bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative and morphometric analysis of Langerhans cells in non‐exposed skin in renal transplant patients
Authors: Servitje O. , Serón D. , Ferrer I. , Carrera M. , Pagerols X. , Peyri J.
Published: April 2006

Renal transplant recipients have a high incidence of cutaneous complications such as neoplasia and viral or fungal infections. Morphologic alterations of epidermal Langerhans cells (LC) have furthermore been described in these patients. Since these changes have been mainly found in sun‐exposed skin, a direct effect of immunosuppressive therapy remains a matter of discussion. A quantitative and morphometric study of epidermal LC in non‐exposed skin was performed in 28 renal transplant patients (RTF). RTF were divided in two groups according to immunosuppressive treatment: group A; azathioprine + prednisone (14 cases) and group B; cyclosporine + prednisone (14 cases). Twenty sex‐age matched non‐immunosuppressed patients acted as controls (group C). Epidermal sheets were obtained by incubation in EDTA and stained for ATPase activity and with the monoclonal antibody T6 (CDI) using the avidin‐biotin peroxidase method. Langerhans cells were counted using a calibrated graticule (400×) and expressed as the mean number of LC/mm2. The mean area of the LC and the number of primary dendrites (pd) and secondary dendrites (sd) were determined with a morphometer adapted to an Apple II computer. The mean number of positive cells in controls was: ATPase, 677±157; T6, 695±164. Patients in group A had the maximum reduction in both ATPase and T6 LC density (ATPase, 339±142, T6, 402±194). Patients in group B had an intermediate reduction in the number of LC (ATPase, 494±121; T6, 529±112). The mean area of the LC and mean number of primary but not sd were significatively higher in RTP (area = 274±65 μ2; pd = 3.1±0.3) than in controls (area = 213±62 μ2; pd = 2.8±0.3). We conclude that RTP have a diminished number of LC in non‐exposed skin and that this decrease is more pronounced in patients receiving azathioprine and prednisone than in patients receiving cyclosporin and prednisone. Langerhans cells in RTP also show hypertrophic changes. These results suggest a role for the immunosuppressive therapy in the pathogenesis of the LC alterations in RTP.
Human gnathostomiasis
Authors: Taniguchi Y. , Hashimoto K. , Ichikawa S. , Shimizu M. , Ando K. , Kotani Y.
Published: April 2006

Two patients became infested with Gnathostoma nipponicum after eating raw loach‐fish they had caught in a rice field in central Japan. A fragment of Gnathostoma was found in a biopsy from one of them. The sera of both patients reacted with Gnathostoma antigen using indirect immunofluorescence. Scanning electron microscopy was performed on blocks of the paraffin‐embedded parasite sample and the viscera of a fish from the same rice field. The risk of eating raw freshwater fish is discussed.
Ultrastructural study of a mucinous carcinoid of the skin
Authors: Sakamoto F. , Ito M. , Matumura G. , Sato Y. , Kimura S.
Published: April 2006

A tumor of 60 years' duration overlying the sternum of an 87‐year‐old woman is described. Histologically, the tumor was composed of lobules and cords of epithelial cells with finely granular, eosinophilic cytoplasm. The epithelial nests were floating in large pools of mucinous stroma, separated by thin fibro‐vascular septa. Cytoplasmic argyrophilia was seen by Grimelius silver stain. Positive reactions of the tumor cells were also found for chromogranin and neuron‐specific enolase. Ultrastructural study revealed that the cytoplasm of the tumor cells contained two types of granules: neurosecretory and mucinous. From these findings, the present tumor is considered to be a carcinoid tumor with amphicrine cells, and the term ‘mucinous carcinoid’ of the skin seems to be appropriate for the diagnosis of the present case.
Generalized eruptive histiocytoma: a report of a variant case showing the presence of dermal indeterminate cells
Authors: Saijo S. , Hara M. , Kuramoto Y. , Tagami H.
Published: April 2006

We describe a 14‐year‐old Japanese girl with a variant of generalized eruptive histiocytoma. She presented with the characteristic features of classical generalized eruptive histiocytoma but with the following minor differences. Clinically, some of the papular eruptions tended to coalesce to form plaques. Histoligically, some of the histiocytic cells were S‐100 protein‐ and OKT‐6‐positive; these were thought to be indeterminate cells because they lacked Birbeck granules. In addition, PAS‐positive cells were few and there were some intermingled lymphocytes and a few eosinophils.
Ultrastructural binding site of pemphigus foliaceus autoantibodies: comparison with pemphigus vulgaris
Authors: Iwatsuki K. , Takigawa M. , Jin F. , Yamada M.
Published: April 2006

We studied in vivo binding sites of pemphigus foliaceus (PF) auto‐antibodies by immuno‐gold labelling technique, and compared them with those of pemphigus vulgaris (PV). In early acantholytic lesions of PF, the bound antibodies indicated by 5 nm protein A‐colloiclal gold particles were observed on the surface of keratinocytes, with particular affinity for desmosomes and separated attachment plaques. Nondesmosomal cell surfaces were sparsely labeled with the gold particles. A similar binding pattern was seen in the epidermal sheets obtained from a PV patient utilizing the Nikolsky phenomenon. These findings indicate that both PF and PV antigen‐antibody complexes are densely located on the desmosomal areas in early pemphigus lesions, suggesting the pathogenic importance of functional impairment of desmosomes by the autoantibodies.
Eosinophils in lupus panniculitis and morphea profunda
Authors: Peters Margot S. , Su W. P. Daniel
Published: April 2006

