bluuebunny/crossref_metadata_2025 huggingface dataset:
Bullous congenital ichthyosiform erythroderma masquerading as dystrophic epidermolysis bullosa
Authors: Hashimoto K. , Takahashi S. , Freilich I.
Published: April 2006

A black baby, born al full term of a normal healthy mother, showed multiple erosions and ulcers. No history of skin diseases was known in the family. A skin biopsy taken shortly after birth from an arm lesion showed subepidermal edema and cavity formation. Electron microscopy showed clumping of microfibrils and anchoring fibril‐like fibers at the dermo‐epidermal junction. In more severely affected areas, absence of anchoring fibrils and collagenolysis were found and the diagnosis of dystrophic epidermolysis bullosa was made. Two weeks later, the lesions healed without leaving scars and a second biopsy from the chest area revealed typical histopathology of epidermolytic hyperkeratosis.
A comparative immunoperoxidase and histopathologic study of condylomata acuminata
Authors: Kimuka S. , Masuda M.
Published: April 2006

Thirty‐seven lesions from 29 patients with condylomata acuminata were comparatively studied by peroxidse‐antiperoxidase (PAP) technique and routine histopathology. PAP staining demonstrated pupillomavirus common antigen (PCA) mostly in the granular layer of the epidermis in 22 of 37 lesions (59%) of condylomata acuininata. Presence of PCA is closely correlated with the following histopathologic findings: 1) coarse keratohyalin granules; 2) perirmclear vacuolization or koilocytotic cells in the granular layer; 3) hypcrkeratosis with focal parakcratosis. From these findings it is concluded that these histopathologic findings suggest the presence of PCA, and that the presence of papillomavirus may play a role in the formation of these histopathologic features of condylomata acuminata.
Pilomatrix carcinoma: an immunohistochemical comparison with benign pilomatrixoma and other benign cutaneous lesions of pilar origin
Authors: Manivel C. , Wick M. R. , Mukai K.
Published: April 2006

Two new cases of pilomatrix carcinoma are reported. They were studied immunohistochemically for the presence of high and low‐molecular weight cytokeratins, beta‐2‐microglobulin, S‐100 protein, carcinoembryonic antigen, epithelial membrane anligen, blood group isoantigens, and peanut agglutinin binding. Results of these studies were compared with those obtained in immunohistologic analysis of 13 typical pilomatrixomas, and 4 other benign lesions with hair follicle differentiation. An attempt was made to correlate antigine expression with malignant transformation; however, there were no consistent differences between the 2 groups. It would seem that immunocytochemistry is of no assistance in differential diagnosis between benign and malignant hair matrical tumors. Hence, the pathologist must rely on morphological criteria alone to make a diagnosis of pilomatrix carcinoma.
Distant skin metastases in a long‐term survivor of malignant ameloblastoma
Authors: White R. M. , Patterson J. W.
Published: April 2006

We report a ease of distant cutaneous metastases in a 68‐year‐old patient with malignant ameloblastoma of the mandible. The metastatic lesions were first noted approximately 31 years after resection of the primary tumor. Metastases to lung, pleura, bone, and brain had also occurred. Histochemical findings differ from those described in adamantinoid basal cell carcinoma. Cutaneous metastasis probably resulted from hematogenous dissemination. To our knowledge, this is the first report of such an occurrence in English language literature.
The value of blood group‐specific lectin and endothelial associated antibodies in the diagnosis of vascular proliferations
Authors: Suzuki Y. , Hashimoto K. , Crissman J. , Kanzaki T. , Nishiyama S.
Published: April 2006

Blood vascular and lymphatic tumors were evaluated immunohistochemically by studying a spectrum of endothelial associated antigens. (1) UEA‐I lectin reacted with the tumor cells of one patient with malignant angioendothelioma in the non‐metastatic stage. However, when metastasis occurred, the binding sites of this lectin completely disappeared from the surface of the tumor cells in both original and metastatic lesions, suggesting the loss of blood group H antigen from the tumor cells could be used as an indicator of metastasis in this tumor. (2) Reaction with anti‐HLA‐A, B, C, intense in normal blood vessels, remained intensely positive in pyogenic granuloma and Kaposi's sarcoma, whereas it did not react with normal lymphatics and lymphangioma. This indicates that anti‐HLA‐A, B, C is useful in differentiating blood vascular structures from lymphatic structures in both normal and pathological conditions. (3) OKM5 reacted intensely with benign hyperplasius in pyogenic granuloma, while barely reacting with proliferating parts in Kaposi's sarcoma, suggesting the difference in staining patterns can be used to distinguish vascular proliferation or malignancy. (4) Reaction with anti‐Type IV collagen and anti‐laminin was intense in normal blood vessels, pyogenic granuloma and Kaposi's sarcoma, whereas reaction with these antibodies in normal lymphatics was patchy and irregular in its thickness.
Ultrastructural study of calcinosis universalis with dermatomyositis
Authors: Kawakami T. , Nakamura C. , Hasegawa H. , Eda S. , Akahane S. , Yamazaki T. , Takasu N.
Published: April 2006

Calcinosis universalis associated with dermatomyositis occurred in a 58‐year‐old woman. Tissues removed from the sublingual region in the patient were studied by ordinary microscopy, electron microscopy, and an electron‐microanalytic method. The calcified materials were distributed on collagen fibers and seemed to have a relationship with foci of fibrinoid degeneration. Moreover, globular and/or membranous structures, considered to originate from the degenerate cells of the stroma, were observed in these calcified zones. Some of them contained electron‐dense materials. Therefore, the globular and/or membranous structures were thought to be concerned with initial calcification in this case. Furthermore, irregular bone tissue was formed adjacent to the calcified masses. In addition, the calcified materials were identified by X‐ray diffraction examination and electron microscopy as hydroxyapatite.
Geographic tongue: an SEM study
Authors: Kullaa‐Mikkonen A.
Published: April 2006

