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Journal of Cutaneous Pathology最新文献

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Determining the utility of IgA immunohistochemistry for the diagnosis of IgA vasculitis 确定 IgA 免疫组化在诊断 IgA 血管炎中的实用性。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-30 DOI: 10.1111/cup.14672
Victoria Ricles BS, Madelyn M. Class BS, Vanden Lamar Grube BS, Lisa Zhai MD, Farhaan Hafeez MD
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引用次数: 0
A case of superficial acral fibromyxoma masquerading as squamous cell carcinoma of the thumb: A case report 一例伪装成拇指鳞状细胞癌的浅表性尖锐湿疣:病例报告。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-28 DOI: 10.1111/cup.14675
Nadra S. Magtulis MD, Bryan Edgar K. Guevara MD, FPDS, FDSP-PDS

A wide spectrum of tumors may affect the periungual spaces of the digits. Superficial acral fibromyxoma (SAF) is a rare, benign soft tissue tumor with diverse clinical presentations. We present a case of a 55-year-old woman with a 2-year history of a solitary periungual tumor on the left thumb, subjected to multiple episodes of trauma. Initially suspected to be a periungual squamous cell carcinoma (SCC) based on clinical and dermoscopic features, the tumor was confirmed to be a CD34 SAF through histopathology and immunohistochemistry. Although CD34 immunoreactivity is common in SAF, one-third of these tumors, including this case, do not stain for this marker. Periungual SCC considered a “great mimicker of nail tumors,” may resemble other benign nail tumors such as SAF. The patient underwent complete surgical excision with primary closure, resulting in no recurrence after 1 year. This case highlights SAF as an underrecognized benign entity that may manifest with features suspicious of malignancy, potentially leading to unnecessarily aggressive interventions. Recognizing SAF through accurate biopsy techniques and thorough histopathologic evaluation, even in the absence of CD34 reactivity, is crucial for appropriate treatment and preservation of hand function and appearance.

有多种肿瘤可能会影响指骨周围间隙。浅表尖锐湿疣(SAF)是一种罕见的良性软组织肿瘤,临床表现多种多样。我们报告了一例 55 岁女性的病例,她的左手拇指受到多次外伤,2 年前出现单发的拇指周围肿瘤。根据临床和皮肤镜特征,最初怀疑是拇指周围鳞状细胞癌(SCC),后经组织病理学和免疫组化证实该肿瘤为 CD34- SAF。虽然 CD34 免疫反应在 SAF 中很常见,但包括本病例在内的三分之一的肿瘤都没有这种标记物染色。甲周 SCC 被认为是 "指甲肿瘤的最佳模仿者",可能与其他良性指甲肿瘤(如 SAF)相似。该患者接受了原发闭合的完全手术切除,1 年后未再复发。本病例强调了SAF是一种未被充分认识的良性实体,可能表现出疑似恶性肿瘤的特征,从而可能导致不必要的积极干预。通过准确的活检技术和彻底的组织病理学评估(即使没有 CD34 反应)来识别 SAF 对于适当的治疗以及保护手部功能和外观至关重要。
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引用次数: 0
Generalized lymphatic anomaly: A case report and review of literature 全身淋巴异常:病例报告和文献综述。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-27 DOI: 10.1111/cup.14674
Eman R. M. Hofny MD, Asmaa M. Ahmed MD, Alaa Ghazally MD, Yasmin Salah MS, Ayman Mahran MD

Generalized lymphatic anomaly (GLA), previously known as lymphangiomatosis, is a rare developmental disease characterized by abnormal proliferation of lymphatic vascular structures that may involve the dermis, soft tissue, bone, and visceral parenchyma. Being an uncommon condition and the lack of specific symptoms often result in a delayed diagnosis or even misdiagnosis, which, in addition to its progressive nature, can lead to dysfunction of vital organs, and ultimately, a poor prognosis. In this report, we present a unique case of GLA in an upper Egyptian female child. Increasing awareness of the possible phenotypic presentations of such anomalies can lead to early diagnosis and possibly more effective management before significant organ damage ensues.