The extent of eosinophils in skin biopsy and peripheral blood specimens of patients with lupus panniculitis and morphea profunda was determined by studying 37 biopsies from 33 patients with lupus panniculitis and 55 biopsies from 53 patients with morphea profunda. Specimens from 8 (24%) of 33 patients with lupus panniculitis showed eosinophils, and 13 (25%) of 53 patients with morphea profunda had eosinophils in the subcutaneous tissue. In all cases, the diagnosis of lupus panniculitis or morphea profunda was established on the basis of other, more characteristic histologic features; the presence of eosinophils was incidental and not a diagnostic criterion. Occasional cases of lupus panniculitis or morphea profunda had numerous eosinophils. However, in most of the specimens, eosinophils were absent or observed in small numbers. Only 3% of patients with lupus panniculitis showed an increase in the number of eosinophils in the peripheral blood, whereas 47% of patients with morphea profunda had peripheral eosinophilia. The degree of hyaline necrosis in lupus panniculitis or of sclerosis in morphea profunda did not correlate with the number of eosinophils present in the biopsy specimen or peripheral blood.
Reactivity of fungal organisms in tissue sections using anti‐mycobacteria antibodies
Authors: Wiley E. L. , Beck B. , Freeman R. G.
Published: April 2006

Sixty‐four cases of deep fungal infections diagnosed using PAS or silver stains and 18 control cases of sarcoidosis, M. tuberculosis and M. leprae infection were stained using commercial polyclonal antibody raised against M. paratuberculosis (MP), M. Duvalii (MD), and Bacillus Calmette‐Guerin (BCG). Nine of 13 cases of sporotrichosis stained positively using anti‐MP antibody only; 13 of 14 cases of histoplasmosis stained with anti‐BCG, anti‐MD, and anti‐MP; seven cases of cryptococcosis had only focal staining of rare individual organisms within masses of negative organisms; seven of eight cases of coccidioidomycosis stained predominantly with anti‐BCG and anti‐MP; eight cases of aspergillus had focal (1 to 5% of organisms) staining of hyphae with anti‐BCG and anti‐MD; and four of 12 cases of Candida infection showed focal nonspecific staining with both antibodies and nonimmune serum. Control cases of sarcoidosis exhibited no staining with any of the three antibodies, whereas cases of mycobacterial infection showed staining of bacilli and intracellular debris with all three antibodies.
Cystic fibroepithelioma of Pinkus
Authors: Jones C. C. , Ansari S. J. , Tschen J. A.
Published: April 2006

A 59‐year‐old female with a cystic fibroepithelioma of Pinkus is presented. The clinical and histopathological features of this unusual variant of basal cell carcinoma are discussed.
Pigmented neuroectodermal tumor of infancy. A light microscopic and immunohistochemical study
Authors: Argenyi Zsolt B. , Schelper Robert L. , Balogh Karoly
Published: April 2006

We studied two cases of pigmented neuroectodermal tumor of infancy (PNTI) by routine light microscopy and immunohistochemistry on formalin fixed, paraffin embedded tissues using antibodies to HMB‐45 “melanoma associated” antigen, S‐100 protein, neuron specific enolase (NSE), Leu‐7 antigen, chromogranin, epithelial membrane antigen, collagen Type IV, alpha‐fetoprotein and muscle‐specific actin and to the intermediate filaments cytokeratin (CK), vimentin, desmin and neural filaments. We found that the large epithelioid cells, many of which contained melanin pigment, were strongly positive for CK and HMB‐45, and less intensively positive for vimentin and NSE. The small neuroblast‐like cells revealed only focal, weak NSE positivity. Both cell types were negative for S‐100 protein and for the other antigens examined. Our results suggest that: (1) the large and small cell populations in PNTI have different immunophenotypes; (2) the expression of CK and HMB‐45, together with the S‐100 negativity, appears unique for the pigmented cells; and (3) this profile may be helpful in the exclusion of melanoma and peripheral neuroblastoma from the differential diagnosis.

Argenyi ZB, Schelper RL, Balogh K. Pigmented neuroectodermal tumor of infancy. A light microscopic and immunohistochemical study.
Cartilaginous papule of the ear
Authors: Paslin D.A.
Published: April 2006

A 65‐year‐old white man developed 2 skin‐colored papules on the left helix. Microscopic examination disclosed hyperplasia of the auricular cartilage, a finding not heretofore described. It is unknown whether these cartilaginous papules of the ear represent a neoplastic or reactive phenomenon.

Paslin DA. Cartilaginous papule of the ear.
Adenosquamous carcinoma of the skin: a report of 10 cases
Authors: Banks Evelyn R. , Cooper Philip H.
Published: April 2006

Cutaneous squamous carcinoma with true glandular differentiation has only rarely been documented. Ten patients with such tumors are presented. There were six men and four women, aged 48 to 87 years. The tumors were located on the central face (eight), scalp (one), and hand (one) and consisted of minimally elevated, indurated, keratotic plaques, up to 6 cm in size. Microscopically, the neoplasms exhibited multifocal origin from the epidermis; deep, dispersed, infiltrative growth; perineural invasion; and stromal desmoplasia. Squamous differentiation was most marked superficially. Glandular differentiation was more obvious in deeper areas. Lumens typically developed within squamous nests and were often lined by cells with cytoplasmic vacuoles, some of which contained mucin. The neoplastic cells had obvious cytologic atypia and easily identified mitotic figures. Immunohistochemically, nine neoplasms studied contained car‐cinoembryonic antigen in glandular foci. Each patient had one or more surgical resections, and six also received radiation and/or chemotherapy. Five patients died with uncontrolled local recurrence, and two are alive with extensive disease and clinical evidence of regional lymph node involvement. Two individuals with small, superficial neoplasms that could be completely removed are disease free. One patient died of unrelated causes shortly after diagnosis. Cutaneous adenosquamous carcinoma is more aggressive than the usual carcinoma of the skin. It must be distinguished from the cytologically bland, microcystic adnexal (sclerosing sweat duct) carcinoma which is capable of recurring but rarely, if ever, proves fatal. The question of whether adenosquamous carcinoma is an epidermally derived squamous tumor with divergent differentiation or should be viewed as a newly recognized adnexal carcinoma remains to be resolved.
Kl 67 immunostaining in melanocytic skin tumors. Correlation with histologic parameters
Authors: Soyer H. P.
Published: April 2006

