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Gilmore A, Castillo B, Golda N, Braudis K, Smith E. Postoperative permanent section evaluation of Mohs micrographic surgery debulk specimens does not result in upstaging of cutaneous squamous cell carcinoma compared to stage at the completion of surgery: A retrospective case series. JAAD Int 2024; 15:100-104. [PMID: 38500871 PMCID: PMC10945241 DOI: 10.1016/j.jdin.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 03/20/2024] Open
Abstract
Background Mohs micrographic surgery (MMS) is used for the treatment of high-risk cutaneous squamous cell carcinoma (cSCC). MMS examines the surgical margins in real time and does not commonly examine the central component of the tumor. Objective To determine if debulk specimens provide additional details relevant to tumor staging not gained from routine MMS. Methods A retrospective chart review of debulk specimens taken during MMS for cSCC was performed. Dermatopathology reports were analyzed and tumors were staged using Brigham and Women's Hospital and American Joint Committee on Cancer's 8th edition staging systems. Results Permanent section evaluation of debulk specimens did not result in clinically meaningful information for staging that could not be gained from MMS layers or initial biopsy analysis. Limitations A single institution, and a small sample size of 39 tumors. Conclusions Evaluation of debulk specimens during MMS may not always be an effective use of time or health care resources.
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Affiliation(s)
- Andrea Gilmore
- Department of Dermatology, University of Missouri Columbia, Columbia, Missouri
| | - Brianna Castillo
- Department of Dermatology, University of Arizona, Tuscon, Arizona
| | | | - Kara Braudis
- Department of Dermatology, University of Missouri Columbia, Columbia, Missouri
| | - Emily Smith
- Department of Dermatology, Saint Louis University, St. Louis, Missouri
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2
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Caro-Chang LA, Fung MA. Eosinophils in psoriasis: A systematic review and meta-analysis introducing a study quality assessment tool for diagnostic pathology studies. J Cutan Pathol 2024; 51:441-449. [PMID: 38415867 DOI: 10.1111/cup.14604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/06/2024] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND The histopathologic features of psoriasis are well-documented, but recent studies have highlighted atypical features, such as eosinophils, in clinically confirmed cases. METHODS A systematic review exploring eosinophils in psoriasis was performed. A novel quality assessment tool (SQAT-Path) we designed for cross-sectional pathology studies was employed. RESULTS Five studies (N = 218) were identified. The pooled prevalence of dermal eosinophils in psoriasis was 46% (95% confidence interval, 0.27-0.66). The prevalences of 1 to 5 lesional eosinophils (24%) compared to >5 eosinophils (26%) were similar. There was no association between eosinophils and prior treatment. There was also no association between eosinophils and spongiosis. In SQAT-Path, studies scored between 9 and 18 (out of a maximum of 27: "fair" to "good"), consistent with the ratings using other assessment tools. CONCLUSION Eosinophils were found in approximately half of systematically studied and published cases of psoriasis. When present, their quantity is variable, with the likelihood of having greater than 5 eosinophils in a biopsy section comparable to having between 1 and 5. Greater than 5 eosinophils, as an isolated finding, would not be typical of psoriasis, but should not preclude its diagnosis without considering the overall histologic context.
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Affiliation(s)
| | - Maxwell A Fung
- Department of Dermatology, University of California, Davis, Sacramento, California, USA
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3
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Narayanan A, Bhatia D, Chopra S, Budania A, Khera S. Acral keratosis with eosinophilic dermal deposits: a rare subtype of colloid milium. Int J Dermatol 2024. [PMID: 38757483 DOI: 10.1111/ijd.17122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 05/18/2024]
Affiliation(s)
- Arunachalam Narayanan
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Divya Bhatia
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shikha Chopra
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Anil Budania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Sudeep Khera
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
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Cockerell CJ, Goldust M. Ethical concerns related to the use of artificial intelligence in dermatopathology. Int J Dermatol 2024. [PMID: 38702951 DOI: 10.1111/ijd.17223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Clay J Cockerell
- Lake Granbury Medical Center, Texas College of Osteopathic Medicine, Dallas, TX, USA
| | - Mohamad Goldust
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
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5
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Harrison I, Patel B, Kunzler E, Walker A, Missall T, Motaparthi K. Dermatopathologist accuracy in classifying angioinvasive fungal infections using virtual microscopy. J Cutan Pathol 2024; 51:387-392. [PMID: 38366893 DOI: 10.1111/cup.14596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/28/2023] [Accepted: 01/28/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Due to perceived difficulty in the categorization of angioinvasive fungal infections based on histopathology, variation exists in dermatopathology reporting. METHODS This study characterized the diagnosis of angioinvasive fungal infections by light microscopy at a single academic institution over an 11-year period. Subsequently, the accuracy of blinded reclassification by virtual microscopy was measured. RESULTS Seventy-six specimens with hematoxylin-eosin slides were obtained from 33 patients. The mean diagnostic accuracy of dermatopathologists in differentiating mucormycosis, hyalohyphomycosis, and phaeohyphomycosis based on blinded reclassification via virtual microscopy was 74%, with a range of 65%-91%. CONCLUSIONS While there was a range in diagnostic accuracy, the highest score of 91% and the identification of common sources of error suggest that histopathologic categorization of angioinvasive fungal infections can frequently be performed. However, accurate identification is not always possible given common pitfalls in diagnosis. In addition, standardized and clinically useful reporting should be considered.
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Affiliation(s)
- Iris Harrison
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Basil Patel
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Elaine Kunzler
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Addie Walker
- Department of Pathology and Laboratory Medicine, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Tricia Missall
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
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6
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Takada T. Relationship between dermoscopic and histopathological findings of extradigital glomus tumors. Clin Case Rep 2024; 12:e8907. [PMID: 38770410 PMCID: PMC11103558 DOI: 10.1002/ccr3.8907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/08/2024] [Accepted: 05/01/2024] [Indexed: 05/22/2024] Open
Abstract
In extradigital glomus tumors, (1) noncontact and (2) contact dermoscopy show (1) a central purplish-white area corresponding to tumor nests surrounding enlarged vessels, a peripheral yellow-white area corresponding to mucin deposition, melanin granules, and fibrous tissue, and (2) white reticular and linear cord areas corresponding to pseudocapsules and collagen fibers.
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7
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Gurley S, Friedman BJ, Shwayder T. Unresectable infantile myofibroma discovered in utero. Pediatr Dermatol 2024; 41:558-559. [PMID: 38409999 DOI: 10.1111/pde.15557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/27/2024] [Indexed: 02/28/2024]
Abstract
The authors present a case of a proliferative nodule located beneath an infant's lower lip that was initially discovered on prenatal ultrasound and fetal magnetic resonance imaging (MRI). Biopsy revealed a smooth muscle actin-positive spindled cell proliferation with hemangiopericytoma-like vessels consistent with infantile myofibromatosis (IM). Since the location prevented surgical management, the clinicians opted to observe the lesion. Ultimately, the lesion fully regressed on its own confirming conservative management is an option for isolated IM.
