{"title":"Primary Systemic Amyloidosis Characterized by Multiple Keratinous Cysts: A Case Report.","authors":"Xiaoou Lu, Weiwei Fu, Demin Xie, Fengjuan Li, Jiali Zhang, Da Wang, Yu Sun, Hongquan Chen","doi":"10.1111/cup.14763","DOIUrl":"https://doi.org/10.1111/cup.14763","url":null,"abstract":"<p><p>A 67-year-old male presented with plaques around the orbit and ecchymosis on the neck and back of hands for 2 years. Physical examination showed seborrheic-keratosis-like plaques around the orbit, ecchymosis on the neck and back of hands, as well as nail dystrophy. Serum λ light chain was positive. Histopathological examination demonstrated multiple keratinous cysts in the dermis and eosinophilic homogeneous material in the dermis, which was positive for Congo red with apple-green birefringence on polarized light. Kidney biopsy showed deposition of acellular eosinophilic material in the arteriole wall. Congo red staining was positive. A bone marrow biopsy revealed multiple myeloma. The diagnosis of primary systemic amyloidosis with multiple myeloma was made.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864388","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}
Spencer Ng, Carla Stephan, Mytrang Do, Denise Frosina, Achim Jungbluth, Klaus J Busam, Linglei Ma
{"title":"Detecting Monkeypox Virus by Immunohistochemistry.","authors":"Spencer Ng, Carla Stephan, Mytrang Do, Denise Frosina, Achim Jungbluth, Klaus J Busam, Linglei Ma","doi":"10.1111/cup.14776","DOIUrl":"https://doi.org/10.1111/cup.14776","url":null,"abstract":"<p><strong>Background: </strong>Mpox (formerly known as monkeypox), a zoonotic disease caused by Monkeypox virus (MPXV), has become an international outbreak since May 2022. Mpox often presents with a mild systemic illness and a characteristic vesiculopustular skin eruption. In addition to molecular testing, histopathology of cutaneous lesions usually shows distinctive findings, such as epidermal necrosis, balloon degeneration, papillary dermal edema, and focal dermal necrosis, which have proven helpful in the diagnosis of mpox. Viral cytopathic changes with areas of multinucleation, smudging of the nuclei, and intracytoplasmic inclusions have also been described. Although useful, these features are relatively nonspecific. The use of a monoclonal antibody for immunohistochemical (IHC) staining of MPXV may be a useful tool in confirming mpox infection.</p><p><strong>Methods: </strong>Three cases of PCR-confirmed mpox were biopsied and subjected to IHC staining with a monoclonal MPXV-specific antibody targeting viral envelope protein A29. As controls, cell lines transduced to express other MPXV viral antigens and samples of cutaneous viral infections involving Molluscum contagiosum, Herpes simplex, Herpes zoster, or Cytomegalovirus were also subjected to IHC staining with this antibody.</p><p><strong>Results: </strong>All three mpox patient biopsies performed on lesional skin subjected to MPXV IHC staining reliably detected viral infection in lesional skin with a diffuse cytoplasmic and focally nuclear staining pattern. No staining was seen in transduced cell lines expressing off-target MPXV viral antigens and in lesional skin of other common viral infections listed above.</p><p><strong>Conclusions: </strong>The monoclonal MPXV-specific antibody may be used as an adjunct tool to confirm mpox infection.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854034","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}
Carlos Manuel Martorell Moreau, Beatriz Bartolomé González, Alberto Danilo Escobar Oblitas, Carlos Saus Sarrias
{"title":"Extensive Leg Ulcers in a Patient With Monoclonal Gammopathy.","authors":"Carlos Manuel Martorell Moreau, Beatriz Bartolomé González, Alberto Danilo Escobar Oblitas, Carlos Saus Sarrias","doi":"10.1111/cup.14777","DOIUrl":"https://doi.org/10.1111/cup.14777","url":null,"abstract":"<p><p>A 60-year-old male was admitted from the emergency department with extensive leg ulcers and polyarticular joint pain. Cryocrystalglobulinemia was diagnosed through positive cryoglobulin studies and characteristic histopathological findings. Treatment with bortezomib led to complete clinical resolution. Cryocrystalglobulinemia poses diagnostic and management challenges, highlighting the importance of interdisciplinary collaboration for optimal patient care.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846843","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}