全身淋巴异常(GLA),以前称为淋巴管瘤病,是一种罕见的发育性疾病,其特点是淋巴管结构异常增生,可累及真皮、软组织、骨骼和内脏实质。由于该病并不常见,且缺乏特异性症状,往往导致诊断延迟甚至误诊,加之其渐进性,可导致重要器官功能障碍,最终导致预后不良。在本报告中,我们介绍了一例独特的上埃及籍女性儿童 GLA 病例。提高对此类异常的可能表型表现的认识,可以在出现严重器官损伤之前及早诊断并进行更有效的治疗。
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引用次数: 0
Antiperspirant-related zirconium and aluminum-containing granulomas; histopathology and in situ chemical analysis 与止汗剂有关的含锆和铝肉芽肿;组织病理学和原位化学分析。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-25 DOI: 10.1111/cup.14662
Jeffrey A. Sanford MD, Roberto Candelaria-Santiago MD, Dominic M. Forte MD, Christian A. Curcio MD, Jill I. Allbritton MD, Stacy L. Strausborger MFS, Michael R. Lewin-Smith MBBS

The potential adverse health effects of antiperspirant use are of interest to patients, primary care providers, dermatologists, and pathologists. In rare instances, antiperspirants containing aluminum–zirconium complexes have been associated with granulomatous dermatoses despite being deemed non-sensitizing in experiments. In this case study, we present a detailed examination of an axillary granuloma in a 28-year-old female who had been using an aluminum–zirconium-based antiperspirant for several years and presented with a left axillary nodule that was excised and analyzed using scanning electron microscopy with energy-dispersive x-ray analysis (SEM/EDXA). Histopathological examination revealed a foreign body-type reaction with amphophilic granular material within giant cells that corresponded to collocated zirconium and aluminum on SEM/EDXA elemental maps. Our case adds to the limited reports of axillary granulomas related to aluminum–zirconium complexes. It illustrates the histopathological appearance and in situ distribution of the aluminum–zirconium complexes, supporting the formation of foreign body-type granulomas. Additionally, our case study illustrates the potential role of these compounds in such reactions and aims to increase awareness among pathologists and clinicians.

患者、初级保健提供者、皮肤科医生和病理学家都很关注使用止汗剂可能对健康造成的不良影响。在极少数情况下,含有铝锆复合物的止汗剂与肉芽肿性皮肤病有关,尽管在实验中被认为不具有致敏性。在本病例研究中,我们对一名 28 岁女性的腋窝肉芽肿进行了详细检查,该女性使用铝锆基止汗剂已有数年,并出现左侧腋窝结节,切除后使用扫描电子显微镜和能量色散 X 射线分析(SEM/EDXA)进行了分析。组织病理学检查显示,在巨细胞内有嗜两性颗粒物质的异物型反应,在 SEM/EDXA 元素图上与锆和铝的组合相对应。我们的病例补充了与铝锆复合物有关的腋窝肉芽肿的有限报道。它说明了铝锆复合物的组织病理学外观和原位分布,支持异物型肉芽肿的形成。此外,我们的病例研究还说明了这些化合物在此类反应中的潜在作用,旨在提高病理学家和临床医生的认识。
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引用次数: 0
Clinical implication of PRAME immunohistochemistry in differentiating melanoma in situ and dysplastic nevus in non-acral nevus-associated melanoma in situ: An institutional experience and meta-analysis PRAME 免疫组化在区分非痤疮相关原位黑色素瘤和发育不良痣中的临床意义:机构经验和荟萃分析
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-21 DOI: 10.1111/cup.14671
Chau M. Bui MD, Huy Gia Vuong MD, PhD, Minh-Khang Le MD, Josephine D'Angelo MD, Kathleen Mannava MD, Bruce R. Smoller MD

Introduction

PReferentially expressed Antigen in MElanoma (PRAME) has shown utility in differentiating benign from malignant melanocytic neoplasms. In this study, we investigated the clinical significance of PRAME expression in dysplastic nevi (DN) and nevus-associated melanoma in situ (MIS).

Methods

We included 172 DN and 38 nevus-associated MIS from our institutional archive. PRAME positive expression was defined as nuclear staining in at least 75% of melanocytes. In addition, relevant studies from PubMed and Web of Science were incorporated into a meta-analysis using the random-effects model to assess PRAME expression in MIS and DN.

