Feifan Chen, Robin H Wang, Jenna J Lullo, Sarah B Cadden, Hunter Koster, Jackson Schaeffer, Jodi J Speiser
{"title":"Vesiculobullous Eruption in Patient With Mycosis Fungoides.","authors":"Feifan Chen, Robin H Wang, Jenna J Lullo, Sarah B Cadden, Hunter Koster, Jackson Schaeffer, Jodi J Speiser","doi":"10.1097/DAD.0000000000003135","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003135","url":null,"abstract":"<p><strong>Abstract: </strong>Mycosis fungoides bullosa is a rare clinical subtype of mycosis fungoides, with less than 40 cases reported in the literature. We report a case of a 66-year-old female with a history of stage IIB folliculotrophic mycosis fungoides with large cell transformation, currently being treated with romidepsin and gemcitabine, transferred to our institution due to worsening cutaneous involvement. On exam, there were large, erythematous, crusted and eroded plaques of the neck, trunk, and bilateral upper and lower extremities, some with overlying tense bullae. Punch biopsy showed a marked infiltrate of atypical CD3+ lymphocytes with epidermotropism of predominantly CD4+ cells (CD4:CD8 ratio of 8:1), loss of CD5 and CD7, and scattered CD30+ cells. Direct immunofluorescence showed a non-diagnostic staining pattern. Blood cultures were negative. Given the clinical and histopathologic findings, a diagnosis of mycosis fungoides bullosa was made. Mycosis fungoides is the most common type of cutaneous T-cell lymphoma. Mycosis fungoides bullosa, a vesiculobullous presentation of mycosis fungoides, is a rare variant first described by Dr. Moritz Kaposi in 1887. Proposed mechanisms of bullae formation include confluence of Pautrier's microabscesses or loss of keratinocyte cohesion due to proliferation of atypical lymphocytes. Diagnosis is based on the presence of vesiculobullous lesions among typical lesions of mycosis fungoides, histopathologic features consistent with mycosis fungoides, and negative evaluation for other causes of vesiculobullous lesions such as infection and autoimmune blistering diseases. Recognition is important as mycosis fungoides bullosa carries poor prognosis, with 50% of reported patients expiring within 1 year of bullae appearance.</p>","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132516","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}
Victoria Martínez-Sernández, José Antonio Oliva-Fernández, Andrea Beatriz Jiménez-Pérez, Diego López-Martínez, Carmen García-Moronta, Alberto Romo-Melgar, Ángel Santos-Briz
{"title":"Venous Malformation-Like Kaposi Sarcoma: Revisiting a Known Variant.","authors":"Victoria Martínez-Sernández, José Antonio Oliva-Fernández, Andrea Beatriz Jiménez-Pérez, Diego López-Martínez, Carmen García-Moronta, Alberto Romo-Melgar, Ángel Santos-Briz","doi":"10.1097/DAD.0000000000003134","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003134","url":null,"abstract":"","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114477","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":"Vulvar Nocardiosis in the Setting of dVIN: A High-Risk Infection.","authors":"Morgan Parker, Kristen Delans, Douglas J Grider","doi":"10.1097/DAD.0000000000003130","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003130","url":null,"abstract":"<p><strong>Abstract: </strong>Nocardia is a Gram positive, aerobic, partially acid-fast filamentous bacteria of the order Actinomycetales. It is a saprophytic organism found in environmental contaminants such as soil and decomposing organic matter. Primary cutaneous nocardiosis is uncommon and may occur through contamination of a wound or through inhalation of the organism with dissemination to multiple organ systems, including the skin. Vulvar nocardiosis is an exceedingly rare manifestation of Nocardia. Described is a patient with a history of lichen sclerosus, differentiated vulvar intraepithelial neoplasia (dVIN), and recurrent vulvar squamous cell carcinoma requiring multiple resections and biopsies who presented with recurrent firm, white, nodular lesions on the right labia and right inferior clitoris. Histopathology of the right inferior clitoral lesion demonstrated dVIN. The right labia majora lesion also revealed dVIN and a dermal epithelioid granuloma with central vacuoles filled with filamentous to small, fragmented forms suggestive of bacteria. Ziehl-Neelsen AFB stain was negative. Gram stain, Gomori methenamine silver (GMS), and FITE stains were positive. The staining pattern of the filamentous and beaded forms supports a diagnosis of Nocardia. Vulvar nocardiosis in the setting of dVIN and history of multiple vulvar surgeries has not been described in the literature to date. This case demonstrates the importance of maintaining atypical infections on the differential for nonhealing vulvar wounds. Timely treatment is crucial to improve outcomes, particularly in the setting of multiple surgical procedures in patients at high risk for infectious complications.