A total of 145 melanocytic tumors (nevus, 38; primary malignant melanoma, 72; metastatic malignant melanoma, 35) were stained with Ki 67 monoclonal antibody using a three‐step immunoperoxidase technique. For each case, mean numerical density and maximum numerical density of Ki 67 positive nuclei (number per mm3) were quantitatively evaluated using interactive image analysis. Maximum numerical densities revealed highly significant differences. Within the group of primary malignant melanomas, there was a significant correlation between proliferative activity and maximum tumor thickness. Further, a ‘Ki 67 – prognostic index’ was assessed in each case of primary malignant melanoma, calculating the product of the Breslow index and maximum numerical density/1000 (103±12; range 1–694). In a prospective, short‐term evaluation of primary malignant melanomas, there was a significant difference concerning ‘Ki 67 – prognostic index’ between disease‐free survival and occurence of metastases. After a follow‐up time of 24 months, only 63% of the patients with a ‘Ki 67 – prognostic index’ greater than 25 were disease‐free, whereas no patient with a ‘Ki 67 ‐prognostic index’ less than 25 was found to have metastases. We conclude: assessment of the maximum numerical density of Ki 67 reflects the degree of malignancy in melanocytic skin tumors; within primary malignant melanomas, maximum numerical density of Ki 67 positive cells correlates with well‐established prognostic parameters (tumor thickness, level of invasion, mitotic rate); assessment of the ‘Ki 67 ‐ prognostic index’ may be of additional prognostic value for patients with primary malignant melanoma.
Splendore‐Hoeppli phenomenon in Pityrosporum folliculitis (pseudoactinomycosis of the skin)
Authors: Clemmensen O. J. , Hagdrup H.
Published: April 2006

Actinomyces‐like granules showing the Splendore‐Hoeppli phenomenon have been demonstrated in histologic material, e.g. uterine curettings, in various conditions unrelated to genuine actinomycotic infection. The exact nature of the granules and the mechanism of their formation is open to speculation. We report two patients with a follicular skin eruption (Pityrosporum folliculitis) where pseudoactinomycotic granules were found in the skin biopsies. To the best of our knowledge, such findings have not previously been reported, but supposedly they are not rare. In order to avoid an incorret diagnosis of actinomycosis and unnecessary therapy, it is important to be familiar with the phenomenon.
Structure and antigenicity of the skin basement membrane zone
Authors: Fine Jo‐David
Published: April 2006

The skin basement membrane zone is comprised of two major ultrastructural regions, four associated structures, and at least 17 different antigens. In this brief review, the ultrastructure, antigenicity, and ontogeny of normal human skin will be discussed in detail, as will alterations in expression or immune response to selected basement membrane components in specific mechanobullous and autoimmune diseases.
Mast cell degranulation and elastolysis in the early stage of striae distensae
Authors: Sheu Hamm‐Ming , Yu Hsin‐Su , Chang Chung‐Hsing
Published: April 2006

The lesions of nine patients with early striae distensae (SD) during puberty were examined by light and electron microscopy. Specific changes were seen in very early stage SD, and in clinically uninvolved skin 0.5 to 3 cm remote from the edge of the long axis of the SD lesions. Sequential changes of elastolysis accompanied by mast cell degranulation appeared first, followed by an influx of activated macrophages that enveloped fragmented elastic fibers. The relationships among elastic fibers, mast cells, and macrophages seen in the present work suggest their critical roles in the process of SD formation, especially in the early stage. Our results also indicate that the elastic fiber is the primary target of the pathological process, and the abnormalities extend as far as 3 cm beyond the lesion into normal skin.
Ultrastructural localization of HMB‐45 binding sites
Authors: Schaumburg‐Lever Gundula , Metzler Gisela , Kaiserling Edwin
Published: April 2006

Three malignant melanomas, two melanoma metastases, two junctional dysplastic nevi, and normal skin were embedded in Lowicryl. Ultrathin sections were incubated with HMB‐45 and a gold‐labeled anti‐mouse antibody. Gold particles indicating the presence of HMB‐45 were found in melanosomes Stage 1 and 2 and in the non‐melanized portion of melanosomes Stage 3. Melanosomes Stage 4 and melanosome complexes in keratino‐cytes, as well as in melanophages, were consistently negative. No specific labelling with HMB‐45 was seen in eccrine glands of normal skin.
DNA ploidy of malignant melanoma determined by image cytometry of fresh frozen and paraffin‐embedded tissue
Authors: Herzberg Arlene J. , Kerns B. J. , Borowitz Michael J. , Seigler Milliard F. , Kinney Robert B.
Published: April 2006