In this study, scanning electron microscopy (SEM) was used to describe in detail the surface structure of geographic tongue. Tissue samples from the anterior part of the tongue were removed from 15 patients with geographic tongue and from 15 control subjects. Normally, the surface mucosa of the tongue was covered by filiform papillae, which consisted of the body and hairs. The mucosal surface of the body was smooth with some desquamating cells, but hairs were covered by an extensive plaque of microorganism. With SEM, the surface of geographic tongue contained 3 different types of mucosa: 1) atrophic area, 2) white margin, and 3) area of normal appearance. On the atrophic area, the mucosa formed low elevations, and hairs were lacking. At high magnification, the superficial cells of the low elevations were polygonal, and they had parallel or branching microplicae. The white margin contained many desquamating cells, which had broken microplicae or no surface structures. Here the inflammatory infiltrate of the epithelium and that of the subepithelial connective tissue was moderate. On the normal‐appearing area, desquamation of the mucosa on the papillar bodies was more pronounced than normally. On every specimen was a fissure, on the walls of which the superficial cells had broken microplicae and knob‐like structures. The adherence of Candidal hyphae within the superficial cells was seen in the area of the fissure. On the geographic tongue some fungiform papillae with taste pores were seen.
Neuroendocrine carcinoma of the skin: an immunohistochemical study of tumor markers and neuroendocrine products
Authors: Layfield L. , Ulich T. , Liao S. , Barr R. , Cheng L. , Lewin K. L.
Published: April 2006

Fifteen neuroendocrine carcinomas of the skin (Merkel cell tumors) were stained within the constraints of tissue availability by the Grimelius method and immunohistochemically for keratin, neuron‐specific enolase (NSE), carcinoembryonic antigen (CEA), S‐100, common leukocyte antigen (CLA), met‐enkephalin, bombesin, calcitonin, ACTH, gastrin, and somatostatin. Focal argyrophilia was present in 5 of 12 tumors. All tumors tested demonstrated immunoreactivity for NSE and 5 tumors were positive for keratin. One tumors appeared to demonstrate focal ACTH‐like immunoreactivity, but otherwise no immunoreactivity for the above mentioned polypeptide hormones was noted in 11 completely studied tumors. One tumor contained histologically obvious areas of squamous differentiation in addition to areas of Merkel cell tumor. In various tumors, keratin immunoreactivity was present either in areas of histologically obvious squamous differentiation, in randomly scattered single cells not histologically identifiable as squamous, or in a paranuelear dot‐like distribution. Immunoreactivity for CEA, S‐100, and CLA was not present in any tumors. The lack of met‐enkephalin and the presence of squamous differention in these tumors indicates multidirectional differentiation in a fashion not phenotypically typical of Merkel cells.
Immunohistochemical studies on epithelial cells in mixed tumor of the skin
Authors: Terui T. , Obata M. , Tagami H.
Published: April 2006

We performed studies on the lectin‐binding pattern in epithelial tumor cell components of 4 cases of mixed tumor of the skin developing on the face in addition to identification of keratin and carcinoembryonic antigen (CEA), compared with those of normal sweat glands. Normal eccrine glands showed specific labelling with Dolichos biflorus agglutinin (DBA) and soybean agglutinin (SBA), whereas none of the studied lectins reacted specifically with normal apocrine glands. In mixed tumors the dark cells, which form the inner layer of the tubuloalveolar and ductal structure, showed the presence of keratin and CEA, as well as of specific sugar structures that bind to DBA and SBA. On the other hand the light cells that form the outer layer of the tubular structures or the solid epithelial cell nests gave only a faint to moderate staining of keratin, and no staining of CEA or lectins. It is probable that the inner dark cells differentiate toward the cells that have the same sugar structures on the cell surface as those of the normal eccrine gland cells, while the outer light cells appear to be immature or in a less differentiated state.
Oral “hairy” leucoplakia in an African AIDS patient
Authors: De Maubeuge J. , Ledoux M. , Feremans W. , Zissis G. , Goens J. , Andre J. , Gourdain J. M. , Menu R. , De Wrr S. , Cran S. , Clumeck N. , Achten G.
Published: April 2006

A 34–year‐old African patient with AIDS developed a new form of oral leucoplakia closely resembling the “hairy” leucoplakia described by Greenspan in male homosexuals in the San Francisco area. A herpes‐like virus was seen on ultrastructural analysis with electron microscopy. This case supplies further evidence suggesting that the syndrome in patients originating in Central Africa is similar to the acquired immunodeficiency syndrome (AIDS) reported in American patients.
The alkaline phosphatase anti‐alkaline phosphatase technique in dermatopathology
Authors: Schaumburg‐Lever. G.
Published: April 2006

The APAAP technique is an unlabelled antibody bridge technique which can be used on either frozen or paraffinembedded sections. One applies first a monoclonal antibody, then a polyclonal bridge antibody, and finally a soluble complex of alkaline phosphatase and monoclonal mouse anti‐alkaline phosphatase. Subsequently, the enzyme label is developed with a naphthol salt and new fuchsia as a dye. This technique was used in our laboratory on frozen and/or paraffin embedded sections by using 15 different monoclonal antibodies, which are commercially available. The reaction product was bright red and could easily be distinguished from the brown color of melanin, which makes the APAAP technique particularly suitable for dermatopathology.
Meningioma of the scalp: a case report with immunohistological features
Authors: Theaker J.M. , Fleming K.A.
Published: April 2006

