Journal of Cutaneous Pathology最新文献

{"title":"Cutaneous Hemangioma With Epithelioid Features Harboring a TPM4::ALK Fusion","authors":"Donn LaTour,&nbsp;Norman L. Lehman,&nbsp;Martin P. Fernandez","doi":"10.1111/cup.70143","DOIUrl":"10.1111/cup.70143","url":null,"abstract":"<div>\u0000 \u0000 <p>Vascular neoplasms comprise a heterogeneous group of tumors ranging from benign to malignant, increasingly defined by recurrent gene fusions. In this report we describe a cutaneous hemangioma with epithelioid features harboring a <i>TPM4::ALK</i> gene fusion in a 43-year-old female. On histology, this dermal-based lesion was composed of epithelioid endothelial cells with no overt cytologic atypia and abundant cytoplasm. Immunohistochemistry showed the epithelioid cells were positive for ERG and showed diffuse intracytoplasmic ALK-1 expression. The fusion was detected via RNA sequencing, highlighting ALK as a potential oncogenic driver in this tumor. The morphology resembled epithelioid hemangioma, a benign vascular tumor known to harbor FOS gene rearrangements. This case represents the second known instance of a cutaneous hemangioma with epithelioid features and a <i>TPM4::ALK</i> fusion. Additional studies are needed to clarify the biological behavior and classification of these tumors within the spectrum of fusion-driven vascular neoplasms.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"1007-1011"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005449","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}

{"title":"Bowenoid Malignant Onychopapilloma","authors":"Kendall Billick,&nbsp;Carli Tucci,&nbsp;Erika Koh,&nbsp;Adam I. Rubin","doi":"10.1111/cup.70142","DOIUrl":"10.1111/cup.70142","url":null,"abstract":"<div>\u0000 \u0000 <p>Onychopapilloma (OP) is a tumor of the nail unit that classically presents as longitudinal erythronychia and exhibits histopathologic features of papillomatosis, matrix metaplasia, and subungual hyperkeratosis. Although historically regarded as benign, emerging reports have identified rare malignant variants demonstrating cytologic atypia and altered maturation while retaining the architectural scaffold of an OP. Herein we describe a 52-year-old man with progressive longitudinal erythronychia of the thumbnail with evolving width, darkening, and distal keratotic change that prompted excisional biopsy. Histopathologic evaluation revealed characteristic background features of OP with superimposed full-thickness epithelial atypia exhibiting a Bowenoid pattern, including a disordered loss of keratinocyte polarity, hyperchromatic nuclei, dyskeratosis, and atypical mitotic figures. Immunohistochemistry demonstrated diffuse full-thickness labeling of the nail bed and matrix with Ki-67, and HPV testing was negative. In conjunction with the clinical features, the histopathologic features established a diagnosis of malignant OP. This unique Bowenoid pattern expands the histopathologic spectrum of malignant OP.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"1016-1020"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030918","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}

{"title":"Dermatofibroma Hypocellularity Is Associated With Patient Age: A Retrospective Study of 307 Cases","authors":"Christian Jordan,&nbsp;Wesley Hodges,&nbsp;Laura Russell,&nbsp;Albert Alhatem,&nbsp;Eric Armbrecht,&nbsp;Gillian Heinecke,&nbsp;Kristin Smith,&nbsp;Nicole Burkemper,&nbsp;M. Yadira Hurley","doi":"10.1111/cup.70148","DOIUrl":"10.1111/cup.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dermatofibromas are benign fibrohistiocytic neoplasms with numerous histologic variants including the hypocellular variant. Anecdotal observations suggest that dermatofibromas may become increasingly sclerotic and hypocellular with advancing patient age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the association between patient age and the frequency of hypocellular dermatofibromas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 392 dermatofibroma specimens were independently classified by two dermatopathologists into discrete histologic variants: conventional, hypocellular, hemosiderotic/aneurysmal, cellular, lipidized, indeterminate, or other. Only cases with concordant classification between the two dermatopathologists were included in the analysis. Linear regression analysis to be used to evaluate the association between patient age and the prevalence of hypocellular dermatofibromas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of the original 392 cases, 307 (78%) specimens received concordant histologic variant classification and were included in the analysis. The frequency of the hypocellular variant was consistently low (0%–18%) in patients in the youngest age groups (10–49 years), increased to 25% in the 50–59 age group, and ranged from 25% to 40% in patients aged 60–89 years old. Linear regression analysis demonstrated a strong positive correlation between patient age and the prevalence of hypocellular dermatofibromas (<i>R</i>-squared = 0.82, <i>p</i> 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>The high proportion of shave biopsy specimens (63%) limited assessment of deep dermal histologic features. Another limitation is the inherent subjectivity of categorizing based on cellularity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hypocellular dermatofibromas are increasingly prevalent with advancing age. One possible explanation is that dermatofibromas undergo gradual involution over time, with a corresponding reduction in cellular density as lesions mature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"978-981"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198985","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}

