Pub Date : 2023-07-01DOI: 10.4103/ijdpdd.ijdpdd_26_23
J. Sandhu, Shriya Garg, Sunil Gupta, Sukhjot Kaur, B. Garg, V. Narang
Becker’s naevus (BN) presents as a unilateral, hyperpigmented patch with hypertrichosis over the upper trunk/proximal upper extremity. Usually, block-like/geographical pattern is seen; however, linear forms have also been reported. A 21-year-old man presented to us with a history of hyperpigmented, well to ill-defined discrete-to-coalescent plaques with brownish macules scattered at the periphery, over posteromedial aspect along Blaschko’s lines, extending from the buttock to the ankle of the right lower limb. No associated hypertrichosis/focal defects were seen. On dermoscopy (10×, DermLite DL4W, Dana Point, California) pigment network, scaling with perifollicular accentuation, perifollicular hypopigmentation, and uniform brown dots/globules/lines were seen. A skin biopsy revealed acanthosis and focal papillomatosis with increased pigment in the basal layer; pigment incontinence and melanophages were seen in the dermis. To the best of our knowledge, only one such case has been reported with Blaschko-linear BN over the lower limb. We present here an uncommon case of Blaschko-linear BN over the lower limb with dermoscopy and a concise literature review of BN over the lower limb.
{"title":"Blaschko-linear Becker’s naevus over lower limb: A case study and literature review","authors":"J. Sandhu, Shriya Garg, Sunil Gupta, Sukhjot Kaur, B. Garg, V. Narang","doi":"10.4103/ijdpdd.ijdpdd_26_23","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_26_23","url":null,"abstract":"Becker’s naevus (BN) presents as a unilateral, hyperpigmented patch with hypertrichosis over the upper trunk/proximal upper extremity. Usually, block-like/geographical pattern is seen; however, linear forms have also been reported. A 21-year-old man presented to us with a history of hyperpigmented, well to ill-defined discrete-to-coalescent plaques with brownish macules scattered at the periphery, over posteromedial aspect along Blaschko’s lines, extending from the buttock to the ankle of the right lower limb. No associated hypertrichosis/focal defects were seen. On dermoscopy (10×, DermLite DL4W, Dana Point, California) pigment network, scaling with perifollicular accentuation, perifollicular hypopigmentation, and uniform brown dots/globules/lines were seen. A skin biopsy revealed acanthosis and focal papillomatosis with increased pigment in the basal layer; pigment incontinence and melanophages were seen in the dermis. To the best of our knowledge, only one such case has been reported with Blaschko-linear BN over the lower limb. We present here an uncommon case of Blaschko-linear BN over the lower limb with dermoscopy and a concise literature review of BN over the lower limb.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"81 1","pages":"48 - 51"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ijdpdd.ijdpdd_27_23
H. Sangma, Singh Anshul, Dhingra Karishma, Misra Vatsala
Malignant melanoma is most lethal skin malignancy accounting for 4% of all cutaneous cancers. It is usually seen in sun exposed areas but can occur anywhere in the body involving mucosal surfaces and internal organs as well. Rarely cases can present with metastases as the first manifestation of the disease, sometimes with unknown primary. Dermal melanomas are rarer which characteristically show lack of epidermotropism and thus enter as a close differential of metastatic melanomas that are exclusively dermal based. Amelanotic melanomas pose diagnostic difficulty clinically as well as on histopathology as the absence of pigments may simulate soft tissue tumors. In our study, we report a case of an elderly female presenting with a mass on the leg since 1 year, which on histopathology looked like a malignant soft tissue tumor with mixed epithelioid and spindle cells but on immunohistochemistry, it turned out to be an amelanotic melanoma that was completely based in the dermis. Following this, extensive serial sectioning of the remaining tissue specimen was done and two foci of lymphovascular invasion were detected favoring a diagnosis of a metastatic melanoma rather than a dermal melanoma. No obvious primary was found even after thorough work up. We are presenting this case to throw light on the difficulties encountered by pathologists in diagnosing melanomas that show lack of melanin and epidermotropism, both are considered to be the most reliable features in clinching the diagnosis and how this tricky presentation should be worked up to render a correct report.
