DermatopathologyPub Date : 2023-12-21DOI: 10.3390/dermatopathology11010001
Chau M. Bui, H. Vuong, Minh-Khang Le, Kristin J Rybski, Hatice B Zengin, Haiming Tang, Bruce R. Smoller
{"title":"Claudin-4 Upregulation in Acantholytic and Autoimmune-Mediated Bullous Disorders","authors":"Chau M. Bui, H. Vuong, Minh-Khang Le, Kristin J Rybski, Hatice B Zengin, Haiming Tang, Bruce R. Smoller","doi":"10.3390/dermatopathology11010001","DOIUrl":"https://doi.org/10.3390/dermatopathology11010001","url":null,"abstract":"Claudin-4 is a key component of tight junctions, which play an important role in the formation of the epidermal barrier by forming a circumferential network in the granular layer that serves as a gatekeeper of the paracellular pathway. The aim of this study is to illustrate claudin-4 immunohistochemical staining patterns of different blistering disorders. We collected 35 cases, including two Hailey–Hailey disease, one Darier disease, three Grover disease, one acantholytic acanthoma, two warty dyskeratoma, 11 pemphigus vulgaris (PV) including six mucosal PV, and two pemphigus foliaceus. For comparison, we included five cases of normal skin, five eczema, and three bullous pemphigoid cases. Claudin-4 demonstrated weak-to-moderate expression in keratinocytes located in the stratum granulosum, keratinocytes surrounding hair follicles, and adnexal glands. Further, claudin-4 exhibited moderate-to-strong membranous staining in disrupted keratinocytes surrounding and within the acantholytic and bullous areas in 16/22 of the acantholytic cases (not seen in the six cases of mucosal PV) and all three bullous pemphigoids. This finding suggests that claudin-4 is upregulated in these conditions, which may be a compensatory response to the disrupted barrier function. This finding could shed light on the molecular mechanisms underlying disrupted barrier function in blistering disorders, independent of the specific underlying disease mechanism.","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"136 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138953346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DermatopathologyPub Date : 2023-11-21DOI: 10.3390/dermatopathology10040039
Isabella I Sanchez, Henry O Herrera, Ashley Elsensohn, Bonnie A Lee, Christina N Kraus
{"title":"Dermatomyositis with Eosinophils.","authors":"Isabella I Sanchez, Henry O Herrera, Ashley Elsensohn, Bonnie A Lee, Christina N Kraus","doi":"10.3390/dermatopathology10040039","DOIUrl":"10.3390/dermatopathology10040039","url":null,"abstract":"<p><p>Dermatomyositis is an idiopathic inflammatory myopathy that often presents with symmetric proximal skeletal muscle weakness and characteristic skin findings. Typical skin biopsy findings include vacuolar changes of the basal layer, increased dermal mucin, and a predominantly lymphocytic infiltrate. We report a case of dermatomyositis presenting as intensely pruritic papules and plaques, with initial histopathology being atypical of dermatomyositis due to the presence of eosinophils. The initial biopsy demonstrated a superficial dermatitis with eosinophils, initially thought to represent a drug eruption. A second biopsy of the same cutaneous manifestation was performed at a later time given high clinical suspicion for dermatomyositis and demonstrated a more classic vacuolar interface dermatitis with increased mucin and an absence of eosinophils. Notably, increased pruritus was specifically associated with the lesion that demonstrated tissue eosinophilia. The case illustrates the importance of considering tissue eosinophilia in the histologic presentation of dermatomyositis.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"10 4","pages":"310-317"},"PeriodicalIF":1.9,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10742320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832115","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}
DermatopathologyPub Date : 2023-10-23DOI: 10.3390/dermatopathology10040038
Haiming Tang, Kristin J Rybski, Yi Luan, Bruce R Smoller
{"title":"Folliculotropic Mycosis Fungoides Is Associated with Decreased PD1 Staining Compared with Classic Mycosis Fungoides.","authors":"Haiming Tang, Kristin J Rybski, Yi Luan, Bruce R Smoller","doi":"10.3390/dermatopathology10040038","DOIUrl":"10.3390/dermatopathology10040038","url":null,"abstract":"<p><p>Programmed cell death protein 1 (PD-1) plays a pivotal role in immune system regulation, with its expression levels linked to malignancy prognosis. However, existing reports on PD-1 staining in mycosis fungoides (MF) present conflicting findings, and little attention has been given to PD-1 staining in different MF variants. To address this, we conducted a retrospective study, employing immunohistochemistry to examine PD-1 expression in cases of folliculotropic MF and non-folliculotropic MF. We analyzed 24 cases of folliculotropic MF and 18 cases of non-folliculotropic MF, and recorded both the percentage of PD-1-labeled tumor cells and the intensity score (negative, weak, medium, or strong). Our results revealed significant disparity in PD-1 labeling between patch/plaque MF and folliculotropic MF (<i>p</i> = 0.028). Non-folliculotropic MF exhibited higher PD-1 labeling in tumor cells (58.3%) compared to folliculotropic MF (40.2%). Notably, there was no significant difference in PD-1 staining between folliculotropic MF and non-folliculotropic MF when both were in the early stage/indolent disease category. However, when considering the tumor stage, folliculotropic MF exhibited PD-1 staining in tumor cells at a rate of 21.1%, while non-folliculotropic MF showed PD-1 staining in tumor cells at a rate of 46.6% (<i>p</i> = 0.005). Additionally, among folliculotropic MF cases, 13 out of 24 cases displayed differing PD-1 expression patterns between epidermal and dermal components, with preserved PD-1 staining in the epidermal component and loss of staining in the dermal component. Furthermore, consistent with the prior literature, tumor cells with large cell transformations exhibited significantly lower PD-1 labeling (<i>p</i> = 0.017). Our findings showcase the unique PD-1 staining patterns in MF.