DermatopathologyPub Date : 2024-11-19DOI: 10.3390/dermatopathology11040033
Erin M McClure, Clay J Cockerell, Stephen Hammond, Evelyn S Marienberg, Bobby N Koneru, Jon Ward, Jeffrey B Stricker
{"title":"Image-Guided Radiation Therapy Is Equally Effective for Basal and Squamous Cell Carcinoma.","authors":"Erin M McClure, Clay J Cockerell, Stephen Hammond, Evelyn S Marienberg, Bobby N Koneru, Jon Ward, Jeffrey B Stricker","doi":"10.3390/dermatopathology11040033","DOIUrl":"10.3390/dermatopathology11040033","url":null,"abstract":"<p><p>Non-melanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are highly prevalent and a significant cause of morbidity. Image-guided superficial radiation therapy (IGSRT) uses integrated high-resolution dermal ultrasound to improve lesion visualization, but it is unknown whether efficacy varies by histology. This large retrospective cohort study was conducted to determine the effect of tumor histology on freedom from recurrence in 20,069 biopsy-proven NMSC lesions treated with IGSRT, including 9928 BCCs (49.5%), 5294 SCCs (26.4%), 4648 SCCIS cases (23.2%), and 199 lesions with ≥2 NMSCs (1.0%). Freedom from recurrence at 2, 4, and 6 years was 99.60%, 99.45%, and 99.45% in BCC; 99.58%, 99.49%, and 99.49% in SCC; and 99.96%, 99.80%, and 99.80% in SCCIS. Freedom from recurrence at 2, 4, and 6 years following IGSRT did not differ significantly comparing BCC vs. non-BCC or SCC vs. non-SCC but were slightly lower among SCCIS vs. non-SCCIS (<i>p</i> = 0.002). There were no significant differences in freedom from recurrence when stratifying lesions by histologic subtype. This study demonstrates that there is no significant effect of histology on freedom from recurrence in IGSRT-treated NMSC except in SCCIS. These findings support IGSRT as a first-line therapeutic option for NMSC regardless of histology.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"315-329"},"PeriodicalIF":1.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711324","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 : 2024-10-25DOI: 10.3390/dermatopathology11040032
Enric Piqué-Duran
{"title":"Collision of Basal Cell Carcinoma with Apocrine-Sebaceous-Follicular Unit Neoplasms.","authors":"Enric Piqué-Duran","doi":"10.3390/dermatopathology11040032","DOIUrl":"10.3390/dermatopathology11040032","url":null,"abstract":"<p><strong>Background: </strong>Tumor collision is a rare event, with an estimated incidence of 0.0017%. Seborrheic keratosis, melanocytic nevi, and basal cell carcinoma (BCC) are by far the most common entities involved in collisions. Most authors consider collision to be an incidental event. I planned a retrospective study comparing BCC/apocrine-sebaceous-follicular unit (ASFu) neoplasm collisions with squamous cell carcinoma (SCC)/ASFu neoplasm collisions.</p><p><strong>Materials and methods: </strong>Files from 2005 to 2017 from Dr. José Molina Orosa Hospital were assessed; in the review, cases of collisions between BCCs or SSCs and ASFu tumors, including cysts, were identified.</p><p><strong>Results: </strong>Out of 3247 BCC cases, 12 biopsies were retrieved. Of 825 biopsies, none belonged to the SCC group. The ASFu tumors that collided with a BCC were as follows: four hidrocystomas, three infundibular cysts, two steatocystomas, two trichilemmomas, one spiradenoma, and one clear-cell hidradenoma (one patient had two cysts associated with a BCC). These cases correspond to seven female patients and five male patients aged between 26 and 91 years old. A quarter of these patients were immunosuppressed. Most ASFu neoplasms were found to be located beneath the BCC (8/12).</p><p><strong>Discussion: </strong>To the best of my knowledge, this report describes three new collisions of BCCs with ASFu neoplasms (infundibular cysts, steatocystomas, and a spiradenoma). My results also suggest that immunosuppression could be a factor that predisposes a patient to these collisions. I review current hypotheses in an effort to explain these collisions and contribute some new theories.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"303-314"},"PeriodicalIF":1.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711323","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 : 2024-10-23DOI: 10.3390/dermatopathology11040031
Kassiani Boulogeorgou, Christos Topalidis, Triantafyllia Koletsa, Georgia Karayannopoulou, Jean Kanitakis