We report a case of a long‐standing subcutaneous nodule of the scalp in a young man, with the histological features of a primary cutaneous meningioma. The results of an immunohistological study using a panel of monoclonal antibodies gave a similar pattern to that seen in intracranial meningiomas, and distinct from other cutaneous lesions which may be considered in the differential diagnosis.
Eccrine sweat gland carcinoma: an histologic and immunohistochemical study of 32 cases*
Authors: Swanson P. E. , Cherwitz D. L. , Neumann M. P. , Wick M. R.
Published: April 2006

In an attempt to characterize the immunocytochemical attributes of eccrine sweat gland carcinoma, we studied 32 examples of this tumor with antibodies to epithelial membrane antigen (EMA), cytokeratin(CK), carcinoembryonic antigen, S100 protein, alpha‐lactalbumin, salivary amylase, blood group isoantigens, beta‐2‐microglobulin, and Leu Ml. All cases expressed EMA and CK, and 28 of 32 cases also displayed at least 2 of the 6 remaining antigens. No significant variations were noted in the immunophenotypes of histologic subtypes of eccrine carcinoma. These results provide an objective means of diagnostic separation between sweat gland carcinoma and other primary malignant cutaneous tumors. However, they do not appear to correlate with the degree of tumoral differentiation, and are of no assistance in the separation of benign and malignant sudoriferous neoplasms. The ability of immunocytochemical techniques to distinguish between primary malignant adnexal cutaneous tumors and metastases to the skin appears unlikely, but remains to be studied further. Also, the use of immunostaining panels is advised in the study of adnexal carcinomas, since no single determinant in isolation is specific for these neoplasms.
Generalized eruptive histiocytoma: an ultrastructural study
Authors: Shimizu N. , Ito M. , Sato Y.
Published: April 2006

A case of generalized eruptive histiocytoma (GEH) was evaluated and examined histopathologically and ultrastructurally. A 24‐year‐old male had an episode of high fever and drug‐induced eruption prior to the appearance of multiple skin lesions. Uniform, red to dark‐red papular lesions appeared on his cheeks and then became generalized. The lesions were composed of a massive dermal infiltrate of histiocytes, which had oval nuclei and amphophilic cytoplasm. The cytoplasm contained unique annular structures, myeloid bodies and vacuoles. The specificity of these structures is as yet unknown. Reactive stimulation rather than neoplastic proliferation may be a causative factor in GEH.
Aggressive digital papillary adenoma and adenocarcinoma. A clinicopathological study of 57 patients, with histochemical, immunopathological, and ultrastructural observations
Authors: Kao G. F. , Helwig E. B. , Graham J. H.
Published: April 2006

Fifty‐seven examples of a rare eccrine sweat gland tumor (aggressive digital papillary adenoma and adenocarcinoma) were studied by means of light microscopy, electron microscopy, and immunoperoxidase techniques. The neoplasm occurred as a single, painless mass, almost exclusively on the fingers, toes, and adjacent skin of the palms and soles. Microscopic features were distinct from those of other eccrine sweat gland tumors and often led to the diagnosis of such metastatic carcinoma as that of the breast. The characteristic histologic features included tubuloalveolar and ductal structures with areas of papillary projections protruding into cystic lumina. The stroma varied from thin, fibrous septae to areas of dense, hyalinized collagen. Forty tumors were classified as adenoma (ADPA) and 17 as adenocarcinoma (ADPAca). Histologically, ADPAca was distinguished from ADPA by its poor glandular differentiation and by necrosis, cellular atypia and pleomorphism, invasion of soft tissue and bone, and invasion of blood vessels. Eighteen (50%) patients with ADPA and 8 (47.0%) who had ADPAca developed recurrent lesions (2 months to 9 years) after surgical removal of the tumor. Seven (41.2%) patients with ADPAca developed metastases, of which 5 involved the lung. Three patients died of metastases, 5 to 20 years after surgical treatment of the primary tumor. The histologic malignant features in ADPAca are indicative of potential for distant metastasis and fatality. The recognition of aggressive digital papillary adenoma and adenocarcinoma as a distinct clinicopathological eccrine sweat gland neoplasm is important because of the potential for aggressive local growth and distant metastasis.
Calcifying epithelioma of Malherbe with ossification. Special reference to lectin binding and immunohistochemistry of ossified sites
Authors: Kumasa S. , Mori H. , Tsujimura T. , Mori M.
Published: April 2006

Lectin binding sites and immunohistochemically detectable fibronectin and carbonic anhydrase II (CA II) were examined in induced bone structure of calcifying epithelioma of Malherbe. Pathological features of ossification were particularly evident in the border zone between tumor epithelium and stroma, and epithelial foci adjacent to sites of bone formation were conspicuously basophilic. The use of lectin binding in these foci coincided with the basophilic epithelial zones: Con A, RCA‐1, PNA, SBA, and WGA bound strongly, indicating thepresence of glucose (Glu), mannose (Man), galactose (Gal), N‐acetyl‐D‐galactosamine (GalNAC), and N‐acetyl‐D‐glucosamine (GlcNAC). Fibronectin was also detected in the same epithclial‐mesenchymal interacting layers as the positive lectin‐binding sites. Staining for CA II was strongly positive in giant cells and in epithelial zones in the bone‐inducting areas. The bond induction mechanism in the stromal tissue of calicifying epithelioma of Malherbe may initially involve the action CA II in the epithelial‐mesenchymal interacting zone, which then brings about ossification of the matrix which is fibronectin‐positive and rich in lectin‐binding sites.
Paget's disease of the groin associated with adenocarcinoma of the urinary bladder
Authors: Ojeda V.J. , Heenan P. J. , Watson S. H.
Published: April 2006

