bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistochemical analysis of dermal mononuclear cell infiltrates in cutaneous lupus erythematosus, polymorphous light eruption, lymphocytic infiltration of Jessner, and cutaneous lymphoid hyperplasia:
Authors: Kuo Tseng‐long , Lo Sing‐Kai , Chan Heng‐Leong
Published: April 2006

Cutaneous lupus erythematosus (LE), polymorphous light‐eruption (PMLE), lymphocytic infiltration of Jessner (LIJ), and cutaneous lymphoid hyperplasia (CLH) are often difficult to differentiate from ok‐ another by light microscopic examination. We conducted an immunohistochemical analysis of the mononuclear cell infiltrates in 13 LE, 12 PMLE, 10 LIJ, and 13 CLH with various antibodies. Antibodies L26, UCHL1, and S100 achieved statistically significant differences among the lour diseases, but because of the overlaps in the number of UCHL1 (+) T cells and S100 protein (+) cells in individual cases, these two antibodies were not useful. Only (11,11 could be distinguished from LE, PMLE, and LIJ by a greater number of CD20(+) B cells. The latter three' conditions could not be differentiated. Contrary to previous reports, plasmacyloid‐monocytes were not found to be increased in LIJ for the differentiation of the latter from LE and PMLE. Our results support the conclusion that CLH is a reactive lymphoid hyperplastic process with proliferation of both ft and T cells, whereas the T cell was the predominant cell type in the infiltrates of LE, PMLE, and LIJ, indicating that they were related to T cell disorders. The histiocyte was only a minor component cell. The plasmacytoid monocyle in general was not significantly present in all four conditions, but relatively more plasmacytoid monocytes were present in CLH.
Tufted angioma with complete regression
Authors: Lam W.Y. , Mac‐Moune Lai F. , Look C.N. , Choi Paul C.L. , Allen Philip W.
Published: April 2006

We describe 2 patients with tufted angioma (angioblastoma of Nakagawa) which regressed spontaneously. Both patients had a solitary but large lesion on the trunk. The 1st patient, a 3‐month‐old girl, presented with a 6‐cm plaque which began to regress 2 years later. It regressed completely over 1 year and had not recurred alter a further 6‐year follow‐up. The other patient, a 3‐month‐old boy, presented with a 12‐cm mass of coalescent angiomatous papules which slowly regressed over 3‐years, while small new lesions appeared in the adjacent contiguous skin. Eventually, gradual and near complete regression was observed alter 8 years. The histology in both cases was typical, but bore some resemblance to the recently described kaposiform hemangioendothelioma, lobular capillary hemangioma and spindle cell hemangioendothelioma.
Clinical and histologic features of striated muscle hamartoma: Possible relationship to Delleman's syndrome
Authors: Sänchez R. L. , Raimer S. S.
Published: April 2006

We describe 5 new cases of striated muscle hamartoma (SMH) and review the 7 cases previously described in the literature. Eleven of the 12 patients had single lesions centrally located on the chin (4), near the ala of the nose (3), on the upper chest (3), and on the upper lip (1). Histologically all of the lesions were characterized by a central core containing bundles and individual fibers of skeletal muscle as well as other mesenchymal elements. The muscle fibers penetrated the dermis among numerous folliculo‐sebaceous structures. Of the 12 cases of SMH, 3 had other associated congenital anomalies including a cleft lip in 1 patient and a thyroglossal duel sinus in another with single lesions, and preauricular sinuses, low‐set ears and bilateral sclerocorneas in the case of multiple SMH. The relationship of SMH with oculocerebrocutaneous syndrome is discussed, and we conclude that at least some of the skin appendages associated with that syndrome are SMH.
Congenital self‐healing reticulohistiocytosis – A benign Langerhans cell disease
Authors: Schaumburg‐Lever G. , Rechowicz E. , Fehrenbacher B. , Möller H. , Nau P.
Published: April 2006

An‐11‐day old girl was seen with brownish nodular lesions scattered over (he body with emphasis on the face and seal). Several lesions had started lo involute. Tissue was studied by histopathology, immunohistopathology, routine electron microscopy, and immuno‐electron microscopy using cryosubstitution and embedding in K4M. Immunohistopathology revealed that the cells of the dermal infiltrate were Langerhans cells. They expressed Leu 6 and HLA‐DR. On routine electron microscopy no Birbeck granules were (bund in the dermal cells. Birbeck granules in epidermal Langerhans cells were deformed and often situated next to laminated dense bodies. The latter expressed Leu 6 and HLA‐DR. on immuno‐electron microscopy. It was concluded that congenital self‐healing reticulohistiocytosis is a benign Langerhans cell disease in which Birbeck granules are transformed to laminated dense bodies and possibly degraded by lysosomal enzymes.
DNA determination of human hair bulbs in normal and androgenetic alopecia
Authors: Villena A. , Alcaraz M.V. , de Vargas I. Pérez
Published: April 2006

We carried out a cytophotometric study of the DNA content of matrix cells from normal hair follicles and those affected by androgenetic alopecia (early and established baldness), using the Feulgen technique. We thereby obtained a 2C reference value from lymphocyte nuclei from normal skin, from which we established a 2C–4C and 4C DNA content. The results obtained showed 71.75% of matrix cells in normal scalp to have a 2C content, while the remaining 28.25% was distributed between the values of 2C–4C and 4C. However, in early baldness, the number of 2C cells dropped to 48%, with a notable increase in cell populations with a 2C–4C and 4C content, which varied from 29.45% and 22.55% respectively. Finally, in established baldness, the 2C values decreased to as low as 29.56%, with the percentage of cells with a 2C–4C content reaching 38.71% and those of 4C, 31.73%.
A fresh morphological and functional at dermal dendritic cells
Authors: Nestle Frank O. , Nickoloff Brian J.
Published: April 2006