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"10 4","pages":"303-309"},"PeriodicalIF":1.9,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692940","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":"The Effect of <i>Bacillus coagulans</i> Induced Interactions among Intestinal Bacteria, Metabolites, and Inflammatory Molecules in Improving Natural Skin Aging.","authors":"Keiichi Hiramoto, Sayaka Kubo, Keiko Tsuji, Daijiro Sugiyama, Yasutaka Iizuka, Hideo Hamano","doi":"10.3390/dermatopathology10040037","DOIUrl":"10.3390/dermatopathology10040037","url":null,"abstract":"<p><strong>Background: </strong>Lactic acid bacteria consumption serves several health benefits to humans. However, their effect on natural skin aging is still unclear.</p><p><strong>Methods: </strong>This study examined the effects of skin naturalization (particularly skin drying) by administering a spore-bearing lactic acid bacteria (<i>Bacillus coagulans</i>) in mice for 2 years.</p><p><strong>Results: </strong><i>B. coagulans</i> administration improved the natural skin of mice and significantly increased proportions of the genera <i>Bacteroides</i> and <i>Muribaculum</i>, among other intestinal bacteria. As metabolites, increases in nicotinic acid, putrescin, and pantothenic acid levels and a decrease in choline levels were observed. Increased hyaluronic acid, interleukin-10, and M2 macrophage levels indicate aging-related molecules in the skin. Intestinal permeability was also suppressed. Thus, these changes together improved natural skin aging.</p><p><strong>Conclusions: </strong>This study revealed that <i>B. coagulans</i> administration improved the natural skin aging in mice. This enhancement might be induced by the interaction of alterations in intestinal flora, metabolites, or inflammatory substances.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"10 4","pages":"287-302"},"PeriodicalIF":1.9,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692941","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}
DermatopathologyPub Date : 2022-10-20DOI: 10.3390/dermatopathology9040041
Gabriella Melson, Elie Saliba, Shreya Patel, Richard Eisen, Candice E Brem
{"title":"Clear Cell Acanthoma with Malignant Cytologic Features: A Case Report and Review of the Literature.","authors":"Gabriella Melson, Elie Saliba, Shreya Patel, Richard Eisen, Candice E Brem","doi":"10.3390/dermatopathology9040041","DOIUrl":"https://doi.org/10.3390/dermatopathology9040041","url":null,"abstract":"<p><p>Clear cell acanthoma (CCA) is classically considered a benign epidermal tumor, although rare case reports have described CCA with malignant features. Here, we present a case of a patient with a biopsy proven CCA that regrew post-biopsy and was subsequently completely excised. Histologic examination of the tumor in the excision specimen revealed malignant cytologic features that were not present in the initial biopsy. A review of the literature identified five additional cases of CCA with similar malignant cytologic features. On analysis, common histopathologic characteristics included cellular pleomorphism, increased nuclear-to-cytoplasmic ratio, prominent nucleoli, and atypical mitotic figures. We support the designation of atypical clear cell acanthoma for these entities with features of both CCA and significant cytologic atypia. As none of these cases exhibited clinically aggressive behavior, further study is warranted.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"355-360"},"PeriodicalIF":1.9,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9590090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40583977","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}
DermatopathologyPub Date : 2022-10-13DOI: 10.3390/dermatopathology9040040
Michelle Weiting Liang, Joel H L Lim, Hui Yi Chia, Shang-Ian Tee, Joyce S S Lee
