bluuebunny/crossref_metadata_2025 huggingface dataset:
Pattern of dental caries experience on tooth surfaces in an adult population
Authors: Hopcraft Matthew Scott , Morgan Michael Vivian
Published: May 2006

Abstract –  Objectives:  To determine the pattern of caries experience across teeth and surfaces in an adult population depending on age and exposure to water fluoridation.

Methods:  Between November 2002 and March 2003 a total of 973 subjects aged 17–51 years had a clinical examination using visual and tactile criteria. Subsequent to this examination, bitewing radiographs were taken and viewed separately. Approximal and occlusal surfaces of molars and premolars were examined on the radiographs.

Results:  Caries experience was relatively low, with mean DMFS scores of 3.21, 5.12, 9.61, 13.04 and 24.35 for subjects aged 17–20, 21–25, 26–30, 31–35 and 36–51 years respectively. The first molar teeth had the greatest caries experience, and occlusal surfaces had more caries experience than approximal surfaces. Subjects with a lifetime exposure to fluoridated drinking water had significantly lower caries experience than those who had no exposure to fluoridated drinking water.

Conclusion:  This study showed that caries prevalence, although relatively low in the study population, was found predominantly in occlusal surfaces, with an increasing prevalence in approximal surfaces of posterior teeth in older subjects. Subjects with a lifetime exposure to fluoridated drinking water had a lower level of caries experience than those with no exposure to fluoridated drinking water, and this was more noticeable in approximal surfaces than occlusal surfaces.
Social gradients in periodontal diseases among adolescents
Authors: López Rodrigo , Fernández Olaya , Baelum Vibeke
Published: May 2006

Abstract –  Objective:  To investigate the association between socioeconomic position and periodontal diseases among adolescents.

Methods:  Data were obtained from 9203 Chilean high school students. Clinical examinations included direct recordings of clinical attachment level and the necrotizing ulcerative gingival lesions. Students answered a questionnaire on various dimensions of socioeconomic position. Seven periodontal outcomes were analyzed. Logistic regression analyses were used to identify socioeconomic variables associated with the periodontal outcomes.

Results:  The occurrence of all periodontal outcomes investigated followed social gradients, and paternal income and parental education were the most influential variables.

Conclusions:  The study demonstrates the existence of significant social gradients in periodontal diseases already among adolescents. This is worrying, and indicates a new potential for further insight into the mechanisms of periodontal disease causation.
Lectin‐binding sites in clear cell acanthoma
Authors: Akiyama M. , Hayakawa K. , Watanabe Y. , Nishikawa T.
Published: April 2006

Lectin‐binding sites in clear cell acanthoma (CCA) were studied using an avidin‐biotin complex (ABC) with 9 lectins. Formaldehyde‐fixed, paraffin‐embedded sections of 7 CCA lesions were employed. Positive stainings, similar to those seen in normal epidermis, were observed on the cell surface in CCA with Ricinus communis agglutinin I (RCA‐I), Ricinus communis agglutinin II (RCA‐II), and wheat germ agglutinin (WGA). Reduced reactivities were observed with Concanavalin A (ConA) and peanut agglutinin (PNA) in CCA. In some areas of CCA lesions, faint stainings were seen with Ulex europaeus agglutinin I (UEA‐I). Capability of staining with soybean agglutinin (SBA) was completely lost in the lesions. With Bandeiraea simplicifolia agglutinin II (BSA‐II), cytoplasmic stain was seen in a part of upper and spinous layers in CCA lesions. Dolichos biflorus agglutinin (DBA) did not bind to either CCA or normal epidermis. These results indicate that the lectin‐binding sites of proliferating cells of CCA resemble those of epidermal keratinocytes and suggest that CCA is a tumor of epidermal origin.
Acid mucopolysaccharide staining in scleredema
Authors: Cole H. G. , Winkelmann R. K.
Published: April 2006

We studied 26 formalin‐fixed biopsy specimens taken from 22 patients with scleredema and found positive staining in 67% of the tissues when both colloidal iron and alcian blue methods were used. Single stains were positive in only half the tissues. Positive findings were noted in both patients with diabetes (11 patients) and in those without it (11 patients). Our experience indicates that multiple biopsies may be necessary to demonstrate mucin in the dermis. Specimens obtained by incisional biopsy are preferred.
Infantile digital fibromatosis. Immunohistochemical and immunoelectron microscopic studies
Authors: Choi Kyu Chul , Hashimoto Ken , Setoyama Mitsuru , Kagetsu Naomi , Tronnier Michael , Sturman Stephen
Published: April 2006

A typical case of infantile digital fibromatosis (IDF) was studied with antibodies raised against actin, vimentin, desmin and several species of cytokeratin. Strong reactions were observed for desmin, cytokeratin and CK‐5, and moderate reactions for vimentin and actin. The diagnostic intracytoplasmic inclusion bodies within the tumor cells were ultrastructurally composed of aggregations of dense microfilaments. Immunoelectron microscopy showed that these filament aggregations are positively stained with anti‐actin antibody. From these results, we suggest that the large tumor cell of IDF is a myofibroblast and may originate from or differentiate toward vascular smooth muscle cells, because only this type of smooth muscle can coexpress desmin, vimentin and cytokeratin.
Targetoid hemosiderotic hemangioma
Authors: Rapini Ronald P. , Golitz Loren E.
Published: April 2006

A case of targetoid hemosiderotic hemangioma on the buttock of a 20‐year‐old pregnant woman is presented. Eight cases of this newly‐described entity were initially reported by Santa Cruz and Aronberg in 1988. It is important to distinguish these vascular lesions from Kaposi's sarcoma, epithelioid hemangioma, and progressive lymphangioma.
Darier's disease involving an epidermoid cyst
Authors: Mittag Hannelore
Published: April 2006