During the past decade, a group of cells located in the dermis and possessing a dendritic morphology have emerged from obscurity and become recognized as important members of the „dermal immune system”. This group of cells is characterized by a considerable degree of immunophenotypic and functional heterogeneity. In this review, the salient features of these dermal dendritic cells are put into a dermatopathology perspective, with particular emphasis on a broad group of inflammatory and neoplastic skin diseases. There appear to be multiple subsets of dermal dendritic cells, and 17 different conditions linked to active participation of these newly recognized cells. Exactly how these different subsets of dermal dendritic cells interact amongst each other, as well as with adjacent cells such as T‐lymphocytes, endothelial cells, fibroblasts, and keratinocytes in these different diseases is unclear at this time. However, isolation techniques and monoclonal antibodies capable of distinguishing these subsets, as well as functional assays, are currently available and will permit definitive conclusions to be drawn regarding their pathophysiological significance. It is highly likely that, as more data is gathered, dermal dendritic cells will be the focus of further investigative activity by dermatopathologists for the next decade, and well past the year 2000.
Proliferating epithelial cysts
Authors: Sau Purnima , Graham James H. , Helwig Elson B.
Published: April 2006

Ninety‐six proliferating cutaneous epithelial cysts were classified into two subtypes, proliferating trichilemmal cysts (PTC) and proliferating epidermoid cysts (PEC), depending on the mode of keratinization or the origin of the tumors. The clinicopathological features and the biological behavior of these two subtypes were compared. Among 63 patients with PTC, 45 (71%) were women and 18 (29%) were men. The most common site was the scalp (78%), followed by the trunk (13%). These tumors were well circumscribed subepidermal lesions and demonstrated uniform histologic pattern with varying degrees of cytologic atypia. A few tumors extended into the epidermis and occasionally became ulcerated. Follow‐up of 59 (94%) PTC for an average of 4 years revealed recurrence in one. Ten tumors demonstrated carcinomatous changes including one with anaplastic carcinoma and regional lymph node metastasis. None of these tumors recurred or developed further metastasis following wide excision. Of 33 PECs, 12 (36%) occurred in women and 21 (64%) in men. These tumors were widely distributed in the pelvic and anogenital areas (36%), followed by the scalp (21%), upper extremities (18%), and trunk (15%). Seventy‐nine percent of the PECs were located in areas outside the scalp. The PECs were subepidermal tumors but often communicated to the surface. The histologic pattern of PEC was more variable than that of PTC. Seven tumors exhibited carcinomatous changes. Follow‐up of 30 (91 %) PEC revealed local recurrences in 6, with multiple recurrences in 3, and extensive local invasion in 2, resulting in death in one. Greater anaplasia, high mitotic rate and deeper invasion were associated with increased incidence of recurrence and aggressive behavior. Although both PTC and PEC were locally aggressive tumors and potentially malignant, distant metastasis was unusual. These tumors should be treated with wide local excision, especially those showing cytologic atypia and carcinomatous changes.
CD44v6 is a marker for systemic spread in cutaneous T‐cell lymphomas
Authors: Dommann Stefan N. W. , Ziegler Thomas , Dommann‐Schener Corina C. , Meyer Jü , Panizzon Renato , Burg Günter
Published: April 2006

Adhesion molecules are involved in leukocyte recruitment, lymphocyte recirculation, and in several aspects of tumour biology. Recent discoveries of surface proteins on tumour cells involved in tumour metastasis may explain the invasive behaviour, the migration involving reversible adhesive contacts, the release into the circulation and the extravasation of tumour cells.

CD44 is a family of glycoproteins involved in cell‐cell and cell‐matrix interactions. The v6 (variant exon v6) form of CD44 confers a metastatic potential onto some carcinoma cells. In the present study, the expression of CD44v6 on skin biopsies of 10 inflammatory skin diseases, 30 cutaneous lymphomas (CL), 11 reactive lymph nodes, 10 primary nodal non‐Hodgkin's lymphomas (NHL) and 5 secondary nodal NHL was investigated immunohistochemically.

None of the 10 nodal NHL were CD44v6 positive for the neo‐plastic B‐ or T‐cells, whereas 11/12 CL with systemic spread showed a distinct CD44vG expression in the skin. CD44v6 was not expressed on the tumour cells of skin biopsies of patients without systemic spread (18 cases of CL). In conclusion, CD44v6 expression is connected to an aggressive behaviour of CL.
Neurotropic melanoma with prominent melanization
Authors: Barnhill Raymond L. , Bolognia Jean L.
Published: April 2006

Neurotropic melanoma has generally been described in the context of desmoplastic melanoma. The vast majority of melanomas displaying neurotropism contain relatively little or no melanin. Herein, we report an unusual case of neurotropic melanoma with prominent melanin content. The patient developed a tumor notable For pagetoid (superficial spreading) melanoma with partial regression and a deep component characterized by perineurial aggregates of melanophages and intraneural infiltration by melanoma cells. This case serves to alert dermatopathologists to the fact that the spectrum of neurotropic melanoma includes tumors with perineurial aggregates of pigment‐containing cells.
Trisomy 7 in keratoacanthoma and squamous cell carcinoma detected by fluorescence in‐situ hybridization
Authors: Cheville John C. , Bromley Christine , Argenyi Zsolt B.
Published: April 2006

