Journal of Cutaneous Pathology最新文献

Histopathologic Features in Vancomycin-Associated Drug-Induced Hypersensitivity Syndrome.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-25 DOI: 10.1111/cup.14804

Hannah B Haberecht, Rachel L Ziebart, Olivia C Iverson, Austin Todd, Mark D Davis, David A Wetter, Julio C Sartori-Valinotti, Hafsa M Cantwell, Marian T McEvoy, Nessa Aghazadeh Mohandesi, Afsaneh Alavi, Emma F Johnson

{"title":"Histopathologic Features in Vancomycin-Associated Drug-Induced Hypersensitivity Syndrome.","authors":"Hannah B Haberecht, Rachel L Ziebart, Olivia C Iverson, Austin Todd, Mark D Davis, David A Wetter, Julio C Sartori-Valinotti, Hafsa M Cantwell, Marian T McEvoy, Nessa Aghazadeh Mohandesi, Afsaneh Alavi, Emma F Johnson","doi":"10.1111/cup.14804","DOIUrl":"https://doi.org/10.1111/cup.14804","url":null,"abstract":"Background: Drug-induced hypersensitivity syndrome (DiHS), or drug reaction with eosinophilia and systemic symptoms (DRESS), is a delayed and severe immune response to certain medications. We investigated vancomycin-induced DiHS/DRESS, notable for frequent and severe organ involvement, to describe its specific histopathology and the correlations between histopathologic and clinical findings.Methods: A retrospective review was conducted to identify patients between 2006 and 2022 who received vancomycin, had archived skin biopsy specimens, and were scored as having probable or definite DiHS/DRESS. Clinical features were retrospectively collected, and biopsy specimens were reviewed by a board-certified dermatopathologist. A subset of histopathologic and clinical features was analyzed for statistical correlation.Results: Twenty-three patients met the inclusion criteria. Most biopsy specimens (87%) showed an eczematous reaction pattern; 17 (74%) showed a secondary reaction pattern. Spongiosis (87%) and neutrophilic infiltration (91%) were common epidermal characteristics. The dermal inflammatory infiltrate was frequently superficial (87%) and consistently included plasma cells (96%). Eosinophils were present in the dermis in 70% of cases. Parakeratosis negatively correlated with liver involvement and positively correlated with desquamative rash. Epidermal lymphocytes were negatively correlated with the RegiSCAR score.Conclusions: Vancomycin-associated DiHS/DRESS histopathology was characterized by a frequent eczematous reaction pattern, multiple coexisting reaction patterns, and epidermal neutrophilic infiltration.","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Fluoroscopy-Induced Subacute Radiation Dermatitis Histologically Mimicking Sclerodermiform Lupus: Immunohistochemical Analysis of Cytotoxic Memory T-Cell Markers.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-24 DOI: 10.1111/cup.14807

Vidya Medepalli, Timar A Mascio, Anthony Thompson, Marc Inglese, Pamela Padilla, Stephen Richardson, András Schaffer

{"title":"A Case of Fluoroscopy-Induced Subacute Radiation Dermatitis Histologically Mimicking Sclerodermiform Lupus: Immunohistochemical Analysis of Cytotoxic Memory T-Cell Markers.","authors":"Vidya Medepalli, Timar A Mascio, Anthony Thompson, Marc Inglese, Pamela Padilla, Stephen Richardson, András Schaffer","doi":"10.1111/cup.14807","DOIUrl":"https://doi.org/10.1111/cup.14807","url":null,"abstract":"The histological hallmark of fluoroscopy-induced subacute radiation dermatitis (FISARD) is basovacuolar interface reaction with satellite cell necrosis mediated by CD8+ cytotoxic T-cells. Most published cases are described in patients who had a single interventional exposure. Here we report a case of FISARD in a 78-year-old man who underwent two cardiovascular interventions within 2 months. Biopsy of the skin lesion on his left back revealed not only epidermal cytotoxic interface activity with superficial perivascular dermatitis but also deep perivascular and interstitial dermal lymphoid infiltrates and dermal sclerosis, features overlapping with lupus and inflammatory morphea. Immunohistochemistry revealed intraepidermal and dermal expression of CD3, CD8, TIA-1, and CD45RA, likely corresponding to terminally differentiated effector memory cytotoxic T cells (TEMRA). In contrast, expression of CD57, a marker of late memory T-cells implicated in scleroderma pathogenesis, was absent in the epidermis but present in the dermis. This case adds to the spectrum of histopathologic findings of FISARD possibly related to the cumulative radiation injury from multiple fluoroscopic procedures. Given the increasing use of fluoroscopy, recognition of this histopathological pattern could aid in the timely and accurate diagnosis of this condition. A potential role of memory CD8+ T-cells in disease pathogenesis is discussed.","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genomic and Transcriptomic Characterization of Protein Kinase C Fusion Melanocytic Neoplasms With Distinctive Hypopigmented Histomorphology: A Single-Institution Study.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-20 DOI: 10.1111/cup.14801

