1/39. Proliferative actinic keratosis: three representative cases.OBJECTIVE: This article describes a new subtype of actinic keratosis that exhibits proliferative characteristics both histologically and clinically. We describe three representative cases occuring in the presence of infiltrative squamous cell carcinoma (SCC) and/or basal cell carcinoma (BCC). methods: Histories of each lesion in the three cases discussed were obtained. The lesions were removed by Mohs micrographic surgery. Permanent sections, stained with hematoxylin and eosin, were examined and studied under light microscopy. RESULTS: All three lesions had failed conventional treatment with liquid nitrogen and/or 5-fluorouracil (5-FU). Histologic examination of the lesions revealed sheets of dysplastic cells growing along the basal layer of the epidermis and migrating down hair follicles and sweat ducts. An associated infiltrative SCC and/or BCC was found in each case. CONCLUSIONS: Proliferative actinic keratosis is resistant to standard therapies because of deep migration of abnormal cells along hair follicles and sweat ducts. It has a strong propensity to develop infiltrative SCC and may occur concomitantly with BCC.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/39. Apocrine acrosyringeal keratosis in association with syringocystoadenoma papilliferum.We report the clinical and histopathological features of a keratosis that developed in association with syringocystadenoma papilliferum. This tumour shows a pinkish, pedunculated, spherical nodule with a cerebriform surface and visible keratinous plugs. In addition to the typical features of syringocystadenoma papilliferum, the tumour shows many hyperkeratotic columns surrounded by acanthotic epidermis with the characteristics of trichilemmal keratinization and keratohyalin granules. This keratosis seems to be derived from the middle to lower portion of the apocrine acrosyringium, based on the distribution of keratohyalin granules and the direct connection with the apocrine acrosyringium in an early lesion. Accordingly, we propose to identify this rare keratosis as apocrine acrosyringeal keratosis.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/39. Sebaceous carcinoma arising on actinic keratosis.We report two cases of sebaceous carcinoma arising on actinic keratosis. The first patient, a 75-year-old female, had a granuloma pyogenicum-like tumor on her left temple, and the second patient, an 81-year-old female, developed a tumor with erythema on her left cheek. In both cases, histopathological examination revealed findings typical of sebaceous carcinoma in the center of the tumors, and in the periphery, actinic elastosis and intraepidermal proliferation of squamoid atypical cells without vacuolation was observed. Immunohistochemical examinations using six antibodies also revealed that neoplastic cells of both cases demonstrated sebaceous differentiation. These cases suggest that extraocular sebaceous carcinoma may arise from actinic keratosis.- - - - - - - - - - ranking = 0.16666666666667keywords = life (Clic here for more details about this article) |
4/39. keratosis lichenoides chronica. Report of a case associated with B-cell lymphoma and leg panniculitis.keratosis lichenoides chronica (KLC) is a rare chronic dermatosis characterized by lichenoid hyperkeratotic papules arranged in a linear and reticular pattern, and seborrheic-dermatitis-like lesions on the face. Less frequently, palmoplantar keratoderma, nail dystrophies, mucosal as well as eye lesions are present. KLC affects adults and very few cases have been reported in childhood. Although infrequently, KLC has been associated with systemic diseases, including chronic infectious diseases, kidney disorders and lymphoma. Here we report the case of an adult KLC patient with skin, nail and mucosal involvement, and onset in the first year of life who developed a leg panniculitis and a mantle cell lymphoma. Following chemotherapy for the lymphoma, panniculitis resolved completely, and skin and mucosal KLC lesions ameliorated.- - - - - - - - - - ranking = 0.16666666666667keywords = life (Clic here for more details about this article) |
5/39. Olmsted syndrome: report of a case with study of the cellular proliferation in keratoderma.Olmsted syndrome is a rare disorder that consists of sharply marginated keratoderma of the palms and soles, constriction of digits and toes that may result in spontaneous amputation of the distal phalanges, hyperkeratotic plaques around the body orifices, onychodystrophy, and other less common cutaneous and extracutaneous anomalies. Although some patients had other affected family members, most cases of Olmsted syndrome seem to be of sporadic occurrence. We describe a patient with the characteristic features of Olmsted syndrome. The symptoms consisted of diffuse transgrediens palmoplantar keratoderma and keratotic plaques around the mouth and nose. Our patient also had the associated anomalies of hyperhidrosis of the palms and soles and congenital deaf-mutism. Histopathologic study of the keratoderma demonstrated epidermal hyperplasia with acanthosis, papillomatosis, and orthokeratotic hyperkeratosis.Immunohistochemical study showed more basal and suprabasal keratinocytes of the epidermis with immunoreactivity for Ki-67 marker when compared with the keratinocytes of the epidermis of the adjacent non-involved skin. These results support the notion that Olmsted syndrome is a hyperproliferative disorder of the epidermis.- - - - - - - - - - ranking = 0.83333333333333keywords = life (Clic here for more details about this article) |