A 70‐year‐old Caucasian male developed a left groin tumor with epidermal infiltration of Paget's type. Five months later the ureter was found to be obstructed by a bladder adenocarcinoma cytologically identical to the skin lesion. Both tumors contained carcinoembryonic antibodies, using the immunoperoxidase method. Despite radiation therapy, the patient died a month later. There are no previous reports of association between urinary bladder adenocarcinoma and extramammary Paget's disease of the skin.
Extramedullary (skin) presentation of acute monocytic leukemia resembling cutaneous lymphoma: morphological and immunulogical features
Authors: Blaustein J.C. , Narang S. , Palutke M. , Karanes C.
Published: April 2006

Acute monocytic leukemia has been noted to exhibit a predilection for extramedullary involvement (gums, skin, and lymph nodes) at presentation. More unusual is the occurrence in an extramedullary site in the absence of bone marrow involvement. A case is reported with initial presentation in skin preceding a subsequent evolution to a leukemic phase by one year. The skin tumor was initially diagnosed and treated as a lymphoma. A second skin tumor, biopsied one year later was immunophenotyped as a T cell lymphoma using a screening panel of anti‐sera (OK.T4 positive, OKM1 negative). Shortly thereafter a monocytic leukemia (M5) was discovered. Using a larger panel of antisera and enzyme markers on the second skin biopsy confirmed the monocytic rather than lymphocytic nature of the skin tumor. This case illustrates the importance of using an expanded panel of monoclonal antisera in certain hematopoietic tumors.
Dermal abscesses with Staphylococcus aureus, cytomegalovirus and acid‐fast bacilli in a patient with acquired immunodeficiency syndrome (AIDS)
Authors: Boudreau S. , Hines H. C. , Hood A. F.
Published: April 2006

A 34‐year‐old man with acquired immunodeficiency syndrome presented with multiple skin lesions clinically suggestive of molluscum contagiosum. Three skin biopsy specimens were obtained which showed dermal abscesses containing multiple gram‐positive cocci admixed with granular necrotic dermal material. In 2, there were cytomegalic inclusions present in macro‐phages and endothelial cells within the granulation tissue; immunohistochemistry was positive for cytomegalovirus (CMV) antigens. One biopsy specimen also contained a few acid‐fast bacilli associated with mononuclear inflammatory cells. Cultures from the lesions grew Staphylococcus aureus and the lesions resolved when the patient was administered a course of systemic cephalosporin. Although lesions with multiple infectious agents have been reported in immunosuppressed patients, this is the first case describing the association of 3 organisms in a single skin biopsy specimen.
Elastic globes: electron microscopic and immunohistochemical observations
Authors: Nakayama H. , Hashimoto K. , Kambe N. , Eng A.
Published: April 2006

Specimens from a patient with epidermolysis bullosa contained many elastic globes in the dermis. Ultrastructurally they were composed of (i) medium electron‐dense amorphous substances, (ii) electron‐dense round structures, and (iii) fine filaments. These various elements were seldom organized into typical normal elastic fiber and, therefore, it was difficult ultrastructurally to recognize them as such or components thereof. Immunohistochemically, elastic globes were strongly reactive with NKH‐1, which stains elastic microfibrils, and antibody to serum amyloid P component (anti‐SAP), which binds to elastic fiber micro‐fibrils. However, elastic globes were negative with EKH‐4 which recognizes 50 kd keratin of amyloid keratin and cytoid bodies. These findings suggested that elastic globes have a close immunologic profile to elastic fiber microfibrils, but not that of epidermal or epithelial keratin.
Quantitation of S100 protein‐positive cells in inflamed and non‐inflamed keratoacanthoma and squamous cell carcinoma
Authors: Korenberg R. , Penneys N. S. , Kowalczyk A. , Nadji M.
Published: April 2006

Langerhans cells (LC) were identified and quantitated in non‐inflamed keratoacanthoma (KA), inflamed KA, non‐inflamed squamous cell carcinoma (SCC), and inflamed SCC, by their content of S100 protein. The number of LCs per high‐power field was markedly increased in inflamed KA when compared to the other groups. Using similar methods on frozen sections, the expression of HLA‐DR was identified on keratinocytes in KA in areas of inflammation but not in other lesions under study. We hypothesize that increased numbers of LCs in inflamed KA are part of the process which results in tumor regression.
Lycopodium granuloma
Authors: Nadjem M. A. , Graham J. H. , Johnson F. B.
Published: April 2006

The spores of Lycopodium (L) clavatum were used as a component of a dusting powder in many hospitals during the 1920's and 1930's. When L spores enter surgical wounds a lesion clinically resembling tuberculosis or neoplasia may develop months or even years later. We recently encountered a case of L granuloma occurring in a patient 50 years after an appendectomy. Three additional cases found in the files of the AFIP are also reported.
Subcutaneous sarcoidosis with extensive caseation necrosis
Authors: Kuramoto Y. , Shindo Y. , Tagami H.
Published: April 2006