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Affiliation(s)
| | - Ben J Friedman
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Tor Shwayder
- Pediatric Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
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Hwang E, Lee T, Okifo K, Murphy M, Damsky W. Retrospective assessment of immunologic and histologic heterogeneity in granuloma annulare by cytokine staining. Int J Dermatol 2024; 63:655-659. [PMID: 38135676 PMCID: PMC11055676 DOI: 10.1111/ijd.16998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Type 1 (Th1) and Type 2 (Th2) immunity have both been implicated in granuloma annulare (GA). To what extent these pathways contribute to clinical/histologic heterogeneity and/or distinct disease endotypes remains unexplored. METHODS We retrospectively analyzed 30 GA biopsies with either palisaded or interstitial histology with and without eosinophils. We performed RNA in situ hybridization to assess how markers of Type 1 (interferon gamma), Type 2 (interleukin [IL]4, IL13, IL5), and Type 3 (IL17A) immunity in GA compared with canonical inflammatory disorders and whether markers correlated with histology. We analyzed another cohort of 14 patients who had multiple biopsies across anatomic space and time for individual conservation of histologic features. RESULTS Interferon (IFN)G staining is highest in GA relative to other cytokines. Type 2 cytokine staining is less prominent, with IL4 increased in interstitial pattern cases. Eosinophils did not correlate with Type 2 markers. Patients with multiple biopsies display intrapatient variability in histology. CONCLUSION Type 1 inflammation predominates over Type 2 inflammation in GA irrespective of histologic pattern. Distinct disease endotypes were not detected.
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Affiliation(s)
- Erica Hwang
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Trinity Lee
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kevin Okifo
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael Murphy
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - William Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
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9
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Pham D, Tabba D, Zhou C, Chow C, Elsensohn A. Histopathological Discrepancy of Biopsy Specimens Compared to Subsequent Mohs Surgery or Wide Local Excision Specimens. J Am Acad Dermatol 2024:S0190-9622(24)00665-0. [PMID: 38685403 DOI: 10.1016/j.jaad.2024.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Affiliation(s)
- Donna Pham
- University of California, Riverside School of Medicine, Riverside, CA
| | - Daim Tabba
- California University of Science and Medicine, Colton, CA
| | - Cici Zhou
- Department of Dermatology, Loma Linda University, Loma Linda, CA
| | - Conroy Chow
- Department of Dermatology, Loma Linda University, Loma Linda, CA
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University, Loma Linda, CA; Department of Pathology, Loma Linda University, Loma Linda, CA.
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Cunha JLS, Andrade CES, da Cunha Filho FAP, da Paz AR, Gordón-Núñez MA, Alves PM, Nonaka CFW. Intratarsal Keratinous Cyst Clinically Misdiagnosed as a Chalazion. Dermatopathology (Basel) 2024; 11:142-146. [PMID: 38651459 PMCID: PMC11036242 DOI: 10.3390/dermatopathology11020014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/27/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
The intratarsal keratinous cyst (IKC) is a recently described entity, often clinically misdiagnosed as a chalazion. We report a case of a 61-year-old male patient with a chief complaint of a small lesion on the upper eyelid that evolved over six months. On physical examination, an asymptomatic, firm nodule was identified on the left upper eyelid. The patient reported no history of trauma. A provisional diagnosis of chalazion was established, and an excisional biopsy was performed. Histopathologically, the lesion was lined with a stratified squamous epithelium, with a corrugated epithelial surface showing abrupt keratinization without keratohyalin granules, and compact keratinous-appearing material in the cystic lumen. The diagnosis was IKC. No signs of recurrence were observed after one year of follow-up. It is essential to accurately diagnose IKC and distinguish it from chalazion and epidermal inclusion cysts, because IKC requires complete surgical excision and can exhibit multiple recurrences if not properly removed.
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Affiliation(s)
- John Lennon Silva Cunha
- Postgraduate Program in Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande 58429-600, PB, Brazil; (M.A.G.-N.); (C.F.W.N.)
| | - Clenia E. S. Andrade
- Residency Program in Oral and Maxillofacial Surgery, School of Public Health of Paraíba, João Pessoa 58040-440, PB, Brazil
| | - Fernando A. P. da Cunha Filho
- Residency Program in Oral and Maxillofacial Surgery, School of Public Health of Paraíba, João Pessoa 58040-440, PB, Brazil
| | - Alexandre R. da Paz
- Department of Physiology and Pathology, Federal University of Paraíba (UFPB), João Pessoa 58051-900, PB, Brazil
| | - Manuel A. Gordón-Núñez
- Postgraduate Program in Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande 58429-600, PB, Brazil; (M.A.G.-N.); (C.F.W.N.)
| | - Pollianna M. Alves
- Postgraduate Program in Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande 58429-600, PB, Brazil; (M.A.G.-N.); (C.F.W.N.)
| | - Cassiano F. W. Nonaka
- Postgraduate Program in Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande 58429-600, PB, Brazil; (M.A.G.-N.); (C.F.W.N.)
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11
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Shehata WA, Hammam MA, Elbakly AR, Elkady N. Reappraisal of psoriasis pathogenesis: the role of TEAD4 expression in keratinocytes. Int J Dermatol 2024. [PMID: 38634683 DOI: 10.1111/ijd.17187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Psoriasis is an immune-mediated inflammatory skin disorder with a multifaceted pathogenesis. Immune dysregulation and immune cell dysfunction are among the mechanisms involved. TEA domain family member 4 (TEAD4) is suggested to play a role in psoriasis development. TEAD4 expression in keratinocytes may have a chemotactic effect and could disturb the function of FOXP3-positive T lymphocytes. This study aimed to evaluate the expressions of TEAD4 and FOXP3 in lesional, nonlesional psoriatic, and healthy skin and assess the clinical impact of their expression. METHODS This case-control study included 32 cases with psoriasis vulgaris and 32 control groups. Hematoxylin and eosin-stained slides were examined to evaluate the histopathological findings. Moreover, other sections were immunohistochemically stained with FOXP3 and TEAD4. RESULTS FOXP3 was expressed in inflammatory cells in 56.5, 37.5, and 12.5% of lesional, nonlesional, and healthy skin, whereas it was entirely negative in the keratinocytes. TEAD4 was expressed in keratinocytes in 93.7 and 46.9% of lesional and nonlesional skin, while negative in healthy skin. Significant differences were observed between their lesional, nonlesional, and healthy skin expressions. Furthermore, FOXP3 expression in lesional skin was significantly associated with early onset (P = 0.016), low PASI score (P = 0.002), mild psoriasis (P = 0.007), and axial affection (P = 0.022), while TEAD4 expression was associated with progressive course (P = 0.032), high PASI score (P = 0.002), severe psoriasis (P = 0.001), severe inflammation (P = 0.001), and progressive course (P = 0.017). CONCLUSION TEAD4 expression was higher in lesional than nonlesional skin and absent in healthy skin, suggesting a role in psoriasis development. TEAD4 expression was also associated with severe and progressive psoriasis. This may be mediated by the downregulation of FOXP3 and dysfunction of Treg cells. TEAD4 could serve as a promising therapeutic target in psoriasis.
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Affiliation(s)
- Wafaa A Shehata
- Dermatology, Andrology and STDs, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Mostafa A Hammam
- Dermatology, Andrology and STDs, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | | | - Noha Elkady
- Pathology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
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Helm TN. Bread loaf sectioning provides variable (but sometimes considerable) useful information on margins: Consistently less than Mohs surgery but not limited to the insignificant amounts sometimes quoted in the literature. J Am Acad Dermatol 2024:S0190-9622(24)00629-7. [PMID: 38614249 DOI: 10.1016/j.jaad.2024.01.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 04/15/2024]
Affiliation(s)
- Thomas N Helm
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania.