Keratoacanthoma (KA) is generally considered to be a clinically and histologically distinct entity, but it often remains difficult to separate from well‐differentiated squamous cell carcinoma (WDSCC). Recently, trisomy 7 has been identified in squamous cell carcinoma of the skin. In this study, we examined classical KA (n=6), WDSCC (n=7) and squamous cell carcinoma with KA‐like features (SCC‐KA) (n=8) for trisomy 7 by fluorescence in‐situ hybridization (FISH) to determine if this chromosomal abnormality is unique to squamous lesions diagnosed as WDSCC, or shared by both KA and SCC. In addition, the pertinent clinical‐histopathologic findings were summarized. Trisomy 7 was identified in one KA, one SCC‐KA and two WDSCC. This study demonstrates that there is a chromosomal abnormality shared by KA and SCC, providing further evidence that KA is most likely a form of SCC. Further studies are required to determine if trisomy 7 in these lesions is of prognostic significance.
A nevoid plaque with histological changes of trichoepithelioma and cylindroma in Brooke‐Spiegler syndrome
Authors: Schirren Carl Georg , Wörle Birgit , Kind Peter , Plewig Gerd
Published: April 2006

Brooke‐Spiegler syndrome is characterized by the development of multiple trichoepitheliomas and cylindromas. In addition, multiple spiradenomas have been observed in this autosomal‐dominant inherited disease. We report a 53‐year‐old woman with multiple cylindromas on the head and neck and multiple trichoepitheliomas on the face. Additionally, she had had since birth a plaque on the right side of her neck containing two nodules with features of both cylindroma and trichoepithelioma. Immunohistochemical investigations revealed in the basaloid cells of trichoepithelioma an expression of CK5/6, CK 14, CK 17, CK 19 and vim en tin. The cells of the cylindroma lacked vimentin but expressed additionally CK 7, CK 8 and CK 18. The occurrence of cylindroma and trichoepithelioma in a single nevoid plaque from a patient with Brooke‐Spiegler syndrome implies an alteration in the stem cells of the folliculosebaceous‐apocrine unit and could be characteristic of the disorder.
Juvenile xanthogranuloma: A clinical, histopathologic and immunohistochemical study
Authors: Sangüeza Omar P. , Salmon Julie K. , Jr. White Clifton R. , Beckstead Jay H.
Published: April 2006

Juvenile xanthogranuloma (JXC) is a benign histiocylic proliferation of uncertain histogenesis which usually resolves spontaneously. Histopathologically, classic lesions are characterized by diffuse proliferations of foamy histiocytes, many of which may be multinucleated (Toulon cells), admixed with lymphocytes and eosinophils. Histologic variants of JXG, perhaps representing evolving lesions, may lack these typical histopathological features, showing diffuse infiltrates of non‐foamy mononuclear histiocytes without Toulon cells, posing problems in differentiation from other histiocylic or melanocylic proliferations. Immunohistochemically, JXG is characterized by variable expressions of several histiocytic markers as well as the absence of staining for SI00 protein. To assess better the spectrum of histopathological and immunohistochemical features of JXG, we studied nine cases of classic or histologic variant of JXG. The cases were evaluated by light microscopy and with an extensive battery of antibodies. All 9 cases, regardless of their light microscopic appearance, showed markedly positive staining with histiocytic markers including CD68, HAM56, cathepsin B and vimentin, but did not stain for S100 protein. Antibodies to factor XIIIa stained positively in 8 cases while staining for other markers was variable. Our results suggest that the histiocytes in JXG lesions have macrophagic differentiation, probably representing a reactive process to an unknown stimulus.
Cutaneous pseudosarcomatous polyp: a histological and immunohistochemical study
Authors: Williams Burson T. , Barr Ronald J. , Barrett Terry L , Everett Mark A. , Lin Fritz
Published: April 2006

Two unusual acquired polypoid skin lesions exhibited prominent histological atypia, but were biologically benign. Both patients were elderly females. The lesions clinically mimicked fibroepithelial polyp or nevus lipomatosus. Both had been present for about 20 years. One lesion was located on the back, the other on the posterior thigh. Each lesion exhibited dilated, hyalinized vessels in the dermis with focal fibrin deposits, myxoid stroma, and a population of bizarre, pleomorphic spindle to stellate cells, some of which were multinucleated. Occasional atypical mitoses were present. One lesion had abundant admixed fat. Immunohistochemical staining was strongly positive only for vimentin. The lesions share features with degenerating angiofibroma and vaginal pseudosarcomatous polyp. As in these lesions, the atypia is most probably reactive and degenerative.
T‐cell receptor β variable region (Vβ) usage in cutaneous T‐cell lymphomas (CTCL) in comparison to normal and eczematous skin
Authors: Potoczna Natascha , Boehncke Wolf‐Henning , Nestle Frank O. , Küenzlen Christiane , Sterry Wolfram , Burg Günter , Dummer Reinhard
Published: April 2006

Cutaneous T‐cell lymphomas (CTCL) are a heterogeneous group of lymphoproliferative disorders. We investigated the variable region (Vβ) of the T‐cell receptor (TCR) repertoire in CTCL and compared it to the Vβ repertoire in normal and eczematous skin.

We used a panel of 21 anti‐Vβ antibodies and investigated 84 biopsies of 71 CTCL patients (4 parapsoriasis en grandes plaques (PA), 1 lymphomatoid papulosis, 29 mycosis fungoides (MF), 13 Sezary syndrome (SS), 1 CD8+ CTCL, 11 pleomorphic CTCL (PLEO), 12 CTCL not classified). Six biopsies of normal skin and 6 of eczematous skin lesions served as controls. We determined the frequency of the Vβ in normal and inflamed skin and compared it to the percentage of the respective Vβ in the malignant clone of the CTCL patients.