{"title":"Amelanotic metastatic dermal melanoma with an unknown primary: A double diagnostic dilemma","authors":"H. Sangma, Singh Anshul, Dhingra Karishma, Misra Vatsala","doi":"10.4103/ijdpdd.ijdpdd_27_23","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_27_23","url":null,"abstract":"Malignant melanoma is most lethal skin malignancy accounting for 4% of all cutaneous cancers. It is usually seen in sun exposed areas but can occur anywhere in the body involving mucosal surfaces and internal organs as well. Rarely cases can present with metastases as the first manifestation of the disease, sometimes with unknown primary. Dermal melanomas are rarer which characteristically show lack of epidermotropism and thus enter as a close differential of metastatic melanomas that are exclusively dermal based. Amelanotic melanomas pose diagnostic difficulty clinically as well as on histopathology as the absence of pigments may simulate soft tissue tumors. In our study, we report a case of an elderly female presenting with a mass on the leg since 1 year, which on histopathology looked like a malignant soft tissue tumor with mixed epithelioid and spindle cells but on immunohistochemistry, it turned out to be an amelanotic melanoma that was completely based in the dermis. Following this, extensive serial sectioning of the remaining tissue specimen was done and two foci of lymphovascular invasion were detected favoring a diagnosis of a metastatic melanoma rather than a dermal melanoma. No obvious primary was found even after thorough work up. We are presenting this case to throw light on the difficulties encountered by pathologists in diagnosing melanomas that show lack of melanin and epidermotropism, both are considered to be the most reliable features in clinching the diagnosis and how this tricky presentation should be worked up to render a correct report.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"5 1","pages":"45 - 47"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ijdpdd.ijdpdd_50_22
Conrad Hempel, Hendrik Bläker, Mirjana Ziemer
Basal cell carcinoma (BCC) is a common epithelial skin cancer. Other than cutaneous squamous cell carcinoma, apart from its aggressive loco-regional destructive growth, it has a very good prognosis. However, metastasis is reported in the literature. Nevertheless, its existence is still discussed controversially and the diagnosis is difficult. We describe the case of a 60-year-old man who had been diagnosed with lymph node and lung metastases of a basaloid carcinoma. Re-microscopy of earlier excised skin tumors revealed a locally recurrent BCC with a histomorphological similar appearance. Additionally performed molecular genetic analysis revealed identical telomerase reverse transcriptase-promoter mutation in the cutaneous BCC and in the lymph node metastasis with a typical UV-signature.
{"title":"Basal cell carcinoma with pulmonary and lymphatic metastases and TERT-promoter mutation","authors":"Conrad Hempel, Hendrik Bläker, Mirjana Ziemer","doi":"10.4103/ijdpdd.ijdpdd_50_22","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_50_22","url":null,"abstract":"Basal cell carcinoma (BCC) is a common epithelial skin cancer. Other than cutaneous squamous cell carcinoma, apart from its aggressive loco-regional destructive growth, it has a very good prognosis. However, metastasis is reported in the literature. Nevertheless, its existence is still discussed controversially and the diagnosis is difficult. We describe the case of a 60-year-old man who had been diagnosed with lymph node and lung metastases of a basaloid carcinoma. Re-microscopy of earlier excised skin tumors revealed a locally recurrent BCC with a histomorphological similar appearance. Additionally performed molecular genetic analysis revealed identical telomerase reverse transcriptase-promoter mutation in the cutaneous BCC and in the lymph node metastasis with a typical UV-signature.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"49 1","pages":"60 - 63"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Syringocystadenoma papilliferum (SCAP) is an uncommon benign hamartomatous adnexal tumor; pathologically characterized by papillary processes lined with bilayered epithelium. The lesions are usually seen at birth or in childhood and are confined to the scalp and face. We report a rare case of SCAP in an adult female presenting as cauliflower-like growth at an unusual site, over the left lower abdomen.
