1
|
Xie F, Agrawal S, Johnson EF, Wieland CN, Davis DMR, Theiler RN, Lehman JS. Updates on the dermatopathology of pregnancy-associated skin conditions. Hum Pathol 2023; 140:173-195. [PMID: 37209919 DOI: 10.1016/j.humpath.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
Pathologists provide valuable input in the dermatological care of pregnant patients in various contexts. This article provides dermatopathology updates on cutaneous changes associated with pregnancy, organized based on the following classification system: physiological skin changes in pregnancy, specific dermatoses of pregnancy, dermatoses modified in pregnancy, and skin neoplasms in pregnancy. Awareness of the impact of pregnancy on the skin by pathologists is important, as this is an opportunity to contribute to diagnostic precision in this patient population.
Collapse
Affiliation(s)
- Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Shruti Agrawal
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Emma F Johnson
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Carilyn N Wieland
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Dawn Marie R Davis
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Regan N Theiler
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
| |
Collapse
|
2
|
Seifi G, Kalantari Y, Etesami I. Multiple dermatofibromas, associated clinical and histological characteristics: A systematic review. J Dtsch Dermatol Ges 2022; 20:1569-1579. [PMID: 36464809 DOI: 10.1111/ddg.14888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/03/2022] [Indexed: 12/12/2022]
Abstract
Multiple dermatofibromas (DFs) are rare benign fibrohistiocytic lesions characterized by asymptomatic hyperpigmented nodules. Several diseases, like systemic lupus erythematosus (SLE) and human immunodeficiency virus (HIV) infection, are found to be associated with multiple DFs. Here, we designed a systematic review by an electronic search of PubMed and Embase databases to select case reports of multiple DFs (29 May 2021). From 2,145 initially found articles, 96 studies (106 cases) were included. We classified multiple DFs (>1 DF lesion) into four subtypes and separately investigated clinical characteristics of each one: multiple eruptive DFs (MEDFs) (n = 45), multiple (n = 41), multiple clustered DFs (MCDFs) (n = 18), and giant combined (n = 2). The patients' mean age was 38.3 ± 14.7 years. The majority were female (61.3 %). The lesions were commonly on the trunk and extremities (36.8 %). MEDFs (n = 36) had the most rapid disease onset (2.0 ± 6.6 years). Immunosuppression induced by either HIV (10.3 %) and hematologic malignancy (9.4 %) or immunosuppressive drugs (23.4 %) along with SLE (19.8 %) were the most observed associations. However, 66.7 % of the MCDF patients were otherwise healthy individuals. As for disease management, surgery and follow-up were the preferred options. Most of the cases showed neither resolution nor development of new lesions in follow-up.
Collapse
Affiliation(s)
- Golnoosh Seifi
- Department of Dermatology, Razi Hospital, Tehran University of medical sciences, Tehran, Iran
| | - Yasamin Kalantari
- Department of Dermatology, Razi Hospital, Tehran University of medical sciences, Tehran, Iran
| | - Ifa Etesami
- Department of Dermatology, Razi Hospital, Tehran University of medical sciences, Tehran, Iran
| |
Collapse
|
3
|
Seifi G, Kalantari Y, Etesami I. Klinische und histologische Charakteristika bei multiplen Dermatofibromen: Eine systematische Übersicht. J Dtsch Dermatol Ges 2022; 20:1569-1580. [PMID: 36508383 DOI: 10.1111/ddg.14888_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/03/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Golnoosh Seifi
- Department of Dermatology, Razi Hospital, Tehran University of medical sciences, Teheran, Iran
| | - Yasamin Kalantari
- Department of Dermatology, Razi Hospital, Tehran University of medical sciences, Teheran, Iran
| | - Ifa Etesami
- Department of Dermatology, Razi Hospital, Tehran University of medical sciences, Teheran, Iran
| |
Collapse
|
4
|
Haiges D, Kurz P, Laaff H, Meiss F, Kutzner H, Technau-Hafsi K. Malignant PEComa. J Cutan Pathol 2017; 45:84-89. [PMID: 29044701 DOI: 10.1111/cup.13061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/08/2017] [Accepted: 10/12/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Daniela Haiges
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Philipp Kurz
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.,Department of Pathology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Helmut Laaff
- Dermatohistologisches Labor Freiburg, Freiburg, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Heinz Kutzner
- Dermatopathologie Friedrichshafen/Bodensee, Friedrichshafen, Germany
| | - Kristin Technau-Hafsi
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| |
Collapse
|
5
|
Giant Hemosiderotic Dermatofibroma: The Largest Giant Dermatofibroma Reported to Date. Am J Dermatopathol 2016; 37:778-82. [PMID: 25621769 DOI: 10.1097/dad.0000000000000256] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Dermatofibroma (DF) is a relatively common benign fibrohistiocytic soft tissue tumor. It has a slightly greater incidence amongst females and typically presents itself during the midadult life as a slowly growing, firm dermal nodule, usually smaller than 2 cm in diameter, on the lower extremities. Giant DF is a rare clinical variant of DF characterized by unusually large size (>5 cm), which mimics malignant soft tissue tumor clinically. Twenty-six cases of giant DF have been reported so far. One of these giant DFs was a giant hemosiderotic DF. We report herein a case of a 47-year-old woman who presented with the largest DF reported in the literature to date. It was hemosiderotic.