The percentage of the Vβ positive CD4+ cells in relation to the total number of T cells in normal skin and inflamed skin differed from the distribution of the Vβ families in the peripheral blood monoiiuclear cells (PBMC). Out of 71 CTCL cases, the clone was identified in 23 (32%). We identified the following clones : 1 V03.1 (1 MF), 7 V05.1 (1 CD8+ CTCL.l CTCL not classified, 1 MF, 1 PA, 3 SS), 1 V|36.7 (1 SS), 7 Vβ8.1/8.2 (2 CTCL not classified,! PLEO, 2 MF, 2 SS), 1 V012.1 (1 PLEO), 3 Vβl7.1 (2 CTCL not classified, 1 MF), 2 Vβ22.1 (1 CTCL not classified, 1 MF), 1 TCR8 (SS). The frequency of the malignant clone Vβ usage corresponded well to the repertoire of Vβ in eczematous skin but not to the repertoire in PBMC. In 6 patients, the malignant clone was mainly localized in the epidermis. In 17 cases, the clone‐specific cells were distributed in epidermis and dermis equally. A retrospective analysis showed that preferential epidermal homing of the clone was associated with a non‐aggressive clinical course.

The Vβ usage of CTCL and eczema suggests a special cutaneous microenvironment which might be co‐created by certain (bacterial?) superantigens. A preferential epidermal homing of the clone might have prognostic implications.
The value of Nm23 expression as an independent prognostic indicator in primary thick melanoma
Authors: Holmes Susan C. , MacKie Rona M.
Published: April 2006

Whilst tumour thickness is of great value in predicting prognosis for groups of patients in different categories, it is of less value for individual patients. It has been proposed that expression of the nm23 gene, a putative tumour suppressor gene, is associated with improved outcome in a number of human neoplasms including malignant melanoma. We assessed nm23 expression in 22 patients who had primary melanomas > 3mm thick. Ten have survived to date and 12 died of melanoma. Using immunohistochemical methods, we found no significant differences in gene expression between the two groups.
Cutaneous angiomyolipoma
Authors: Fernando Val‐Bernal J. , Mira Conceptión
Published: April 2006

Extrarenal angiomyolipomas are rare lesions. An angiomyolipoma located on the right ear lobe in a 49‐year‐old man is reported. Pathologic examination showed a well‐circumscribed subcutaneous nodule, 2 cm in diameter. The components of the tumor were confirmed by immunohistochemistry. Reactivity for HMB‐45 was negative. A review of the twelve published cases, including the present, reveals that the patients' age ranged from 33 to 77 years (mean 53.6); the male/female ratio was 11:1. The tumors were solitary, asymptomatic, noninvasive, located most commonly in acral skin or on the ear. The clinical impression is that of a cyst, a lipoma or a vascular tumor. Signs of tuberous sclerosis were absent in all cases. In contrast to the renal form, the cutaneous angiomyolipoma is a tumor differing in sex predominance, clinical associations, circumscription, solitariness, and HMB‐45 immunoreactivity. Distinction from other mesenchymal lesions depends on recognition of traditional histologic criteria.
Ossifying fibromyxoid tumor of soft parts: a case report and review
Authors: Barrett Terry L. , Skelton Henry G. , Smith Kathleen J. , O'Grady Terry C. , Proctor‐Shipman Lynn
Published: April 2006

Ossifying fibromyxoid tumor of soft parts is a recently described, rare but morphologically distinctive tumor of soft tissue, including subcutaneous soft tissue. We report a case of ossifying fibromyxoid tumor of soft parts which occurred in the subcutaneous tissue of a 68‐year‐olcl male, and review the clinical, histologic, and immunohistologic features of this tumor. Ossifying fibromyxoid tumor of soft parts tends to occur in the subcutaneous tissue and have been reported from the head and neck, upper and lower extremities, and trunk. Immunohistologic studies have supported a neural origin. While considered benign, local recurrence after excision is common and these tumors should be excised with clear margins to prevent recurrence.
Comparative genomic hybridization (CGH) discloses chromosomal and subchromosomal copy number changes in Merkel cell carcinomas
Authors: Härle M. , Arens N. , Moll I. , Back W. , Schulz T. , Scherthan H.
Published: April 2006

We analyzed three Merkel cell carcinomas (MCC), applying comparative genomic hybridization (CGH) with DNA from paraffin‐embedded and cultured tumor material as the probes. By this method, numerous changes in chromosome copy numbers were observed in each tumor investigated. Recurrent gains of chromosomes 1, 6, 18q and 20 were detected in two tumors. A third tumor showed complex chromosomal copy number changes, including gain of chromosome 8 and 9. These gains, as well as gain of chromosome 1 in the first two tumors, were confirmed by fluorescence in situ hybridization to paraffin tissue sections. Our results support the view that important genes for MCC development may be located on chromosomes 1, 6, 18q and 20.
Changes in T‐cell phenotype and adhesion molecules expression in psoriatic lesions after low‐dose cyclosporin therapy
Authors: Servitje O. , Bordas X. , Serón D. , Vidaller A. , Moreno A. , Curcó N. , Sais G. , Peyrí J.
Published: April 2006

Cyclosporin is a very effective treatment for severe psoriasis, but its exact mechanism of action in this disease is not completely understood. It has been hypothesized that the drug could act through (lie inhibition of the expression of certain cell adhesion molecules on the keratinocytes prior to the reduction in the number of epidermal inflammatory cells. Several studies have focused on ICAM‐1 changes on keratinocytes and endothelial cells after cyclosporin treatment in psoriatic patients but their results have been somewhat contradictory. We examined changes in T‐cell markers and adhesion molecules among keratinocytes, enclothelial and inflammatory cells after low‐dose cyclosporin treatment for severe psoriasis.

