Dermatopathology最新文献

{"title":"Dysplastic Nevi and Superficial Borderline Atypical Melanocytic Lesions: Description of an Algorithmic Clinico-Pathological Classification.","authors":"Sébastien Menzinger, Rastine Merat, Gürkan Kaya","doi":"10.3390/dermatopathology12010003","DOIUrl":"10.3390/dermatopathology12010003","url":null,"abstract":"<p><p>The diagnosis, interpretation, and classification of melanocytic tumors is a very complex topic in the pathology and dermatopathology field that lacks standardization and is still subject to discordance and debate. Here, we review the definitions of dysplastic nevus and superficial atypical melanocytic proliferations and provide an overview of some areas still subject to debate and some attempts of standardization. Furthermore, we describe an algorithmic classification, and provide some examples of clinico-pathological correlation. This step-by-step algorithm has an educational purpose and may automatize the work of dermatopathologists. We hope that through further molecular studies, this fine-grained scheme will prove to be related to the biological behavior of these atypical melanocytic lesions.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"12 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Violaceous Nodules on the Left Forearm of an Immunosuppressed Patient Following Heart Transplantation for Cardiac Amyloidosis.","authors":"Zachary Corey, Lydia A Luu, Sabrina Newman, Shyam S Raghavan","doi":"10.3390/dermatopathology12010002","DOIUrl":"10.3390/dermatopathology12010002","url":null,"abstract":"<p><p>We present the case of a 60-year-old immunocompromised man who presented with two pruritic pink-red indurated nodules with overlying scale and focal areas of ulceration on his left dorsal and left medial forearm, which evolved over a 2-month period. The pathology showed numerous fungal hyphae present that were pauci-septate with various branched angles and variable hyphal thickness. Fungal cultures grew <i>Rhizopus</i> species and a universal fungal PCR detected the <i>Rhizopus oryzae</i> complex. Based on the clinicopathologic correlation, the diagnosis of cutaneous mucormycosis was made. Cutaneous mucormycosis is an aggressive fungal infection of the <i>Mucorales</i> family occurring after the inoculation of fungal spores in disrupted skin. It usually presents as a necrotic eschar but can also present as cellulitis that evolves into a necrotic ulcer. A prompt diagnosis is critical for the effective management of cutaneous mucormycosis. The treatment includes an immediate systemic treatment with amphotericin B and a surgical debridement of the necrotic regions. Given the wide range of presenting symptoms, clinical suspicion for this emergent condition must remain high in immunocompromised and diabetic patients.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"12 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Squamomelanocytic Tumor, An Entity Still Shrouded in Mystery: Case Report and Literature Review.","authors":"Joana Sorino, Mario Della Mura, Anna Colagrande, Cecilia Salzillo, Giuseppe Ingravallo, Gerardo Cazzato","doi":"10.3390/dermatopathology12010001","DOIUrl":"10.3390/dermatopathology12010001","url":null,"abstract":"<p><p>Cutaneous squamomelanocytic tumor (SMT) is a very rare cutaneous malignancy, composed of a dual phenotypic population of both malignant melanocytes and keratinocytes, intimately intermingled together. Herein, we report a new case of a SMT occurring in an 82-year-old man, located on the scalp. Histopathology revealed a mixed population consisting of squamous cell carcinoma and melanoma within the same lesion, also confirmed using immunohistochemical staining for high molecular-weight cytokeratins (HMWCKs) and Melan-A. Moreover, to the best of our knowledge, for the first time, we tested SMT for the preferentially expressed antigen in melanoma (PRAME), which revealed a strong and diffuse positivity in the melanocytic component. These tumors need to be distinguished by more frequent collision tumors and colonization. Furthermore, we provide a comprehensive review of the literature, focusing on clinical and histopathological aspects, biological behavior and still-debated, but fascinating histogenesis of this elusive entity.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"12 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Pitfalls of IgG4 Immunohistochemical Staining on Lesional Tissue in Cutaneous Acantholytic Disorders.","authors":"Carla Stephan, Linglei Ma","doi":"10.3390/dermatopathology11040041","DOIUrl":"10.3390/dermatopathology11040041","url":null,"abstract":"<p><p>The diagnostic utility of immunohistochemistry on paraffin-embedded sections in bullous disorders is useful when frozen tissue is not available. In pemphigus vulgaris and pemphigus foliaceus, an intercellular lace-like staining pattern of IgG4 on lesional tissue by immunohistochemistry has been described, with a comparable sensitivity and specificity to direct immunofluorescence on perilesional tissue. This study aimed to evaluate the staining pattern of IgG4 in non-immunobullous disorders to highlight the potential pitfalls when using this stain. In this study, we conducted a retrospective review of our institution's database of non-immunobullous disorders where immunohistochemistry of IgG4 was performed to rule out pemphigus. We identified 27 cases where IgG4 immunohistochemistry was performed and observed intercellular IgG4 staining in some cases of Grover disease, bullous impetigo, irritated dermal hypersensitivity reaction, acantholytic actinic keratosis, and graft versus host disease. Our results indicate that the interpretation of IgG4 staining by immunohistochemistry in cutaneous acantholytic disorders should be approached with caution. Confirmation on cryosections with direct immunofluorescence study results is important in these settings.