Histological signs of Darier's disease, including ‘corps ronds’, ‘grains’, and acantholytic clefts are demonstrated in the wall of an epidermoid cyst in a patient with Darier's disease of the skin. Possible mechanisms in the development of cyst wall changes are discussed.
Immunohistochemical demonstration of actinically damaged elastic fibers in keratoacanthomas: an aid in diagnosis
Authors: Jordan R.C.K. , Kahn H.J. , From L. , Jambrosic J.
Published: April 2006

The inclusion of elastic fibers within the epithelium of keratoacanthomas is a phenomenon suggested to be an aid in differentiating this lesion from squamous cell carcinoma. Antilysozyme antibodies have recently been noted to stain actinically damaged elastic fibers but not those from sunprotected skin. In this study, 54 keratoacanthomas and 46 squamous cell carcinomas were stained with a histochemical elastic tissue stain and polyclonal antibody to lysozyme using an immunoperoxidase technique. Elastic fibers were demonstrated in keratoacanthomas (37/54, 68%) significantly more often than squamous cell carcinomas (12/46, 26%) (p < 0.001) using both techniques. This study confirms that the inclusion of elastic fibers occurs significantly more often in keratoacanthomas than squamous cell carcinomas. These elastic fibers were also actinically damaged, suggesting a role for sun damage in the evolution of keratoacanthoma.
Meningoceles, meningomyeloceles, and encephaloceles: a neuro‐dermatopathologic study of 132 cases
Authors: Berry A. D. , Patterson J. W.
Published: April 2006

Because there have been few comprehensive histopathologic studies of meningomyeloceles and related malformations, we undertook a systematic study of these lesions. One hundred and thirty two cases were obtained from our surgical pathology files; these included 38 meningoceles, 71 meningomyeloceles, and 23 encephaloceles. Tissue sections were stained with hematoxylin and eosin; special stains included trichrome, alcian blue, Fontana‐Masson, Nissl, Holzer, and immunoperoxidase for glial fibrillary acidic protein. Epithelial changes included ulceration, atrophy, or nevoid hyperplasia of the epidermis, and loss of appendages. Mesodermal features included fibrous zones resembling dura, subarachnoid tissue or scar (99% of cases), increased numbers of blood vessels (83%), hypertrophy of arrector pili muscle (42%), lipoma formation (38%), and immature skeletal muscle fibers (5%) that rarely intermingled with neuropil‐like matrix. The latter tissue was identified in 71% of cases and included neurons, astrocytes, oligodendroglia, and ependyma. Forty‐eight percent of cases included peripheral nerve fibers or roots, and some fibers formed onion bulb or Pacinian corpuscle‐like structures. Meningothelial cells were observed in 26% of cases and sometimes formed recognizable whorls. Choroid plexus was noted in 3 cases, one example showing an unusual dystrophic calcification that formed long parallel spicules. Pigmented dendritic cells were observed within zones of fibrous tissue in 10% of cases. These malformations involve complex arrangements of cutaneous, neuroectodermal, and mesodermal elements. Because they may be encountered by dermatopathologists, familiarity with the microscopic features of dysraphic lesions is essential.
Polymerase chain reaction: relevance for dermatopathology
Authors: Penneys N. S. , Leonardi C.
Published: April 2006

Medical knowledge has been significantly expanded by the techniques of molecular genetics. A new technology, the polymerase chain reaction (PCR) (1–6), has produced a quantum leap in the field of molecular genetics. PCR uses an in vitro chemical reaction to amplify impure DNA, either fragmented or intact. A defined DNA fragment can be amplified a millionfold in a relatively brief incubation (a few hours). The ability to amplify minute quantities of crude DNA gives the method extraordinary power and sensitivity, DNA can be amplified from fixed pathologic specimens (7), buccal cells from mouth washes (8), a single human hair (9), and solitary cells (10). Once amplified, large DNA samples can be studied by electrophoresis, Southern and slot blot, and other techniques.
Benign cutaneous adnexal tumors in childhood and young adults, excluding pilomatrixoma: review of 28 cases and literature
Authors: Marrogi A. J. , Wick Mark R. , Dehner Louis P.
Published: April 2006

Benign adnexal tumors of the skin, excluding pilomatrixomas, were identified in 28 patients between the ages of 4 and 20 years with a mean age of 15; 23 women and 5 men. Most lesions were described as papules and they occurred on the face, scalp and neck in 75% of cases. Trichoepithelioma and syringoma accounted for 56% of all neoplasms. Only one patient gave a history of familial trichoepitheliomas. The remaining tumors were examples of syringocystadenoma papilliferum, eccrine acrospiroma, and eccrine and apocrine hidrocystomas. Excisional biopsy constituted the treatment in all cases; only one neoplasm, an eccrine acrospiroma, recurred locally.
Primary cutaneous mucoepidermoid carcinoma: report of a case
Authors: Landman Gilles , Farmer Evan R.
Published: April 2006

Primary mucoepidermoid carcinomas of the skin are extremely rare tumors. We describe a primary cutaneous mucoepidermoid carcinoma arising in the right ear (posterior mid helix) of a 66‐year‐old white man. The tumor was 0.6 cm in diameter, ulcerated and nonencapsulated. No other tumors were found in the patient. Histologically the tumor showed the characteristics of a ‘low grade” mucoepidermoid carcinoma, consisting of lobules of polygonal cells with vesicular nuclei. In the center of the lobules were large vacuolated cells (goblet cells). Transitions between the two cell populations were present throughout the tumor. An epidermal attachment of the tumor, as well as epidermal dysplasia, predominantly at the acrosyringium was present, consistent with the theory of sweat duct histogenesis of these tumors. Immunoperoxidase staining showed positivity for epithelial membrane antigen, keratin and carcinoembryonic antigen. The latter was predominantly positive in the goblet cells. Cutaneous metastasis of mucoepidermoid carcinomas with epidermal attachment has been reported. Our case showed only ear involvement and follow‐up at 8 months has revealed no evidence of recurrence. These findings are consistent with the diagnosis of primary cutaneous mucoepidermoid carcinoma.