Aofei Li, Brandon Umphress, Carina Dehner, Ryan Jones, Keller Toral, Simon Warren, Ahmed K Alomari

{"title":"Genomic and Transcriptomic Characterization of Protein Kinase C Fusion Melanocytic Neoplasms With Distinctive Hypopigmented Histomorphology: A Single-Institution Study.","authors":"Aofei Li, Brandon Umphress, Carina Dehner, Ryan Jones, Keller Toral, Simon Warren, Ahmed K Alomari","doi":"10.1111/cup.14801","DOIUrl":"https://doi.org/10.1111/cup.14801","url":null,"abstract":"Background: Genomic fusions involving Protein Kinase C (PKC or PRKC) have been classically identified in a subset of melanocytic neoplasms with heavy melanin pigmentation as described in older series. They were recently reclassified from the pigmented epithelioid melanocytoma (PEM) category to the blue nevus (BN) category in the fifth edition of the World Health Organization (WHO) Classification of Skin Tumors.Methods: Herein, we report a series of eight mostly hypopigmented PRKC fusion melanocytic tumors with novel comprehensive molecular characterization. Clinical, histopathologic, and immunohistochemical findings were reviewed. Next-generation sequencing (NGS) data on genomic and transcriptomic levels were explored.Results: Histomorphology showed a biphasic pattern with hypercellular areas and hypocellular areas with dense fibrotic stroma and collagen trapping. The clinical courses were uncomplicated after excisions. NGS revealed three cases of PRKCB fusion and five cases of PRKCA fusions. RNA differential analysis against six blue nevi showed a group of genes with significantly higher transcription levels and strong enrichment in the direct p53 effectors gene set. PRKC fusion tumors also demonstrated significantly stronger p53 IHC staining.Conclusion: We further expand the morphologic spectrum of PRKC fusion melanocytic tumors and provide insight into their morphologic identification. Our novel transcriptome-level findings provide insight into the nuanced molecular events and new evidence for classification.","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary Cutaneous Neoplasm With Rhabdomyosarcomatous Differentiation and a Melanoma-Like Mutational Landscape.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-16 DOI: 10.1111/cup.14806

Maximillian A Weigelt, Shinoj Pattali, Josephine K Dermawan, Jennifer S Ko, Karen J Fritchie, Steven D Billings

{"title":"Primary Cutaneous Neoplasm With Rhabdomyosarcomatous Differentiation and a Melanoma-Like Mutational Landscape.","authors":"Maximillian A Weigelt, Shinoj Pattali, Josephine K Dermawan, Jennifer S Ko, Karen J Fritchie, Steven D Billings","doi":"10.1111/cup.14806","DOIUrl":"https://doi.org/10.1111/cup.14806","url":null,"abstract":"Malignant melanoma (MM) is notorious for its wide range of morphologic variability. Rarely, MM may lose all melanocytic markers and adopt the morphologic and immunophenotypic characteristics of a different neoplasm in a process known as trans-differentiation (TMM). Distinguishing TMM from primary cutaneous neoplasms may be challenging and is often dependent on the identification of an adjacent conventional melanoma. In particularly difficult cases, molecular analysis may be helpful; TMMs are known to exhibit highly similar mutational landscapes to conventional melanomas (e.g., mutations in NF1, NRAS; variable BRAF V600E). Herein, we present an exceedingly rare case of likely TMM with rhabdomyosarcomatous differentiation in which high tumor mutational burden (TMB) was an important clue to the diagnosis. An 83-year-old woman presented with an 8.2 cm fungating mass on the upper arm. Biopsy revealed a sheet-like proliferation of mitotically active pleomorphic cells which were positive for myogenin/MyoD1 and negative for S100/SOX10. A diagnosis of epithelioid rhabdomyosarcoma was rendered. Subsequent axillary lymph node metastasis prompted whole exome sequencing, which revealed a molecular signature more indicative of MM, including: high TMB (19 mutations/Mb); ultraviolet mutational signature (i.e., preponderance of C>T base changes); TERT promoter mutation; and ARID2 mutation. After discussion at the interdisciplinary tumor board, a diagnosis of TMM was considered most likely, and the patient was initiated on pembrolizumab. Morphologic features more typical of MM than cutaneous sarcomas, such as tumor-infiltrating lymphocytes, junctional epidermal tumor nests, and satellitosis, may provide further clues to the accurate diagnosis of TMM, which has important prognostic and therapeutic implications for the patient.","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Cutaneous Vascular Neoplasm With an EWSR1-NFATC2 Translocation-Contributing to the Spectrum of Vascular Lesions Characterized by NFATC-Related Fusions.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-04 DOI: 10.1111/cup.14800