{"title":"Expression of TRPS1 in Metastatic Tumors of the Skin: An Immunohistochemical Study of 72 Cases.","authors":"Kassiani Boulogeorgou, Christos Topalidis, Triantafyllia Koletsa, Georgia Karayannopoulou, Jean Kanitakis","doi":"10.3390/dermatopathology11040031","DOIUrl":"10.3390/dermatopathology11040031","url":null,"abstract":"<p><p><i>TRPS1</i> (Tricho-rhino-phalangeal syndrome 1) is a GATA transcriptional activator gene encoding for a protein used as a sensitive immunohistochemical marker of breast carcinomas. In dermatopathology, TRPS1 is used as a marker of mammary and extramammary Paget's disease and is also expressed by a variety of primary cutaneous tumors, mostly of adnexal origin. So far, very limited data exist on the expression of TRPS1 in metastatic skin tumors. We studied the immunohistochemical expression of TRPS1 in 72 cutaneous metastatic tumors from the breast (n: 19) and other origins (n: 53) in order to assess its diagnostic usefulness. The intensity of TRPS1 immunostaining was expressed as a histoscore: the product of the percentage of positive cells (scored semi-quantitatively 0-4) and the staining intensity (scored 0-3). In normal skin, nuclear TRPS1 expression was predominantly observed in cells of adnexal structures (pilosebaceous follicles and sweat glands). Eighteen (18/19, 94.7%) metastatic breast carcinomas showed diffuse and strong TRPS1 positivity (histoscore 12). Lower reactivity was found in some other metastases, including from the lung (11/22), the female genital tract (3/4), and the kidney (2/4), whereas most (20/22) metastases from the digestive system and peritoneum, along with a case of metastatic prostate carcinoma, were negative. These results suggest that a high histoscore for TRPS1 is in favor of the mammary origin of metastatic cutaneous carcinoma. Although TRPS1 is not absolutely specific or sensitive to a particular primary, we consider that it can be added to a panel of other markers when investigating the origin of a cutaneous metastasis, namely when this is the first manifestation of the neoplastic disease.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"293-302"},"PeriodicalIF":1.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509993","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":"Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report.","authors":"Navinda Donsakul, Suthep Jerasutus, Ittipon Tubtieng, Ravion Assavanatenapa, Voraphol Vejjabhinanta","doi":"10.3390/dermatopathology11040030","DOIUrl":"10.3390/dermatopathology11040030","url":null,"abstract":"<p><p>Undifferentiated pleomorphic sarcoma (UPS) is an aggressive soft tissue sarcoma with a poor prognosis. The patients are usually found to have metastasis when the primary tumor is diagnosed. Eccrine syringofibroadenoma (ESFA) is a rare cutaneous adnexal lesion of eccrine duct origin. There are five subtypes, one of which is reactive ESFA, known to occur in reaction to an inflammatory or neoplastic process. In this article, we report a case of the co-existence of both UPS and ESFA in a 70-year-old male patient, presenting with a painless, erythematous, irregular surface nodule with a peripherally extended brownish hyperkeratotic plaque on the right palm. The histologic findings revealed an ill-defined dermal tumor of atypical epithelioid and spindle-shaped cells with large pleomorphic hyperchromatic nuclei and abundant eosinophilic cytoplasm. Some of those cells were multinucleated giant cells in the stroma with vascular proliferation and mixed inflammatory cell infiltrate. The tumor cells, which were only positive for vimentin, supported the diagnosis of undifferentiated pleomorphic sarcoma (UPS). Meanwhile, the overlying epidermis demonstrated hyperkeratosis, papillated epidermal hyperplasia, and proliferation of anastomosing slender cords and strands of cuboid cells within loose fibrovascular stroma. These findings are the characteristics of eccrine syringofibroadenoma (ESFA). We describe here a patient in whom reactive ESFA occurred on and surrounded the UPS tumor.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"286-292"},"PeriodicalIF":1.6,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516702","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 : 2024-10-08DOI: 10.3390/dermatopathology11040029
Hisham F Bahmad, Kalin Stoyanov, Teresita Mendez, Sally Trinh, Kristy Terp, Linda Qian, John Alexis