Landman G, Farmer ER. Primary cutaneous mucoepidermoid carcinoma: report of a case.
Microvenular hemangioma
Authors: Hunt S. J. , Santa Cruz D. J. , Barr R. J.
Published: April 2006

Ten examples of a distinctive vascular tumor are reported. These benign acquired lesions typically occur as small, enlarging lesions that favor the extremities, particularly the forearms, of young to middle‐aged adults. Clinically, they are purple to red lesions generally thought to be hemangiomas. Histologically, there is a pattern of irregular, branching venules with inconspicuous lumina and lack of cellular atypia. Because the lesions do not conform to existing classifications of vascular tumors, they have been designated with the histologically descriptive name of microvenular hemangioma. Although speculative, they are felt to represent a form of acquired venous hemangioma.
HMB‐45 staining of dysplastic melanocytic nevi in melanoma risk groups
Authors: Ahmed I. , Piepkorn M. , Goldgar D. E. , Cannon‐Albright L. A. , Meyer L. J. , Skolnick M. H. , Zone J. J.
Published: April 2006

To evaluate the hypothesis that reactivity of the intradermal component of melanocytic nevi to the monoclonal antibody HMB‐45 correlates with melanoma risk, dysplastic compound melanocytic nevi were examined for expression of the HMB‐45 epitope in three subject groups differing in epidemiological risk for melanoma. The study groups consisted of 10 subjects with dysplastic nevi and a personal history of melanoma, 25 subjects with dysplastic nevi and a history of melanoma in one or more first degree relatives, and 15 population control subjects with sporadic dysplastic nevi. For each case, sections from one lesion, immunohistochemically processed for HMB‐45 binding, were evaluated by two pathologists without knowledge of the clinical data. Of all dysplastic nevi, 98% showed diffusely positive cytoplasmic staining of the junctional nevomelanocytes and 90% had such positive staining of those cells within the superficial dermis. Nevus cells within the deeper dermis did not stain positively in any case. Furthermore, the data showed no differences in frequency, pattern, or intensity of HMB‐45 reactivity between the subject groups. These observations indicate that evaluation of dysplastic nevi with the monoclonal antibody HMB‐45, an apparent marker of proliferative or otherwise stimulated melanocytes, has no discriminating value for identifying subjects at increased historical risk for melanoma. The data, however, support the concept that so‐called dysplasia within nevi, as defined by histologic criteria, actually represents the active or proliferative phase of melanocytic nevi.
Lack of evidence of Ki‐ras codon 12 mutations in melanocytic lesions
Authors: Albino Anthony P. , Nanus David M. , Davis Maria L. , Scott McNutt N.
Published: April 2006

A number of studies have failed to detect point mutations at codon 12 in the Ki‐ras gene in melanocytic neoplasms. One recent study, however, has found a high percentage of Ki‐ras codon 12 point mutations. In an effort to resolve this difference, the present study examined noncultured melanocytic lesions (i.e., 5 benign nevi, 10 dysplastic nevi, and 8 primary melanomas: 4 in situ and 4 invasive) for point mutations at codon 12 in the first exon of the Ki‐ras proto‐oncogene using polymerase chain reaction methodology with oligonucleotide hybridization and direct DNA sequencing. The results of this study indicates no detectable mutations in the 12th codon of the first exon of the Ki‐ras gene in any premalignant or malignant melanocytic lesion examined.
Application of DNA flow cytometry from paraffin‐embedded tissue to the diagnosis of mycosis fungoides
Authors: Pastel‐Levy C. , Flotte T. J. , Preffer F. , Ware A. , Graeme‐Cook F. , Bell D. A. , Colvin R. B.
Published: April 2006

The distinction of mycosis fungoides from benign inflammatory lesions is sometimes difficult by conventional histological techniques. Aneuploidy, a feature often associated with malignant tumors, can be assessed even in tissue routinely processed in paraffin using the flow cytometric technique of Hedley and associates. In many tumor systems, there are significant diploid clones. We have evaluated the flow cytometric DNA ploidy of paraffin‐embedded tissue in the diagnosis and prognosis of mycosis fungoides (MF). We studied 22 cases of MF and 10 control cases of inflammatory skin lesions with epidermal involvement. Aneuploidy was found in 27% of the MF cases, but in none of the controls (ED). Aneuploid features were seen in 23% of tissues from early stage disease. Aneuploidy did not correlate with atypia, epidermotropism, or number of mitoses. There was a trend towards showing adverse outcome in those patients with aneuploid lesions. The detection of aneuploidy might be helpful for early diagnosis of MF.
Fibrous papule of the nose with granular cells: two cases
Authors: Guitart Joan , Bergfeld Wilma F. , Tuthill Ralph J.
Published: April 2006

Two cases of fibrous papule of the nose (FPN) with granular cell features are presented and discussed. Both lesions have classic architectural features of FPN; however, the main stromal cells show large cytoplasmic granules of the type seen in granular cells. We are uncertain of the significance of these findings. Our hypotheses include a perifollicular granular cell reaction and a granular degenerative change of local dermal dendrocytes.
Medusa head‐like granules in squamous cell carcinoma with differentiation toward a hair follicle structure
Authors: Yamamoto O. , Asahi M. , Horie A. , Fujimoto S. , Nakayama K.
Published: April 2006

