DermatopathologyPub Date : 2022-07-25DOI: 10.3390/dermatopathology9030031
Antonio Córdoba-Fernández, María Dolores Jiménez-Cristino, Victoria Eugenia Córdoba-Jiménez
{"title":"Large Lobular Capillary Hemangioma Associated with Ingrown Toenail: Histopathological Features and Case Report.","authors":"Antonio Córdoba-Fernández, María Dolores Jiménez-Cristino, Victoria Eugenia Córdoba-Jiménez","doi":"10.3390/dermatopathology9030031","DOIUrl":"https://doi.org/10.3390/dermatopathology9030031","url":null,"abstract":"<p><p>Lobular capillary hemangioma (LCH-PG) is a type of pyogenic granuloma characterized by proliferating blood vessels that resemble conventional granulation tissue. Granulation tissue is very often seen in association with ingrown toenails. Despite the close relationship between both entities, LCH-PG shows clinically different behaviors, such as rapid growth and frequent recurrence. Currently, it is unknown exactly how the different etiological factors contribute to the formation of differences between entities. We present a case of a large LCH-PG associated with chronic onychocryptosis in a 26-year-old man. Histopathological features included extensive signs of ulceration, hyperkeratosis, and patchy epidermal acanthosis with the presence of fibrous septa with lobular areas beneath the ulcerative area. The presence of stroma with a marked proliferation of blood vessels with wall thickening and mixed-type inflammatory changes was also characteristic. In advanced stages of onychocryptosis, as presented here, conventional granulation tissue or pyogenic granuloma can be clinically difficult to distinguish from other benign or malignant neoplasms. Histological examination is mandatory, and excisional biopsy can provide a definitive diagnosis.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"271-276"},"PeriodicalIF":1.9,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40564211","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 : 2022-07-15DOI: 10.3390/dermatopathology9030030
Alyssa D Higgins, Richard J Dunn, Omer Malikzai, Mirwais Ahmadzai, Jerad M Gardner, Benjamin K Stoff, Josette R McMichael
{"title":"Kaposi Sarcoma in Afghanistan: A Case Series from a Tertiary Referral Center.","authors":"Alyssa D Higgins, Richard J Dunn, Omer Malikzai, Mirwais Ahmadzai, Jerad M Gardner, Benjamin K Stoff, Josette R McMichael","doi":"10.3390/dermatopathology9030030","DOIUrl":"https://doi.org/10.3390/dermatopathology9030030","url":null,"abstract":"Kaposi sarcoma is a vascular endothelial neoplasm caused by human herpesvirus 8. Although it is a well-studied disease, little is known about the specific characteristics or epidemiology of Kaposi sarcoma in Afghanistan. The data consist primarily of anecdotal reports and epidemiological studies extrapolated from neighboring countries. In this case series, we summarize existing data about Kaposi sarcoma in Afghanistan and present seven histologically confirmed cases with associated clinical features to shed light on the characteristics of Kaposi sarcoma in this unique geographic setting.","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"258-270"},"PeriodicalIF":1.9,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40564210","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 : 2022-07-14DOI: 10.3390/dermatopathology9030029
Shane David Basil Smith, Ginette A Okoye, Olayemi Sokumbi
{"title":"Histopathology of Hidradenitis Suppurativa: A Systematic Review.","authors":"Shane David Basil Smith, Ginette A Okoye, Olayemi Sokumbi","doi":"10.3390/dermatopathology9030029","DOIUrl":"https://doi.org/10.3390/dermatopathology9030029","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a chronic inflammatory scarring disease felt to be related to occlusion of the hair follicle unit in intertriginous areas. We perform a systematic review on HS histopathology to evaluate current knowledge and discuss future directions. PubMed and Scopus databases were searched for relevant articles published from January 1985 to January 2021 that discussed the pathology of HS. Additional articles were identified by hand-searching, which entailed manually scanning selected journals. A total of 355 citations