We performed a histological and immunohistochemical study on psoriatic skin among 10 patients (7 males and 3 females; mean age 37 years) treated with low‐dose (2.5 mg/kg/day) cyclosporin, prior to therapy, after 1 month, and after 3 months of treatment. The mean PASI (Psoriasis Area and Severity Index) before treatment was 23±4, 13±7 after the first month of therapy, and 8±2 at the end of the third month of therapy. Pretherapy samples showed a moderate to severe inflammatory infiltrate mainly clue to T‐lymphocytes expressing a T‐cell memory (UCHL‐1) and helper/inducer (CD4) phenotype. Most of these cells also expressed HLA‐DR and LFA‐1 and ICAM‐1 antigens. Alter the treatment, an overall reduction in the degree of epidermal hyperplasia was seen (p=0.01). The severity of the infiltrate was clearly reduced (p=0.05), but no significant changes in the phenotype profile were observed. Although slightly reduced, endothelial ICAM‐1 expression persisted after cyclosporin therapy. Keratinocyte ICAM‐1 expression was uniformly and significantly reduced after 1 month and 3 months of therapy (p=0.01). These results support the hypothesis that cyclosporin interferes with the expression of keratinocyte adhesion molecules in patients with psoriasis.
Skin lesions revealing neonatal acute leukemias with monocytic differentiation. A report of 3 cases
Authors: Canioni D. , Fraitag S. , Thomas C. , Valensi F. , Griscelli C. , Brousse N.
Published: April 2006

Acute myelo‐monoblastic (AMML) and acute monoblastic (AML) leukemias have a bad prognosis, especially in children when occurring in the first months of life. We report 3 cases of such leukemias in which skin lesions preceded and revealed the leukaemia. For the 3 infants, cutaneous lesions appeared about one month before the other signs of leukaemia (2 AML and 1 AMML). Skin biopsies from all 3 infants revealed a heavy dermic infiltration by large cells with round or irregular vesicular nuclei and abundant pale cytoplasm. These atypical cells did not express any lymphoid markers but reacted strongly with monocytic‐macrophagic antibodies (CD68, GDIS and CD14). Two infants were treated by mitoxanthrone and cytarabine with complete remission. The third one was not treated because of a very poor general status. Skin involvement is frequent in these non‐lymphoid leukaemias (30% to 50% of cases). In only 7% of cases, leukemic skin lesions precede and reveal the other signs of leukemia by weeks or months. Then, it is very important to repeat the blood cell counts and to biopsy the skin lesions in order to make a diagnosis of leukemia as early as possible.
Induction of psoriasiform inflammation by a bacterial superantigen in the SCID‐hu xenogeneic transplantation model
Authors: Boehncke Wolf‐Henning , Zollner Thomas Matthias , Dressel Daniela , Kaufmann Roland
Published: April 2006

Psoriasis is a chronic skin disease affecting about 2% of the Caucasian population, characterized by co‐existing inflammation and epidermal hyperproliferation. A T‐lymphocyte‐mediated autoimmune reaction induced by bacterial superantigens might be central in its pathogenesis. To model psoriasiform inflammation, we transplanted clinically uninvolved skin from psoriatic patients onto SCID mice. Repetitive intradermal injections with a bacterial superantigen and simultaneous intraperitoneal injections with the patients' superantigen‐stimulated peripheral mononuclear blood cells resulted in an inflammatory reaction exhibiting some of the hallmarks of psoriasis, e.g. epidermal hy‐perproliferation, papillomatosis, focal neo‐expression of ICAM‐1, and an exocytotic T‐lymphocytic infiltrate characterized by the expression of the cutaneous lymphocyte‐associated antigen. These observations document the potential of superantigens to trigger psoriasiform dermatitis and provide a model to study lymphocyte homing.
Focal necrotizing panniculitis and vascular necrosis in rats given subcutaneous injections of cocaine hydrochloride
Authors: Scott Danny W. , Morrell Joan I. , Vernotica Ellen M.
Published: April 2006

Subcutaneous injections of cocaine hydrochloride in sterile physiological saline were administered to rats at a dosage of 20 or 40 mg. kg−1. Resultant skin lesions included focal areas of alopecia (within 1 to 2 days) which progressed to necrosis (within 2 to 7 days). Histologically, the skin lesions were characterized by necrotizing panniculitis and vascular necrosis, with only small numbers of inflammatory cells. The lesions may be ischemic in nature, and associated with cytotoxic properties of cocaine.
Primary cutaneous immunocytoma: report of an unusual case with secondary spreading to the gastrointestinal tract
Authors: Sangüeza Omar P. , Burket John M. , Sacks Yale
Published: April 2006

Cutaneous immunocytoma are low‐grade B‐cell lymphomas, which affect the skin either primarily or secondarily. Primary cutaneous immunocytomas usually present with one or a small number of lesions, mainly in the extremities. They generally remain confined to the skin. Histologically, there are polymorphous infiltrates of cells, in which the presence of monoclonal plasma cells is characteristic. We describe a case of cutaneous immunocytoma with secondary spread to the gastrointestinal tract.
Overexpression of the cyclin‐dependent kinase inhibitor p21WAF1/GIP1 in human cutaneous malignant melanoma
Authors: Trotter Martin J. , Tang Liren , Tron Victor A.
Published: April 2006