A case of squamous cell carcinoma (SCC) with regional lymph node metastasis in a 69‐year‐old Japanese man is reported. The tumor was characterized by the proliferation of peripheral basaloid, inner squamoid, and glycogen‐rich cells, the presence of trichilemmal keratinization, and the presence of ladder‐like, membrane‐coating granules. These findings suggested that this tumor differentiates toward a hair‐follicle structure. The most interesting feature of this tumor was the presence of medusa head‐like granules in the cytoplasm of the clear squamoid cells adjacent to the keratinized cells. We have been unable to find any other studies of these granules in squamous cell carcinoma.
Characterization of the changes in matrix molecules at the dermoepidermal junction in lupus erythematosus
Authors: Mooney Ellen , Gammon W. Ray , Jennette J. Charles
Published: April 2006

Electron microscopy has revealed that the deposition of immunoglobulin in the skin of lupus erythematosus (LE) patients occurs on and below the basal lamina of the basement membrane (BM). The composition of the BM is now to some extent known, and antibodies have been developed against several of its individual components. In this study, we attempt to elucidate the status of some matrix molecules in the dermoepidermal junction in LE. Lesional and nonlesional skin from LE patients was examined using immunofluoresence microscopy with monoclonal and polyclonal antibodies against 6 matrix molecules. Immunoelectron microscopy using monoclonal antibodies was used to discern changes in type IV and type VII collagen. By immunofluorescence microscopy, type IV collagen, type VII collagen, and fibronectin were altered in lesional skin. There was a statistically significant correlation between the presence of immunoglobulin and alteration of type IV collagen and type VII collagen in lesional skin. The alterations in type IV and type VII collagens were confirmed on immune‐electron microscopy which showed fragmentation of staining of both antigenic components, particularly type IV collagen.
Pemphigus and the terminal hair follicle
Authors: Wilson C. L. , Dean D. , Wojnarowska F.
Published: April 2006

The scalp is frequently involved in the autoimmune skin disease pemphigus. This study demonstrates the distribution of pemphigus antigen in the scalp terminal hair follicle; as well as being found in the epidermis, it is distributed throughout the whole hair follicle outer root sheath and in the dermal bulb matrix cells. The increase in volume of target antigen offered by the follicular epithelium could be a factor determining scalp involvement in pemphigus.
Immunoperoxidase technique modified by counterstain with azure B as a diagnostic aid in evaluating heavily pigmented melanocytic neoplasms
Authors: Kamino H. , Tarn S. T.
Published: April 2006

Heavily‐pigmented melanocytic neoplasms are difficult to evaluate on routine hematoxylin and eosin stained slides because pigmented melanocytes arc difficult to distinguish from the numerous melanophages that are usually seen in the background of these lesions. Immunoperoxidase staining for SI00 protein or HMB‐45 antibody using diaminobenzidine (DAB) as chromogen, which forms a brown product, does not adequately distinguish melanocytes from melanophages. We modified this technique by replacing hematoxylin as the counterstain with azure B, which stains melanin green‐blue. Thus, positive melanocytes appear brown while melanin granules in their cytoplasm are green‐blue. However, negative melanophages only stain green‐blue. This technique is useful in evaluating heavily pigmented melanocytic lesions such as malignant melanomas, melanosis of regressing malignant melanoma, residual malignant melanoma in areas of granulation tissue with melanophages, blue nevi, pigmented spindle cell variant of Spitz's nevi and combined
Transient bullous dermolysis of the newborn
Authors: Eng Ana M. , Keegan Colleen A. , Hashimoto Ken , Rhee Hwaja L. , Bronson Darryl M. , Tenner Laura K. , Goldin Harry M.
Published: April 2006

A case of transient bullous dermolysis of the newborn is reported. A healthy Hispanic newborn developed bullae during the first two days of life. From age two to four weeks, the lesions healed with milia formation. There was no residual scarring or hypopigmentation. An induced blister showed dermal‐epidermal separation with the PAS‐positive basement membrane in the epidermal roof. PAS‐positive inclusions were present in the cytoplasm of a few basal cells. Examination by electron microscopy showed degeneration of the collagen and anchoring fibrils. There were numerous stellate inclusions in the endoplasmic reticulum of the cytoplasm of the lesional basal keratinocytes.
Mucinous syringometaplasia mimicked by a clear cell hidradenoma with mutinous change
Authors: Hunt S. J. , Abell E.
Published: April 2006

An adnexal tumor with features of both clear cell hidradenoma and mucinous syringometaplasia is reported. The lesion occurred as a solitary, asymptomatic, slow growing nodule of 6‐months duration on the anterior neck of a 55‐year‐old woman. Serous fluid could be expressed from a central skin opening. Histologically, there was a squamous‐lined imagination with foci of mucin‐ladcn cells. A ductal component with a variable admixture of mucinous cells merged with a nearby clear cell hidradenoma. Because clinicopathologic similarities exist between mucinous syringometaplasia and clear cell hidradenoma with mucinous change, thorough sectioning of mucinous syringo‐metaplasia‐like lesions is necessary to exclude an associated sweat gland neoplasm.
Ultrastructural signs of altered intracellular metabolism in acral persistent papular mucinosis
Authors: Ahó Heikki J. , Forsten Yrsa , Hopsu‐Havu Välnö K.
Published: April 2006