Tatsiana Pukhalskaya, Mitchell Finkelstein, Dacia A Miyake-Caballero, Michael T Tetzlaff, Jeffrey P North, Jarish N Cohen
{"title":"Cytokine Profiling of Erythroderma Biopsies Reveals Types 2 and 17 Immune Activation Status.","authors":"Tatsiana Pukhalskaya, Mitchell Finkelstein, Dacia A Miyake-Caballero, Michael T Tetzlaff, Jeffrey P North, Jarish N Cohen","doi":"10.1111/cup.14775","DOIUrl":"https://doi.org/10.1111/cup.14775","url":null,"abstract":"<p><strong>Background: </strong>Erythroderma is a dermatologic condition characterized by widespread red and scaly skin. The causes include, but are not limited to, psoriasis, eczema, drug eruptions, pityriasis rubra pilaris (PRP), and cutaneous T-cell lymphoma. Most of these are typified by Type 2 (e.g., eczema) or Type 17 (e.g., psoriasis) immune activation. However, since the clinicopathologic features of erythroderma can be nonspecific, assays that determine the underlying immune activation status are desirable.</p><p><strong>Methods: </strong>IL-13 RNA in situ hybridization and IL-36 immunohistochemistry were performed on 30 specimens of erythroderma, to ascertain Type 2 and Type 17 immune signatures, respectively.</p><p><strong>Results: </strong>Specimens of erythrodermic psoriasis and PRP showed strong expression of IL-36 and less than one IL-13-positive cell per millimeter. Conversely, those of spongiotic dermatitis showed low expression of IL-36 and greater than one IL-13-positive cell per millimeter. Most specimens of spongiotic, psoriasiform dermatitis demonstrated low IL-36 expression and greater than one IL-13-positive cell per millimeter, but a subset showed high IL-36 expression and greater than one IL-13-positive cell per millimeter.</p><p><strong>Conclusions: </strong>We developed a Type 2/17 immune signature classifier based on cytokine profiling, which showed that cases of erythroderma fall within distinct categories of immune activation. This categorization may have utility in guiding clinical decisions.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813377","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":"Foamy Cell Angiosarcoma Resembling a Xanthomatous Histiocytic Infiltrate Without Evidence of Vascular Malignancy.","authors":"Jolee Potts, George J Harocopos, Aaron J Russell","doi":"10.1111/cup.14772","DOIUrl":"https://doi.org/10.1111/cup.14772","url":null,"abstract":"<p><p>Angiosarcoma is a rare and aggressive malignancy of endothelial cells with multiple subtypes. Foamy cell angiosarcoma is a rare variant in which endothelial cells demonstrate \"foamy\" cytoplasmic change. We present the case of a 59-year-old male who presented with progressive erythema and swelling of the midface and bilateral eyelids. Two biopsies obtained 3 months apart showed an infiltrate of foamy mononuclear cells in the deep dermis, resembling a xanthomatous histiocytic process. Clinical work-up for disorders including Erdheim-Chester disease, Langerhans cell histiocytosis, and necrobiotic xanthogranuloma was negative. Nine months later, a third set of biopsies was performed showing a similar infiltrate of foamy histiocyte-like cells within the deep dermis. However, there was also a dermal proliferation of irregular vascular spaces lined by atypical endothelial cells, diagnostic of angiosarcoma. Subsequent immunohistochemical stains demonstrated expression of CD31 and ERG within the foamy cells in both sets of biopsies, strongly suggesting endothelial lineage and supporting a diagnosis of foamy cell angiosarcoma. CD34 was negative. This case represents a very unusual presentation of angiosarcoma and a diagnostic conundrum. In cases such as these, especially when features of a vascular proliferation are absent, ERG appears to be the most useful marker for differentiating foamy cell angiosarcoma from histopathologic mimickers.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791928","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}
Hermin Aminah Usman, Fitria Sholihah, Birgitta M Dewayani, Octavianus Giovani