Image analysis of DNA content was performed from single nuclei of melanoma monolayer imprints made from fresh frozen (issue of 14 patients with primary malignant melanoma and 16 patients with local recurrences at the incision site and local or distant metastases. This procedure requires fewer cells and is an advantage when the quantity of tumor available is limited, especially in thin low Breslow depth cutaneous melanomas. Image analysis allowed reproducible measurement of DNA ploidy from 100 cells. The frequency of aneuploidy was similar in primary and metastatic melanomas. Three of 3 patients with euploid primary melanomas showed no evidence of recurrences or meta‐stases, though one died of unrelated disease with short follow‐up. The 4 patients with primary melanoma who developed metastases had aneuploid primaries; two of these patients died of metastatic disease. Three of 4 patients with euploid metastatic tumors were free of disease at last follow‐up, and 1 patient died with stable disease. Nine of 12 patients with aneuploid tumors died of metastatic disease. The frequency of DNA ploidy in the present image analysis study correlated with previous (low cytometry studies. In 9 patients with primary tumors with a Bin‐slow depth greater than 0.75 mm, the. DNA content was also determined in nuclei obtained from formalin‐fixed paraffin‐embedded tissue. The frequency of aneuploidy was higher in fresh tissue (7 of 9) as compared with paraffin‐embedded tissue of the same cases (4 of 9).
Irritated seborrheic keratoses and benign verrucous acanthomas do not contain papillomavirus DNA
Authors: Zhu Wen‐Yuan , Leonardi Craig , Kinsey Willian , Penneys Neal S.
Published: April 2006

Sections from paraffin‐embedded tissues of lesions thought to represent verrucous lesions (benign verrucous acanthomas: BVA) as well as materials from controls including seborrheic keratoses (SK), irritated SK, and verruca vulgaris from areas other than the genitalia were analyzed for the presence of multiple human papillomaviruses (HPV) including types 6, 11, 16, 18, and 33 using DNA amplification methodology. HPV DNA sequences were not found in amplified samples of BVA, SK, and irritated SK samples, but were identified in those obtained from verruca vulgaris. Our results suggest that BVA, SK, and irritated SK are generally not associated with HPV DNA even though certain of these lesions may histologically mimic the architecture of verruca.
Cutaneous ganglion cell choristoma
Authors: Rios J. J. , Diaz‐Cano S. J. , Rivera‐Hueto F. , Villar J. L.
Published: April 2006

We describe the histological, immunohistochemical, and ultrastructural findings of a cutaneous tumour composed of ganglion cells, without any other proliferating component. As ganglion cells are not normal components of the skin, we propose the term “ganglion cell choristoma” for this lesion. The differential diagnosis of related lesions such as cutaneous ganglioneuroma, well‐differentiated metastases from neuroblastoma, autonomic ganglia entrapped by neuroflbroma, and reactive processes, and the possible histogenesis of ganglion cell choristoma are discussed.
Cytotoxic folliculitis in GvHD
Authors: Murphy G. F. , Lavker R. M. , Whitaker D. , Korngold R.
Published: April 2006

Recent observations indicate that stem cells of the murine hair follicle exist exclusively as a subpopulation of relatively undiffer‐entiated outer root sheath cells located in the bulge region at the mid‐portion of the follicle. Because it has been hypothesized that stem cells of interfollicular epidermis may represent targets of cytotoxic responses in acute graft‐versus‐host disease (AGVHD), we studied murine AGVHD and observed sequential skin biopsies for the presence and evolutionary pattern of follicular injury. Highly purified subsets of donor T cells were used to produce AGVHD to multiple minor histocompatibility (H) antigens in two strain combinations of mice matched for the major histocompatibility complex (MHC). In the C3H.SW‐>B6 strain combination, only CD8+ effector cells produced histologic evidence in skin of AGVHD, which peaked three weeks post‐transplant. In the B10.D2‐>DBA/2 strain combination, CD4+ effector cells, and to a lesser extent, GD8+ cells, mediated disease, which peaked during the fourth week posttransplant. Analysis of skin from both strain/effector cell combinations revealed follicular infiltrates preferentially involving follicular stem cell (FSC) regions (bulge) of anagen follicles between the second and third weeks post‐transplant. These infiltrates often preceded infiltration of adjacent interfollicular epidermis and were associated with follicular involution to telogen (resting) phase. By the fourth week post‐transplant, > 50% of follicles were in telogen phase and residual inflammation was minimal. This provided a unique opportunity to observe follicular recovery from telogen. This involved formation of buds of premordial hair matrix derived from FSC populations of the bulge regions, and subsequent descent of these buds, initially tethered by elongate columns of putative stem cell progeny, along the course of fibrous tracts corresponding to follicular sheaths. These findings suggest that stem cells of hair follicles, as well as epidermis, represent potential targets of cytotoxicity in AGVHD. Moreover, they provide in vivo demonstration that the newly‐described FSC population of the follicular bulge give rise to germinative matrix epithelium upon pathological stimulation.
Reactivity of monoclonal antibody OKM5 with sebaceous carcinoma
Authors: Zhao Yuming , Chen Hongduo , He Chundi
Published: April 2006

Two cases of sebaceous carcinoma (SC), as well as epithelial tumours, melanoma, and lymphoma, were examined using immunoperoxidase and a panel of monoclonal antibodies on cryostat sections. The results showed that, whereas all SC cells in both cases reacted strongly with monoclonal antibody OK.M5, other tumour cells (except juvenile xanthogranuloma cells) did not. The pagetoid cells within the epidermis of SC also reacted with OKM5 antibody. Although the nature of the phenomenon merits further study, this reactivity, or cross‐reactivity, might possibly aid diagnosis of SC.
Localized epidermal necrolysis (erythema multiforme‐like reaction) following intravenous injection of vinblastine
Authors: Arias D. , Requena L. , Hasson A. , Gutierrez M. , Domine M. , Martin L. , Barat A.
Published: April 2006