An asymptomatic 24‐year‐old woman presented with multiple discrete papules on the extensor surfaces of the hands and wrists. Light microscopy revealed focal increase in the amount of dermal fibroblasts as well as deposition of hyaluronidase‐labile mucoid substance. The collagen and elastin were decreased. The changes were consistent with acral persistent papular mucinosis (APPM). In electron microscopy, the intercellular glycosaminoglycans showed small ruthenium red‐positive granules and thin filaments indicating normal morphology. The fibroblastic cells, however, were conspicuously altered. Endoplasmic reticulum was dilated, cytoplasm contained large amounts of osmiophilic, concentric lysosomal structures, and there was distinct fibrous lamina in the nuclear membrane. It was concluded that the primary event in APPM probably affects the intracellular metabolism of the dermal fibroblast. The accumulation of lysosomal structures may be a distinct feature of APPM differentiating it from the other reactive cutaneous muci‐noses, or it may only reflect nonspecific degeneration in a longstanding lesion.
Analysis of the 14;18 translocation in cutaneous lymphomas using the polymerase chain reaction
Authors: Volkenandt M. , Cerroni L. , Rieger E. , Soyer H. P. , Koch O. , Wienecke R. , Atzpodien J. , Bertino J. R. , Kerl H.
Published: April 2006

A series of 25 cutaneous B‐cell lymphoid proliferations was analyzed for the presence of the (14;18) translocation using the polymerase chain reaction, functional sequences of rearranged chromosomes 14 and 18 were amplified in vitro, and t (14;18) specific sequences were detected in 1 of 14 primary cutaneous B‐cell lymphomas, in 1 of 14 primary nodal B‐cell lymphomas and in none of 3 B‐cell pseudolymphomas. These results indicate that the t (14;18) may occur in a small subset of primary cutaneous lymphoma. However, the difference in incidence of the t (14;18) between primary nodal and primary cutaneous lymphomas suggests that different molecular mechanisms are involved in the pathogenesis of these lymphomas.
Trichogerminoma
Authors: Sau P. , Lupton G. P. , Graham J. H.
Published: April 2006

We report 14 cases of trichogerminoma, a rare form of cutaneous adnexal neoplasm, derived from hair germ epithelium. The neoplasm occurred in 9 men and 5 women. Their ages ranged from 16 to 73 years (median 53 years). The tumors were slow growing, asymptomatic dermal or subcutaneous nodules, located on the head and neck (6), trunk (4), extremities (2) and hip (1), with no distinguishing clinical features. Histologically, trichogerminomas were characterized by sharply circumscribed, pseudo‐encapsulated dermal and subcutaneous nodules, ranging in size from 0.4 to 4.0 cm in diameter (mean 1.9 cm). The nodules were subdivided into lobules separated by variable amounts of stroma that demonstrated varying cellularity and mucin content. The lobules were composed of basaloid cells that formed densely packed, round nests or “cell balls” resembling hair bulbs. The basaloid cells demonstrated peripheral palisading, keratinization and differentiation towards various pilosebaceous structures. Retraction spaces, well developed hair follicles and hair shafts were not observed. These distinctive histologic features separated these neoplasms from other tumors of pilar origin and from basal cell carcinoma. The trichogerminomas behaved in a benign fashion with one exception. Complete excision of the lesions is the treatment of choice.
Epidermolysis bullosa complicated by squamous cell carcinoma: report of 10 cases
Authors: McGrath J. A. , Schofield O. M. V. , Mayou B. J. , McKee P. H. , Eady R. A. J.
Published: April 2006

Epidermolysis bullosa (KB) refers to a group of hereditary mechano‐bullous conditions, many of which arc associated with chronic scarring. Several forms of (he disease have been reported in association with cutaneous malignancy. We present a series of 10 EB patients (eight generalised recessive dystrophic EB, one dominant dystrophic EB, one non‐lethal junctional EB) aged 24–25 years with a total of 29 squamous cell carcinomas (SCC). Three patients died from metastatic disease associated with invasive, poorly differentiated SCC. Six cases had multiple primary SCG, including three patients with simultaneous multifocal disease. Twenty‐eight of the 29 SCC arose on the limbs. I Histology revealed that most of the SCC were well or moderately differentiated (22/29). Unusual histological findings included two verrucous SCC, as well as a spindle cell (angiosarcoma‐like) SCC. Most of the SCC developed in areas of chronic non‐healing ulceration (10/29) or longstanding hyperkeratotic crusting (14/29). The dermis around or beneath the carcinomas was densely scarred, more so than in non‐malignant areas. In some cases it was difficult to distinguish the clinical appearances of certain areas of chronic ulceration, scarring, and crusting typical of dystrophic EB from many of the SCC. This study underlines the need for constant vigilance for the development of carcinomas in this group of patients, the occasional diagnostic difficulty, and the potential for metastasis.
Modulation of growth in normal and malignant melanocytic cells by all‐trans retinoic acid
Authors: Fligiel S.E.G. , Inman D.R. , Talwar H.S. , Fisher G.J. , Voorhees J.J. , Varani J.
Published: April 2006

Human epidermal melanocytes were examined for proliferation nuclei' various conditions in the presence or absence of all‐trans retinoic acid (RA). Under conditions which supported proliferation, RA at concentrations of 0.25–1.0 μg/ml inhibited cell growth bill was not cytotoxic. When melanocytes were cultured under conditions which by themselves did 1101 support growth, RA did not overcome the growth limitation. Treatment of melanocytes with RA altered their morphological appearance. Alterations included retraction of dendritic processes, increased flattening, and a slight darkening of the cytoplasm in some of the cells. However, when examined biochemically, there was no significant change in the amount of malanin per cell or in lyrosinase activity. RA also inhibited proliferation of six different malignant melanoma lines. Inhibition was observed over the same RA concentrations and over the same time course in the melanoma cells as was seen in melanocytes. Inhibition of melanocytic and melanoma cell proliferation was slowly reversed following removal of RA from the culture medium. These results indicate that RA can inhibit proliferation of melanocytic cells.
Rheumatoid neutrophilic dermatitis
Authors: Lowe Lori , Kornfeld Bruce , Clayman Joseph , Golitz Loren E.
Published: April 2006