We report a 24‐year‐old male patient with sarcoidosis who developed subcutaneous nodules on his thighs and buttocks at the sites of repeated intramuscular injections. Histologically, there were extensive areas of caseation necrosis surrounded by typical sarcoidal granuloma. The nodules regressed spontaneously over a period of 4 months, concurrently, both his bilateral hilar adenopathy and the results of immunological tests, returned to normal. We think that these lesions developed at the sites of subcutaneous scar tissue induced by frequent injections in childhood. We believe the pathomechanism to be similar to that for scar sarcoidosis, and that the extensive caseation necrosis reflected a regressing stage of the disease.
Anti‐Leu 19 monoclonal antibody detects an antigen on autonomic nerves in human skin
Authors: Niedecken H. , Wehrmann W. , Bauer R. , Kreysel H. W.
Published: April 2006

The monoclonal antibody anti‐Leu 19 recognizes the NKH‐1 antigen of active natural killer cells. In immunohistological preparations of the skin, the antibody reacts with cutaneous nerves and labels nerve fibers in the region of the sweat glands, the blood vessels and the hair arrector muscles. This staining pattern corresponds to the distribution of the autonomic sympathetic nervous system of the skin. On the other hand, anti‐Leu 7 labels a myelin‐associated glycoprotein which is to be found in the myelin‐sheath of sensory cutaneous nerves. The reactivity of neural structures of the skin can thus be differentiated. Anti‐Leu 7 labels the myelinated sensory nervous system, whereas anti‐Leu 19 seems to constitute a new marker for the autonomic nervous system of the skin.
Multiple eccrine spiradenoma: case report and review
Authors: Revis P. , Chyu J. , Medenica M.
Published: April 2006

Benign eccrine spiradenoma is an adnexal tumor that occurs as either a solitary lesion or as multiple nodules. A case of multiple eccrine spiradenoma occurring on the scalp and mimicking multiple cylindroma is described and discussed. In addition, 9 previously reported cases of multiple eccrine spiradenoma are reviewed.
Cutaneous IgA subclasses in dermatitis herpetiformis and linear IgA disease
Authors: Wojnarowska F. , Delacroix D. , Gengoux P.
Published: April 2006

The subclasses of the cutaneous IgA were studied in 8 patients with dermatitis herpetiformis and 4 with linear IgA disease. The cutaneous IgA in dermatitis herpetiformis consisted of both IgAl and IgA2, although IgAl predominated. This demonstrated that the IgA is polyclonal and may be both mucosal and blood derived. The IgA in linear IgA disease was exclusively IgA1, confirming previous work, and suggesting that mucosal IgA may not make a major contribution to the skin deposits.
Progressive macular hypomelanosis of the trunk: primary acquired hypopigmentation
Authors: Guillet G. , Helenon R. , Gauthier Y. , Surleve‐Bazeille J. E. , Plantin P. , Sassolas B.
Published: April 2006

Dermatological practice in Martinique frequently encounters a bizarre skin condition presenting as a progressive and extensive hypomelanosis on the back. The course of this disorder is highly characteristic: it occurs mainly in females from 18–25 years of age, with a progressive development of round, pale, coalescent macules on the back and sometimes on the abdomen. This disease, which does not respond to therapy, spontaneously regresses within 3 to 4 years. Decreased epidermal melanin is the only histological feature. Ultrastructural examination of two cases found that the macular lesions were characterized by a switch from Stage IV single melanosomes (negroid) to small Type I‐III aggregated melanosomes (caucasoid). It may thus be stated that the variation in skin coloration in these patients was due to a variation in melanosome size and distribution.
The 43 kDa papain inhibitor in normal and diseased skin
Authors: Aho H. , Joronen I. , Järvinen M. , Rinne A. , Hopsu‐Havu V. K.
Published: April 2006

The presence of 43 kDa papain inhibitor in 43 different skin diseases was immunohistochemically studied by using both poly‐and monoclonal antibodies. Psoriasis and various eczematoid reactions as well as viral infections showed the most pronounced staining in the squamous cells of the epidermis. The antigen was also present in benign tumours or precancerous lesions which showed keratinization. Cells of poorly differentiated squamous cell carcinomas, basal cell carcinomas and melanocytic tumours were negative. The antigen seems to be related to disturbed keratinization and benign proliferation in non‐neoplastic derma‐toses and it is also present in differentiating squamous neoplasms.
Perforating pilomatricoma
Authors: Zulaica A. , Peteiro C. , Quintas C. , Pereiro M. , Toribio J.
Published: April 2006

A case of perforating pilomatricoma is described. A few published cases have shared the following features: rapid development, reddish exophytic clinical appearance with surface alterations suggestive of perforation, relatively shallow location making contact with the epidermis, and the occurrence of transepithelial elimination phenomena.
Clear cell carcinoma of the skin: a tricholemmal carcinoma?
Authors: Lee J. Y. , Tang C. K. , Leung Y. S.
Published: April 2006