Collapse
|
6
|
Dermatofibromes multiples « éruptifs » familiaux. Ann Dermatol Venereol 2013; 140:452-4. [DOI: 10.1016/j.annder.2013.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 01/02/2013] [Accepted: 02/14/2013] [Indexed: 11/24/2022]
|
7
|
Generalized Eruptive Multinucleate Cell Angiohistiocytoma in a Pregnant Woman: A Case Report and Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
8
|
Villanueva CA, Tardío JC, Romero-Maté A, Borbujo J. [Generalized eruptive multinucleate cell angiohistiocytoma in a pregnant woman: a case report and review of the literature]. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:450-2. [PMID: 22341877 DOI: 10.1016/j.ad.2011.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 08/07/2011] [Accepted: 09/15/2011] [Indexed: 11/27/2022] Open
|
9
|
Zaccaria E, Rebora A, Rongioletti F. Multiple eruptive dermatofibromas and immunosuppression: report of two cases and review of the literature. Int J Dermatol 2008; 47:723-7. [DOI: 10.1111/j.1365-4632.2008.03575.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Huang PY, Chu CY, Hsiao CH. Multiple eruptive dermatofibromas in a patient with dermatomyositis taking prednisolone and methotrexate. J Am Acad Dermatol 2007; 57:S81-4. [PMID: 17097372 DOI: 10.1016/j.jaad.2006.05.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2006] [Revised: 05/31/2006] [Accepted: 05/31/2006] [Indexed: 10/24/2022]
Abstract
Dermatofibroma (DF) is a common, benign, dermal tumor, often occurring as a single lesion. Multiple eruptive DFs are rare and usually associated with autoimmune diseases, immunosuppressant therapy, or both. We present the case of a 28-year-old woman with dermatomyositis who developed multiple eruptive DFs after undergoing methotrexate and corticosteroid treatment. Immunosuppressants such as methotrexate and corticosteroids might cause multiple eruptive DFs.
Collapse
Affiliation(s)
- Pei-Ying Huang
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | |
Collapse
|
11
|
Antal A, Zelger B, Reifenberger J, Niehues T, Feyen O, Megahed M, Ruzicka T, Homey B. Multiple eruptive myxoid dermatofibromas: report of first case and review of literature. Br J Dermatol 2007; 157:382-5. [PMID: 17596172 DOI: 10.1111/j.1365-2133.2007.08032.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Multiple eruptive dermatofibromas are a rare presentation of dermatofibroma which are frequently associated with underlying diseases such as human immunodeficiency virus infection or lupus erythematosus. Eruptive dermatofibromas generally present a characteristic histology with a poorly circumscribed lesion showing hyperplasia of the epidermis, prominent bundles of collagen and a diffuse proliferation of fibrocytes. We report an unusual case of multiple eruptive dermatofibromas showing massive depositions of mucin within the dermis. A 20-year-old woman presented with nearly 100 red to yellowish papules and nodules distributed symmetrically all over the integument which developed over a period of 9 years. Comprehensive clinical and laboratory diagnostics showed no signs indicating any underlying disease. To our knowledge this is the first report of multiple eruptive myxoid dermatofibromas. We consider this case to be a unique presentation of multiple eruptive dermatofibroma showing massive deposition of mucin.