We report a case of localized epidermal necrolysis that developed 24 hours after an intravenous injection of vinblastine. Clinically, the lesions consisted of erythematous macules, vesicles, and bullae with a linear arrangement over the injected vein. Histologically, the lesions showed features closely resemr bling erythema multiforme (epidermal necrolysis). We discuss, the pathogenesis of this curious cutaneous drug reaction and review the literature concerning local cutaneous complications associated with intravenously administered chemotherapeutic agents.
Mast cell quantitation by image analysis in adult mastocytosis and inflammatory skin disorders
Authors: Wilkinson Barbara , Jones Allan , Kossard Steven
Published: April 2006

Mast cell numbers were quantitated in adult cases of mastocytosis demonstrating non‐diffuse perivascular and upper dermal concentrations of mast cells. Using the Leder stain and computerised video image analysis, a mean of 382 (± 28 SE) mast cell per mm2 were counted in the superficial dermis in skin biopsies from 30 adult cases of mastocytosis, in contrast to a mean of 43 (± 5 SE) mast cells per mm2 in skin biopsies from 50 inflammatory dermatoses represented by subacute dermatitis, pigmented purpuric dermatosis, erythema multiforme, lichen planus and granuloma annulare. Ten skin biopsies showing no significant inflammation had a mean of 54 (± 7 SE) mast cells per mm2 in the upper dermis. The mean area of individual mast cells as assessed by image analysis in the mastocytosis group was 47.40 um2 (± 2.26 um2, SE) which was significantly different (P < 0.01) than the mast cell area (32.34 μm2± 2.22 μm2, SE) in all other groups combined. Computerised video image analysis represents an alternative technique which is useful in assessing mast cell numbers and particularly mast cell size in adult cases of macular mastocytosis and in other dermatoses.
Occurrence of melanoma in “dysplastic” nevus spilus: report of case and analysis by flow cytometry
Authors: Kurban R. S. , Preffer F. I. , Sober A. J. , Mihm M. C. , Barnhill R. L.
Published: April 2006

We report a case of melanoma arising in a large nevus spilus. On histologic examination, the nexus spilus had diagnostic' features of melanocytic dysplasia. Further characterization by flow cytometry showed DNA‐aneuploidy within the melanoma as well as in one of the darker pigmented papules within the nevus spilus. The significance of this finding and a review of melanomas originating in nevi spili are presented.
Bubble hair
Authors: Elston D. M. , Bergfeld W. F. , Whiting D. A. , McMahon J. T. , Dawson D. M. , Quint K. L. , Muhlbauer J. E.
Published: April 2006

An unusual hair dystrophy was studied by moans of light and electron microscopy. Hair fibers demonstrated a boomerang deformity containing small and large “bubbles”. Electron microscopy revealed a loss of cortical cells and medulla at these sites. Cross‐section images showed either a single large cavity or a reticulated, “swiss cheese‐like” loss of cells. These two cases represent the second and third reported cases of bubble hair deformity. We present the second light and electron microscopic study of this disorder, including new electron microscopic findings. The cause of bubble hair deformity remains obscure. The involved tufts of wiry hair resolved with gentle hair care. This suggests that trauma to the hair shaft may play a role. It is likely that additional cases of bubble hair remain unrecognized. Investigation of other patients with localized tufts of wiry hair is likely to reveal additional cases.
Dermatomyofibroma
Authors: Kamino Hideko , Reddy Vijaya B. , Gero Melanie , Greco M. Alba
Published: April 2006

We report nine examples of a distinct cutaneous plaque‐like proliferation of fibroblasts and myofibroblasts. Eight of nine lesions were located in or around the shoulder, including axilla and upper arm. There was a predominance of women to men of 8:1. The lesions measured from 1 to 2 cm in greatest diameter. All patients were voting adults (mean age 29.8 yr). All lesions involved the reticular dermis in a plaque‐like fashion and extended to the upper part of the subcutaneous septa in seven cases. The lesions consisted of a proliferation of very uniform slender spindle‐shaped cells arranged as well‐defined elongated and intersecting fascicles with a predominantly parallel arrangement to the skin surface. There was no evidence of cytologic atypia and mitotic figures were infrequent. The spindle‐shaped cells were separated by thin collagen fibers. Elastic libers were preserved and some of them appeared thicker than normal. All adnexal structures were spared. Immunohistochemistry revealed that the cells stained positively for vimentin and muscle actin, but lacked smooth‐muscle specific actin. desmin, and S‐100 protein. Some dermal dendrocytes stained positively for Factor XIIa, but the spindle‐shaped cells were negative. Electron microscopy studies revealed a mixture of fibroblasts, myofibroblasts, and undifferentialted mesenchymal cells. All lesions were treated by conservative excision; follow‐up information revealed no evidence of recurrence. We name tins distinct lesion dermatolmyofibroma. To the best of our knowledge, this entity has not been previously described in the literature
Tricholemmal carcinoma:
Authors: Boscaino Amedeo , Terracciano Luigi Maria , Donofrio Vittoria , Ferrara Gerardo , De Rosa Gaetano
Published: April 2006