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13
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Maniam GB, Comfere N, Nguyen GH. Cutaneous Collagenous Vasculopathy: A Rare Entity Treated With Pulsed Dye Laser. Cureus 2024; 16:e58391. [PMID: 38765411 PMCID: PMC11099496 DOI: 10.7759/cureus.58391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/22/2024] Open
Abstract
Cutaneous collagenous vasculopathy (CCV) is a rare idiopathic dermal microangiopathy. Clinically, it presents as diffuse cutaneous telangiectasias that are indistinguishable from other benign vascular entities, thereby posing a diagnostic challenge. We present a case of CCV successfully treated with pulsed dye laser (PDL). A 27-year-old male presented with generalized erythematous macules, diagnosed as CCV via histopathology. After a successful test spot, PDL treatment resulted in significant improvement. The pathogenesis of CCV involves altered dermal microvasculature and veil cell activation. Epidemiologically, it primarily affects Caucasians, most often in the middle-aged adult population. A negative family history of similar lesions can help narrow down the differential diagnosis. Diagnosis requires biopsy, with histopathological examination demonstrating vessel ectasia and collagenous vessel wall thickening. Given its rarity, CCV presents diagnostic and management challenges though PDL emerges as a promising treatment modality for this condition.
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Affiliation(s)
| | - Nneka Comfere
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
- Dermatology, Mayo Clinic, Rochester, USA
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Bernales-Mendoza AM, Shimizu A, Mochizuki T, Anzawa K, Yamaguchi R, Takeda K. A case of dermatophyte abscess and adjunctive use of a novel RNA: In situ hybridization to confirm Trichophyton rubrum. JAAD Case Rep 2024; 46:100-104. [PMID: 38590734 PMCID: PMC10999370 DOI: 10.1016/j.jdcr.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
- Andrea Marie Bernales-Mendoza
- Dermatology Department, Kanazawa Medical University, Ishikawa Prefecture, Japan
- Jose R. Reyes Memorial Medical Center, National Specialty Center for Dermatology, Manila, Philippines
- Dermatology Department, Jose N. Rodriguez Memorial Hospital and Sanitarium, Caloocan, Philippines
| | - Akira Shimizu
- Dermatology Department, Kanazawa Medical University, Ishikawa Prefecture, Japan
| | - Takashi Mochizuki
- Dermatology Department, Kanazawa Medical University, Ishikawa Prefecture, Japan
| | - Kazushi Anzawa
- Dermatology Department, Kanazawa Medical University, Ishikawa Prefecture, Japan
| | - Reimon Yamaguchi
- Dermatology Department, Kanazawa Medical University, Ishikawa Prefecture, Japan
| | - Kiminobu Takeda
- Dermatology Department, Kanazawa Medical University, Ishikawa Prefecture, Japan
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15
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Borg L, Micallef D, Betts A, Boffa MJ. A plantar subcutaneous nodule in a healthy infant. Pediatr Dermatol 2024. [PMID: 38561328 DOI: 10.1111/pde.15609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Luca Borg
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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16
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Costa Fechine CO, Sakai Valente NY, Romiti R, Senna MM. Correlation of clinical and trichoscopy features with the degree of histologic inflammation in lichen planopilaris and frontal fibrosing alopecia in a cross-sectional study. J Am Acad Dermatol 2024:S0190-9622(24)00510-3. [PMID: 38537747 DOI: 10.1016/j.jaad.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 04/26/2024]
Affiliation(s)
| | | | - Ricardo Romiti
- Department of Dermatology, Universidade de São Paulo, Faculdade de Medicina São Paulo, Brazil
| | - Maryanne Makredes Senna
- Department of Dermatology, Lahey Hospital and Medical Center, Burlington, Massachusetts; Harvard Medical School, Boston, Massachusetts
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17
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Poupart S, Coulombe J. An enlarging ulcerative nodule. Pediatr Dermatol 2024. [PMID: 38529733 DOI: 10.1111/pde.15606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/09/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Steffany Poupart
- Division of Dermatology. Centre Hospitalier Universitaire de Montreal (CHUM), Department of Medicine, Université de Montreal, Montreal, Québec, Canada
| | - Jerome Coulombe
- Division of Dermatology, Department of Pediatrics, CHU Sainte-Justine, Université de Montreal, Montreal, Québec, Canada
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18
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Ertop Doğan P, Topuz M, Hazinedar E, Doğan Gün B, Türk Y, Koca R. Clinical and dermoscopic findings of linear atrophoderma of Moulin: a case with an autoimmune and inflammatory background. Int J Dermatol 2024. [PMID: 38511542 DOI: 10.1111/ijd.17140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Pelin Ertop Doğan
- Dermatology Department, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Merve Topuz
- Dermatology Department, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Emel Hazinedar
- Dermatology Department, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Banu Doğan Gün
- Pathology Department, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Yaşar Türk
- Radiology Department, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Rafet Koca
- Dermatology Department, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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Tripathy S, Warbasse E, Ronen S, Al-Rohil R, Cohen GF, Chen WS, Patel AB. Clinicopathologic correlation of dermatologic diseases in patients with darker pigmentation. Am J Clin Pathol 2024:aqae013. [PMID: 38513285 DOI: 10.1093/ajcp/aqae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/20/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES Cutaneous diseases that disproportionately affect patients with darker pigmentation and their histologic features are historically understudied and undertreated. This review article aims to highlight the key clinical features, histopathology, and diagnostic pearls of several cutaneous diseases that commonly present in patients with darker pigmentation. METHODS A literature search was conducted, and a list of cutaneous diseases that frequently affect patients with darker pigmentation was compiled. A group of experts expounded upon those that were most common or misdiagnosed according to scientific evidence and clinical practice. RESULTS The diseases were divided into hypopigmented disorders, hyperpigmented disorders, scarring disorders, and alopecic disorders. Within each category, the etiology, clinical features, histopathology, and key histologic differential diagnoses are described and discussed. CONCLUSIONS As many clinicians are taught that there are no effective treatment options or that these diseases are considered "cosmetic" in nature, patients often do not get a thorough medical workup or skin biopsy. This article aims to decrease the knowledge gap and serve as a resource for anyone involved in the care of patients with these cutaneous conditions.