were identified in the primary search within the main databases. Two hundred and seventy-nine articles were excluded after a review of titles, abstracts, and duplicates. Sixty-one studies did not meet the inclusion criteria or were found to be duplicates, resulting in a total of 15 articles for analysis. Three articles were hand-searched. This comprehensive systematic review of the histopathology of HS confirms a high prevalence of follicular occlusion, follicular hyperkeratosis, and hyperplasia of the follicular epithelium. These findings support the central role of follicular occlusion in the development and progression of HS while providing a potential path to directing therapeutics against follicular occlusion.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"251-257"},"PeriodicalIF":1.9,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40564209","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 : 2022-06-29DOI: 10.3390/dermatopathology9030026
Mirjana Urosevic-Maiwald, Jan-Hendrik B Hardenberg, Jürg Hafner, Marie-Charlotte Brüggen
{"title":"Cocaine/Levamisole-Induced, Skin-Limited ANCA-Associated Vasculitis with Pyoderma Gangrenosum-like Presentation.","authors":"Mirjana Urosevic-Maiwald, Jan-Hendrik B Hardenberg, Jürg Hafner, Marie-Charlotte Brüggen","doi":"10.3390/dermatopathology9030026","DOIUrl":"https://doi.org/10.3390/dermatopathology9030026","url":null,"abstract":"<p><p>The use of levamisole as the most frequent adulterant of cocaine has merged in previously unknown toxicities, notably a disease entity called cocaine/levamisole-associated autoimmune syndrome (CLAAS). Clinically, CLAAS can manifest with diverse cutaneous and extracutaneous features sharing common laboratory findings (neutropenia, autoantibody patterns). We report the case of a cocaine-abusing female patient with relapsing episodes of painful ulcers, worsening and expanding over a three-year period. The case exhibited all features of a drug-induced, skin-limited, ANCA-associated vasculitis, evolving over time to PG-like findings. In both disease stages, the patient responded well to the cessation of cocaine exposure and systemic glucocorticosteroids. This case demonstrates the continuous nature of cutaneous CLAAS manifestations in a single patient. CLAAS has become a major public health issue in the at-risk group of cocaine users, and clinicians should be alert of this condition when treating cocaine users presenting with single or multiple skin ulcerations.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"207-211"},"PeriodicalIF":1.9,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40564207","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 : 2022-06-24DOI: 10.3390/dermatopathology9030025
Caroline de Lorenzi, Gürkan Kaya, Laurence Toutous Trellu
{"title":"Pseudo-Pemphigoid Gestationis Eruption Following SARS-CoV-2 Vaccination with mRNA Vaccine.","authors":"Caroline de Lorenzi, Gürkan Kaya, Laurence Toutous Trellu","doi":"10.3390/dermatopathology9030025","DOIUrl":"https://doi.org/10.3390/dermatopathology9030025","url":null,"abstract":"<p><p>Auto-immune reactions, including auto-immune bullous disease, have been reported following SARS-CoV-2 virus vaccination. Few cases of bullous pemphigoid are described, but there has been no case of pemphigoid gestationis. We report the first case here.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"203-206"},"PeriodicalIF":1.9,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40548371","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 : 2022-06-20DOI: 10.3390/dermatopathology9020024
Rosanna Fox, Effie Katsarma, Nick Tiffin, Manuraj Singh