Results

Our institutional data revealed that 71.1% of nevus-associated MIS cases exhibited positive PRAME expression in the MIS components, whereas all DN components were negative for PRAME. 5.7% of cases diagnosed as DN in our cohort demonstrated diffuse positivity for PRAME. Notably, MIS associated with DN displaying epidermal and dermal components displayed a higher likelihood of PRAME positivity compared to those arising on a background of DN with solely epidermal (junctional) components (84% vs. 46%, p = 0.024). The meta-analysis indicated that the pooled PRAME positivity in MIS and DN was 54.5% and 1.9%, respectively.

Conclusion

PRAME is a valuable immunohistochemical marker for differentiating MIS from DN, particularly in the context of nevus-associated MIS.

引言 黑色素瘤中的干扰性表达抗原(PRAME)在区分良性和恶性黑色素细胞瘤方面具有一定的作用。在这项研究中,我们调查了PRAME在发育不良痣(DN)和痣相关原位黑色素瘤(MIS)中表达的临床意义。PRAME阳性表达的定义是至少75%的黑色素细胞核染色。此外,我们还将PubMed和Web of Science上的相关研究纳入荟萃分析,使用随机效应模型评估PRAME在MIS和DN中的表达。结果我们的机构数据显示,71.1%的痣相关MIS病例在MIS成分中显示PRAME阳性表达,而所有DN成分的PRAME均为阴性。我们队列中 5.7% 诊断为 DN 的病例显示 PRAME 呈弥漫性阳性。值得注意的是,与那些仅有表皮(交界处)成分的 DN 相关的 MIS 显示出 PRAME 阳性的可能性更高(84% 对 46%,P = 0.024),而与那些显示出表皮和真皮成分的 DN 相关的 MIS 显示出 PRAME 阳性的可能性更高。荟萃分析表明,MIS 和 DN 中汇总的 PRAME 阳性率分别为 54.5% 和 1.9%。
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引用次数: 0
Squamous cell carcinoma of the nail apparatus: Histopathology and immunohistochemistry correlation study 指甲鳞状细胞癌:组织病理学与免疫组化相关性研究
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-21 DOI: 10.1111/cup.14666
Florine Moulart MD, Catherine Olemans MD, Nicolas de Saint Aubain MD, Bertrand Richert MD, PhD, Josette André MD

Background

Nail squamous cell carcinoma (NSCC) is the most frequent ungual malignant tumor, but its incidence remains low. The histopathological description is sparse. We aim to characterize NSCC histopathological aspects, search for a correlation with clinical subtypes, and investigate immunohistochemistry expression of p16, p53, and Ki67.

Methods

This retrospective study collected NSCC diagnosed in our dermatology department between 2007 and 2021. The histopathological features were correlated with the clinical signs and immunohistochemistry.

Results

A total of 48 patients were included, and immunohistochemistry was available for 36 of them. Two histopathological patterns became prominent: a blue-basaloid type characterized by koilocytosis (p < 0.001), and a pink-keratinizing type. Mean ages were similar when comparing basaloid and periungual versus keratinizing and subungual (p < 0.001). p16 was positive in 31 of 36 cases: 18 basaloid and 13 keratinizing (p = 0.167). p53 and Ki67 were all abnormal.

Conclusions

Our study described two histopathological NSCC subtypes and associated them with the two clinical subtypes: the blue-basaloid type, HPV-induced, in situ, of periungual localization in younger males; and the pink-keratinizing type, non-HPV-induced, invasive, of subungual site, in elderly. Immunohistochemistry was not contributing on its own, but p16 positivity associated with basaloid histopathological profile helps support HPV etiology.

背景趾甲鳞状细胞癌(NSCC)是最常见的趾甲恶性肿瘤,但其发病率仍然很低。组织病理学描述很少。我们旨在描述 NSCC 的组织病理学特征,寻找与临床亚型的相关性,并研究 p16、p53 和 Ki67 的免疫组化表达。结果 共纳入 48 例患者,其中 36 例可进行免疫组化。有两种组织病理学模式比较突出:一种是蓝色基底细胞增多型(p< 0.001),另一种是粉红色角化型。基底型和真皮周围型与角化型和真皮下型相比,平均年龄相似(p <0.001):结论:我们的研究描述了两种组织病理学 NSCC 亚型,并将其与两种临床亚型联系起来:蓝色基底型,HPV 诱导,原位,位于真皮周围,多见于年轻男性;粉红色角化型,非 HPV 诱导,浸润性,位于真皮下,多见于老年人。免疫组化本身并无作用,但 p16 阳性与基底样组织病理学特征相关,有助于支持 HPV 病因。
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引用次数: 0
Ulcerated CRTC1::TRIM11 cutaneous tumor with metastases 溃疡性 CRTC1::TRIM11 皮肤肿瘤伴转移。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-15 DOI: 10.1111/cup.14669
Calvin Tseng MD, Erica C. Koch Hein MD, Stephen M. Smith MD, Ian King PhD, Sam Saibil MD, Zaid Saeed Kamil MBChB