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Affiliation(s)
- Sanjna Tripathy
- McGovern School of Medicine, The University of Texas Health Sciences, Houston, TX, US
| | | | - Shira Ronen
- Department of Pathology, Cleveland Clinic, Cleveland, OH, US
| | - Rami Al-Rohil
- Department of Dermatology, Duke University Hospital, Durham, NC, US
- Department of Pathology, Duke University Hospital, Durham, NC, US
| | - George F Cohen
- Department of Dermatology, University of South Florida, Tampa, FL, US
| | - Wei-Shen Chen
- Department of Dermatology, University of South Florida, Tampa, FL, US
| | - Anisha B Patel
- McGovern School of Medicine, The University of Texas Health Sciences, Houston, TX, US
- Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX, US
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20
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Mehta N, McShane DB, Miedema J, Morrell DS, Nieman EL. An expanding violaceous lesion on the plantar surface. Int J Dermatol 2024. [PMID: 38504622 DOI: 10.1111/ijd.17142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Nina Mehta
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Diana B McShane
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jayson Miedema
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Dean S Morrell
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Elizabeth L Nieman
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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21
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Forchhammer S, Aebischer V, Lenders D, Seitz CM, Schroeder C, Liebmann A, Abele M, Wild H, Bien E, Krawczyk M, Schneider DT, Brecht IB, Flatz L, Hahn M. Characterization of PRAME immunohistochemistry reveals lower expression in pediatric melanoma compared to adult melanoma. Pigment Cell Melanoma Res 2024. [PMID: 38509752 DOI: 10.1111/pcmr.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
Pediatric melanomas are rare tumors that have clinical and histological differences from adult melanomas. In adult melanoma, the immunohistochemical marker PRAME is increasingly employed as a diagnostic adjunct. PRAME is also under investigation as a target structure for next-generation immunotherapies including T-cell engagers. Little is known about the characteristics of PRAME expression in pediatric melanoma. In this retrospective study, samples from 25 pediatric melanomas were compared with control groups of melanomas in young adults (18-30 years; n = 32), adult melanoma (>30 years, n = 30), and benign melanocytic nevi in children (0-18 years; n = 30) with regard to the immunohistochemical expression of PRAME (diffuse PRAME expression >75%/absolute expression). Pediatric melanomas show lower diffuse PRAME expression (4%) and lower absolute PRAME expression (25%) compared to young adult melanomas (15.6%/46.8%) and adult melanomas (50%/70%). A significant age-dependent expression could be observed. An analysis of event-free survival shows no prognostic role for PRAME in pediatric melanoma and young adult melanoma, but a significant association with diffuse PRAME expression in adulthood. The age dependency of PRAME expression poses a potential pitfall in the diagnostic application of melanocytic tumors in young patients and may limit therapeutic options within this age group. The immunohistochemical expression of the tumor-associated antigen PRAME is an increasingly important diagnostic marker for melanocytic tumors and is gaining attention as a possible immunotherapeutic target in melanoma. As the available data primarily stem from adult melanoma, and given the clinical and histological distinctions in pediatric melanomas, our understanding of PRAME expression in this specific patient group remains limited. The age-dependent low PRAME expression shown here constrains the use of this marker in pediatric melanoma and may also limit the use of immunotherapeutic strategies against PRAME in young patients.
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Affiliation(s)
- Stephan Forchhammer
- Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Valentin Aebischer
- Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Daniela Lenders
- Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Christian M Seitz
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Christopher Schroeder
- Institute of Medical Genetics and Applied Genomics, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Alexandra Liebmann
- Institute of Medical Genetics and Applied Genomics, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Michael Abele
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Hannah Wild
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Malgorzata Krawczyk
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Dominik T Schneider
- Clinic of Pediatrics, Dortmund Municipal Hospital, University Witten/Herdecke, Dortmund, Germany
| | - Ines B Brecht
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Lukas Flatz
- Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Matthias Hahn
- Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
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22
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Wei ML, Tada M, So A, Torres R. Artificial intelligence and skin cancer. Front Med (Lausanne) 2024; 11:1331895. [PMID: 38566925 PMCID: PMC10985205 DOI: 10.3389/fmed.2024.1331895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Artificial intelligence is poised to rapidly reshape many fields, including that of skin cancer screening and diagnosis, both as a disruptive and assistive technology. Together with the collection and availability of large medical data sets, artificial intelligence will become a powerful tool that can be leveraged by physicians in their diagnoses and treatment plans for patients. This comprehensive review focuses on current progress toward AI applications for patients, primary care providers, dermatologists, and dermatopathologists, explores the diverse applications of image and molecular processing for skin cancer, and highlights AI's potential for patient self-screening and improving diagnostic accuracy for non-dermatologists. We additionally delve into the challenges and barriers to clinical implementation, paths forward for implementation and areas of active research.
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Affiliation(s)
- Maria L. Wei
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
- Dermatology Service, San Francisco VA Health Care System, San Francisco, CA, United States
| | - Mikio Tada
- Institute for Neurodegenerative Diseases, University of California, San Francisco, San Francisco, CA, United States
| | - Alexandra So
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Rodrigo Torres
- Dermatology Service, San Francisco VA Health Care System, San Francisco, CA, United States
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23
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Toker M, Forelli N, Wind O, Khanna U, Jaller JA, Fischer S, Mardakhaev E, Wu B. Histopathology and radiologic imaging for the confirmation of calciphylaxis in a diverse population: A retrospective cohort study. J Am Acad Dermatol 2024:S0190-9622(24)00503-6. [PMID: 38513831 DOI: 10.1016/j.jaad.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/22/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Michelle Toker
- Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
| | - Nicholas Forelli
- Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Olivia Wind
- Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Urmi Khanna
- Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Jose A Jaller
- Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Sarah Fischer
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Edward Mardakhaev
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Benedict Wu
- Division of Dermatology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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24
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Bhat K, Madhudiya R, Elhence PA, Singh S. Waxy papules, infiltrated alopecic plaques, and shin ichthyosis. Int J Dermatol 2024. [PMID: 38501702 DOI: 10.1111/ijd.17087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 03/20/2024]
Abstract
A 38-year-old male presented with waxy papules, plaques over the neck and extremities, and ichthyotic scales over the lower limbs. Skin biopsy revealed a dense medium-sized lymphocytic infiltrate in the dermis, with perifollicular accentuation and focal exocytosis into the follicular epithelium with strong positivity for CD 3, 4, and 5. Considering the clinicopathological correlation, a diagnosis of follicular mycosis fungoides (FMF) was made. It is a variant of classic mycosis fungoides (MF) where atypical cells invade the follicular epithelium.
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Affiliation(s)
- Kriti Bhat
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rinkal Madhudiya
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Poonam A Elhence
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Saurabh Singh
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
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25
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Bower RP, Leiphart P, Samson T, Helm KF, Zaenglein A. Diffuse neurofibroma with hypertrichosis in a toddler. Pediatr Dermatol 2024. [PMID: 38459636 DOI: 10.1111/pde.15558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/27/2024] [Indexed: 03/10/2024]
Abstract
Diffuse neurofibroma is a rare type of neurofibroma uncommonly reported in infancy. It is a slow growing tumor originating in the peripheral nerve sheath. We present the case of a 17-month-old boy with diffuse neurofibroma of the scalp associated with hypertrichosis. His genetic and clinical workup for neurofibromatosis was negative.