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"377-382"},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Insights in Paediatric Dermatopathology-2nd Edition.","authors":"Sylvie Fraitag","doi":"10.3390/dermatopathology11040040","DOIUrl":"10.3390/dermatopathology11040040","url":null,"abstract":"<p><p>Paediatric dermatology is still an expanding subspeciality, which is well illustrated by the growing number of books and articles that have been published on this subject in recent years [...].</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"374-376"},"PeriodicalIF":1.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRAME Staining of Adnexal Lesions and Common Skin Cancer Types: Biomarker with Potential Diagnostic Utility.","authors":"Hisham F Bahmad, John Alexis","doi":"10.3390/dermatopathology11040039","DOIUrl":"10.3390/dermatopathology11040039","url":null,"abstract":"<p><p>PRAME (PReferentially expressed Antigen in MElanoma) is a tumor-associated antigen first identified in tumor-reactive T-cell clones derived from a patient with metastatic melanoma. Immunohistochemistry (IHC) for PRAME is useful for diagnostic purposes to support a suspected diagnosis of melanoma. Anecdotally, PRAME has been observed to stain sebaceous units in glands in background skin. We examined the expression of PRAME in adnexal lesions and common skin cancers to determine whether it is of potential diagnostic utility in supporting the differentiation between sebaceous and non-sebaceous lesions. IRB approval from Mount Sinai Medical Center (MSMC) was obtained. This is a single-center retrospective cohort analysis over a ten-year period (1 January 2012, and 31 December 2023). We used the pathological database of skin lesions, including sebaceous, sweat gland, and follicular lesions, in addition to basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), from 81 patients who underwent shave/punch biopsies or surgical excisions. We evaluated the IHC staining percentage positivity and intensity for PRAME. Staining intensity was subcategorized into negative, weak, moderate, and strong, whereas expression percentage positivity was subcategorized into 0%, 1-25%, 26-50%, 51-75%, and 76-100%. Most sebaceous versus non-sebaceous lesions exhibited cytoplasmic staining of moderate to strong intensity in >75% of cells. PRAME has a sensitivity and specificity of 100.0% and 86.7%, respectively, to support distinguishing between sebaceous and non-sebaceous adnexal lesions (regardless of whether they are benign or malignant). BCCs and SCCs showed weak to moderate nuclear staining for PRAME in >75% of cells. None of the 13 lesions of hair follicle origin showed any staining. A total of 26 of the 32 lesions of sweat gland origin were negative while 6 (18.75%) showed positive staining. In conclusion, we confirm the potential utility of PRAME for supporting the distinction between sebaceous and non-sebaceous adnexal lesions on one hand, and on the other, distinguishing BCC and SCC that may show nuclear staining from sebaceous carcinoma that shows cytoplasmic staining.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"364-373"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of a Malignant Proliferating Trichilemmal Tumor: A Molecular Study Harboring Potential Therapeutic Significance and a Review of Literature.","authors":"Mokhtar H Abdelhammed, Hanna Siatecka, A Hafeez Diwan, Christie J Finch, Angela D Haskins, David J Hernandez, Ya Xu","doi":"10.3390/dermatopathology11040038","DOIUrl":"10.3390/dermatopathology11040038","url":null,"abstract":"<p><p>Malignant proliferating trichilemmal tumors (MPTTs), arising from the external root sheath of hair follicles, are exceptionally rare, with limited documentation of their genetic alterations. We present a case of a 64-year-old African American woman who initially presented with a gradually enlarging nodule on her posterior scalp. An initial biopsy at an outside hospital suggested metastatic adenocarcinoma or squamous cell carcinoma (SCC) of an uncertain origin. A subsequent wide local excision revealed a 2.0 cm tumor demonstrating characteristic trichilemmal keratinization, characterized by an abrupt transition from the nucleated epithelium to a laminated keratinized layer, confirming MPTT. Immunohistochemistry demonstrated diffuse p53 expression, patchy CD 34 expression, focal HER2 membranous expression, and patchy p16 staining (negative HPV ISH). A molecular analysis identified TP53 mutation and amplifications in the ERBB2 (HER2), BRD4, and TYMS. Additional gene mutations of uncertain significance included HSPH1, ATM, PDCD1 (PD-1), BARD1, MSH3, LRP1B, KMT2C (MLL3), GNA11, and RUNX1. Assessments for the homologous recombination deficiency, PD-L1 expression, gene rearrangement, altered splicing, and DNA mismatch repair gene expression were negative. The confirmation of ERBB2 (HER2) amplification in the MPTT through a molecular analysis suggests potential therapeutic avenues involving anti-HER2 monoclonal antibodies. The presence of the TP53 mutation, without the concurrent gene mutations typically observed in SCC, significantly aided in this differential diagnosis.