Seven cases of tricholemmal carcinoma (TLC), a rarely recognized cutaneous adnexal neoplasm of external hair sheath origin, are described. Most occurred on sun‐exposed skin; five involved the head and neck, one the right leg, and one the right thigh. TLC had a generally short history and all were treated by local excision. The lesions had an exophytic (3 cases) or polypoid (4 cases) gross appearance. Histologically, TLG exhibited a sharply circumscribed, tabular epithelial proliferation in continuity with the epidermis. A cytologic hallmark of these tumors was the presence of large cells with PAS‐reactive, diastase‐sensitive, clear iii‐ pale eosinophilic cytoplasm. High mitotic rate was a constant feature. Four tumors were infiltrative, with pushing borders, whereas three were intraepithelial. One case showed acantholysis. Immunocytochemistry revealed positively for prekeratin and negativity for (CEA and EMA, supporting the trichogenic origin of these tumors. Ultrastructural examination gave clear indication of epithelial origin for (he cells but did not verify hair follicular differentiation. Despite locally aggressive growth, (he clinical course of TLC appeared indolent. Moreover, there are no cases with metastases reported in the literature.
Prognostic significance of proliferation and motility in primary malignant melanoma of the skin
Authors: Smolle Josef , Hofmann‐Wellenhof Rainer , Kerl Helmut
Published: April 2006

The metastatic cascade depends on the presence of tumor cells which are capable of proliferation as well as of invasion with active motility. In the present study, it was examined whether the demonstration of both features in the primary lesion of malignant melanoma of the skin carries prognostic significance. Proliferation was assessed by mitotic counts and Ki 67 staining, and motility was estimated by image analysis and comparison of the image analysis results with computer simulations; 27 cases of primary malignant melanoma with a maximum vertical tumor thickness exceeding 1 mm were prospectively sampled. Mitotic counts were carried out on H&E stained sections, image analysis of the tumor pattern on S‐100 immunostained paraffin slides, and Ki67 labeling of actively cycling cells was evaluated on frozen sections. Neither proliferation nor pattern analysis alone provided a significant prognostic result with respect to overall survival and to metastasis free survival. The estimates of motility, derived from a combination of pattern analysis and proliferation values, however, proved to be significant predictors of overall survival and metastasis‐free survival (log rank test: p 0.05). The motility features were superior to Clark level and Breslow index in this set of cases. The results demonstrate that the assessment of tumor cell proliferation and motility in histological sections may reflect the metastatic potential of primary malignant melanomas of the skin.
Fibroepithelioma‐like changes associated with anogenital epidermotropic mucinous carcinoma
Authors: Hurt Mark A. , Hardarson Sverrir , Stadecker Miguel J. , Santa Cruz Daniel J.
Published: April 2006

We describe two patients with crusted perincal plaques that were biopsied and diagnosed as Paget's disease. Resection specimens of each contained a dermal mucinous carcinoma with extensive epidermotropism and coexistent epidermal basaloid proliferations closely resembling fibroepithelioma (Pinkus). The presence of the Paget phenomenon was supported by histochemical, immnunohistochemical, and ultrastructrual evidence. No other primary neoplasms were found in either patient. Followup at 2 1/2 and 3 1/2 years, respectively, has been negative. We conclude that either the fibroepitheliomatous changes may be induced by or may represent a collision (unlikely) with the epidermotropic mucinous carcinoma. It is proposed that the concept fibroepitheliomatous Paget phenomenon be used to stand for the histologic changes common to our cases as well as those previously reported.
Cutaneous lymphadenoma with focal mucinosis
Authors: Wechsler Janine , Fromont Gaelle , André Jean‐Michel , Zafrani Elie S.
Published: April 2006

Cutaneous lymphadenoma of the eyebrow occurred in a 72‐year‐old man. The nodular tumor was well circumscribed but non encapsulated and invaded the reticular dermis and superficial hypodermis without any connection with the epidermis. Tumor cells had a basal‐like appearance and were arranged in small lobules and islands with peripheral palisading and areas of central keratinization. They were often dissociated by an extracellular mucinous material. The stroma was fibroblastic and contained a marked lymphoid infiltrate that surrounded and penetrated the neoplastic lobules. Occasional germ‐like hair follicle structures were noted. The immunohistocheimical pattern was similar to that of hair follicles, and the leucocytic component was predominantly composed of T‐Iymphocytes and Langerhans cells, which were specially numerous within the neoplastic lobules. We believe that the tumor, in the present case, has morphologic features consistent with epithelial and stromal attributes observed in hair follicles.
Primary osteosarcoma of the skin
Authors: Kuo T‐t.
Published: April 2006

Primary cutaneous ostcosarcoma is extremely rare. An extra‐skeletal osteosarcoma of the skin occurring in the popliteal region of a 51‐year‐old woman is described. There were no associated prediposing conditions.
Immunohistochemical distribution of aromatase and 3B‐hydroxysteroid dehydrogenase in human hair follicle and sebaceous gland
Authors: Sawaya M. E. , Penneys N. S.
Published: April 2006

Human hair follicles (HF) and sebaceous glands (SG) were assessed for the presence and distribution of the cytochrome P‐450‐aromatase (AR) and 3B‐hydroxysteroid dehydrogenase (3B‐HSD) enzymes. Immunohistochemical methods were used to examine both enzymes in male and female human skin specimens at various ages and different body sites. AR was found in the external root sheath of anagen, terminal HF, and in SG, whereas the 3B‐HSD was found only in the SG. AR was rarely found in telogen HF. The expression of both enzymes, AR and 3B‐HSD, did not vary with body site or sex. Localizing AR in the external root sheath of anagen HF suggests that AR may have a function in the HF cycle. We hypothesize that AR may be one of many enzymes or factors that play a role in the HF cycle by regulating the level of androgens formed locally, whereas 3B‐HSD is localized in SG, converting weak androgen precursors to potent androgens, stimulating lipogenesis.
Sweat gland carcinoma with mucinous and infiltrating duct‐like patterns
Authors: Yamamoto Osamu , Nakayama Kan‐ichiro , Asahi Masakazu
Published: April 2006