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Affiliation(s)
- Robert P Bower
- Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA
| | - Paul Leiphart
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Thomas Samson
- Department of Plastic Surgery, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
- Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania, USA
| | - Klaus F Helm
- Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Andrea Zaenglein
- Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
- Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania, USA
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26
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Herrera HO, Ibraheim MK, Chow C, Lawrence N, Bordeaux JS, Elsensohn A. Concordance rates among dermatopathologists and Mohs surgeons in frozen section Mohs slides: A systematic review. JAAD Int 2024; 14:34-35. [PMID: 38025992 PMCID: PMC10667770 DOI: 10.1016/j.jdin.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Affiliation(s)
- Henry O. Herrera
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Marina K. Ibraheim
- Department of Dermatology, Loma Linda University Health, Loma Linda, California
| | - Conroy Chow
- Department of Dermatology, Loma Linda University Health, Loma Linda, California
| | - Naomi Lawrence
- Department of Dermatology, Cooper Hospital, Rowan University, Camden, New Jersey
| | - Jeremy S. Bordeaux
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University Health, Loma Linda, California
- Department of Pathology, Loma Linda University Health, Loma Linda, California
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27
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Saberi SA, Kumar AM, Davis D, Nambudiri VE. Florid cutaneous morbilliform eruption in the setting of primary Epstein-Barr virus infection. JAAD Case Rep 2024; 45:102-105. [PMID: 38434596 PMCID: PMC10907508 DOI: 10.1016/j.jdcr.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Affiliation(s)
| | - Anusha M. Kumar
- Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dale Davis
- Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Vinod E. Nambudiri
- Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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28
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Palmer V, Djunadi TA, Tantry B, Grigos A. Sepsis Associated With Aggressive Cutaneous Angiosarcoma. Cureus 2024; 16:e55619. [PMID: 38586674 PMCID: PMC10995759 DOI: 10.7759/cureus.55619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
Cutaneous angiosarcoma is an aggressive tumor most commonly presenting on the head and neck. In this case report, we describe the presentation of sepsis secondary to an aggressive and rapidly expanding wound, located in a sun-protected area on the body, in a patient with multiple concurrent comorbidities. Treatment was tailored toward targeting the causative organisms, as well as identifying the histologic morphology of the pathologic legion. Histopathology and immunohistochemistry were used to confirm the diagnosis of cutaneous angiosarcoma, and the patient-centered decision surrounding palliative chemotherapy is outlined.
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Affiliation(s)
- Victoria Palmer
- Internal Medicine, Richmond University Medical Center, Staten Island, USA
| | - Trie Arni Djunadi
- Internal Medicine, Richmond University Medical Center, Staten Island, USA
| | - Bhuvana Tantry
- Internal Medicine, Richmond University Medical Center, Staten Island, USA
| | - Angela Grigos
- Internal Medicine, Richmond University Medical Center, Staten Island, USA
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29
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Kozlov M, Levit E, Husain S, Mardakhaev E. Angioleiomyoma of the Ankle: Case Report and Literature Review of a Rare Benign Soft Tissue Tumor. Cureus 2024; 16:e55647. [PMID: 38586740 PMCID: PMC10996887 DOI: 10.7759/cureus.55647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
Angioleiomyoma is a benign soft tissue tumor originating in the smooth muscle of blood vessels. It most frequently presents as a painful, free-moving subcutaneous nodule in the lower extremities and is most common in middle-aged women. Angioleiomyoma is rare amongst benign foot neoplasms, and a preoperative diagnosis of angioleiomyoma is rare. We present a case of angioleiomyoma involving the ankle of a 28-year-old female. To prevent patient suffering, we emphasize the importance of an early and accurate diagnosis. Furthermore, we highlight the salient features of angioleiomyoma, which help with the early detection and differentiation of similar malignant variants, including leiomyosarcoma.
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Affiliation(s)
| | - Eyal Levit
- Dermatology, Columbia University Irving Medical Center, New York, USA
| | - Sameera Husain
- Dermatopathology, Columbia University Irving Medical Center, New York, USA
| | - Edward Mardakhaev
- Radiology, Montefiore Medical Center, Wakefield Campus, New York, USA
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30
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Bhushan G, Simmers J, Flamm A. Presence of bacteria in psoriatic lesions: A retrospective cohort study. JAAD Int 2024; 14:24-25. [PMID: 38054198 PMCID: PMC10694571 DOI: 10.1016/j.jdin.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Affiliation(s)
| | | | - Alexandra Flamm
- Department of Dermatology, Milton S. Hershey Medical Center, Hershey, Pennsylvania
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31
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Farrugia S, Cachia M, Betts A, Clark E. Nodular vasculitis (erythema induratum) associated with systemic minocycline. Australas J Dermatol 2024; 65:167-170. [PMID: 38057959 DOI: 10.1111/ajd.14195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/29/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations showed deranged liver function test with positive ANA and mixed antinuclear factor (ANF) pattern. A skin biopsy was in keeping with a diagnosis of nodular vasculitis. Her skin lesions and liver function test improved within 3 months of stopping the minocycline treatment. This case report raises the awareness that minocycline could be a potential cause of nodular vasculitis, patients on minocycline should be closely monitored and minocycline should ideally not be prescribed for more than 12 weeks, given the possible adverse effects.
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Affiliation(s)
| | - Monique Cachia
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | | | - Eileen Clark
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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32
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Hansen E, Pettit C, Chung CG, Korman AM. Papulonodular mucinosis with features of discoid lupus erythematosus. JAAD Case Rep 2024; 45:59-61. [PMID: 38389858 PMCID: PMC10882011 DOI: 10.1016/j.jdcr.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Affiliation(s)
- Emma Hansen
- The Ohio State University College of Medicine, Columbus, Ohio
| | - Cory Pettit
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Catherine G Chung
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Abraham M Korman
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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33
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Curatolo R, Madanchi M, Juratli HA. Delayed-type hypersensitivity reaction to jellyfish. Int J Dermatol 2024. [PMID: 38415851 DOI: 10.1111/ijd.17110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Riccardo Curatolo
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Matiar Madanchi
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Hazem A Juratli
- Department of Dermatology, Dermatopathology Training Center, University Hospital Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
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34
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Maredia H, Campbell E, Munavalli G, Cohen J, Comfere N, Wyles S. Delayed foreign body reaction to polymethyl methacrylate-based dermal filler following SARS-CoV-2 vaccination. Int J Dermatol 2024. [PMID: 38402538 DOI: 10.1111/ijd.17095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/20/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | | | - Girish Munavalli
- Dermatology, Laser, & Vein Specialists of the Carolinas, Charlotte, NC, USA
| | - Joel Cohen
- Department of Dermatology, University of California Irvine, Irvine, CA, USA
| | - Nneka Comfere
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Saranya Wyles
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Center for Aesthetic Medicine and Surgery, Mayo Clinic, Rochester, MN, USA
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35
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Stefanski M, Le Guern A, Visseaux L, Ehret M, Colomb M, Jeudy G, Le Duff F, Vourc'h M, Baroudjian B, Perea-Villacorta R, Bernigaud C, Mallet S, Norberciak L, Debarbieux S, Perrot JL, Grange F, Modiano P, Monnier J, Bahadoran P. Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study. J Am Acad Dermatol 2024:S0190-9622(24)00383-9. [PMID: 38387851 DOI: 10.1016/j.jaad.2024.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/03/2023] [Accepted: 01/10/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions. OBJECTIVE To provide an overview of RCM practice in real-life. METHODS A multicenter, prospective study carried out in 10 university dermatology departments in France. RESULTS Overall, 410 patients were enrolled. One-half of the patients (48%) were referred by private practice dermatologists. They were referred for diagnosis (84.9%) or presurgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13.6%), and presurgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these, 50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82). LIMITATIONS This study was performed in the settings of French tertiary referral hospitals. CONCLUSION This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients.