{"title":"Subungual Exostosis Presenting as a Pyogenic Granuloma-like Lesion with Reactive Myofibroblastic Proliferation in Two Young Women.","authors":"Rosanna Fox, Effie Katsarma, Nick Tiffin, Manuraj Singh","doi":"10.3390/dermatopathology9020024","DOIUrl":"https://doi.org/10.3390/dermatopathology9020024","url":null,"abstract":"<p><p>Subungual exostosis (SE) is a well-recognised benign proliferation of the distal phalanx most often seen in young adults and affecting the big toe. Possible triggers include previous trauma and chronic irritation or infection. We describe two atypical cases of SE in two young women presenting with pyogenic granuloma-like lesions clinically. Diagnostic biopsies were performed to confirm the diagnosis and excluded amelanotic melanoma. However, histology unexpectedly revealed reactive myofibroblastic proliferations mimicking nodular fasciitis overlying the SE. Given the atypical clinical presentation, the diagnosis was initially missed or not considered in both patients. They highlight two important points; the first is that SEs may present with pyogenic granuloma-like lesions clinically and that histological analysis is then required to exclude malignancy, particularly amelanotic melanoma. Secondly, that the histology will show a reactive myofibroblastic proliferation and if the sample is relatively superficial and pathologists are not aware of this potential reaction pattern, the underlying diagnosis of SE may be missed.</p>","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":" ","pages":"196-202"},"PeriodicalIF":1.9,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40254149","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 : 2022-05-07DOI: 10.3390/dermatopathology9020021
S. Khandpur, R. Ahuja
{"title":"Drug-Induced vs. Viral Maculopapular Exanthem—Resolving the Dilemma","authors":"S. Khandpur, R. Ahuja","doi":"10.3390/dermatopathology9020021","DOIUrl":"https://doi.org/10.3390/dermatopathology9020021","url":null,"abstract":"Maculopapular exanthem is a commonly encountered presentation in routine clinical practice, and differentiation between its two most common etiologies, i.e., viral- and drug-induced, often poses a diagnostic dilemma. Clinical, hematological and biochemical investigations are seldom reliable in distinguishing between a drug reaction and a viral exanthem. Certain key histopathological features such as the presence of a moderate degree of spongiosis, extensive basal cell damage with multiple necrotic keratinocytes and dermal infiltrate rich in eosinophils or lymphocytes and histiocytes may favor a drug exanthem, while distinctive epidermal cytopathic changes and lymphocytic vasculitis point towards a viral etiology. Similarly, notable immunohistochemical markers such as IL-5, eotaxin and FAS ligand may support a diagnosis of a drug-induced maculopapular eruption. Histopathological and immunohistochemical evaluations may help in distinguishing between the two etiologies when faced with a clinical overlap, especially in patients on multiple essential drugs when drug withdrawal and rechallenge is not feasible.","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"9 1","pages":"164 - 171"},"PeriodicalIF":1.9,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44683807","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 : 2022-05-05DOI: 10.3390/dermatopathology9020020
R. Nepali, S. Upadhyaya Kafle, T. Pradhan, Jibanath Dhamala
{"title":"Scar Endometriosis: A Rare Cause of Abdominal Pain","authors":"R. Nepali, S. Upadhyaya Kafle, T. Pradhan, Jibanath Dhamala","doi":"10.3390/dermatopathology9020020","DOIUrl":"https://doi.org/10.3390/dermatopathology9020020","url":null,"abstract":"Scar endometriosis or incisional endometriosis is the presence of endometrial tissues with glands in the previous incision or scar. Its overall estimated incidence after post-cesarean and post-hysterectomy is 0.03–0.4% and 1.08–2%, respectively. The patient presents with non-specific symptoms such as cyclical abdominal pain at the site of a previous surgical incision and scar and an abdominal lump with a cyclical increment in size, which is tender. The diagnosis is made only after the surgical excision with confirmation by histopathological analysis. We present the case of a 31-year-old female complaining of cyclical abdominal pain and a lump on the right side of a Pfannenstiel incision for five months. She had undergone two Lower Segment Caesarean Sections (LSCSs); the last surgery was eight months prior. Surgical excision was planned with the corresponding clinical features and radiological data. After the surgical excision, the sample was sent for histopathological examination, and scar endometriosis was diagnosed.","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"9 1","pages":"158 - 163"},"PeriodicalIF":1.9,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47151837","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 : 2022-05-02DOI: 10.3390/dermatopathology9020019