Rheumatoid neutrophilic dermatitis is a rare entity reported to occur in association with severe rheumatoid arthritis. Three patients with seropositive rheumatoid arthritis and rheumatoid neutrophilic dermatitis are described. Clinically, the eruption is characterized by symmetric erythematous papules, plaques, and rarely vesicles on extensor skin surfaces. Light microscopy reveals a dermal neutrophilic infiltrate without vasculitis. Spongiotic intraepidermal blisters, subepidermal bullae, or papillary neutrophilic microabscesses may be seen. The histologic differential diagnosis includes the oilier dermatoses in which neutrophils predominate. Rheumatoid neutrophilic dermatitis is one of several neutrophilic dermatoses seen in association with rheumatoid arthritis. Suggesting that it may be part of a spectrum of neutrophilic cutaneous reaction patterns in a predisposed host.
Immunohistochemical demonstration of breast‐derived and/or carcinoma‐associated glycoproteins in normal skin appendages and their tumors
Authors: Tsubura A. , Senzaki H. , Sasaki M. , Hilgers J. , Morii S.
Published: April 2006

Sixty‐six benign and malignant skin appendage tumors were studied for the expression and localization of the glycoproteins identified by the monoclonal antibodies (MoAbs) GCDFP‐15, GU18, B72.3, and VU‐1D9. Formalin‐fixed, paraffin‐embedded tissue was processed by the avidin‐biotin complex method. In normal ecerine and apocrine sweat glands, GCDFP‐15, GUI8, B72.3, and VU‐1D9 staining was localized differently (intracellular, membranous, or intraluminal), whereas eccrine glands showed no B72.3 staining. There were various patterns of positive staining of tumors arising from sweat glands, but no immunoreactivity for B72.3 was found in eccrine‐derived tumors. GUI8 and VU‐1D9 labeled mature sebocytes in a vacuolar fashion and stained sebaceous carcinomas. VU‐1D9 labeled membranes of the secondary germ cells in early anagen of a hair follicle bulb as well as the basaloid cells of trichoepitheliomas and basal cell carcinomas. These MoAbs appear to be valuable markers for the study of normal skin appendages and their tumors.
Intravascular lymphomatosis: report of an unusual case with T cell phenotype occurring in an adolescent male
Authors: Sangueza O. , Hyder D. M. , Sangueza Pastor
Published: April 2006

Intravascular lymphomatosis is a rare disorder which most often occurs in the elderly. The overwhelming majority of the cases studied immiinophenotypically have expressed a B cell pheno‐typc. We report an unusual case of T cell intravascular lymphomatosis occurring in an adolescent male.
Cutaneous histiocytic malignancy. Immunohistochemical re‐examination of cases previously diagnosed as cutaneous “histiocytic lymphoma” and “malignant histiocytosis”
Authors: Arai Eiichi , Daniel Su W. P. , Roche Patrick C. , Li Chin‐Yang
Published: April 2006

True histiocytic lymphoma (THL) and malignant histiocytosis (MH) have been defined by clinical and histologic findings and enzyme histochemistry. We reviewed cases previously diagnosed as cutaneous histiocytic lymphoma (HL) and MH with cutaneous lesions. These cases had been classified as “histiocytic” on the basis of previous enzyme histochemistry profiles of frozen tissue. Cutaneous tumor cells were reevaluated using a panel of immunohistochemical stains in formalin‐fixed, paraffin‐embedded tissue in correlation with histopathologic examination. The antibodies used in this study were directed against CD45 (leukocyte common antigen [LCA]), CD20 (L26) for B cells, CDS and CD45RO (UCHL‐1) for T cells, CD68 (KP‐1) and lysozyme for histiocytes, as well as CD30 (BerH2) for Ki‐1 positive cells. On re‐evaluation, the seven cases originally classified as HL were reclassified as one case of THL with neoplastic cells positive for CD68 (KP‐1) and lysozyme, two cases with immunohistochemical features of Ki‐1 lymphoma (including one of T‐cell lineage), three cases of T‐cell lymphoma, and one case of B‐cell lymphoma, all associated with variable degrees of reactive histiocytosis. The four cases originally classified as MH were reclassified as two cases of MH and two cases of uncertain lineage. Although rare, histiocytic malignancies do exist. However, the diagnosis of histiocytic malignancy should be made only after careful correlation of atypical tumor cells in histopathologic sections and sections stained immunohistochemically. Erroneous classification of reactive histiocytes as neoplastic histiocytes using only enzyme histochemistry in frozen sections is a pitfall to be avoided.
Atypical fibroxanthoma: DNA ploidy analysis of 14 cases with possible histogenetic implications
Authors: Worrell J. Trace , Ansari M. Qasim , Ansari S. Jaweed , Cockerell Clay J.
Published: April 2006

The histogenesis of atypical fibroxanthoma (AFX) and its relationship to malignant fibrous histiocytoma (MFH) arc a subject of controversy. Many investigators have proposed that AFX may represent a reactive process, while others contend that it is a true fibrohistiocytic neoplasm, closely related to MFH. In an attempt to determine whether biologic differences between AFX and MFH may be accounted for at the cellular DNA level, we performed ploidy analysis on 14 cases of AFX by flow cytometry and compared our results with previously reported DNA analyses of MFH. Thirteen of the 14 lesions demonstrated diploid distribution of nuclear DNA, and only 1 case had an aneuploid population. This contrasts with prior data on MFH, the vast majority of which are aneuploid. Our results suggest that, despite histologic similarities, AFX may be distinguished from MFH on the basis of DNA content. These findings may be significant in understanding the biologic behavior of AFX.
Histological and ultrastructural study of a family with erythrokeratodermia progressiva symmetrica
Authors: Niemi Kirsti‐Maria , Kanerva Lasse
Published: April 2006