CRTC1::TRIM11 cutaneous tumor (CTCT) is a rare skin tumor of uncertain differentiation. In the 49 reported cases, only four cases showed regional or distant metastasis, but follow-up remains limited. Herein, we present a case of metastatic CTCT with ulceration, a histological feature that has not been previously described. A 75-year-old male with a 2-month history of toe ulceration underwent a shave biopsy, which showed a dermal nodular neoplasm that was immunoreactive for SOX10 and S100, negative for Melan-A, and was initially diagnosed as melanoma. Upon pathology review at our institution, the tumor was composed of intersecting fascicles and nests of epithelioid and spindle cells. Additional immunohistochemistry revealed immunoreactivity of the tumor for MiTF and NTRK and negativity for HMB-45 and PRAME. Next-generation sequencing identified CRTC1::TRIM11 fusion, leading to a revised diagnosis of CTCT. The patient proceeded to a toe amputation and sentinel lymph node (SLN) biopsy 5 months after the shave biopsy. The amputation showed residual CTCT and a focus on lymphovascular invasion. The SLN revealed multifocal subcapsular metastases. The patient was started on adjuvant nivolumab and showed biopsy-proven recurrence in the right inguinal lymph nodes and imaging findings suspicious for pulmonary metastases 8 months after the excision. In summary, we present a case of CTCT with ulceration and lymphovascular invasion. We also provide additional evidence that a subset of CTCT behaves aggressively. The optimal surgical and medical treatments are unknown.

CRTC1::TRIM11皮肤肿瘤(CTCT)是一种分化不确定的罕见皮肤肿瘤。在已报道的 49 例病例中,只有 4 例出现区域或远处转移,但随访仍然有限。在此,我们介绍了一例伴有溃疡的转移性 CTCT,这是以前从未描述过的组织学特征。一名 75 岁的男性患者有 2 个月的脚趾溃疡病史,接受了剃须活检,结果显示真皮结节性肿瘤,对 SOX10 和 S100 有免疫反应,Melan-A 阴性,初步诊断为黑色素瘤。在我院进行病理复查时,肿瘤由上皮样细胞和纺锤形细胞的交错束簇和巢组成。免疫组化结果显示,肿瘤对MiTF和NTRK有免疫反应,而对HMB-45和PRAME呈阴性反应。下一代测序确定了 CRTC1::TRIM11 融合,从而修订了 CTCT 诊断。剃须活检 5 个月后,患者接受了脚趾截肢和前哨淋巴结 (SLN) 活检。截肢显示有残留 CTCT 和淋巴管侵犯病灶。前哨淋巴结活检显示多灶性囊下转移。患者开始接受 nivolumab 辅助治疗,切除术后 8 个月,活检证实右侧腹股沟淋巴结复发,影像学检查结果怀疑肺转移。总之,我们介绍了一例 CTCT 伴有溃疡和淋巴管侵犯的病例。我们还提供了更多证据,证明 CTCT 的一部分具有侵袭性。最佳的手术和药物治疗方法尚不清楚。
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引用次数: 0
Disseminated protothecosis: Case report and review of the literature 播散性原皮细胞增多症:病例报告和文献综述。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-11 DOI: 10.1111/cup.14668
Safoura Shakoei MD, Farid Mohamadi MD, Fereshteh Ghiasvand MD, Ali Reza Khosravi MD, Kambiz Kamyab MD, Faeze Salahshour MD

Background

Human protothecosis is an uncommon infection caused by Prototheca spp that rarely infects humans.

Aim

Description of a rare disease and a review of its articles.

Materials and Methods

We reported a 24-year-old man who presented with red-brown papules and plaques on the trunk's lateral side. We reviewed the literature about disseminated protothecosis and reported our experience with a patient with protothecosis between 2021 and 2023.