{"title":"Epidermolytic Acanthomata on the Scrotum: A Enigmatic Entity With Human Papilloma Virus 52 Positivity","authors":"Tejas Vishwanath,&nbsp;Sunanda Mahajan,&nbsp;Prachi Gole,&nbsp;Surupa Das","doi":"10.1111/cup.70130","DOIUrl":"10.1111/cup.70130","url":null,"abstract":"<div>\u0000 \u0000 <p>We report the case of a 55-year-old male who presented with asymptomatic scrotal papules since 3–4 months. He had no comorbidities. Clinical differentials comprised genital verrucae and high-grade squamous intraepithelial lesion (previously called bowenoid papulosis). Skin biopsy findings comprised perinuclear vacuolization of the stratum spinosum and granulosum, reticular degeneration, and coarse keratohyaline granules. These features were suggestive of epidermolytic acanthoma. Surprisingly, DNA PCR was positive for HPV52, a high-risk HPV type, unlike previous case reports. Further research may be warranted on the pathogenesis, especially keratin 10 mutations and HPV positivity.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"986-989"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147929518","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}

{"title":"A Rare Case of a T-Cell Rich Angiomatoid Polypoid Pseudolymphoma in a 31-Year-Old Pregnant Woman","authors":"Jasmine Zaremba,&nbsp;Olumide Adebambo,&nbsp;Vivek Mudaliar,&nbsp;Shahd Nour,&nbsp;Wayne Jaffe","doi":"10.1111/cup.70160","DOIUrl":"10.1111/cup.70160","url":null,"abstract":"<div>\u0000 \u0000 <p>T-cell rich angiomatoid polypoid pseudolymphoma (TRAPP) is a rare skin condition with important clinical and histological differentials. We report a case arising on the left cheek of a 31-year-old pregnant female, first noticed at 7 months of pregnancy. By the time of excision soon after delivery, it was 6 mm in diameter. Histology showed a relatively circumscribed dermal proliferation of high endothelial venule-like vessels, surrounded and densely infiltrated by non-atypical CD4 positive T lymphocytes. A diagnosis of TRAPP was made. To our knowledge this is only the second case in the literature to arise during pregnancy. We review the literature on TRAPP, discuss its histological and immunohistochemical features, recently proposed changes to its nomenclature, and distinguishing features that separate it from its main differential diagnoses.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"1051-1054"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198994","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}

{"title":"Post-Streptococcal Neutrophilic Pustular Dermatosis: Expanding the Histopathological Paradigm of Reactive Neutrophilic Dermatoses","authors":"Gustavo Almeida-Silva,&nbsp;Joana Antunes,&nbsp;Inês Pereira Amaral,&nbsp;Inês Tribolet de Abreu,&nbsp;Filipe Monteiro,&nbsp;Pedro de Vasconcelos,&nbsp;Luís Soares-Almeida,&nbsp;Paulo Filipe","doi":"10.1111/cup.70153","DOIUrl":"10.1111/cup.70153","url":null,"abstract":"<div>\u0000 \u0000 <p>Post-streptococcal pustulosis was first described in 1974 by Tan et al., and was only clearly distinguished from acute generalized exanthematous pustulosis in 1995. It is a rare neutrophilic dermatosis which usually arises following group A streptococcal infections, and is self-limited in time, typically resolving with 1 month. Clinical presentation includes a roughly symmetrical sterile pustular eruption arising in normal skin, most often affecting acral areas, like palms, soles, and legs. Up to this date, only 26 cases have been documented worldwide, making it a rare phenomenon. Differential diagnosis with other conditions, namely AGEP and pustular psoriasis (PP), might prove challenging. We present a case of a 52-year-old woman who came to our clinic with a 2-day pustular eruption of the acral areas that arose after a streptococcal pharyngitis. A skin biopsy was performed and revealed a dense neutrophilic infiltrate around the superficial dermis with microabscess formation in the dermal papillae, which was consistent with the diagnosis of post-streptococcal pustulosis. The patient was treated with topical steroids and the lesions resolved within 2 weeks. In this paper, we highlight this rare entity and provide some clinical clues that may help distinguish this disease from AGEP and PP.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"1035-1041"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163394","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}

