Journal of Cutaneous Pathology最新文献

Clear cell sarcoma (CCS) is a rare sarcoma that typically arises in the deep soft tissue of the extremities. We describe two patients with molecularly confirmed CCS in genital skin. Patient 1 was a 22-year-old woman with a vulvar mass, and Patient 2 was a 25-year-old man with a scrotal plaque. Histopathological examination in each case revealed a cellular tumor distributed in nests and sheets, composed of epithelioid and spindled cells. The tumor cells exhibited clear and eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli. Immunohistochemical analysis demonstrated that both tumors expressed Sox10 and HMB45. FISH testing revealed EWSR1 rearrangements in both cases, and further NGS analysis in Case 1 confirmed the presence of an EWSR1-ATF1 fusion. To date, only 3 cases of CCS have been reported involving the genital region, all originating in deep soft tissues. Our report expands the known anatomical sites of cutaneous clear cell sarcoma involvement.

Syringomatous tumor of the nipple (SyT) is a rare benign tumor that arises in the nipple or areolar region. Due to its locally infiltrative growth pattern, it is often misdiagnosed as a malignant tumor. SyT primarily occurs in middle-aged women, with a reported mean age of onset of 46.1 years. Fewer than 100 cases have been documented in the literature to date, and occurrence in adolescents is exceedingly rare. This case report describes a rare instance of SyT in a 16-year-old asymptomatic female, who presented with progressive unilateral nipple enlargement over 5 years. Breast ultrasound and subsequent surgical excision were performed, and the final histopathological diagnosis confirmed SyT. This report highlights the imaging and pathological features of SyT and discusses main differential diagnoses, emphasizing the importance of accurate clinical recognition and appropriate management to avoid overtreatment. It provides valuable insights to aid in the diagnosis and clinical decision-making for this rare entity.

Martin C. (Marty) Mihm made multiple, pivotal contributions over four decades of discovery, innovation, and development leading to the world-wide application of lasers in dermatology. This started with trying to understand how pulses of light could be tailored to affect microscopic “target” structures in skin where the light is absorbed. There were many surprises, often first observed by light or electron microscopy. A host of new capabilities ensued, including laser treatments for microvascular and vascular malformations, non-melanoma pigmented lesions, tattoo and hair removal, rehabilitation of scars, improvement of photoaged skin, and lipid-targeting lasers for reduction of fat and acne. Dr. Mihm extended himself directly to patients, especially children with vascular anomalies. He contributed to the discovery that GLUT1, a glucose transporter expressed on vascular endothelium, is a defining diagnostic for infantile hemangiomas. He established a multispecialty vascular-anomalies clinic at the Massachusetts General Hospital, and co-founded the Vietnam Vascular Anomalies Center (VVAC) in Ho Chi Minh City. In Vietnam, topical radioactive phosphorus (³²P) is applied as a misguided treatment for infantile hemangiomas, leading to radiation damage in uncounted thousands of children. By teaching the use of beta-adrenergic drug treatment, the use of ³²P has been greatly reduced. Dr. Mihm pioneered the concept of pulsed dye laser (PDL) in combination with angiogenic inhibitors to improve the clinical efficacy of port wine stain (PWS) treatment. Moreover, he made seminal contributions to our understanding of the pathogenesis and spectrum of phenotypes of PWS lesions. The legacy of Martin C. Mihm extends to the entire world.

Skin cancer is a major global health concern, where early and accurate detection is crucial for improving patient outcomes. Traditional diagnostic methods, such as manual visual inspection and conventional machine learning models, often suffer from subjectivity, high computational costs, and limited annotated data. Althoug deep learning has improved automated skin cancer detection, existing models face challenges like overfitting, insufficient generalization, and complex architectures that limit real-time clinical application. To address these limitations, we propose MAF-DermNet, a deep learning framework that integrates Multi-Scale Attention Fusion (MAF) with depthwise separable convolutions for efficient and accurate skin cancer detection. Our approach enhances data diversity using DCGAN-based synthetic augmentation to improve model robustness. By leveraging multi-resolution inputs and a residual attention block, MAF-DermNet effectively captures subtle lesion features while preserving critical low-level information. Extensive experiments demonstrate exceptional performance, with accuracy exceeding 99.9% and macro F1 scores above 99.5%. In addition to its superior classification capabilities, MAF-DermNet offers enhanced interpretability and computational efficiency, making it well-suited for clinical deployment. Future work will focus on integrating clinical metadata and optimizing the model for diverse healthcare settings to further improve early diagnosis and treatment outcomes.