We have examined a family with 4 members in three succeeding generations suffering from a severe keratinization disorder. The clinical phenotype, with symmetric plaques on the extremities, corresponded to erythrokeratodermia progressiva symmetrica. It was manifested at birth, however, and in addition to the hyperkeratotic plaques, follicular hyperkeratosis was also observed. Electron microscopy revealed multiple morphological changes such as myelinated membrane structures, or needles, which were similar to those occurring in ichthyotic disorders and tyro sinemia, as well as in harlequin fetuses, all of which were excluded clinically or biochemically in our patients.
Suction‐induced basal cell cytolysis in the Weber‐Cockayne variant of epidermolysis bullosa simplex
Authors: Taylor G. , Venning V. , Wojnarowska F. , Millard P. R.
Published: April 2006

In the Weber‐Cockayne form of epidermolysis bullosa simplex (EBS‐WC), trauma induces blisters which are confined to the palms and soles. Histologically, basal cell cytolysis is seen. We studied 6 patients with EBS‐WC to determine the ultrastructural level at which artificially‐induced suction blisters form. Blisters were raised by application of a suction blister cup to uninvolved forearm skin, the cup being connected to a negative pressure of 200 mm of mercury. The blisters were biopsied and examined by light and electron microscopy. On light microscopy, all biopsies showed marked vacuolization of keratinocytes in the lower two‐thirds of the epidermis, and in all but one there was a cleavage plane through the basal keratinocytes. These findings were confirmed by electron microscopy in 4 patients. The separation through the basal cells is in contrast to the situation in normal individuals in whom cleavage occurs below the level of the basal cells, within the lamina lucida. Thus, even apparently normal skin from non‐acral sites has the same structural abnormality as the affected acral sites in EBS‐WC.
The specificity of histopathology in erythroderma
Authors: Zip Catherine , Murray Scott , Walsh Noreen M. G.
Published: April 2006

Conflicting views about the diagnostic value of skin biopsy in the investigation of erythrodermic patients are extant. The objective of the present study was to establish the frequency with which a correct diagnosis can be based on histopathological assessment alone. This was achieved by comparison of the “blinded” microscopic diagnosis with the final diagnosis (based on combined clinico‐pathologic parameters and response to therapy). In a retrospective review of 56 skin biopsies from 40 patients with erythroderma, we found a positive correlation between the pathological diagnosis and the final diagnosis in 66%; furthermore, when the microscopic characteristics observed in different diagnostic categories were assessed, these proved lo simulate those seen in conventional manifestations of the various underlying diseases but tended to be subtle in the setting of erythroderma. We conclude that, despite the homogeneity of the clinical expression of erythroderma, diagnostic histopathological features of the underlying disease are retained in the majority of cases.
Proliferating cell nuclear antigen distribution in keratoacanthoma and squamous cell carcinoma
Authors: Phillips P. , Helm K. F.
Published: April 2006

Histologic differentiation of keratoacanthoma (KA) and squamous cell carcinoma (SCC) is often difficult despite well‐delineated histopathologic criteria. This has prompted a search for more objective methods to differentiate these two lesions. In the present study, we immunohistochemically examined the distribution of proliferating cell nuclear antigen (PCNA)‐positive cells in 11 cases of KA, 7 cutaneous SCC, and 2 atypical squamous proliferations (for which a definitive diagnosis could not be made on routine histology) using a commercially prepared anti‐PCNA monoclonal antibody. We found PCNA‐positive cells predominantly in the periphery of squamous nests in KA. In contrast, SCC showed a diffuse staining pattern with PCNA‐positive cells seen throughout squamous nests. Determining the pattern of PCNA‐positive cells is easy, does not require cell counting, and may provide additional histochemical data facilitating the distinction between KA and SCC.
Varicella‐zoster virus DNA in granulomatous skin lesions following herpes zoster
Authors: Serfling Ulrike , Penneys Neal S. , Zhu Wen‐Yuan , Sisto Manuel , Leonardi Craig
Published: April 2006

Granulomatous reactions at sites of previous cutaneous herpes zosier lesions occur, but their etiology is not known. Three tissue specimens from 5 cases identified clinically and hislologically as post‐zosteric granulomatous reactions were studied for the presence of varicella‐zoster virus (VZV) deoxyribonucleic acid (DNA) by the polymerase chain reaction using specific primers For VZV. VZV DNA was detected in 1 of 3 cases where the granulomatous reaction occurred immediately in the wake of resolving vesicular herpes zoster lesions. Finding viral DNA in earlier reactions probably represents residue from the active herpetic process. VZV DNA was not identified in granulomatous reactions arising between 1 month and up to 4 years after resolved herpes zoster. The negative result in these cases supports the hypothesis that there is no association between persistence of VZV DNA and granuloma formation. How long VZV DNA is detectable at sites of resolved herpes zoster lesions could be the subject of further studies.
Plexiform and other unusual variants of palisaded encapsulated neuroma
Authors: Argenyi Zsolt B. , Cooper Philip H. , Cruz Daniel Santa
Published: April 2006

Palisaded, encapsulated neuroma (PEN) has been described as a predominantly solitary, nodular tumor; plexiform or multinodular growth patterns have not been reported in detail. We reviewed 55 PEN in order to evaluate: 1) the predominant growth patterns: 2) features that may indicate previous trauma; and 3) association with acne‐like changes. Sixteen cases (29%) had growth patterns other than the solitary, nodular type. These patterns were: a) plexiform (7/16), b) multinodular (5/16), and c) fungating (4/16). Other unusual features included evidence of trauma, i.e., fibrosis, myxoid change, chronic inflammation (5/16), partially incomplete capsule (6/16), and association with acne‐like features (13/16). These results suggest that: 1) plexiform or multinodular growth patterns occur relatively often in PEN; 2) some changes indicate a possible histogenetic relation to traumatic neuroma, probably via secondary traumatization; 3) a high frequency of association with acne‐like changes which could imply, but does not prove, an acne‐induced histogenesis; and 4) the differential diagnosis of cutaneous plexiform lesions should include PEN.
Nodular fasciitis of the dermis
Authors: Lai F. Mac‐Moune , Lam W. Y.
Published: April 2006