We report the light and electron microscopic findings of an unusual, locally aggressive cutaneous clear cell carcinoma involving extensively the left cheek and upper lip of a 61–year‐old woman. The patient remained free of recurrence 5 years after wide local excision. Microscopically, the tumor was a poorly circumscribed and deeply invasive clear cell neoplasm characterized by large lobules and convoluted trabeculae of polygonal and columnar cells with palisading of the peripheral cells rimmed by thick basement membranes, and horn microcysts with tricholemmal keratinization. The tumor infiltrated the muscle and the salivary glands. Only slight cytologic atypia and a few mitotic figures were present. No definite ductal differentiation was found. Immunoperoxidase staining for carcinoembryonic and epithelial membrane antigens was negative. Ultrastructurally, the tumor cells were joined by desmosomes, and surrounded by thick basal lamina. The cytoplasm contained large pools of glycogen. Peculiar whorls of tonofilaments and aggregates of needle‐shaped and club‐shaped structures were observed in a small keratinizing focus. The tumor showed features resembling the outer root sheath of the hair follicle microscopically. Furthermore, the lack of duct‐like structures and immunoreactivity of carcinoembryonic antigen tend to favor tricholemmal over sweat gland differentiation in this tumor which possibly represents a rare example of tricholemmal carcinoma.
Focal acantholytic dyskeratosis in condyloma acuminata
Authors: Kolbusz R. V. , Fretzin D. F.
Published: April 2006

Focal acantholytic dyskeratosis (FAD) is considered an incidental histological finding of unknown etiology. It has been described in association with only few pathological conditions. To the best of our knowledge, we report the first case of focal acantholytic dyskeratosis occurring in condyloma acuminata.
HMB‐45 recognizes stimulated melanocytes
Authors: Smoller B. R. , McNutt N. S. , Hsu A.
Published: April 2006

A monoclonal antibody (HMB‐45) was previously reported to bind to melanoma cells, and the junctional component of nevus cells, but not to normal adult melanocytes. We have tested HMB‐45 binding in several conditions under which melanocyte stimulation might be expected in adults, i.e.3 simple lentigines, 2 solar lentigines, 7 recent surgical scars from re‐excision of non‐melanocytic tumors), 2 surgical scars from re‐excisions of melanomas (after complete primary excisions), 9hemangiomas from non‐sun‐exposed skin, I basal cell carcinoma, I acute ecchymosis, I keloid, and I dermatofibroma. Positive controls included 6 malignant melanomas and I fetal skin sample. Melanocytes were strongly positively stained overlying hemangiomas, within or near recent surgical scars of melanocytic and non melanocytic tumor re‐excisons, near basel cell carcinoma, and in fetal skin. Melanocytes either were not stained or were stained only focally for trace amounts in the normal skin near the new margins of the wide re‐excision specimens for melanoma, i.e., at a distance from the scar, in the simple lentigines and in the fibrotic lesions. Thus HMB‐45 is staining an antigen which appears in adult melanocytes during stimulation and in fetal skin, as well as in melanomas. This stimulation is associated with condition that would have increased vascularity, suggesting a melanocyte response to a plasma factor, or other endothelial cell derived factor. HMB‐45 would not be a useful marker for residual melanoma cells in melanoma re‐excision specimens.
Follicular cyst derived from hair matrix and outer root sheath
Authors: Satoh T. , Mitoh Y. , Katsumata M. , Tokura Y. , Takigawa M.
Published: April 2006

A new follicular cyst was reported. The lower part of the cyst wall was composed of both basophilic and shadow cells as seen in pilomatricoma, whereas the upper part of the wall consisted of clear cells. Our case apparently derives from hair matrix and outer root sheath.
Histologic changes induced in skin by extravasation of doxorubicin (adriamycin)
Authors: Bhawan J. , Petry J. , Rybak M.E.
Published: April 2006

Extravasation of doxorubicin in skin and soft tissue causes necrosis and ulceration. These ulcers form slowly and heal with great difficulty. The cause of ulceration is not known. Histologic changes in two patients suggest that an exaggeration of interface dermatitis like epidermal changes may be responsible for epidermal necrosis. This process may be enhanced or complicated by ischemic changes caused by thrombosis of the venous tributaries at the site of the intravenous infusions. Squamous syringometaplasia seen in both cases can be confused with squamous cell carcinoma. Dermal changes mimic those seen in radiation injury.
Cyanoacrylate skin surface stripping: an improved approach for distinguishing dysplastic nevi from malignant melanomas
Authors: Piérard G. E. , Piérard‐Franchimont C. , Estrada J. Arrese , Delvoye P. , Henry C. , Damseaux M. , Leć T. , Hermans J. F. , Letot B. , Mélotte P. , Van Cauwenberge D. , Ben Mosbah T. , Gharbi R.
Published: April 2006

We present a novel approach for improving the management of patients with pigmented neoplasms including malignant melanomas and dysplastic nevi. A cohort of 215 dysplastic nevi and malignant melanomas was studied by cyanoacrylate skin surface stripping (CSSS) and conventional histology. Presence of atypical melanocytes was found in the stratum corneum in more than 95% of malignant melanomas and was always absent in dysplastic nevi. We conclude that this non‐invasive technique is rapid, easy to perform, and inexpensive. Its specificity and sensitivity are high enough to be considered by clinicians as an aid for distinguishing dysplastic nevi from malignant melanomas. We recommend this ancillary technique as a screening procedure though not as a substitute for conservative excisional biopsy, when doubt persists in the diagnosis of atypical pigmented neoplasms.
Xanthomatous infiltrate of the face
Authors: Smoller B. R. , McNutt N. S. , Kline M. , Gray M. H. , Balin A.
Published: April 2006