We report a rare case of mucinous carcinoma of the skin with mammary infiltrating carcinoma‐like patterns. An 82‐year‐old Japanese male had a gourd‐shaped tumor on his scalp. Histopathologically, the posterior portion of the tumor showed small lobules of cuboidal tumor cells with no atypia floating in mucinous lakes. In the anterior portion, there were solid lobules, cords, and strands of anaplastic tumor cells infiltrating into the surrounding stroma. Enzyme‐ and immunohistochemistry and electron microscopy confirmed the eccrine origin of this tumor. It is suggested that mucinous carcinoma of the skin can occur in association with diverse histological patterns, analogous to mucinous carcinoma of the breast.
Minocycline hyperpigmentation: model for in situ phagocytic activity of factor XIIIa positive dermal dendrocytes
Authors: Altman David A. , Fivenson David P. , Lee Min W.
Published: April 2006

Pigmentary disorders resulting from the prolonged use of the semisynthetic tetracycline derivative antibiotic, minocycline, are rare but well recognized sequelae of ingestion of this drug. We present two eases of women with billions pemphigoid who developed blue‐black pigmentation in areas of scarring on the legs after oral minocycline therapy. On histologic examination, the deposited pigment was localized within dendritic cells limited to the upper dermis. Immunohistochemical analysis revealed these cells to be factor XIIIa positive dermal dendrocytes which was confirmed by transmission electron microscopy. We believe these cases demonstrate, in‐situ, the phagocytic capabilities of this recently described cell population.
Pathogenesis of hair infection and black dots in tinea capitis caused by Trichophyton violaceum: a histopathological study
Authors: Lee J. Yu‐Yun , Hsu Ming‐Long
Published: April 2006

The majority of tinea capitis in southern Taiwan occur in adult women and are caused by Trichophyton violaceum. We report the histopathological Endings of a series of 10 cases of tinea capitis caused by T. violaceum, the largest such study to date. Our study provides new information regarding the process of hair infection, mechanism of black dot formation, and chronicity of infection caused by this fungus. The cuticle remains intact. The fungi enter the proximal cortex where the cuticle is immature. They then colonize the proximal keratinized cortex and generate septate hyphae which transform gradually into arthrospores as they arc carried upwards by the growing hair. At the infundibular level, the hair cortex is almost completely replaced by spores and swells, impeding further exit of the growing hair and causing the already weakened hair to coil up inside the infundibulum, forming a black dol. In one patient who had infection for more than 20 years, there were changes suggestive of cyclic rein‐lection of the same follicles which might contribute to the chronicity of die infection.
Lymphocyte markers on formalin‐fixed tissue in Jessner's lymphocytic infiltrate and lupus erythematosus
Authors: Akasu R. , Kahn H. J. , From L.
Published: April 2006

Clinical and histological differentiation between Jessner's lymphocytic infiltration of the skin (JLI) and lupus erythematosus (LE) may he difficult. Previous immunohistochemical studies using monoclonal antibodies on frozen sections have shown that the majority of inflammatory cells in JL1 and LE are T lymphocytes, whereas B lymphocytes are few or absent. We have performed an immunohistochemical study on formalin‐fixed, paraffin‐embedded tissue sections from seven patients with JLI and live with LE using monoclonal antibodies MT1 (pan T‐cells), OPD4 (helper/inducer T‐cells CD4), MT2 (mantle/one B and some T‐cells), MB2 (pan B‐cells), L26 (pan B‐cells), and LN 1 (germinal centre B‐cells). In both diseases, the‐majority of the inflammatory cells were T lymphocytes (MT1 positive), confirming the results others have obtained on frozen material. OPD4 positive cells were detected in varying numbers in all cases. However, the percentage of B lymphocytes tended to be higher in JLI than LE. LN1 was the most useful H‐cell marker in distinguishing JLI from LE. However, a combination of M T2 and LN 1 gave the most significant difference. We conclude that immunohistochemical analysis using a panel of monoclonal antibodies to T and B lymphocytes may be useful in differentiating JLI from LE, although there is still considerable overlap.
Proliferating cell nuclear antigen (PCNA) in common epidermal lesions.
Authors: Geary W. A. , Cooper P. H.
Published: April 2006

A commercially available antibody to proliferating (HI nuclear antigen was used in characterize and compare proliferating cell populations in paraffin sections of benign, premalignant, and malignant lesions of human epidermis using routine immunohistochemical techniques. Three patterns emerged. An ordered pattern was found in prurigo nodularis and keratoacanthoma, wherein moderately and strongly positive nuclei were distributed in a continuous, basal‐suprabasal layer of relatively uniform thickness. I here was graded loss and ultimate extinction of PCNA staining in progressively more superficial epidermal cells. A basal dysplastic pattern was found in actinic keratosis and squamous cell carcinoma. Nuclei of essentially all dysplastic cells of both categories expressed PCNA, with a preponderance of Strongly positive nuclei. These were localized to basal‐suprabasal zones that were often expanded. Loss of PCNA reactivity inward die surface was often abrupt. Bowen's disease exhibited a diffuse dysplastic pattern, wherein large numbers of moderately and strongly positive nuclei, in random array, were present in essential full thickness distribution. In many fields, however, a layer of cytologically bland basal cells, with faint or no nuclear staining, was interposed between dysplastic epithelium and dermis. This study has demonstrated that proliferating cell populations in epidermal lesions can be assessed with simple, inexpensive methods. There were consistent differences between the proliferating cell populations of die various entities studied, difference's that can be reasonably correlated with other known clinical, microscopic, and biologic features of the lesions. This technique should provide an interesting new avenue for study of diverse cutaneous diseases.
Chordoma involving the skin: an immunohistochemical study of 11 cases
Authors: Gagné Eric J. , Su W. P. Daniel
Published: April 2006