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Affiliation(s)
- Marion Stefanski
- Department of Oncodermatology, Reims University Hospital, Reims France; Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | - Aurore Le Guern
- Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | | | - Marine Ehret
- Department of Dermatology, Emile Muller Hospital, Mulhouse, France
| | - Michel Colomb
- Department of Oncodermatology, Reims University Hospital, Reims France
| | - Géraldine Jeudy
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | - Florence Le Duff
- Department of Dermatology, Nice University Hospital, Nice, France
| | - Morgane Vourc'h
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | | | - Rosa Perea-Villacorta
- Department of Dermatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Stéphanie Mallet
- Department of Dermatology and Skin Cancers, La Timone Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Laurène Norberciak
- Delegation of Clinical Research and Innovation, Biostatistics, Saint Philibert Hospital, Catholic University of Lille, Lille, France
| | | | - Jean-Luc Perrot
- Department of Dermatology, Saint Etienne University Hospital et Laboratoire Hubert Curien UMR CNRS 5516, Saint Etienne, France
| | - Florent Grange
- Department of Dermatology, Valence Hospital, Valence, France
| | - Philippe Modiano
- Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | - Jilliana Monnier
- Department of Dermatology and Skin Cancers, La Timone Hospital, AP-HM, Aix-Marseille University, Marseille, France
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Shah A, Wahood S, Guermazi D, Brem CE, Saliba E. Skin and Syntax: Large Language Models in Dermatopathology. Dermatopathology (Basel) 2024; 11:101-111. [PMID: 38390851 PMCID: PMC10885095 DOI: 10.3390/dermatopathology11010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/04/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
This literature review introduces the integration of Large Language Models (LLMs) in the field of dermatopathology, outlining their potential benefits, challenges, and prospects. It discusses the changing landscape of dermatopathology with the emergence of LLMs. The potential advantages of LLMs include a streamlined generation of pathology reports, the ability to learn and provide up-to-date information, and simplified patient education. Existing instances of LLMs encompass diagnostic support, research acceleration, and trainee education. Challenges involve biases, data privacy and quality, and establishing a balance between AI and dermatopathological expertise. Prospects include the integration of LLMs with other AI technologies to improve diagnostics and the improvement of multimodal LLMs that can handle both text and image input. Our implementation guidelines highlight the importance of model transparency and interpretability, data quality, and continuous oversight. The transformative potential of LLMs in dermatopathology is underscored, with an emphasis on a dynamic collaboration between artificial intelligence (AI) experts (technical specialists) and dermatopathologists (clinicians) for improved patient outcomes.
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Affiliation(s)
- Asghar Shah
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Samer Wahood
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Dorra Guermazi
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Candice E Brem
- Section of Dermatopathology, Department of Dermatology, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA 02118, USA
| | - Elie Saliba
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
- Department of Dermatology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 13-5053, Lebanon
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Helkkula T, Christensen G, Ingvar C, Isaksson K, Harbst K, Persson B, Ingvar Å, Hafström A, Carneiro A, Gaspar V, Jönsson G, Nielsen K. BioMEL: a translational research biobank of melanocytic lesions and melanoma. BMJ Open 2024; 14:e069694. [PMID: 38309755 PMCID: PMC10840057 DOI: 10.1136/bmjopen-2022-069694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/17/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION Diagnosing invasive cutaneous melanoma (CM) can be challenging due to subjectivity in distinguishing equivocal nevi, melanoma in situ and thin CMs. The underlying molecular mechanisms of progression from nevus to melanoma must be better understood. Identifying biomarkers for treatment response, diagnostics and prognostics is crucial. Using biomedical data from biobanks and population-based healthcare data, translational research can improve patient care by implementing evidence-based findings. The BioMEL biobank is a prospective, multicentre, large-scale biomedical database on equivocal nevi and all stages of primary melanoma to metastases. Its purpose is to serve as a translational resource, enabling researchers to uncover objective molecular, genotypic, phenotypic and structural differences in nevi and all stages of melanoma. The main objective is to leverage BioMEL to significantly improve diagnostics, prognostics and therapy outcomes of patients with melanoma. METHODS AND ANALYSIS The BioMEL biobank contains biological samples, epidemiological information and medical data from adult patients who receive routine care for melanoma. BioMEL is focused on primary and metastatic melanoma, but equivocal pigmented lesions such as clinically atypical nevi and melanoma in situ are also included. BioMEL data are gathered by questionnaires, blood sampling, tumour imaging, tissue sampling, medical records and histopathological reports. ETHICS AND DISSEMINATION The BioMEL biobank project is approved by the national Swedish Ethical Review Authority (Dnr. 2013/101, 2013/339, 2020/00469, 2021/01432 and 2022/02421-02). The datasets generated are not publicly available due to regulations related to the ethical review authority. TRIAL REGISTRATION NUMBER NCT05446155.
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Affiliation(s)
- Teo Helkkula
- Dermatology and Venereology, Lund University Skin Cancer research group, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Dermatology and Venereology, Skåne University Hospital Lund, Lund, Sweden
- Lund Melanoma Study Group, Lund University, Lund, Sweden
| | - Gustav Christensen
- Dermatology and Venereology, Lund University Skin Cancer research group, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Dermatology and Venereology, Skåne University Hospital Lund, Lund, Sweden
- Lund Melanoma Study Group, Lund University, Lund, Sweden
| | - Christian Ingvar
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Surgery, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Karolin Isaksson
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Surgery, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Surgery, Central Hospital in Kristianstad, Kristianstad, Sweden
| | - Katja Harbst
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Bertil Persson
- Dermatology and Venereology, Lund University Skin Cancer research group, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Dermatology and Venereology, Skåne University Hospital Lund, Lund, Sweden
- Lund Melanoma Study Group, Lund University, Lund, Sweden
| | - Åsa Ingvar
- Dermatology and Venereology, Lund University Skin Cancer research group, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Dermatology and Venereology, Skåne University Hospital Lund, Lund, Sweden
- Lund Melanoma Study Group, Lund University, Lund, Sweden
| | - Anna Hafström
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Otorhinolaryngology, wtih Head and Neck Surgery, Skåne University Hospital Lund, Lund, Sweden
| | - Ana Carneiro
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Oncology, Skåne University Hospital Lund, Lund, Sweden
| | - Viktoria Gaspar
- Dermatology and Venereology, Lund University Skin Cancer research group, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Pathology, Hospital in Helsingborg, Helsingborg, Sweden
| | - Göran Jönsson
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Oncology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Kari Nielsen
- Dermatology and Venereology, Lund University Skin Cancer research group, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Dermatology and Venereology, Skåne University Hospital Lund, Lund, Sweden
- Lund Melanoma Study Group, Lund University, Lund, Sweden
- Department of Dermatology and Venereology, Hospital in Helsingborg, Helsingborg, Sweden