We report 2 cases which shared an unusual histopathologic pattern of a xanthomatous infiltrate occurring on the nose. Both patients were women in their fifth decade. Each presented to the dermatology clinic with multiple soft, flesh‐colored papules, up to 1 cm, in diameter on the lateral aspects of the nose. The lesions had been present for several years. Both patients were otherwise completely well, and asymptomatic. In one case, focal telangiectasia and central umbilication was noted, and the clinical differential diagnoses included basal cell carcinomas and appendageal tumors. In each case, a biopsy was performed. The lesions appeared histologically quite similar. The epidermis was unremarkable. Within the dermis, there was a mid‐reticular dermal infiltrate of macrophages with unilocular and multilocular fat laden cytoplasm, and scalloped nuclei. Only a scant inflammatory infiltrate of lymphocytes and histiocytes was present. Minimal dermal fibrosis was also present. We believe that xanthomatous infiltrate of the face is a distinct clinical entity which presents as multiple flesh‐colored papules on the nose, which have a characteristic histologic appearance of abundant lipid‐laden macrophages within the dermis.
Histochemical differentiation of localized morphea‐scleroderma and lichen sclerosus et atrophicus
Authors: Rahbari H.
Published: April 2006

Dermatologic literature has debated the occurrence of concommitant morphea‐scleroderma (M‐S) and lichen sclerosus et atrophicus (LSA) for sometime. Presentation of a case which has the appearance of both M‐S and LSA creates a diagnostic dilemma frequently unresolved even by histopathology. Routine hematoxylin and eosin stained sections may add to the confusion and the difficulty of the differentiation, but examination for the presence or absence of elastic fibers in the upper corium of the lesions affords a definitive separation of these two conditions.
Oral melanoacanthoma with prominent spongiotic intraepithelial vesicles
Authors: Zemtsov A. , Bergfeld W. F.
Published: April 2006

Oral melanoacanthoma is a rarely‐reported, benign pigmented lesion of oral mucosa. Spongiosis was only recently mentioned as a light‐microscopical finding occasionally seen in oral melanoacanthoma, and the formation of spongiotic intraepithelial vesicles to our knowledge has never been reported. The authors discuss a case of a 34‐year‐old, black woman who acutely developed extensive hyperpigmented oral lesions which on the biopsy showed both intraepithelial dendritic melanocytes and severe spongiosis forming intraepithelial vesicles. These lesions resolved spontaneously in a few months which led the authors to believe that the term melanoacanthoma, implying that it is a tumor, is a misnomer. This report supports findings of other investigators who consider oral melanoacanthoma to be a mucositis with unusual proliferation of dendritic melanocytes in the epidermis.
Bullous pemphigoid and dermatitis herpetiformis: mixed bullous disease or coexistence of two separate entities?
Authors: Sander H. M. , Utz M. M. P. , Peters M. S.
Published: April 2006

We present a 73‐year‐old man with a 5‐year history of dermatitis herpetiformis who developed lesions with the clinical, histologic, and immunologic features of bullous pemphigoid. Direct immunoflurescence testing of a skin biopsy demonstrated both granular deposition of IgA, predominantly in the papillary bodies, and linear deposition of IgG and C3 at the basement membrane zone. This mixed direct immunofluorescence pattern, typical for dermatitis herpetiformis in the type of IgA deposits, but also typical for pemphigoid in the linear localization of IgG and C3, is unusual. This case emphasizes that even after a specific diagnosis has been established, if the clinical morphology or response to therapy changes, repeat histologic and immunofluorescence studies may be indicated in diagnosis and management of patients with bullous disease.
Immunoelectron microscopic study of the basement membrane in oral lichen planus
Authors: Jungell Peter
Published: April 2006

The present study investigated the nature of basement membrane changes in oral lichen planus. For this purpose antibodies to type IV collagen, laminin and fibronectin were applied in avidin‐biotin peroxidase complex staining using a pre‐embed‐ding immunoelectron microscopy technique. Immunoreactivity to type IV collagen and laminin was restricted to the sub‐basal basement membrane and the basement membrane branches extending into the lamina propria. Immunoreactivity to fibronectin was noted also in the connective tissue as a network‐like arrangement of thin strands. Although local activated CDB+ cytotoxic lymphocytes and tissue macrophages may be involved in the local pathogenetic process, these findings suggest that the basement membrane alterations are secondary to pathologic changes in the basal cells.
Extraocular sebaceous carcinoma of the skin with visceral metastases: case report
Authors: Jensen M.L.
Published: April 2006

Extraocular sebaceous gland carcinomas of the skin are uncommon neoplasms that may recur locally, but in contrast to their ocular counterparts infrequently metastasize. A case is reported in which a 62‐year‐old woman had a 1 cm scalp tumor incompletely excised. Microscopic examination revealed a sebaceous carcinoma. No further surgical treatment was performed and 31 months after diagnosis the patient presented with regional and distant metastases resulting in death. It is emphasized that extraocular sebaceous carcinoma may behave in a biologically aggressive manner, just as their counterparts arising in the ocular adnexae, and the necessity to ensure complete tumor excision is stressed.
Nucleolar organizer regions in fibrohistiocytic tumors of the skin
Authors: Merot Yves , Durgniat Anne‐Christine , Frenk Edgar
Published: April 2006