Immunohistochemical properties were studied in 16 lesions from 11 patients with chordoma involving the skin. Their were nine men and two women ranging from 21 to 62 years old (mean, 42.6). The initial tumor was saeroeoccygeal in 10 cases and nasopharyngeal in I case. Three lesions represented a direct extension from the primary tumor to the skin, and 13 lesions were examples of local recurrences in the skin. Immunohistochemically, all lesions showed positively for keratin, whereas 14 lesions were positive for vimentin and 12 for protein, 8–100. Epithelial membrane antigen was positive in four instances and carcinoembryonic antigen was negative in all studies. No significant difference was observed between the immnuoprofile of cases of direct extension and those of local recurrences. Overall, the remarkable triple positivity (or keratin, vimentin, and protein S‐IOO was observed in 11 lesions from eight different cases (73%). This study confirmed the utility of imnmunohistochemistry in the differential diagnosis of chordoma from tumors with similar histologie characteristics encountered in the skin.
Lectin‐binding profiles for normal skin appendages and their tumors
Authors: Tsubura Airo , Fujita Y. , Sasaki M. , Morii S.
Published: April 2006

A histochemical investigation of lectin‐binding sites was carried out on formalin‐fixed paraffin‐embedded sections of 60 skin appendage tumors and adjacent normal skin appendages, using four different biotinylated lectins, peanut agglutinin (PNA), Dolichos biflorus agglutinin (DBA), soybean agglutinin (SBA), and Ulex europaeus agglutinin‐1 (UEA‐1), and avidin‐biotin‐horseradish peroxidase labeling. In the secretory segments of eccrine sweat glands, the superficial dark cells showed strong cytoplasmic staining with UEA‐1, whereas DBA and SBA strongly stained the plasma membranes of basal clear cells. The acinar cells of apocrine sweat glands revealed sporadic apical membrane staining with all four lectins. In some cases, the luminal membranes of sweat gland ducts showed apical membranous Staining with all four lectins. In the hair follicles, the inner root sheath was positive for all four lectins, and the outer root sheath was stained by PNA. The sebaceous ducts, as well as the outer root sheath al the level of sebaceous duct insertion, were also labeled by all four lectins. Sebaceous lobules showed cytoplasmic and membrane staining of mature sebocytes with PNA and SBA. Although sweat gland tumors revealed differences in lectin binding when compared to their corresponding normal tissues, the lectin‐binding pattern of pilosebaceous tumors was analogous to the pilosebaceous apparatus.
Transient bullous dermolysis of the newborn
Authors: Hashimoto Ken , Eng Ana M.
Published: April 2006

In a freshly induced blister from transient bullous dermolysis of the newborn, we found in epidermal basal cells structures similar to anchoring fibrils and lamina densa, often in combination. In the upper dermis, collagenolysis and phagocytosis of degenerated collagen fragments were observed. It is concluded that the stellate inclusions previously reported in this disease are prematurely assembled anchoring fibrils and lamina densa. A disturbance of delivery mechanism of precursor materials for anchoring fibrils and lamina densa may cause the deficiency of these structures which are essential for the integrity of dermo‐epidermal adhesion. The presence of many normal anchoring fibrils and lamina densa in perilesional skin and their prompt degeneration after rupture of the inclusions previously led us to conclude that lytic enzymes are involved in the formation of blisters in this disease. The new finding of collagen phagocytosis in the lesional dermis seemed to support this contention.
Role of adhesion molecules in cutaneous inflammation and neoplasia
Authors: Walsh Laurence J. , Murphy George F.
Published: April 2006

There is accumulating evidence that the expression of certain adhesion molecules has important consequences for understanding patterns of evil movement in normal and pathologically altered skin. This paper reviews recent work regarding the role of integrins and other adhesion molecules (ICAM‐1, YCAM‐1, PKCAM‐1, PECAM‐1, and ELAM‐1) in cutaneous inflammation and neoplasia, and presents a unifying hypothesis which outlines how sequential expression of cytokines and adhesion molecules in evolving inflammation may alter the nature of the cellular response.
Deep penetrating (plexiform spindle cell) nevus
Authors: Cooper Philip H.
Published: April 2006

This report describes 41 patients with lesions similar to those previously termed “deep penetrating” or “plexiform spindle cell” nevus (DPN). DPN occurs primarily during the first four decades, is somewhat more common in females, and has a predilection for the face, trunk, and proximal extremities. It is usually less than 1 cm in diameter and often shows variegation in color, including shades of brown, blue, and black, that create clinical concern regarding malignant melanoma. None of the present tumors nor those from the literature recurred following excision. Microscopically, DPN usually has a wedge shape, invariably involves reticular dermis, and may penetrate subcutis. Involvement of neurovascular structures and adnexae and spread between fibers of the reticular dermis create a lascicular‐plexiform architecture. The melanocytes are fusiform or epithelioid, lightly to moderately pigmented, and exhibit mild to locally prominent nuclear alypia. Sparse to abundant melanophages are characteristic. Milolic figures are few and present in only a small minority of lesions. The present study of a consecutive series also indicates that DPN is a frequent participant in combined nevus, as it was associated with ordinary nevus in two‐thirds of the lesions.