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Zhang Y, Chen R, Nguyen D, Choi S, Gabel C, Leonard N, Yim K, O'Donnell P, Elaba Z, Deng A, Levin NA. Assessing the ability of an artificial intelligence chatbot to translate dermatopathology reports into patient-friendly language: A cross-sectional study. J Am Acad Dermatol 2024; 90:397-399. [PMID: 37804932 DOI: 10.1016/j.jaad.2023.09.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/30/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Yuying Zhang
- University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Ryan Chen
- University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Dan Nguyen
- University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Stephanie Choi
- University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Colleen Gabel
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Nicholas Leonard
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Kaitlyn Yim
- Department of Pathology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Patrick O'Donnell
- Department of Pathology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Zendee Elaba
- Department of Pathology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - April Deng
- Department of Pathology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Nikki A Levin
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
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Hossain OB, Antohi DR, Zhu TR, Occidental M, Bijal A, Wu B. Macroglossia and lip edema: A case of paraproteinemia-associated scleredema responsive to intravenous immunoglobulins. JAAD Case Rep 2024; 44:110-112. [PMID: 38362123 PMCID: PMC10867333 DOI: 10.1016/j.jdcr.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Affiliation(s)
- Onjona B. Hossain
- Division of Dermatology, Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
| | - Daniel R. Antohi
- Division of Dermatology, Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
| | - Tian Ran Zhu
- Division of Dermatology, Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
| | - Michael Occidental
- Department of Pathology, Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
| | - Amin Bijal
- Division of Dermatology, Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
- Department of Pathology, Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
| | - Benedict Wu
- Division of Dermatology, Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
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40
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Han S, Patel T, Garcia ML, Tirado M. Blasts with folded nuclei: A histopathologic finding in myeloid leukemia cutis with NPM1 and FLT3 mutations. J Cutan Pathol 2024; 51:130-134. [PMID: 37866827 DOI: 10.1111/cup.14549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023]
Abstract
Leukemia cutis is a term used to describe cutaneous manifestations of leukemic infiltration of the skin and portends a poor prognosis. Cutaneous involvement by hematopoietic/lymphoid tumors can occur before, concurrently, or after the initial diagnosis. Early involvement of dermatologists and timely biopsies play a crucial role in achieving a prompt diagnosis. Prior reports of acute myeloid leukemia have revealed a strong association between the cup-like nuclear morphology observed in bone marrow specimens and concurrent mutations of NPM1 and FLT3-ITD. In cutaneous tissue sections of leukemia cutis, folded or indented nuclei may represent the "cup-like" counterpart previously described in bone marrow specimens. Recognizing this morphological feature could aid in identifying this molecular subtype of leukemia cutis. In this study, we present a case of leukemia cutis in a 63-year-old female with AML and NPM1 and FLT3-ITD mutations, demonstrating scattered indented/folded nuclei.
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Affiliation(s)
- Shannon Han
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Tejesh Patel
- Kaplan-Amonette Department of Dermatology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Marie-Laure Garcia
- Department of Pathology, Hospital Universitario de Caceres, Cáceres, Spain
| | - Mariantonieta Tirado
- Kaplan-Amonette Department of Dermatology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
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41
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Cortez JL, Elwood H, Matsumoto A. Atypical vascular lesions cleared with Mohs micrographic surgery. JAAD Case Rep 2024; 44:41-43. [PMID: 38292578 PMCID: PMC10824695 DOI: 10.1016/j.jdcr.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Jose L. Cortez
- Department of Dermatology, University of New Mexico, Albuquerque, New Mexico
| | - Hillary Elwood
- Department of Dermatopathology, TriCore Reference Laboratories, Albuquerque, New Mexico
| | - Andrew Matsumoto
- Department of Dermatology, University of New Mexico, Albuquerque, New Mexico
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42
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Ambrogio F, Rubino L, Laface C, Cazzato G, Foti C. Pembrolizumab-Induced Rupioid Psoriasis Treated by Apremilast Without Interrupting the Ongoing Antineoplastic Treatment. Cureus 2024; 16:e55249. [PMID: 38558625 PMCID: PMC10981470 DOI: 10.7759/cureus.55249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
We report the case of a 77-year-old man affected by a poorly differentiated metastatic pulmonary adenocarcinoma who, after the first course of therapy with cisplatin-pemetrexed-pembrolizumab treatment, developed rupioid psoriasis. We decided to discontinue pembrolizumab for four weeks until lesions improved and to start therapy with apremilast (an oral small molecule phosphodiesterase (PDE)4 inhibitor) in combination with systemic methylprednisolone 16 mg/day with consequent tapering until discontinuation in a few weeks. After accomplishing three months of treatment with apremilast, the patient gained complete remission of the rupioid lesions. Pembrolizumab therapy was reintroduced, and cycles were carried out without exacerbating the clinical picture. During the fourth month of therapy with apremilast, it was attempted to stop the treatment despite continuing the therapy with pembrolizumab. As a result, there was a relapse of the erythematous scaling plaques. After the subsequent reintroduction of apremilast, a new remission of the clinical picture occurred despite the absence of interruption of pembrolizumab. As far as we know, this is the second case of rupioid psoriasis induced by immunotherapy with pembrolizumab. Still, while the previous case was undergoing therapy with acitretin and methylprednisone, our patient is the first case treated with apremilast with excellent and rapid remission even after discontinuation and re-administration of pembrolizumab without exacerbation of dermatitis. In addition, the appearance of psoriasis during immunotherapy can be properly treated, which does not contraindicate the continuation of the antineoplastic treatment.
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Affiliation(s)
- Francesca Ambrogio
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, ITA
| | - Luca Rubino
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, ITA
| | - Carmelo Laface
- Medical Oncology, Dario Camberlingo Hospital, Francavilla Fontana, ITA
| | - Gerardo Cazzato
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, ITA
| | - Caterina Foti
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, ITA
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43
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Ezaldein HH. Rapidly Growing and Aggressive Squamous Cell Carcinoma of the Forearm: A Report of Successful Treatment With Mohs Surgery and Complex Reconstruction With Rhombic Triple Z-Plasty. Cureus 2024; 16:e55182. [PMID: 38558613 PMCID: PMC10980786 DOI: 10.7759/cureus.55182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
Reconstruction of complex post-surgical wounds requires functional and aesthetic considerations. We present a case of a complex radial-dorsal forearm defect in a patient who underwent Mohs surgery for an aggressive and rapidly growing squamous cell carcinoma. Following complete tumor excision, we utilized a modified rhombic flap for complete wound coverage with long-term conservation of extensor function. The rhombic flap modification included three Z-plasties at the flap base to add rotational components to the flap transposition. Long-term follow-up showed acceptable cosmesis, preserved extensor tendon function, and no evidence of tumor recurrence.