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"354-363"},"PeriodicalIF":1.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Papillary Adenocarcinoma Is HPV-42-Associated and BRAFV600E Negative: Perspectives for Diagnostic Practice.","authors":"Tassilo Dege, Arno Rütten, Matthias Goebeler, Hermann Kneitz","doi":"10.3390/dermatopathology11040037","DOIUrl":"10.3390/dermatopathology11040037","url":null,"abstract":"<p><p>Digital papillary adenocarcinoma (DPAC) is a rare, low-grade sweat gland carcinoma primarily found on the hands, fingers, or toes and predominantly affecting males. Distinguishing DPAC from benign sweat gland tumors can be challenging. We present the case of a 52-year-old patient with a progressive tumor on the finger initially misdiagnosed as a viral wart. Histological examination revealed a cytologically basophilic sweat gland tumor with tubular structures, papillary protrusions, and a characteristic immunohistochemical staining pattern for CK 7 and Actin. HPV-42 positivity and molecular analysis confirmed the diagnosis of DPAC. HPV-42 has been strongly associated with DPAC. Additionally, p16 positivity and BRAFV600E negativity were observed. These findings aid in the differential diagnosis of acral sweat gland tumors and guide clinical management, including with respect to the potential for recurrence and metastasis.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"348-353"},"PeriodicalIF":1.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Presentation of Spindle Cell Lipoma in a Young Male with a History of Malignant Melanoma.","authors":"Ty Theriot, John David Cattar, Lacey Falgout, Nicholas Culotta, Christopher Haas","doi":"10.3390/dermatopathology11040036","DOIUrl":"10.3390/dermatopathology11040036","url":null,"abstract":"<p><p>Spindle cell lipoma (SCL) is a benign adipocytic tumor usually found in the subcutis of the posterior neck, upper back, and shoulder, predominantly in middle-aged males. This case report describes an atypical presentation of SCL in a 26-year-old male with a history of malignant melanoma. The patient presented with an erythematous plaque with central hyperpigmentation on the right upper arm, an uncommon location and presentation for SCL. Histopathological examination revealed an atypical myxoid spindle cell neoplasm with CD34 positivity and an overlying mildly atypical compound melanocytic nevus. The unusual clinical and histological features, combined with the patient's melanoma history, complicated the differential diagnosis, which included dermatofibrosarcoma protuberans (DFSP) and solitary fibrous tumors (SFTs). A wide local excision with 2 cm margins was performed, and subsequent pathology confirmed clear margins, supporting the diagnosis of SCL. This case highlights the importance of including SCL in the differential diagnosis of CD34-positive spindle cell tumors, even when clinical and histological presentations are atypical, and underscores the need for thorough histopathological evaluation and a broad differential diagnosis in patients with a history of melanoma.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"342-347"},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Chasing Rainbows\" Beyond Kaposi Sarcoma's Dermoscopy: A Mini-Review.","authors":"Emmanouil Karampinis, Olga Toli, Georgia Pappa, Anna Vardiampasi, Melpomeni Theofili, Efterpi Zafiriou, Mattheos Bobos, Aimilios Lallas, Elizabeth Lazaridou, Biswanath Behera, Zoe Apalla","doi":"10.3390/dermatopathology11040035","DOIUrl":"10.3390/dermatopathology11040035","url":null,"abstract":"<p><p>The dermoscopic rainbow pattern (RP), also known as polychromatic pattern, is characterized by a multicolored appearance, resulting from the dispersion of polarized light as it penetrates various tissue components. Its separation into different wavelengths occurs according to the physics principles of scattering, absorption, and interference of light, creating the optical effect of RP. Even though the RP is regarded as a highly specific dermoscopic indicator of Kaposi's sarcoma, in the medical literature, it has also been documented as an atypical dermoscopic finding of other non-Kaposi skin entities. We aim to present two distinct cases-a pigmented basal cell carcinoma (pBCC) and an aneurysmatic dermatofibroma-that exhibited RP in dermoscopy and to conduct a thorough review of skin conditions that display RP, revealing any predisposing factors that could increase the likelihood of its occurrence in certain lesions. We identified 33 case reports and large-scale studies with diverse entities characterized by the presence of RP, including skin cancers (Merkel cell carcinoma, BCC, melanoma, etc.), adnexal tumors, special types of nevi (blue, deep penetrating), vascular lesions (acroangiodermatitis, strawberry angioma, angiokeratoma, aneurismatic dermatofibromas, etc.), granulation tissue, hypertrophic scars and fibrous lesions, skin infections (sporotrichosis and cutaneous leishmaniasis), and inflammatory dermatoses (lichen simplex and stasis dermatitis). According to our results, the majority of the lesions exhibiting the RP were located on the extremities. Identified precipitating factors included the nodular shape, lesion composition and vascularization, skin pigmentation, and lesions' depth and thickness. These parameters lead to increased scattering and interference of light, producing a spectrum of colors that resemble a rainbow.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"333-341"},"PeriodicalIF":1.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}