{"title":"Cauliflower-like growth at an unusual site: A clinical diagnostic dilemma","authors":"Bhargavi Mayakuntla, Budeda Hasini, Sushmitha Meda, Vella Satyanarayana","doi":"10.4103/ijdpdd.ijdpdd_61_22","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_61_22","url":null,"abstract":"Syringocystadenoma papilliferum (SCAP) is an uncommon benign hamartomatous adnexal tumor; pathologically characterized by papillary processes lined with bilayered epithelium. The lesions are usually seen at birth or in childhood and are confined to the scalp and face. We report a rare case of SCAP in an adult female presenting as cauliflower-like growth at an unusual site, over the left lower abdomen.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"48 1","pages":"52 - 54"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ijdpdd.ijdpdd_43_22
A. Shende, P. Gole, T. Vishwanath, V. Kharkar
{"title":"Adding insult to injury: Fatal rhino-orbital mucormycosis eventuating in cutaneous involvement post-SARS-COV2 infection in a young female","authors":"A. Shende, P. Gole, T. Vishwanath, V. Kharkar","doi":"10.4103/ijdpdd.ijdpdd_43_22","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_43_22","url":null,"abstract":"","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"62 1","pages":"64 - 66"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ijdpdd.ijdpdd_34_22
Sunanda Mahajan, Shreya Singh, Hershada S Mithari
Endogenous ochronosis/Alkaptonuria is a rare, genetic metabolic disease presenting with cutaneous hyperpigmentation, disabling arthropathy, and homogentisic aciduria. The dermoscopic features of this entity have a good correlation with the histopathological findings, and its knowledge can facilitate early diagnosis to decrease long-term morbidity and improve the quality of life.
{"title":"Endogenous ochronosis/Alkaptonuria: A case report highlighting the correlation between dermoscopy and histopathology","authors":"Sunanda Mahajan, Shreya Singh, Hershada S Mithari","doi":"10.4103/ijdpdd.ijdpdd_34_22","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_34_22","url":null,"abstract":"Endogenous ochronosis/Alkaptonuria is a rare, genetic metabolic disease presenting with cutaneous hyperpigmentation, disabling arthropathy, and homogentisic aciduria. The dermoscopic features of this entity have a good correlation with the histopathological findings, and its knowledge can facilitate early diagnosis to decrease long-term morbidity and improve the quality of life.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"9 1","pages":"55 - 59"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/ijdpdd.ijdpdd_15_21
B. Behera, R. Rajamohanan, B. Srinivas
{"title":"Schwannoma: Another dermoscopic pitfall?","authors":"B. Behera, R. Rajamohanan, B. Srinivas","doi":"10.4103/ijdpdd.ijdpdd_15_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_15_21","url":null,"abstract":"","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117217166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/ijdpdd.ijdpdd_26_22
Prateek Sharma, S. Shruti, C. Ahluwalia, V. Ramesh
The distinction between basal cell carcinoma (BCC) and trichoepithelioma (TE) may be difficult due to close similarities, more so histopathologically than clinically. We present a case of a 66-year-old female presented with a lesion that was clinically and dermoscopically diagnosed as pigmented BCC but had histological features favoring TE in an initial punch biopsy, followed by an excision biopsy which showed features of adenoid BCC; a rare histological variant of BCC, reinforcing the importance of an excision biopsy in cases with high index of clinical suspicion in order to avoid mistreatment.