Results

Overall, 54 cases of disseminated protothecosis were evaluated, 39 were due to P. wickerhamii, 12 were due to P. zopfii (22.2%), and three were due to Prototheca spp. We found that males were more affected (37 cases, 68.5%) than females (16 cases, 29.6%). The mean age of patients was 39.53 ± 22.48 years. However, disseminated protothecosis can affect people of any age (1–80 years). In contrast to P. wickerhamii, which causes blood, skin, brain, and gastrointestinal tract infections, P. zopfii was mainly found in the blood (7/22) and did not have a significant difference in the mortality rate (P = 0.11).

Discussion

Disseminated protothecosis is a rare disease in immunocompromised patients but is generally rarer in immunocompetent hosts. Several underlying disorders include immunocompromised patients, prolonged application of steroids, diabetes mellitus, malignancies, organ transplantation, AIDS, and surgeries. Amphotericin B has been the most effective agent for protothecosis and is reserved for visceral and disseminated infections. Regarding localized cutaneous types, excision or surgical debridement is used.

Conclusion

Mulberry's appearance and appropriate cultural environments are helpful in diagnosing it.

背景:目的:描述一种罕见疾病并回顾相关文章:我们报告了一名24岁的男性,他的躯干外侧出现红褐色丘疹和斑块。我们回顾了有关播散性原皮细胞增多症的文献,并报告了我们在 2021 年至 2023 年期间收治一名原皮细胞增多症患者的经历:我们发现,男性患者(37 例,68.5%)多于女性患者(16 例,29.6%)。患者的平均年龄为(39.53 ± 22.48)岁。然而,播散性原皮霉病可影响任何年龄的人(1-80 岁)。与导致血液、皮肤、大脑和胃肠道感染的威克汉姆原虫相比,佐普菲原虫主要存在于血液中(7/22),且死亡率无显著差异(P = 0.11):讨论:播散性原虫病在免疫力低下的患者中是一种罕见的疾病,但在免疫力正常的宿主中一般更为罕见。一些潜在疾病包括免疫力低下患者、长期应用类固醇、糖尿病、恶性肿瘤、器官移植、艾滋病和手术。两性霉素 B 是治疗原霉菌病最有效的药物,适用于内脏感染和播散性感染。对于局部皮肤类型,则采用切除或手术清创:结论:桑葚的外观和适当的文化环境有助于诊断。
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引用次数: 0
Invasive squamous cell carcinoma within a plaque of circumscribed palmar hypokeratosis 浸润性鳞状细胞癌,位于周缘性掌皮下角化不全的斑块内。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-08 DOI: 10.1111/cup.14670
Luis Araya MD, Celia Horcajada MD, Amalia Moreno MD, Jesús M. Borbujo MD, PhD, Juan C. Tardío MD, PhD

Circumscribed palmar hypokeratosis (CPH) is a localized disorder of epidermal keratinization that is presented as a well-delimited, depressed, erythematous plaque on the palms or on the soles. It is histopathologically characterized by an abrupt thinning of the corneal epidermal layer. CPH is considered a benign condition, but a few cases with dysplastic changes/carcinoma in situ in the hypokeratotic epidermis have been described. We report hereby a case of invasive squamous cell carcinoma developed within a plaque of CPH. The pathogenesis of the malignant changes in this disorder remains to be clarified. Clinicians should be aware of the potential for developing malignancy in CPH and carry out a closer follow-up of this disorder.

环状手掌角化过度症(CPH)是一种局部表皮角化障碍性疾病,表现为手掌或足底出现局限性、凹陷的红斑。其组织病理学特征是角膜表皮层突然变薄。CPH 被认为是一种良性病变,但也有少数病例在角化不全的表皮层出现了发育不良的变化/原位癌。我们在此报告一例在 CPH 斑块内发生浸润性鳞状细胞癌的病例。这种疾病恶变的发病机制仍有待明确。临床医生应认识到 CPH 发生恶变的可能性,并对这种疾病进行更密切的随访。
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引用次数: 0
Identifying epidermolysis bullosa subtypes through immune antigenic mapping in Turkish patients 通过土耳其患者的免疫抗原图谱确定大疱性表皮松解症亚型。
IF 1.6 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-06-07 DOI: 10.1111/cup.14667
Sibel Doğan Günaydın, Özay Gököz, Başak Yalıcı Armağan, Sibel Ersoy-Evans
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引用次数: 0
期刊
Journal of Cutaneous Pathology
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