Nucleolar organizer regions (NORs) are loops of DNA which are present within the nucleoli of cells that possess ribosomal RNA (rRNA) genes. NORs are associated with proteins which can be visualized by a simple silver staining technique. As the number of NORs appears to reflect cell and nuclear activity its determination in benign, intermediate and malignant conditions could be of help in their differential diagnosis. In this study, we investigated 35 fibrohistiocytic tumors of the skin of benign, intermediate and malignant potential from 32 patients: 15 fibrous histiocytomas (FH), 5 FH with atypia (AFH), 7 atypical fibroxanthomas (AFX), 5 dermatofibrosarcoma protuberans (DFSP) and 3 malignant FH (MFH). A one‐step silver technique was used on formalin or Bouin fixed specimens. Ag‐NOR counts from benign conditions (FH, AFH) significantly differed from that of their intermediate‐risk (AFX, DFSP) and malignant (MFH) counterparts. Furthermore, in 2 cases (one AFX; one MFH) which twice recurred, Ag‐NOR counts steadily increased with time. However, a distinction could not be achieved between AFX and MFH. Although Ag‐NOR is a simple and valuable technique, it does not allow a definite distinction between malignant and intermediate processes, at least as far as fibrohistiocytic tumors of the skin are concerned.
Achromic verrucous large cell acanthoma
Authors: Ambrojo Prudencio , Aguilar A. , Requena L. , Yus E. Sánchez
Published: April 2006

Large cell acanthoma (LCA) is an epidermal neoplasm whose nature has been variously explained. Though frequently hyper‐pigmented, we describe for the first time an achromic case located on the dorsum of the right hand of a 83‐year‐old woman. This observation is largely inconsistent with one of the theories about the nature of this condition: that it is merely a solar lentigo with large nuclei of keratinocytes.
Comparison of Dolichos biflorus lectin and other lectin‐horseradish peroxidase conjugates in staining of cutaneous blood vessels in the hairless mini‐pig
Authors: Darr D. , McCormack K. M. , Manning T. , Dunston S. , Winston D. C. , Schulte B. A. , Buller T. , Pinnell S. R.
Published: April 2006

Angiogenesis is necessary for normal growth, wound healing, and plays a key role in many pathologic processes. A variety of endothelial markers have been used to investigate angiogenesis. Unfortunately, excellent markers for vascular endothelium in human tissues exhibit little or no staining of endothelia in tissues of other animal species, including the pig. We are interested in the hairless Yucatan strain of mini‐pig as an animal model for studying cutaneous wound healing because its skin is histologically and functionally very similar to that of man. Hoping to find a specific marker to identify vascular endothelium in the mini‐pig, we therefore screened a battery of 11 different lectin‐horseradish peroxidase conjugates. Based on specificity and staining intensity, Dolichos biflorus agglutinin (DBA) was chosen from this battery to investigate vascular changes in the healing of cutaneous wounds in the mini‐pig. When compared with routine histologic sections stained with hematoxylin and eosin, blood vessels were much easier to identify in sections stained histochemically with DBA. Lectin histochemistry was particularly useful in investigations of early events in angiogenesis during wound healing when newly derived capillary buds and minute blood vessels were obscured in normal histologic sections by an inflammatory cell infiltrate associated with the healing wound. Ultrastructural lectin cytochemistry revealed staining along the luminal surface and the basolateral plasmalemma of endothelial cells. Histochemical staining with DBA promises to provide a useful method for further investigation of angiogenesis and other vascular phenomena in a variety of normal and pathologic processes using the hairless Yucatan strain of mini‐pig as the animal model.
Electron microscopic observations of dyskeratosis, apoptosis, colloid bodies and fibrillar degeneration after skin irritation with dithranol
Authors: Kanerva L.
Published: April 2006

Dying cells undergo coagulative necrosis or apoptosis. In the skin, apoptosis is known to occur in graft‐versus‐host reactions, in lichen planus, during regression of plane warts and neoplasms, and after physical injury caused by ultraviolet light resulting in sunburn cells. The present study shows that primary skin irritation also causes apoptosis. Mild, or moderate‐to‐con‐siderable, dithranol irritation of healthy uninvolved human skin caused focally coagulative necrosis of keratinocytes and also apoptosis of scattered keratinocytes, i.e. condensation of chromatin and cytosol, clumping of tonofilaments and budding of membrane‐bound cell fragments. These apoptotic cell fragments were engulfed in the epidermis by macrophages. Colloid bodies were detected in the upper dermis and apparently represented non‐phagocytosed apoptotic cell fragments that had dropped down from the epidermis. Dithranol also caused fibrillar degeneration of melanocytes and in some cases of Langerhans' cells, indicating that colloid bodies in the upper dermis could partly derive from these cell types. The significance of apoptosis in irritant contact dermatitis could be to maintain homeostasis of epidermis and counteract the hyperplastic response caused by irritant stimuli. Another possibility is that apoptosis was the response to an injury less severe than that causing necrosis.
Lichen striatus – a chameleon: An histopathological and immunohistological study of forty‐one cases
Authors: Gianotti Raffaele , Restano Lucia , Grimalt Ramon , Berti Emilio , Alessi Elvio , Caputo Ruggero
Published: April 2006

Lichen striatus (LS) is an uncommon dermatosis that generally affects children. The histopathology of LS often shows a polymorphic epidermal reaction process of variable lichenoid and spongiotic changes having no specific histopathological criteria or simulating other diseases. In the present study, we have evaluated the histopathological features of 41 biopsy specimens and the immunohistochemical aspects of 10 cases of LS. In 50% of the cases, we found histopathological and immunopathological features constantly present and allowing a correct diagnosis. In 9 cases, the histopathology was not specific, and in 10 cases, a clear differentiation from other diseases was not possible. Immunohistochemical study demonstrated a CD3+ T‐lymphocytic infiltration in which CD8+ cells surrounded necrotic keratinocytes and intraepidermal vesicles filled with Langerhans cells. These findings seem to corroborate the hypothesis that a somatic mutation of a keratinocytic clone could induce an autoimmune response of the host.