V. Glutsch, M. Wobser, B. Schilling, A. Gesierich, M. Goebeler, H. Kneitz
{"title":"PRAME Expression as Helpful Immunohistochemical Marker in Rhabdoid Melanoma","authors":"V. Glutsch, M. Wobser, B. Schilling, A. Gesierich, M. Goebeler, H. Kneitz","doi":"10.3390/dermatopathology9020019","DOIUrl":"https://doi.org/10.3390/dermatopathology9020019","url":null,"abstract":"Background: Rhabdoid melanoma is a rare variant of malignant melanoma with characteristic cytomorphologic features. Due to the potential loss of conventional melanocytic markers, histopathologic diagnosis is often challenging. We hypothesize that immunostaining for PReferentially expressed Antigen in MElanoma (PRAME) might have the potential to uncover the melanocytic origin of these dedifferentiated tumors. Methods: Four cases of rhabdoid primary melanomas were assessed by immunohistochemistry for expression of PRAME and conventional melanocytic markers. Immunohistochemical expression patterns were analyzed in the rhabdoid primaries and, if available, associated metastases. Results: All four cases of rhabdoid primary melanomas showed a strong nuclear positivity for PRAME, while the expression of conventional melanocytic markers S100, MART-1, SOX-10 and HMB-45 was variable between the analyzed cases. Conclusions: In summary, we report four cases of rhabdoid primary melanoma with high to intermediate expression of PRAME despite the partial and variable loss of other melanocytic markers. Hence, PRAME might facilitate the recognition of this highly aggressive entity to avoid misdiagnosis due to histopathologic pitfalls.","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"9 1","pages":"148 - 157"},"PeriodicalIF":1.9,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42188972","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 : 2022-04-29DOI: 10.3390/dermatopathology9020018
Chika Hirata, K. Nakai, Yusuke Kurasawa, N. Maekawa, S. Kuniyuki, K. Yamagami, M. Ohsawa, D. Tsuruta
{"title":"Primary Cutaneous Gamma-Delta T-Cell Lymphoma Initially Diagnosed as Subcutaneous Panniculitis-like T-Cell Lymphoma with Dermatomyositis","authors":"Chika Hirata, K. Nakai, Yusuke Kurasawa, N. Maekawa, S. Kuniyuki, K. Yamagami, M. Ohsawa, D. Tsuruta","doi":"10.3390/dermatopathology9020018","DOIUrl":"https://doi.org/10.3390/dermatopathology9020018","url":null,"abstract":"Primary cutaneous gamma-delta T-cell lymphoma (CGD-TCL) is a rare cutaneous lymphoma. Panniculitis-like T-cell lymphoma (SPTCL) has a better prognosis than CGD-TCL. SPTCL is sometimes associated with autoimmune disease. A 64-year-old Japanese female with a history of dermatomyositis presented with subcutaneous nodules on the upper extremities and exacerbated dermatomyositis. A skin biopsy showed lobular panniculitis, a vacuolar interface change, and a dermal mucin deposit. Fat cells rimmed by neoplastic cells, fat necrosis, and karyorrhexis were observed. The atypical lymphoid cells showed CD3+, CD4−, CD8+, granzyme B+, CD20−, and CD56−. Polymerase chain reaction analysis demonstrated a T-cell receptor rearrangement. The patient was initially diagnosed with SPTCL, so the dose of prednisone was raised from 7.5 to 50 mg daily (1 mg/kg). After one month, erythematous nodules regressed, and muscle symptoms improved. Subsequently, prednisone was tapered, and cyclosporin A was added. After one year, the patient remained symptom-free and continued taking 7.5 mg prednisone and 100 mg cyclosporin A daily. Afterward, we immunostained skin samples with antibodies against TCR-ß and δ and found positive TCR-δ and negative TCR-ß. Therefore, we corrected the diagnosis to CGD-TCL, although the clinical course and the presence of dermatomyositis were reminiscent of SPTCL.","PeriodicalId":42885,"journal":{"name":"Dermatopathology","volume":"9 1","pages":"143 - 147"},"PeriodicalIF":1.9,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47733979","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}