Collapse
Affiliation(s)
- A Antal
- Department of Dermatology, Heinrich Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Micantonio T, Fargnoli MC, Peris K. Giant dermatofibroma appearing during pregnancy. Acta Derm Venereol 2006; 86:86-7. [PMID: 16586006 DOI: 10.1080/00015550510011538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
13
|
Massone C, Parodi A, Virno G, Rebora A. Multiple eruptive dermatofibromas in patients with systemic lupus erythematosus treated with prednisone. Int J Dermatol 2002; 41:279-81. [PMID: 12100703 DOI: 10.1046/j.1365-4362.2002.01493.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Solitary dermatofibromas are a common occurrence, especially on the lower limbs of young women, while multiple dermatofibromas (MDF) are rare, accounting for less than 0.3% of all dermatofibromas and may suddenly develop in immunosuppressed patients. We report a patient with systemic lupus erythematosus (SLE) who developed MDF while she was taking oral prednisone. A 46-year-old woman presented in 1989 complaining of photosensitivity, arthralgias, fatigue, malaise and dyspepsia. The patient denied fever, Raynaud's phenomenon, oral ulcer and hair loss. On examination she presented a typical SLE malar rash. Erythrocyte sedimentation rate (ESR) was elevated (54 mm/h). Speckle patterned IgG/IgM antinuclear antibodies were present at 1/1280 titer. Antibodies anti Ro/SSA were detected by counterimmunelectrophoresis up to 1/8 titer. Other laboratory findings were negative or within normal limits. Systemic lupus erythematosus was diagnosed and the patient given 50 mg/day prednisone. After a few months, both clinical symptoms and immunologic parameters improved. Eighteen months later, prednisone was replaced by 500 mg/day hydroxychloroquine. In 1994, she presented again with malar rash, arthralgias and facial hyperpigmentation. Prednisone 15 mg/day was reintroduced and hydroxychloroquine stopped being a possible cause of the facial hyperpigmented macules. In 1996, while she was taking 5 mg/day prednisone, several nodules developed on her limbs within a few months. On examination we observed 16 firm, slightly elevated 3-15-mm wide brown nodules on her arms, legs and trunk. A biopsy specimen of a lesion of the trunk revealed an epidermal seborrheic-keratosis-like hyperplasia with dermal fibrosis and fibroblastic proliferation (Fig. 1). Dermatofibroma was diagnosed.
Collapse
Affiliation(s)
- C Massone
- Di.S.E.M., Section of Dermatology, University of Genoa, Italy.
| | | | | | | |
Collapse
|
14
|
Chang SE, Choi JH, Sung KJ, Moon KC, Koh JK. Multiple eruptive dermatofibromas occurring in a patient with acute myeloid leukaemia. Br J Dermatol 2000; 142:1062-3. [PMID: 10809884 DOI: 10.1046/j.1365-2133.2000.03508.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
15
|
Chaudhry SI, Tappuni AR, Challacombe SJ. Multiple maxillary and mandibular exostoses associated with multiple dermatofibromas: a case report. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 89:319-22. [PMID: 10710457 DOI: 10.1016/s1079-2104(00)70096-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Exostoses of the maxilla and mandible are nodular protuberances of mature bone that need to be accurately distinguished from other more diagnostically significant lesions, notably exosteal osteomas. Multiple dermatofibromas are rare and may be associated with altered immune function. We report the case of an otherwise healthy 47-year-old woman who was first seen with multiple maxillary and mandibular exostoses associated with multiple dermatofibromas. This association has not been previously reported.
Collapse
Affiliation(s)
- S I Chaudhry
- Department of Oral Medicine and Pathology, GKT Dental Institute, Guy's Hospital, London, England
| | | | | |
Collapse
|
16
|
Lu I, Cohen PR, Grossman ME. Multiple dermatofibromas in a woman with HIV infection and systemic lupus erythematosus. J Am Acad Dermatol 1995; 32:901-3. [PMID: 7722054 DOI: 10.1016/0190-9622(95)91558-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Associations of multiple dermatofibromas with autoimmune disorders, altered immunity, or both have been described. We report the case of a 33-year-old black woman with HIV infection and an 11-year history of systemic lupus erythematosus in whom 15 dermatofibromas developed while she was receiving systemic corticosteroid therapy. Including our patient, multiple dermatofibromas have been described in 15 patients with an autoimmune disease, altered immunity, or both. All 12 of the women with multiple dermatofibromas had systemic lupus erythematosus.
Collapse
Affiliation(s)
- I Lu
- Department of Dermatology, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | | | | |
Collapse
|