B Schurink, A M van Huizen, C D Savci-Heijink, E-J Kooi

引用次数: 0

Determining the Relationship Between Cutaneous Keratocysts and Basal Cell Nevus Syndrome.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-03 DOI: 10.1111/cup.14803

Madelyn M Class, Claire Rose Kissinger, Sidra Ibad, Aspen Trautz, Lisa Zhai, Farhaan Hafeez

引用次数: 0

CD138: A Potential Novel Diagnostic Marker for Cellular Neurothekeoma. CD138：细胞神经骨化瘤的潜在新型诊断标记物

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-03 DOI: 10.1111/cup.14790

Sarah Williamson, Arlene Rosenberg, Sarmad Jassim, Stephen Somach

引用次数: 0

Training Residents in Dermatopathology in the 21st Century: The Pros and Cons of Harnessing Virtual Microscopy and Remote Learning.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-03-03 DOI: 10.1111/cup.14802

Marianna Shvartsbeyn, Ata S Moshiri

引用次数: 0

A Case of Hybrid Cellular Neurothekeoma and Perineurioma With a Folliculin Gene Mutation.

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-02-27 DOI: 10.1111/cup.14799

Taylor J Prechtel, Emma Brashear, Carina A Dehner, Ahmed K Alomari

{"title":"A Case of Hybrid Cellular Neurothekeoma and Perineurioma With a Folliculin Gene Mutation.","authors":"Taylor J Prechtel, Emma Brashear, Carina A Dehner, Ahmed K Alomari","doi":"10.1111/cup.14799","DOIUrl":"https://doi.org/10.1111/cup.14799","url":null,"abstract":"Hybrid peripheral nerve sheath tumors (PNSTs) are benign tumors that show features of more than one type of PNST. Benign cutaneous plexiform hybrid tumor of perineurioma and cellular neurothekeoma (BCPHTPCN) is a rare, recently described entity that shows various combinations of histomorphologic and immunophenotypic features of the PNSTs perineurioma and cellular neurothekeoma. Our case describes a middle-aged man initially presenting with an acute papulopustular rosacea flare. Rosacea treatment unmasked a prominent erythematous papule on the forehead. A biopsy was taken, and histopathological examination showed a proliferation of epithelioid, ovoid, and spindled cells arranged in a compact nested and intersecting fascicular growth. Immunohistochemical stains were positive for NKI/C3, CD10, PGP9.5, MITF, and GLUT-1. There was weak reactivity with EMA and minimal reactivity with Claudin-1. Tumor cells were negative for SOX10, CD163, CD68, CD34, ALK, and Pan-TRK. The patient was diagnosed with BCPHTPCN. DNA and RNA sequencing showed a folliculin (FLCN) gene mutation, which is most commonly associated with Birt-Hogg-Dubé syndrome. The patient underwent excision and has remained without recurrence or complications several months post-diagnosis. We hope to expand the clinical and histopathologic characteristics of this peculiar neoplasm, as well as provide additional insight that might improve our understanding of BCPHTPCN tumorigenesis.","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric Post-Vaccine Aluminum Granuloma: Morin Stain as a Diagnostic Aid. 小儿疫苗接种后铝肉芽肿：莫林染色作为诊断辅助工具。

IF 1.6 4区医学

Journal of Cutaneous Pathology Pub Date : 2025-02-24 DOI: 10.1111/cup.14797

Justin R Chang, Alvin Wong, Julio A Diaz-Perez, Chunyu Cai, Mark C Mochel

引用次数: 0