{"title":"Keratoacanthoma versus Squamous-Cell Carcinoma: Histopathological Features and Molecular Markers.","authors":"Hisham F Bahmad, Kalin Stoyanov, Teresita Mendez, Sally Trinh, Kristy Terp, Linda Qian, John Alexis","doi":"10.3390/dermatopathology11040029","DOIUrl":"10.3390/dermatopathology11040029","url":null,"abstract":"<p><p>Considerable controversy exists within the field of dermatopathology in differentiating keratoacanthoma (KA) from squamous-cell carcinoma (SCC). KAs are rapidly growing, benign squamous tumors that are typically well differentiated. This controversy stems from the diverging perspectives on the management, classification, and diagnosis of each entity. Many believe that KAs are benign neoplasms in which intervention may be unnecessary since they are self-limiting and resolve on their own. On the other hand, SCC needs to be treated, as it carries significant morbidity and mortality risks. Early diagnosis and treatment are vital to prevent serious consequences of SCC. Nevertheless, KAs may resemble SCC grossly and microscopically. Various ancillary tests, including immunohistochemical (IHC) staining, have been proposed to differentiate between these entities, though mixed patterns of expression can limit the diagnostic utility of these techniques. Research into this topic is ongoing, with newer genetic and molecular findings illuminating the previously difficult-to-understand aspects of KA and increasing our understanding of this entity. In this review, KA and SCC will be compared along the lines of histological features, genetic, immune, and molecular markers, differential diagnosis, and management to clarify the similarities, differences, and misconceptions about both entities.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"272-285"},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509994","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 Rapidly Growing Nodule on the Eyebrow of a Pediatric Patient.","authors":"Italo Francesco Aromolo, Michela Brena, Nicola Adriano Monzani, Fabio Caviggioli, Emilio Berti, Donata Micello, Riccardo Cavalli","doi":"10.3390/dermatopathology11040028","DOIUrl":"10.3390/dermatopathology11040028","url":null,"abstract":"<p><p>A 11-year-old Caucasian girl presented to our Dermatology Unit with a 2-month history of an erythematous nodule, localized to the medial portion of her left eyebrow, rapidly growing in the two weeks before presentation. The histopathological examination revealed a dermal multi-nodular epithelial neoplasm composed of clear cells, squamous cells, and glandular cells, characterized by cytologic atypia, high mitotic activity, and an infiltrative deep growth pattern. The immunohistochemical profile of the lesion was as follows: CKAE1/AE3+, EMA+, CK8/18+, CK7+, CK19+, AR negative, p63 focally +, Ki67 25%, rare cells GCDFP15+, p53+.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"266-271"},"PeriodicalIF":1.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721856","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 : 2024-09-24DOI: 10.3390/dermatopathology11040027
Samir Kamat, Ross O'Hagan, Catherine Brahe, Curtis L Hardy, Vikas Shrivastava, Jane M Grant-Kels, Angela M Crotty
{"title":"Ethical Issues Regarding Dermatopathology Care for Service-Members: A Review.","authors":"Samir Kamat, Ross O'Hagan, Catherine Brahe, Curtis L Hardy, Vikas Shrivastava, Jane M Grant-Kels, Angela M Crotty","doi":"10.3390/dermatopathology11040027","DOIUrl":"10.3390/dermatopathology11040027","url":null,"abstract":"<p><p>Dermatologic care within the military faces unique ethical challenges. Service members are stationed across nationally and globally diverse settings, and therefore, dermatologic care rendered ranges from within resource-rich, advanced military medical treatment facilities to austere, resource-limited, deployed field environments. Additionally, military service members are often at unique risk for dermatologic disease, given occupational, environmental, and geographic exposures not commonly faced by their civilian counterparts. This review explores topics in dermatoethics via case analyses of ethical considerations within the scope of dermatologic care for military service members.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 4","pages":"253-265"},"PeriodicalIF":1.6,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509992","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 : 2024-08-15DOI: 10.3390/dermatopathology11030026