6/39. Trichilemmal horn on burn scar tissue.We describe the case of a 53-year-old Japanese woman with a trichilemmal horn on burn scar tissue on her left arm. When examined using light microscopy, the lesion showed U-shaped epidermal proliferations which keratinized in a fashion either identical or similar to trichilemmal keratinization. Immunohistochemical results established a relationship between the trichilemmal horn and the outer root sheath of the hair follicle. Trichilemmal keratinization was observed using electron microscopy. Apparently, the tumor had developed on a skin scar where hair follicles were not clinically present. We concluded that the tumor had originated from some hair follicle cells remaining in the epidermis after the burn.- - - - - - - - - - ranking = 0.16666666666667keywords = life (Clic here for more details about this article) |
7/39. Proliferative verrucous leukoplakia: a case report.Proliferative verrucous leukoplakia (PVL) is a particularly aggressive form of oral leukoplakia that is resistant to treatment and presents a high risk of recurrence and malignant transformation. This article describes the microscopic and clinical characteristics of one case of PVL, which initially presented as hyperkeratosis with mild dysplasia and posteriorly developed multifocal areas and verrucous carcinoma despite treatment.- - - - - - - - - - ranking = 0.83333333333333keywords = life (Clic here for more details about this article) |
8/39. sports-related pads.Knuckle pads, first described by Garrod in 1893, 1 are benign, asymptomatic, well- circumscribed, smooth, firm, skin colored papules, nodules, or plaques. They most commonly occur on the dorsal aspect of the proximal interphalangeal joint of the finger, 2 but also may occur on the dorsal aspects of the foot over joints. 3-5 Knuckle pads may be inherited or acquired. 1 While some authors suggest that trauma is not a significant factor, 6 acquired knuckle pads have been associated with repetitive friction and trauma, 2,7 and may resemble athlete's nodules (also referred to as collagenomas). 1 Histologically, knuckle pads are characterized by hyperkeratosis, hypergranulosis, proliferation of fibroblasts and capillaries, and thickened and irregular collagen bundles. 1 Few cases of knuckle pads involving the lower extremities have been reported. 7 Knuckle pads of the feet have been described in association with inherited syndromes, such as acrokeratoelastoidosis Costa, 3 a syndrome of knuckle pads, leukonychia and deafness, 4 and a syndrome of knuckle pads, leukonychia, deafness and keratosis palmoplantaris. 5 We report a case that illustrates an unusual presentation of acquired knuckle pads of the feet secondary to repetitive friction from athletic gear.- - - - - - - - - - ranking = 0.16666666666667keywords = life (Clic here for more details about this article) |
9/39. hyperplasia of the subcutaneous adipose tissue is the primary histopathologic abnormality in lipedematous scalp.A 51-year-old white woman presented with thickening of the scalp located at the vertex and left lateral occiput without hair abnormalities or alopecia. skin biopsies of the thickened scalp showed thickening of the subcutaneous tissue with proliferation of mature subcutaneous fat cells but no signs of inflammation or hair abnormalities. During 2.5 years of follow-up, scalp thickening progressed over the entire hair-bearing scalp and persisted without signs of further progression at 3.5 year follow-up. Lipedematous scalp is an extremely rare diagnosis. It is defined by a thickening of the subcutaneous layer of the scalp and can be distinguished from lipedematous alopecia, in which subcutaneous thickening is associated with diffuse alopecia and shortening of scalp hairs. A total of seven cases of lipedematous alopecia and two cases of lipedematous scalp have been reported. We report the third case of lipedematous scalp in a 51-year-old white woman associated with early symptoms of meningitis. Additional features described in the literature include pruritus, pain, and paresthesia of the scalp as well as associated medical problems such as hyperelasticity of skin and laxity of joints, renal failure, and diabetes mellitus. This sporadic disorder is predominantly located at the vertex and occiput. The etiology and pathogenesis of lipedematous scalp and alopecia remain unclear. The treatment is symptomatic.- - - - - - - - - - ranking = 0.16666666666667keywords = life (Clic here for more details about this article) |
10/39. Pigmented squamous cell carcinoma of the cheek skin probably arising from solar keratosis.We report a rare case of pigmented squamous cell carcinoma (SCC) of the cheek skin probably arising from solar keratosis. An 80-year-old man was referred to our clinic because of a black skin nodule in the right cheek. The nodular lesion was 1 cm in diameter, dome-shaped, hard, sharply demarcated, partially erosive and telangiectatic at the border. The lesion was completely excised under the clinical diagnosis of probable seborrheic keratosis. Microscopically, cutaneous horn and mildly atypical squamous epithelia suggestive of previous solar keratosis were present in the surface of the lesion. The lesion consisted of atypical squamous cells with keratinization and intercellular bridges, and it was regarded as SCC. The SCC cells were seen to invade lightly into the upper dermis, where lymphocytic infiltrations and melanophages were noted. Characteristically, heavy deposition of melanin pigment was recognized in the SCC cells as well as in proliferated dendritic and pigment blockade melanocytes that were scattered or colonized within the SCC cell nests. Masson-Fontana stain revealed numerous melanin granules in the SCC cells, as well as in dendritic and pigment blockade melanocytes. Immunohistochemically, the SCC cells were positive for cytokeratins and epithelial membrane antigen, and negative for S-100 protein and HMB45 antigen. Dendritic and pigment blockade melanocytes were negative for cytokeratins, epithelial membrane antigen, and HMB45 antigen, but positive for S-100 protein. The present case suggests that SCC cells of the skin may induce proliferation of melanocytes. The differential diagnosis and the histogenesis of pigmented SCC of the skin are discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = life (Clic here for more details about this article) |
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