{"title":"The Roles of Vitamin D Receptor (VDR) and CD8+ T-Lymphocytes in Acral and Mucosal Melanoma Invasion Depth.","authors":"Hermin Aminah Usman, Fitria Sholihah, Birgitta M Dewayani, Octavianus Giovani","doi":"10.1111/cup.14771","DOIUrl":"https://doi.org/10.1111/cup.14771","url":null,"abstract":"<p><strong>Background: </strong>Acral and mucosal melanomas, the most common sun-shielded site melanoma subtypes in Asia and Indonesia, often yield poor prognoses. The invasion depth reflects their progressivity, and the pathogenesis is influenced by vitamin D receptor (VDR) status and CD8+ T-Lymphocyte amount. This study aims to determine the association between the invasion depth of acral and mucosal melanomas with their VDR and CD8+ immunoexpression.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted on 60 formalin-fixed paraffin-embedded (FPPE) samples, with equal representation in acral and mucosal melanoma groups from 2017 to 2021. The samples were assessed for the invasion depth and immunoexpression of VDR and CD8+. A chi-square test with an alternative Exact-Fisher analysis was used to determine the association between the variables in both subtype groups.</p><p><strong>Results: </strong>An association between VDR and CD8+ immunoexpression and invasion depth in acral melanoma (p value = 0.0001 and 0.009, respectively) was observed, while only VDR immunoexpression was associated with the invasion depth in mucosal melanoma (p-value =0.004). Interestingly, no association was found between CD8+ immunoexpression and the invasion depth in mucosal melanoma (p = 0.640).</p><p><strong>Conclusion: </strong>The role of VDR and CD8+ T-lymphocytes are inversely associated with melanoma depth in acral melanoma, while only VDR is associated with melanoma depth in mucosal melanoma.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780244","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":"Adolescent Superficial CD34-Positive Fibroblastic Tumor With Unique IHC Profile.","authors":"Scott Kuan-Wen Wang, Srinivas Mandavilli","doi":"10.1111/cup.14770","DOIUrl":"https://doi.org/10.1111/cup.14770","url":null,"abstract":"<p><p>Superficial CD34-positive fibroblastic tumor (SCD34FT) is a relatively uncommon soft tissue neoplasm, first identified in 2014 and included in the latest, fifth edition of the World Health Organization Soft Tissue and Bone Tumors Classification. A subset of SCD34FTs that exhibit PRDM10 rearrangement may overlap with other PRDM10-rearranged soft tissue tumors, suggesting a shared pathogenic pathway. We report a case of a 16-year-old patient, one of the youngest diagnosed, with an SCD34FT on the forearm, featuring both PRDM10 rearrangement and a unique, diffuse expression of cytokeratin (CK AE1/AE3). This case contributes to the expanding literature on SCD34FT, highlighting its clinical and pathological diversity.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785919","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}
Seraphima Sidhom, Eric Yang, Asha Gowda, Lori S Kim, Leslie Robinson-Bostom, Cathy Massoud
{"title":"Atypical Type 2 Lepra Reaction Masquerading as Recurrent Sweet Syndrome.","authors":"Seraphima Sidhom, Eric Yang, Asha Gowda, Lori S Kim, Leslie Robinson-Bostom, Cathy Massoud","doi":"10.1111/cup.14762","DOIUrl":"https://doi.org/10.1111/cup.14762","url":null,"abstract":"<p><p>Erythema nodosum leprosum (ENL) is an immune complex-mediated response in Mycobacterium leprae infection, presenting with fever, arthralgias, and tender cutaneous lesions. It mimics Sweet syndrome (SS) clinically and histologically but requires distinct management. A 65-year-old man with recent travel presented with fever and edematous plaques. Initial findings supported SS, improving with corticosteroids. Symptom recurrence and a contact's leprosy diagnosis led to further testing, revealing M. leprae through repeat staining and tissue PCR. This case underscores the need to consider ENL in Sweet-like cases with relevant travel history. Repeat staining and molecular testing are essential for accurate diagnosis and treatment.</p>","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780239","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":"Diagnostic Accuracy of Treponema pallidum Immunostaining in a Cohort of Patients With Secondary Syphilis.","authors":"Luis J Borda, Ryan C Saal, Robert J Pariser","doi":"10.1111/cup.14760","DOIUrl":"https://doi.org/10.1111/cup.14760","url":null,"abstract":"","PeriodicalId":15407,"journal":{"name":"Journal of Cutaneous Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780242","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}