p2lWAFI/CIPI (p21) is an inhibitor of cyclin‐dependent kinases recently identified as the downstream effector of wild‐type p53‐me‐diated cell cycle arrest. The gene coding for p21 may function as a negative regulator of melanoma growth, progression, and metastasis. Using immunohistochemistry and Western blotting, we investigated the expression of p21 in human melanocytic proliferations. Immunohistochemical staining was performed on 13 common acquired nevi, 12 dysplastic nevi, 23 primary malignant melanomas, and 12 metastatic melanomas. Common acquired nevi showed minimal p21 staining (1.8±0.3%, mean±SEM). The percentage of positive nuclei was slightly elevated in dysplastic nevi (8.9±1.7%). Both primary malignant melanoma (29±3%) and metastatic melanoma (33±5%) demonstrated a significantly increased number of p21‐positive nuclei compared to benign lesions (p<0.001). p21 was strongly expressed even in actively proliferating lesions as confirmed by MIB‐1 labelling, and although the majority of p21‐positive cells likely represent a non‐proliferating population, staining was occasionally observed in cells undergoing mitosis, suggesting abnormal function of this cell cycle inhibitor in malignant melanoma. Overexpression of p21 in metastatic melanoma compared to common acquired nevi was confirmed by Western blot analysis of human tumor samples. These findings suggest that increased p21 expression relative to benign nevi is not sufficient to control melanoma growth in vivo.
An immunohistochemical analysis of radiation fibroblasts
Authors: Meehan Shane A. , LeBoit Philip E.
Published: April 2006

A commonly recognized feature of chronic radiation dermatitis is the presence of mesenchymal cells with large atypical nuclei known as radiation fibroblasts. Little is known about their lineage or potential for neoplastic transformation. To investigate these properties, we examined 16 biopsy specimens in which radiation fibroblasts were present with antisera to mesenchymal determinants (FXIIIa, CD34, HHF‐35), a proliferation marker (Ki‐67), and a tumor‐suppressor protein that is overexpressed in many cancers (p53). Radiation fibroblasts were largely negative for the markers of lineage that we employed – only 2 of 16 specimens showed strong expression of FXIIIa, with weak expression in another case. Scattered radiation fibroblasts expressed CD34 in one case. HHF‐35 (muscle specific actin) stained small, dendritic cells in the superficial dermis, but not radiation fibroblasts. P53 was not detected within radiation fibroblasts in any of our cases, but was overexpressed by endothelial cells in 2 cases. Ki‐67 stained rare endothelial and interstitial cells but not radiation fibroblasts. Radiation fibroblasts are immunophenotypically distinct from dermal dendrocytes and myofibroblasts. They appear to be non‐cycling cells, and do not express high levels of p53 despite their marked nuclear atypia. Their phenotype argues against their possible role as progenitors of atypical fibroxanthoma (AFX) and dermatofibrosarcoama protuberans (DFSP) which are associated with ionizing radiation‐induced skin damage.
The Revised European‐American Classification of Lymphoid Neoplasms (REAL): a new perspective for the classification of cutaneous lymphomas
Authors: Sander Christian A. , Kind Peter , Kaudewitz Peter , Raffeld Mark , Jaffe Elaine S.
Published: April 2006

Differing classification schemes for malignant lymphomas have been used in Europe and the United States. Attempts to translate between the principle classifications have been unsuccessful and historically it has been difficult to arrive at an unified approach. In addition, many new lymphoma entities have been recognized in recent years that are not delineated in any of the existing classification schemes.

To provide a unified international basis for clinical and investigative work in this field, in 1994 the International Lymphoma Study Group (ILSG) proposed a new classification termed Revised European‐American Classification of Lymphoid Neoplasms (REAL). This review discusses the REAL classification, especially as it pertains to cutaneous lymphomas, and provides insight into the clinicopathologic features of lymphoproliferative disease involving the skin.

The premise of the REAL classification is that a classification scheme should be based on the delineation of disease entities, utilizing pathologic, immunophenotypic, genetic, and clinical features. Therefore, if cutaneous involvement is an integral aspect of any lymphoma subtype, this clinical information is included in the definition of that neoplasm. We conclude that the principles of the REAL classification are applicable to cutaneous lymphomas, as well as lymphomas involving other anatomic sites.
Immunohistochemical analysis of keratin expression in clear cell syringoma
Authors: Ohnishi Takamitsu , Watanabe Shinichi
Published: April 2006

Immunophenotypes, especially expression of cytokeratins, in 9 cases of clear cell syringoma were examined using antibodies against epithelial membrane antigen (EMA), and 17 kinds of monoclonal anti‐keratin antibodies to investigate its histogenesis. In addition, 7 cases of conventional syringoma were selected for parallel assessment. Conventional syringoma expressed CK1 and CK10, which exists in the acrosyringium and the transitional portion between the acrosyringium and the dermal duct. Based on immunostaining with RCK102 and 35βH11, syringoma was thought to express CK5. Because expression of CK5 was observed in the basal cells of sweat duct ridge (lower acrosyringium) and the outer cells of the dermal duct, but not in the acrosyringium located at upper epidermis, we speculated that syringoma differentiated toward the transitional portion between the acrosyringium and the dermal duct. A comparative study of keratin expression between conventional and clear cell syringoma showed that there was no difference in the immunoreactivities. Based on the above observations, we confirmed that clear cell syringoma is a metabolic variant of conventional syringoma, and differentiates into the transitional portion between the acrosyringium and the dermal duct.
Herpetic syringitis associated with eccrine squamous syringometaplasia in HIV‐positive patients
Authors: Muñoz E. , Valks R. , Fernández‐Herrera J. , Fraga J.
Published: April 2006

Herpetic syringitis has been described as a rare manifestation of herpes virus infection in patients with an immunodeficiency, usually secondary to human immunodeficiency virus (HIV) infection. Eccrine squamous syringometaplasia (ESS) is an infrequent alteration of the eccrine duct epithelium reported in association with several conditions, including chronic ulcers, inflammatory processes, and patients receiving chemotherapy. The association of herpetic syringitis with ESS has not been reported before. We identified 3 cases of herpetic syringitis associated with ESS in patients with the acquired immunodeficiency syndrome. In 2 of 3 cases the signs of herpetic syringitis were limited to the meta‐plastic duct epithelium, but in 1 case there were also herpetic alterations without ESS.