{"title":"Reactive Epidermal Hyperplasia and Angiogenesis of the Rear (REAR): A Proposed Unifying Name for Senile Gluteal Dermatosis and Prurigiform Angiomatosis.","authors":"Michelle Weiting Liang, Joel H L Lim, Hui Yi Chia, Shang-Ian Tee, Joyce S S Lee","doi":"10.3390/dermatopathology9040040","DOIUrl":"https://doi.org/10.3390/dermatopathology9040040","url":null,"abstract":"<p><p>Senile gluteal dermatosis (SGD) is a common but seldom recognized condition. It is characterized clinically by unilateral or bilateral hyperkeratotic, lichenified plaques on the gluteal area, being attributed to prolonged sitting, particularly in the elderly. SGD also encompasses the recently proposed entity of prurigiform angiomatosis. Histologically, there are features of lichenification, such as epidermal hyperplasia and a preserved granular layer, with prominent dermal angioproliferation. We report 4 cases of this condition as well as novel findings of variably increased mast cells and superficial lymphatic vessels in addition to the proliferation of dermal blood vessels. We propose a unifying name for Reactive Epidermal hyperplasia and Angiogenesis of the Rear (REAR) to encapsulate the characteristic clinical and histological features of this distinct entity.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"343-354"},"PeriodicalIF":1.9,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9590008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40583976","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}
DermatopathologyPub Date : 2022-10-01DOI: 10.1007/978-3-030-82820-2
Werner Kempf, Markus Hantschke, H. Kutzner
{"title":"Dermatopathology","authors":"Werner Kempf, Markus Hantschke, H. Kutzner","doi":"10.1007/978-3-030-82820-2","DOIUrl":"https://doi.org/10.1007/978-3-030-82820-2","url":null,"abstract":"","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50980086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Rare Case of Blastic Plasmacytoid Dendritic Cell Neoplasm in a Child Mimicking Lymphoma/Leukemia Cutis.","authors":"Phanitchanat Phusuphitchayanan, Voraphol Vejjabhinanta, Chayamon Takpradit, Poonnawis Sudtikoonaseth, Manasmon Chairatchaneeboon, Thamonpan Kiatvichukul, Sanya Sukpanichnant","doi":"10.3390/dermatopathology9040038","DOIUrl":"https://doi.org/10.3390/dermatopathology9040038","url":null,"abstract":"<p><p>Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare tumor that affects elderly individuals and presents a poor prognosis. Skin is the most common site of involvement, accounting for 89% of the cases. Extracutaneous organs, especially bone marrow, lymph nodes, and peripheral blood, can be involved at the time of diagnosis. We report a case of BPDCN in a child, presenting with a cutaneous lesion mimicking lymphoma or leukemia cutis. The histologic findings revealed a dense diffuse infiltration by monomorphic agranular medium-sized blast cells with sparing of the grenz zone, whose first immunophenotypic profile raised the possibility of diagnosing B lymphoblastic lymphoma or leukemia. However, the absence of CD10 expression and strongly positive expression for CD4, CD56, CD45RA, and the plasmacytoid dendritic cell-associated antigens, including CD123, supported the definite diagnosis of BPDCN. The patient responded well to a systemic combination chemotherapy regimen, modified from the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) protocol for anaplastic large cell lymphoma (ALCL), that differed from the established recommendation using ALL protocol. Owing to the patient's excellent treatment outcome, this regimen could represent an effective alternative regimen for BPDCN in children.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"321-326"},"PeriodicalIF":1.9,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9590061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40568287","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":"Cutaneous Involvement of Extranodal NK/T Cell Lymphoma, Nasal Type, a Clinical and Histopathological Mimicker of Various Skin Diseases.","authors":"Preeyawat Ngamdamrongkiat, Sanya Sukpanichnant, Manasmon Chairatchaneeboon, Archrob Khuhapinant, Panitta Sitthinamsuwan","doi":"10.3390/dermatopathology9030037","DOIUrl":"https://doi.org/10.3390/dermatopathology9030037","url":null,"abstract":"<p><strong>Background: </strong>Extranodal NK/T cell lymphoma, nasal type (ENK/T) with cutaneous involvement has various histopathological findings and diverse clinical manifestations.</p><p><strong>Methods: </strong>A retrospective study of cutaneous involvement of ENK/T lymphoma between 2006 and 2018 was conducted.</p><p><strong>Results: </strong>Twenty-two cases were eligible for this study. Twelve cases could be proven as secondary cutaneous involvement by ENK/T lymphoma, while the remaining could not be confirmed as primary cutaneous ENK/T lymphoma. The histopathological patterns included dermal and subcutaneous nodular infiltration pattern in 11/22 cases (50%), lobular panniculitis pattern in 6/22 cases (27.3%), interface dermatitis pattern in 4/22 cases (18.2%), and granulomatous dermatitis pattern in 1/22 case (4.5%). The median follow-up was 18.3 months. Overall, the one-year and five-year survival rates were 31.3% and 13.3%, respectively.</p><p><strong>Conclusions: </strong>A variety of histopathological patterns of cutaneous involvement by ENK/T lymphoma should be differentiated from other cutaneous lymphomas, dermatitis, and infection. When atypical medium or large-sized lymphoid cells are encountered within skin lesions, pathologists should realize these lesions can be ENK/T lymphoma, especially in cases with coexisting tumor necrosis or angioinvasion. A complete evaluation of the upper aerodigestive tract is mandatory to identify the occult primary site of ENK/T lymphoma before establishing primary cutaneous ENK/T lymphoma.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"307-320"},"PeriodicalIF":1.9,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33469847","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}