We describe the second reported patient with nodular fasciitis involving the dermis. Our case was morphologically a typical example of nodular fasciitis, but was distinctive by its cutaneous location and recurrence. As in the first reported case, the unexpected dermal involvement caused diagnostic difficulty, despite a typical histology.
Basal cell carcinoma with monster cells
Authors: Elston Dirk M. , Bergfeld Wilma F. , Petroff Nina
Published: April 2006

A case of basal cell carcinoma with “monster cells” is reported. Clinically, the lesion presented as a red nodule on the forearm of a 58‐year‐old male. The histologic picture was striking, with large, “monstrous” nuclei scattered throughout a well defined nodule. Basal cell carcinoma with monster cells appears to represent a histologic variant of nodular basal cell carcinoma. The prognostic significance of the monster cells remains to be established.
Immunohistochemical detection of keratin with the monoclonal antibody MNF116 is useful in the diagnosis of epidermolysis bullosa simplex
Authors: Prieto V.G. , McNutt N.S.
Published: April 2006

Epidermolysis bullosa simplex (EBS) is an uncommon genetic skin disease characterized by fragility of the basal keratinocytes and propensity to develop blisters. While a panel of antibodies against type IV collagen, laminin, and bullous pemphigoid antigen has been used to identify cases of EBS in frozen sections, we have found that a monoclonal antibody detecting cytokeratin in basal keratinocytes is useful in paraffin sections. Formalin‐fixed, paraffin‐embedded tissues from 12 patients with EBS were studied with the following monoclonal antibodies: MNF11G (DAKO, Carpintería, CA), CAM 5.2 (Becton Dickinson, San Jose, CA), and AE1‐AE3 mixture (Boehringer Mannheim Corp, Indianapolis, IN). Histologically, all the cases had focal vacuolization of the basal cell layer, with areas of dermal‐epidermal separation. MNF116 was strongly positive in the basal keratinocytes, including the vacuolated ones, and demonstrated the presence of fragments of keratinocytes attached to the floor of the blister. CAM 5.2 stained sweat ducts only. AE1‐AE3 was weakly positive in the basal cells, and almost completely negative on the fragmented basal cell keratinocytes. We consider that the immunostain with MNE116 in tissues fixed routinely in formalin and embedded in paraffin is helpful for the direct demonstration of the level of splitting in EBS.
Ultrastructural localization of factor XIIIa
Authors: Schaumburg‐Lever Gundala , Gehring Birgitte , Kaiserling Edwin
Published: April 2006

Thin sections of dermatofibromas, of a basal cell epithelioma, a patch stage lesion of Kaposi's sarcoma, a case of angiolymphoid hyperplasia with eosinophilia, and one case of malignant mastocytosis were incubated with antibody to factor XIIIa (FXIIIa). Regardless whether the tissue had been embedded in Lowicryl K4M, Epon, or Araldite, labeling was found in dermal dendrocytes, mast cells, and endothelial cells. In dermal dendrocytes, the reaction product was seen in dilated cisternae of the rough endoplasmic reticulum as well as free within the cytoplasm. In endothelial cells, FXIIIa was localized within Weibel Palade bodies, free within the cytoplasm, and in villous projections into the vasucular lumen. In mast cells, the reaction was found in mast cell granules exclusively. Mast cells, dermal dendrocytes, and endothelial cells have in common that all three express FXIIIa, belong to the microvascular unit, and are increased in number during angiogenesis and in fibrovascular processes. It thus seems that these cells are functionally related.
Hamartoma of the tongue in an infant with a primary diagnosis of ectrodactyly‐ectodermal dysplasia‐cleft lip and palate syndrome
Authors: Hanna Rafik , Argenyi Zsolt B. , Benda Jo Ann
Published: April 2006

We describe a case of an unusual tongue hamartoma associated with ectrodactyly‐ectodermal dysplasia‐clefting syndrome in a 3‐month‐old white female infant. The lesion was composed of a mixture of salivary glands, adipose tissue, smooth muscle and skeletal muscle in a haphazard fashion. Lingual hamartomas are rare and can present a clinical differential diagnostic problem. We review the literature on this unique combination of malformations.
HPV‐associated epithelial atypia in oral warts in HIV+ patients
Authors: Regezi Joseph A. , Greenspan Deborah , Greenspan John S. , Wong Eileen , MacPhail Laurie A.
Published: April 2006

Reported are oral mucosal warts (HPV common antigen‐positive) from 7 adult HIV+ patients in which there was cytologic atypia and disordered growth. Lesions were papillary, white to red in color, and were located on the lip, gingiya, palate, tongue, and buccal mucosa. Histologically, the keratinocytes in the lesions exhibited atypical features in the form of hyper‐chromatism and karyomegaly. Koilocytes were frequently seen in the upper level keratinocytes where HPV common antigen was identified. The dysplastic areas, which ranged from mild to severe, typically showed abrupt limiting margins. All lesions exhibited intense PCNA reactivity from basement membrane to surface. Nuclei of mid‐level and basal keratinocytes of 3 specimens stained positively for p53 protein. We believe that the atypia found in these lesions represents cytologic change that has malignant potential. The subtype of the HPV in these lesions has not yet been determined.