin lesion coincided with the onset of his disease. The skin biopsy was consistent with the diagnosis of acquired dermal melanocytosis. The relationship between the appearance of acquired pigmented macules and spots and systemic sclerosis has been known for years, although it is an infrequent finding...
August 15, 2018: American Journal of Dermatopathology
Rachel M Bierbrier, Esiahas Amdemichael, David N Adam
An 8-year-old girl presented with a persistent 5 × 2-cm violaceous doughy plaque on the left lower leg. Histologic examination revealed hyperkeratosis, variable but mild epidermal hyperplasia, and vacuolar interface changes with melanin pigment incontinence confined to the papillary dermis. A diagnosis of pretibial lymphoplasmacytic plaque in children was made. This report outlines the clinical characteristics of this entity and a review of other cases reported in the literature.
August 15, 2018: American Journal of Dermatopathology
Victoria Alegría-Landa, Viviana Lora, Carlo Cota, Heinz Kutzner, Luis Requena
Alveolar soft-part sarcoma is a rare neoplasm of unknown histogenesis that accounts for less than 1% of all soft-tissue sarcomas. The tumor is highly vascularized with small vascular spaces separating nests of cells, and from cytogenetic point of view, is characterized by chromosome rearrangement der(17)t(X:17)(p11:q25) that results in the ASPL-TFE3 translocation. It can occur at any age, but it is most common between 15 and 35 years of age. The prognosis is poor, despite the relatively slow growth of the tumor...
August 15, 2018: American Journal of Dermatopathology
Shira Ronen, Saul Suster
No abstract text is available yet for this article.
August 6, 2018: American Journal of Dermatopathology
Mariya Miteva, Samar Sabiq
Frontal fibrosing alopecia (FFA) is an irreversible scarring alopecia with unknown etiology and no cure. The goal is to establish the diagnosis in the early stage, before developing a hairless band of atrophy involving the frontal, temporal scalp and sideburns. Pathology is rarely needed once the disease is clinically apparent. The classic histologic features include follicular dropout with the absence or atrophy of the sebaceous glands and lichenoid lymphohistiocytic infiltrate with concentric layered fibrosis at the upper follicular level...
August 6, 2018: American Journal of Dermatopathology
Tien Anh N Tran, Konstantinos Linos, Francine B de Abreu, John Andrew Carlson
Malignant melanoma (MM) may display highly variable phenotypic diversity, sometimes associated with loss of immunohistochemical melanocytic markers and acquisition of nonmelanocytic lineage of differentiation. Primary cutaneous MM with rhabdomyosarcomatous differentiation is extremely rare with only 5 reported cases in the literature. To date, a chronological progression of a MM to rhabdomyosarcoma has not been conclusively documented. A 96-year-old man underwent a re-excision of an "atypical fibroxanthoma" of the forearm, which revealed a small lentigo maligna melanoma associated with a dominant dermal high-grade spindle cell nodule admixed with a population of malignant polygonal epithelioid cells...
August 6, 2018: American Journal of Dermatopathology
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