Serra Aksoy, Pinar Demircioglu, Ismail Bogrekci
{"title":"Enhancing Melanoma Diagnosis with Advanced Deep Learning Models Focusing on Vision Transformer, Swin Transformer, and ConvNeXt.","authors":"Serra Aksoy, Pinar Demircioglu, Ismail Bogrekci","doi":"10.3390/dermatopathology11030026","DOIUrl":"10.3390/dermatopathology11030026","url":null,"abstract":"<p><p>Skin tumors, especially melanoma, which is highly aggressive and progresses quickly to other sites, are an issue in various parts of the world. Nevertheless, the one and only way to save lives is to detect it at its initial stages. This study explores the application of advanced deep learning models for classifying benign and malignant melanoma using dermoscopic images. The aim of the study is to enhance the accuracy and efficiency of melanoma diagnosis with the ConvNeXt, Vision Transformer (ViT) Base-16, and Swin Transformer V2 Small (Swin V2 S) deep learning models. The ConvNeXt model, which integrates principles of both convolutional neural networks and transformers, demonstrated superior performance, with balanced precision and recall metrics. The dataset, sourced from Kaggle, comprises 13,900 uniformly sized images, preprocessed to standardize the inputs for the models. Experimental results revealed that ConvNeXt achieved the highest diagnostic accuracy among the tested models. Experimental results revealed that ConvNeXt achieved an accuracy of 91.5%, with balanced precision and recall rates of 90.45% and 92.8% for benign cases, and 92.61% and 90.2% for malignant cases, respectively. The F1-scores for ConvNeXt were 91.61% for benign cases and 91.39% for malignant cases. This research points out the potential of hybrid deep learning architectures in medical image analysis, particularly for early melanoma detection.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 3","pages":"239-252"},"PeriodicalIF":1.6,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074219","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 : 2024-08-14DOI: 10.3390/dermatopathology11030025
Gürkan Kaya
{"title":"Clinicopathological Challenge: A New Article Type in <i>Dermatopathology</i>.","authors":"Gürkan Kaya","doi":"10.3390/dermatopathology11030025","DOIUrl":"10.3390/dermatopathology11030025","url":null,"abstract":"<p><p>As the Editor-in-Chief of <i>Dermatopathology</i>, I have the great pleasure of announcing a new article type: \"Clinicopathological Challenge\" [...].</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 3","pages":"238"},"PeriodicalIF":1.6,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074218","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 : 2024-08-12DOI: 10.3390/dermatopathology11030024
Johannes Pawlowski, Tatsiana Pukhalskaya, Kelly Cordoro, Marina Kristy Ibraheim, Jeffrey P North
{"title":"Interleukin-36 Is Highly Expressed in Skin Biopsies from Two Patients with Netherton Syndrome.","authors":"Johannes Pawlowski, Tatsiana Pukhalskaya, Kelly Cordoro, Marina Kristy Ibraheim, Jeffrey P North","doi":"10.3390/dermatopathology11030024","DOIUrl":"10.3390/dermatopathology11030024","url":null,"abstract":"<p><p>Netherton syndrome (NS) is a rare autosomal recessive disorder that occurs due to a loss-of-function mutation in SPINK5; this loss results in significant inflammation, as well as perturbations of the skin barrier's integrity and functionality. While it is unclear which inflammatory pathways contribute to the development of NS, recent studies have demonstrated the expression of interleukin (IL)-17/IL-36, as well as several Th2 cytokines. Consequently, immunohistochemistry (IHC) with IL-36 may serve as a potential tool for aiding the histopathological diagnosis of this condition. In this case series, we present two cases of NS and capture their immunostaining pattern with IL-36. Both cases demonstrated robust expression of IL-36. This finding bolsters the hypothesis that NS is partially driven by Th17 activation and suggests the potential utility of IL-36 IHC as part of the workup for this rare and diagnostically elusive entity. LEKTI IHC was negative in one biopsy, revealing a limitation of this stain in diagnosing NS.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"11 3","pages":"230-237"},"PeriodicalIF":1.6,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074220","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}