The histological features of herpetic infection in HIV‐positive patients may be atypical and lack the typical epidermal alterations, observing only an extensive epidermal necrosis. In those cases, the alterations of the eccrine ducts may be a diagnostic clue in the diagnosis of herpetic infection. ESS of the ductal epithelium is probably secondary to the herpetic infection, although it might also stimulate the extension of the herpetic infection. Futher studies are needed to elucidate the association of ESS and herpes virus infection.
Spitz's nevi with halo reaction: a histopathologic study of 17 cases
Authors: Harvell Jeff D. , Meehan Shane A. , LeBoit Philip E.
Published: April 2006

Halo reactions to melanocytic nevi are a well‐recognized phenomenon. In contrast, halo reactions to Spitz's nevi have been reported only infrequently. Halo reactions may cause misdiagnosis of an otherwise benign nevus as melanoma because inflammatory cells sometimes obscure the architectural features of the underlying nevus, and may induce cytologic atypia. For Spitz's nevus where the distinction between malignancy and benignancy is already challenging, halo reactions compound the problem. We describe 17 examples of Spitz's nevus with halo reaction, and compare their immunohistochemical features with those of “ordinary” halo nevi. Only 2 of 17 lesions demonstrated clinically apparent halos. Clinical follow‐up was available for 12 of 17 cases. None of the 12 has persisted at the biopsy site or metastasized after an average 3.6‐year follow‐up period. Junctional, compound, intradermal, and combined types of Spitz's nevi were represented. All were characterized by symmetrical lymphocytic infiltrates which permeated the full thickness of the nevus, including junctional nests. Combined Spitz's nevi constituted more than one‐half of examples in this series (9/17 cases). The combined Spitz's nevus included a combination of Spitz's nevus with either an ordinary (common, banal) nevus or a superficial congenital type nevus. In these combined Spitz's nevi, the lymphocytic response was often directed exclusively to the Spitz's nevic component. Important distinguishing features from malignant melanoma arising in a pre‐existing nevus included symmetry and lateral circumscription of the spitzoid component, no large expansile‐appearing aggregates of melanocytes, a decrease in size of nests with increasing dermal depth, a lack of mitotic figures among melanocytes at the base, and a symmetrical and diffusely permeative lymphocytic response. Although the combined Spitz's nevus with halo reaction sometimes appeared asymmetrical at scanning magnification, each component of the combination was symmetrical, when examined independently. Probably because of reactive atypia, nuclear maturation with progressive descent into the dermis was sometimes absent. There were no obvious differences in immunohistochemical staining patterns among 4 Spitz's nevi with halo reaction, 5 regressing melanomas, and 5 benign halo nevi when stained with antibodies to S100, HMB‐45, OPD4, CDS, TIA‐1, CD1a, CD68, and Ki‐67.
Ultrastructural localization of gap junction protein connexin 43 in normal human skin, basal cell carcinoma, and squamous cell carcinoma
Authors: Tada Joji , Hashimoto Ken
Published: April 2006

The expression and localization of connexin 43 (Cx43) were investigated in normal human epidermis, pilosebaceous apparatus, basal cell carcinoma, and squamous cell carcinoma by immunofluorescence as well as by immunoelectron microscopy. In the normal epidermis the immunofluorescence was weak in the basal layer, increased in spinous layer and negative in the horny layer. In the sebaceous gland, peripheral lobular cells showed weak cell membrane dotted pattern. Cell membrane and cytoplasmic fluorescence was strong in the central lobular cells. In the lower hair follicle, the cortex, inner and outer root sheath cells showed cell membrane fluorecence. As cortical cells underwent keratinization, they lost Cx43 epitopes. Basal cell carcinoma and squamous cell carcinoma were poorly stained, and eccrine and apocrine glands were unstained. In immunoelectron microscopy, close membrane appositions of typical gap junctions were often observed in the spinous layers of the epidermis and the immunolabeling for Cx43 was seen along the gap junction structures. Circular and long gap junctions often were found in follicular root sheaths and sebaceous glands. Gold particles labeling Cx43 in these gap junctions were found on the gap junctions or localized in the cytoplasm near the gap junction membranes. Basal cell carcinoma and squamous cell carcinoma had a small number of small gap junctions, and gold particles were not only localized to gap junctions but scattered in the cytoplasm. No gap junctions were labeled in eccrine and apocrine glands. These findings confirmed that 1) long, curved or circular membrane appositions found in hair follicle and sebaceous gland are true gap junctions, 2) immature cells such as epidermal basal cells, peripheral germinative cells of sebaceous gland and basal and squamous cell carcinoma cells do not have fully developed gap junctions, and 3) Cx43 or its precursors are present in the cytoplasm as well as on poorly developed gap junctions in these immature cells. Immunofluorescence findings generally corresponded to ultrastructural distribution and structural maturity of gap junctions.
Hypopigmented common blue nevus
Authors: Carr Susan , See Jo‐anne , Wilkinson Barbara , Kossard Steven
Published: April 2006

Blue nevus is a benign pigmented lesion of dermal melanocytes with a number of histologic and clinical variants, of which the major types are the common blue nevus, cellular blue nevus and combined nevus.