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Affiliation(s)
- Harib H Ezaldein
- Mohs Micrographic Surgery, Bennett Surgery Center, Santa Monica, USA
- Dermatology, Miami Dermatology and Mohs Surgery, Miami, USA
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44
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Alsawas M, Alzayadneh E, Mou E, Liu V. Sezary syndrome initially presenting as pityriasis rubra pilaris: Clinicopathologic study of 3 cases. JAAD Case Rep 2024; 44:101-106. [PMID: 38357556 PMCID: PMC10864165 DOI: 10.1016/j.jdcr.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Affiliation(s)
- Mouaz Alsawas
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Eyas Alzayadneh
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Eric Mou
- Division of Hematology and Oncology, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Vincent Liu
- Departments of Dermatology and Pathology, University of Iowa, Iowa City, Iowa
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45
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Ronchi A, Cazzato G, Ingravallo G, D’Abbronzo G, Argenziano G, Moscarella E, Brancaccio G, Franco R. PRAME Is an Effective Tool for the Diagnosis of Nevus-Associated Cutaneous Melanoma. Cancers (Basel) 2024; 16:278. [PMID: 38254769 PMCID: PMC10813997 DOI: 10.3390/cancers16020278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
(1) Background: Nevus-associated cutaneous melanoma (CM) is relatively common in the clinical practice of dermatopathologists. The correct diagnosis and staging of nevus-associated cutaneous melanoma (CM) mainly relies on the correct discrimination between benign and malignant cells. Recently, PRAME has emerged as a promising immunohistochemical marker of malignant melanocytes. (2) Methods: PRAME immunohistochemistry (IHC) was performed in 69 cases of nevus-associated CMs. Its expression was evaluated using a score ranging from 0 to 4+ based on the percentage of melanocytic cells with a nuclear expression. PRAME IHC sensitivity, specificity, positive predictive values, and negative predictive values were assessed. Furthermore, the agreement between morphological data and PRAME expression was evaluated for the diagnosis of melanoma components and nevus components. (3) Results: PRAME IHC showed a sensitivity of 59%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 71%. The diagnostic agreement between morphology and PRAME IHC was fair (Cohen's Kappa: 0.3); the diagnostic agreement regarding the benign nevus components associated with CM was perfect (Cohen's Kappa: 1.0). PRAME was significantly more expressed in thick invasive CMs than in thin cases (p = 0.02). (4) Conclusions: PRAME IHC should be considered for the diagnostic evaluation of nevus-associated CM and is most useful in cases of thick melanomas. Pathologists should carefully consider that a PRAME-positive cellular population within the context of a nevus could indicate a CM associated with the nevus. A negative result does not rule out this possibility.
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Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.); (G.D.)
| | - Gerardo Cazzato
- Section of Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70125 Bari, Italy; (G.C.); (G.I.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70125 Bari, Italy; (G.C.); (G.I.)
| | - Giuseppe D’Abbronzo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.); (G.D.)
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.A.); (E.M.); (G.B.)
| | - Elvira Moscarella
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.A.); (E.M.); (G.B.)
| | - Gabriella Brancaccio
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.A.); (E.M.); (G.B.)
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.); (G.D.)
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46
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Alzaabi M, Almutairi R, Alrushood A, Al-Sabah H. White Fibrous Papulosis of the Neck in a 70-Year-Old Female: A Case Report. Cureus 2024; 16:e51957. [PMID: 38333470 PMCID: PMC10852350 DOI: 10.7759/cureus.51957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
White fibrous papulosis of the neck (WFPN) manifests through the presence of numerous solid, persistent, and asymptomatic yellowish-white papules, displaying a distinctive asymmetrical distribution primarily localized on the neck and antecubital fossa. This case report describes the clinical presentation of a 70-year-old female diagnosed with WFPN, highlighting the significant finding of collagen fiber thickening upon histopathological analysis. Despite its predilection for specific anatomical sites, the elusive pathogenesis of WFPN adds diagnostic complexity, emphasizing the need for further research in this unique condition that generally follows a benign course.
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Affiliation(s)
- Maryam Alzaabi
- Dermatology, As'ad K. Al-Hamad Dermatological Center, Kuwait, KWT
| | - Rawan Almutairi
- Dermatology, As'ad K. Al-Hamad Dermatological Center, Kuwait, KWT
| | - Amal Alrushood
- Dermatology, As'ad K. Al-Hamad Dermatological Center, Kuwait, KWT
| | - Humoud Al-Sabah
- Dermatopathology, As'ad K. Al-Hamad Dermatological Center, Kuwait, KWT
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47
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Kantor J. This Month in JAAD International: January 2024: Mohs surgeon and dermatopathologist concordance. J Am Acad Dermatol 2024; 90:42. [PMID: 37924952 DOI: 10.1016/j.jaad.2023.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Affiliation(s)
- Jonathan Kantor
- Department of Dermatology, Center for Global Health, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and Florida Center for Dermatology, St Augustine, Florida.
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48
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Alarcón Pérez CE, Planas S, Baselga Torres E. A 3-year-old-girl with multiple clustered, indurated nodules. Pediatr Dermatol 2024; 41:133-135. [PMID: 37495418 DOI: 10.1111/pde.15390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/22/2023] [Indexed: 07/28/2023]
Affiliation(s)
| | - Silvia Planas
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
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49
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Mahoney MJ, Gaddis KJ, Polcari IC. Chronic Crusted Plaque after Skin Injury. J Pediatr 2024; 264:113771. [PMID: 37838285 DOI: 10.1016/j.jpeds.2023.113771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Affiliation(s)
| | - Kevin J Gaddis
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Ingrid C Polcari
- Department of Pediatrics, University of Minnesota, Minneapolis, MN; Division of Pediatric Dermatology, Department of Dermatology, University of Minnesota, Minneapolis, MN
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Moody R, Darji K, Missall TA, Chow P, Behshad R. A Case of Pleomorphic Dermal Sarcoma: Giant Exophytic Tumor of the Medial Canthus. Dermatopathology (Basel) 2023; 11:13-18. [PMID: 38247725 PMCID: PMC10801471 DOI: 10.3390/dermatopathology11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
We present the case of a 99-year-old Caucasian female who was referred for treatment of a painless, 8.0 cm × 7.8 cm exophytic, pedunculated, ulcerated tumor of the left medial canthus. Pathology showed spindled, oval, and polygonal cells with pleomorphic nuclei. Many multinuclear giant cells and mitotic figures were also noted. The tumor was highlighted with CD10, showed focal positivity with actin, desmin, and CD68, and had increased Ki67 immunohistochemical staining. The tumor was negative for pancytokeratin, CK5/6, p63, MART-1/MelanA, S100, Sox10, p40, CD34, and CD23. Based on clinicopathologic correlation, the diagnosis of pleomorphic dermal sarcoma (PDS) was made. Pleomorphic dermal sarcoma (PDS) refers to a deep, histologically high-grade tumor that often resembles other tumors clinically and histologically. As PDS is frequently aggressive and related to adverse outcomes, it is important to recognize its distinguishing features in comparison to other similar entities, including atypical fibroxanthoma (AFX) and pleomorphic leiomyosarcoma (PLMS). To our knowledge, there is only one other reported case in the literature of PDS occurring on the eye. By reviewing and understanding characteristic etiologies, locations of presentation, histopathological features, and management techniques, pathologists can make a more accurate diagnosis and dermatologists can provide more effective patient care in a timely manner.
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Affiliation(s)
- Rylee Moody
- School of Medicine, Saint Louis University, 1008 S Spring Ave, St. Louis, MO 63110, USA
| | - Kavita Darji
- Department of Dermatology, SSMHealth SLUCare, Saint Louis University, 1008 S Spring Ave, St. Louis, MO 63110, USA
| | - Tricia A. Missall
- Department of Dermatology, University of Florida, Gainesville, FL 32606, USA
| | - Peter Chow
- Department of Dermatology, SSMHealth SLUCare, Saint Louis University, 1008 S Spring Ave, St. Louis, MO 63110, USA
| | - Ramona Behshad
- Department of Dermatology, SSMHealth SLUCare, Saint Louis University, 1008 S Spring Ave, St. Louis, MO 63110, USA
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