{"title":"Case Series of Ocular Oncocytoma of the Caruncle, Conjunctiva, and Eyelid","authors":"Janie Leathers,&nbsp;Laura Russell,&nbsp;Peter Chow,&nbsp;M. Yadira Hurley,&nbsp;Gillian Heinecke","doi":"10.1111/cup.70133","DOIUrl":"10.1111/cup.70133","url":null,"abstract":"<div>\u0000 \u0000 <p>Periocular oncocytomas are a benign proliferation of oncocytic cells. As this entity has been better documented in ophthalmology literature than dermatopathology literature, we present three original cases of periocular oncocytomas with their histologic descriptions and immunohistochemical staining patterns. All three cases demonstrated dermal proliferations of eosinophilic cells with granular cytoplasm. As these lesions typically resolve completely with surgical excision, recognition of these entities can help guide appropriate management.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"990-993"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147929475","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}

{"title":"Pregnancy Associated Atypical Onychopapilloma: A Novel Presentation of an Emerging Entity in Dermatopathology","authors":"Carli Tucci,&nbsp;Erika Koh,&nbsp;John A. Carucci,&nbsp;Adam I. Rubin","doi":"10.1111/cup.70149","DOIUrl":"10.1111/cup.70149","url":null,"abstract":"<div>\u0000 \u0000 <p>Onychopapilloma (OP) is a benign nail unit tumor of the distal nail matrix and nail bed that typically presents as solitary longitudinal erythronychia with distal subungual hyperkeratosis and focal onycholysis. Atypical OP is a newly recognized and evolving concept in dermatopathology. Herein, we present a histopathologically-proven atypical OP with a classic clinical appearance that developed during pregnancy. A 37-year-old Gravida two Para one woman presented with a red longitudinal band on the left thumbnail that appeared during the first trimester of an uncomplicated pregnancy. The lesion was asymptomatic; however, it was gradually increasing in size, prompting a longitudinal excisional biopsy of the lesion post-partum. Histopathologic evaluation of the nail unit revealed common features of an OP, including acanthosis and papillomatosis of the nail bed with focal matrix metaplasia. There were focal areas of cytologic atypia and mitotic figures with corresponding increased suprabasilar Ki-67 expression. The tumor was excised with Mohs micrographic surgery in one stage, and the resulting defect healed with secondary intention. No recurrence was observed at 6-month follow-up. This case expands the current literature on histopathologically-proven atypical OP and describes the novel occurrence during pregnancy.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"1012-1015"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015384","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}

{"title":"Cutaneous P. lilacinum Hyalohyphomycosis Infection: Atypical Histomorphology in an Immunocompetent Patient","authors":"Alexandra Hill-Ricciuti,&nbsp;Roman Drozdowski,&nbsp;Brett Sloan,&nbsp;P. Rocco LaSala,&nbsp;Michael Murphy","doi":"10.1111/cup.70151","DOIUrl":"10.1111/cup.70151","url":null,"abstract":"<div>\u0000 \u0000 <p>Hyalohyphomycosis is an opportunistic fungal infection caused by a variety of environmental, hyaline (i.e., non-pigmented) molds and is often associated with skin and/or systemic manifestations in immuncompromised individuals. Herein, we describe a case of a 73-year-old immunocompetent individual who recently immigrated from Cambodia with cutaneous hyalohyphomycosis caused by <i>Purpureocillium lilacinum</i>. The patient presented with pruritic, pink-to-violaceous, linear plaques and papules on the right dorsal forearm that had been present for 2–3 years. Biopsy showed superficial granulomatous dermatitis without appreciable fungal forms on H&amp;E staining; special stains revealed non-pigmented, fungal elements, prompting tissue culture, from which a filamentous fungus exhibiting pale mauve colonies was recovered. Phenotypic and morphologic features were consistent with <i>Paecilyomyces</i> spp., and the identity was confirmed as <i>Purpureocillium lilacinum</i> (formerly <i>Paecilomyces lilacinus</i>) by reference lab testing. The patient was successfully treated with oral terbinafine, with lesions resolving by 12 weeks post-treatment. This study examines the clinical features of hyalohyphomycosis and summarizes the relevant literature, including treatment guidelines and antifungal susceptibility patterns. It also emphasizes the importance of histopathology and microbiologic culture in the diagnosis of cutaneous fungal infections.</p>\u0000 </div>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"1030-1034"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148984","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}

{"title":"Profile of a Founder: Herbert Zachareus Lund","authors":"Jayson Miedema","doi":"10.1111/cup.70169","DOIUrl":"10.1111/cup.70169","url":null,"abstract":"","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":"53 11","pages":"975-977"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352064","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}