{"title":"A rare case of adenoid BCC mimicking trichoepithelioma: Clinical, dermoscopic, and histopathological evaluation","authors":"Prateek Sharma, S. Shruti, C. Ahluwalia, V. Ramesh","doi":"10.4103/ijdpdd.ijdpdd_26_22","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_26_22","url":null,"abstract":"The distinction between basal cell carcinoma (BCC) and trichoepithelioma (TE) may be difficult due to close similarities, more so histopathologically than clinically. We present a case of a 66-year-old female presented with a lesion that was clinically and dermoscopically diagnosed as pigmented BCC but had histological features favoring TE in an initial punch biopsy, followed by an excision biopsy which showed features of adenoid BCC; a rare histological variant of BCC, reinforcing the importance of an excision biopsy in cases with high index of clinical suspicion in order to avoid mistreatment.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125989391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/ijdpdd.ijdpdd_2_22
Hiral Shah, U. Khopkar
Seborrheic keratoses are common benign cutaneous neoplasms. Here we report a case because of the peculiar histological appearance characterized by acantholysis. An elderly woman presented with gradually progressive keratotic nodular growth over her thigh. Although the basic histologic findings suggestive of seborrheic keratosis like papillomatosis, acanthosis, hyperkeratosis, presence of horn pseudocyst and squamous eddies were present with upper layers of epidermis showed focal spongiosis and acantholysis. Differentiation with acantholytic dyskeratotic acanthoma, warty dyskeratoma, acantholytic actinic keratosis could be made on histological features. Although the histogenesis is uncertain, it seems that acantholytic variant is a rare variant of irritated seborrheic keratosis.
{"title":"Acantholytic variant of seborrheic keratoses: Uncommon histological feature","authors":"Hiral Shah, U. Khopkar","doi":"10.4103/ijdpdd.ijdpdd_2_22","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_2_22","url":null,"abstract":"Seborrheic keratoses are common benign cutaneous neoplasms. Here we report a case because of the peculiar histological appearance characterized by acantholysis. An elderly woman presented with gradually progressive keratotic nodular growth over her thigh. Although the basic histologic findings suggestive of seborrheic keratosis like papillomatosis, acanthosis, hyperkeratosis, presence of horn pseudocyst and squamous eddies were present with upper layers of epidermis showed focal spongiosis and acantholysis. Differentiation with acantholytic dyskeratotic acanthoma, warty dyskeratoma, acantholytic actinic keratosis could be made on histological features. Although the histogenesis is uncertain, it seems that acantholytic variant is a rare variant of irritated seborrheic keratosis.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132479810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/ijdpdd.ijdpdd_23_21
B. Shashikumar, S. Somaiah
Sarcoidosis is a multisystem disorder of unknown etiology. 25%–30% of patients with systemic sarcoidosis have cutaneous involvement. Sarcoidosis is called a great imitator due to its varied clinical presentation. Micropapular sarcoidosis is a rare morphological type of cutaneous sarcoidosis that rarely has systemic involvement. A case of a middle-aged man who presented with multiple tiny papules all over the back, shoulders and arms was discussed. He was initially diagnosed to have leprosy and treated with multibacillary multidrug therapy. Histopathology showed noncaseating epithelioid granuloma in upper dermis. On the basis of clinical, demographic, and histopathological findings, a diagnosis of cutaneous micropapular sarcoidosis was made. The patient was treated with systemic steroids tapered over 3 months, following which the lesions resolved completely. There are very few reports of micropapular sarcoidosis available in the literature.
{"title":"Micropapular sarcoidosis: A diagnostic dilemma","authors":"B. Shashikumar, S. Somaiah","doi":"10.4103/ijdpdd.ijdpdd_23_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_23_21","url":null,"abstract":"Sarcoidosis is a multisystem disorder of unknown etiology. 25%–30% of patients with systemic sarcoidosis have cutaneous involvement. Sarcoidosis is called a great imitator due to its varied clinical presentation. Micropapular sarcoidosis is a rare morphological type of cutaneous sarcoidosis that rarely has systemic involvement. A case of a middle-aged man who presented with multiple tiny papules all over the back, shoulders and arms was discussed. He was initially diagnosed to have leprosy and treated with multibacillary multidrug therapy. Histopathology showed noncaseating epithelioid granuloma in upper dermis. On the basis of clinical, demographic, and histopathological findings, a diagnosis of cutaneous micropapular sarcoidosis was made. The patient was treated with systemic steroids tapered over 3 months, following which the lesions resolved completely. There are very few reports of micropapular sarcoidosis available in the literature.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128086157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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