This study describes 9 cases of hypopigmented blue nevus (HBN), a variant of common blue nevus in which there is minimal identifiable melanin pigment. We also discuss the usefulness of the immunoperoxidase stain HMB‐45 in relation to the diagnosis of HBN and the lesions with which it may be histologically confused, namely common intradermal nevus, dermatofibroma, neurofibroma, dermal scar and desmoplastic malignant melanoma. The HMB‐45 stain was found to be uniformly positive in all 9 cases of HBN, in contrast to the other dermal lesions which have been reported as either negative or showing only focal positivity. The physical distribution and age range of the patients in this study was similar to the age and sites for common BN, supporting the relationship between the 2 lesions. The occurrence of HBN in predominantly young adults indicates that this lesion is not a phenomenon due to ageing or degenerative change, and should be regarded as a variant of common blue nevus.
Histopathological changes of primary HIV infection. Description of three cases and review of the literature
Authors: Barnadas M. A. , Alegre M. , Baselga E. , Randazzo L. , Margall N. , Rabella N. , Curell R. , de Moragas J. M.
Published: April 2006

The histopathological changes observed in the cutaneous rash of three patients who suffered the acute phase of HFV infection are described. In all three patients a perivascular and interstitial inflammatory infiltrate was present in the upper and mid‐reticular dermis. In one biopsy isolated areas of epidermal necrosis were observed and in the two other biopsies a perifollicular inflammatory infiltrate was detected with perforation in one case. Furthermore, a periductal infiltrate was observed in one of these biopsies.
Perineurial cell tumor (perineurioma) with granular cells
Authors: Díaz‐Flores L. , Alvarez‐Argüelles H. , Madrid J. F. , Varela H. , Gonzalez MaP. , Gutierrez R.
Published: April 2006

A form of benign cutaneous tumor with perineurioma findings and with the presence of associated granular cells is described. The two cases studied consisted of whorls made up of a high number of circumferentially arranged flattened cells, with perineurial characteristics, including bipolar cell processes, pinocytotic vesicles, a basal lamina, a positive immunoreactivity for EMA, and absence of immunostaining for S‐100 protein. The granular cells, enclosed within the whorls, contained densely packed vesicles, particles with an apparently solid core, as well as membrane‐limited vacuoles with disintegrating cellular organelles and electron‐dense amorphous material. While failing to demonstrate any immunoreactivity for EMA, the granular cells showed positivity for S‐100 protein, which supports their Schwann‐cell origin. Due to its morphological and immunohistochemical characteristics, this peculiar form of tumor can be considered as a perineurioma with perineurial cell whorls and granular cell changes occurring in associated Schwann cells at the center of the whorls.
The intermediate filament peripherin is expressed in cutaneous melanocytic lesions
Authors: Prieto Victor G. , McNutt N. Scott , Lugo Jorge , Reed Jon A.
Published: April 2006

Peripherin is an intermediate filament involved in growth and development of the peripheral nervous system and is localized to neurons, some other cells derived from neural tube and neural crest, and some neuroendocrine cells (e.g. β cells of islets of Langerhans). Peripherin also has been demonstrated in neuroblastomas and cutaneous neuroendocrine (Merkel cell) carcinomas. The expression of peripherin by other cells derived from the neural crest is unknown.

We evaluated by immunohistochemistry 74 cutaneous melanocytic lesions including primary invasive malignant melanoma (IMM), melanoma in situ (MIS), atypical nevus (nevus with architectural disorder and cytologic atypia of melanocytes) (AN), spindle and epithelioid cell nevus (Spit/nevus) (SN), blue nevus (BN), and common intradermal benign melanocytic nevus (BMN) for expression of peripherin.

Peripherin was detected in a cytoplasmic distribution within tumor cells in 14/14 IMM and 8/10 MIS. For IMM, peripherin localised to both the intraepidermal and invasive dermal components. Peripherin was detected in 10/10 AN and 9/9 SN, being localized to the intraepidermal component and, focally, to the superficial dermal component of the lesions. The dendritic nevus cells in 15/15 BN also expressed peripherin. For most of the BMN, expression of peripherin was absent or limited to rare, scattered cells in the superficial portion of the lesions. Melanocytes in adjacent normal skin were not labeled in any of the lesions studied.

These results indicate that expression of peripherin is common in both benign and malignant melanocytic lesions, but not in normal resting adult melanocytes. Among benign lesions, expression of peripherin in the dermal component is rare except in the dendritic cells of BN. These findings provide evidence that the expression of peripherin, a marker of neuronal differentiation, is maintained by IMM, MIS, and BN, but is lost in the normal maturational sequence of the dermal component of other melanocytic lesions.
Eccrine syringofibroadenoma surrounding a squamous cell carcinoma: A case report
Authors: Lele Subodh M. , Gloster Elizabeth S. , Heilman Edward R. , Chen Patrick C. , Chen Chun‐Kuo , Anzil Archinto P. , Pozner Jason N. , Reardon Michael J.
Published: April 2006

A 91‐year‐old man presented with a 9.0 × 7.0 cm exophytic mass on the dorsum of the right foot, surrounded by a scaling hyperkeratotic plaque‐like lesion that had been present for many years. He had similar long‐standing hyperkeratotic plaque‐like lesions on both legs. Histopathologic examination of the exophytic mass revealed a well‐differentiated squamous cell carcinoma surrounded by an eccrine syringofibroadenoma (ESFA). Histochemistry, immunohistochemistry and electron microscopy support this diagnosis. To our knowledge, this is the only reported case of ESFA being intimately associated with a malignant neoplasm.