</p>","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092708","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":"Superficial ALK-Rearranged Myxoid Spindle Cell Neoplasm With Aberrant Keratin Expression and a Rare Gene Fusion Partner.","authors":"Bethany Batson, Shaymaa Hegazy, Rana Naous","doi":"10.1097/DAD.0000000000003132","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003132","url":null,"abstract":"<p><strong>Abstract: </strong>Superficial ALK-rearranged myxoid spindle cell neoplasms/epithelioid fibrous histiocytoma (SAMS/EFH) are newly defined hybrid soft tissue tumors within the broader class of S100 and CD34 coexpressing spindle cell tumors that harbor receptor tyrosine kinase fusions. Several research groups have contributed to describing and characterizing the morphologic and immunophenotypic spectrum of SAMS/EFH and exploring its relationship with other similar appearing and molecularly driven neoplasms. To further expand the knowledge of this entity, we present a unique hybrid case of superficial ALK-rearranged myxoid spindle cell neoplasm/EFH with novel aberrant cytokeratin expression and rare ALK::PRKAR1A fusion, thus, adding to the spectrum of such unique and newly emerging tumors.</p>","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076651","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}
Lauren C Morehead, Atif Ahmed, Tyler Ketterl, Markus D Boos
{"title":"A Teenager With a Painful Arm Nodule: Challenge.","authors":"Lauren C Morehead, Atif Ahmed, Tyler Ketterl, Markus D Boos","doi":"10.1097/DAD.0000000000003075","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003075","url":null,"abstract":"","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042157","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}
Francesco Fortarezza, Tito Brambullo, Gerardo Cazzato, Franco Bassetto, Angelo Paolo Dei Tos
{"title":"Myoepithelial Neoplasm of the Eyelid Harboring a Novel HAS2::PLAG1 Fusion and Aberrant ALK Expression: A Case Report.","authors":"Francesco Fortarezza, Tito Brambullo, Gerardo Cazzato, Franco Bassetto, Angelo Paolo Dei Tos","doi":"10.1097/DAD.0000000000003128","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003128","url":null,"abstract":"<p><strong>Abstract: </strong>We report an exceptional case of a neoplasm with myoepithelial differentiation arising in the eyelid of a 50-year-old woman, representing the first documented instance of a HAS2::PLAG1 gene fusion in this anatomical location. The tumor exhibited a biphasic morphology with both spindle and epithelioid cell components and demonstrated aberrant immunohistochemical expression of ALK protein, although molecular analysis did not reveal any ALK gene rearrangements. This case underscores the importance of comprehensive molecular diagnostics in resolving immunophenotypic ambiguities and accurately classifying rare adnexal tumors.</p>","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042192","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}
Karima M Osman, John J Fowler, Sabrina A Newman, Shyam S Raghavan
{"title":"Unmasking a Persistent Rash: Challenge.","authors":"Karima M Osman, John J Fowler, Sabrina A Newman, Shyam S Raghavan","doi":"10.1097/DAD.0000000000003085","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003085","url":null,"abstract":"","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042127","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}
Satyatejas G Reddy, Katherine B Kemple, Kathryn A Potter, Matthew R Powell
{"title":"Fever, Weight Loss, and Cutaneous Nodules in an Immunocompromised Host: Challenge.","authors":"Satyatejas G Reddy, Katherine B Kemple, Kathryn A Potter, Matthew R Powell","doi":"10.1097/DAD.0000000000003062","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003062","url":null,"abstract":"","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042179","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":"Bland Spindle Cell Lesion on the Leg of a 43-Year-Old Man: Challenge.","authors":"Chase T Trybula, Daniel D Wong, Benjamin A Wood","doi":"10.1097/DAD.0000000000003049","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003049","url":null,"abstract":"","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042210","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":"Multiple Exophytic and Ulcerated Plaques and Nodules: Challenge.","authors":"Kinan M Hayani, Rute F Lellis, Omar P Sangüeza","doi":"10.1097/DAD.0000000000003067","DOIUrl":"https://doi.org/10.1097/DAD.0000000000003067","url":null,"abstract":"","PeriodicalId":50967,"journal":{"name":"American Journal of Dermatopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042143","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}