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Dermatopathology Case Index: Case 21 to Case 40

Dermatopathology Case Index : Case 21 = Bowen's Disease Case 22 = Fibroepithelioma of Pinkus Case 23 = Pilomatrixoma (Pilomatricoma ; Calcifying epithelioma of Malherbe) Case 24 = Poroma Case 25 = Clear Cell Acanthoma Case 26 = Glomangioma Case 27 = Sebaceoma Case 28 = Molluscum Contagiosum Case 29 = Pilomatrix Carcinoma Case 30 = Xanthelasma Case 31 = Reticulohistiocytoma Case 32 = Sebaceous Hyperplasia Case 33 = Glomeruloid Hemangioma Case 34 = Bacillary Angiomatosis Case 35 = Chromomycosis (Chromoblastomycosis) Case 36 = Angiolymphoid Hyperplasia with Eosinophilia (Epithelioid Hemangioma) Case 37 = Dermatitis Herpetiformis Case 38 = Trichoblastoma Case 39 = Desmoplastic Melanoma Case 40 = Acute Febrile Neutrophilic Dermatosis or Sweet's Syndrome

Answer of Dermatopathology Case 40

Acute Febrile Neutrophilic Dermatosis or Sweet's Syndrome Visit: Dermatopathology site Visit: emedicine article: http://emedicine.medscape.com/article/1122152-overview Abstracts: Sweet's syndrome: an update and review.G Ital Dermatol Venereol. 2009 Oct;144(5):603-12. Sweet's syndrome, or acute neutrophilic dermatosis, is an unusual dermatologic disorder that may serve as a marker of leukemia or lymphoma, other malignancy or another serious systemic disorder. It is characterized by the sudden eruption of tender discrete erythematous nodules or plaques which are sometimes associated with fever, neutrophilic leukocytosis, and a dense dermal infiltrate of mature neutrophils. It may occur as a hypersensitivity reaction with cytokines playing a pivotal role. It may remit after the treatment of an underlying cancer or discontinuation of an offending pharmacologic agent, although it con also resolve spontaneously without therapeutic intervention. The gold standard of treatment is

Dermatopathology Case 40

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Image1 Image2 Image3 Image4 Case 40 A 52 year old female with fever, an elevated neutrophil count, and tender, dark-red plaques on the upper extremities . Answer

Answer of Dermatopathology Case 39

Desmoplastic Melanoma Visit: Pathology of Desmoplastic Melanoma ; Visit: Dermatopathology site Abstract: Procollagen 1 and Melan-A expression in desmoplastic melanomas.Am J Dermatopathol. 2009 Apr;31(2):173-6. The histopathologic diagnosis of desmoplastic melanoma (DM) is usually based on typical conventional microscopic findings coupled with expression of S100 protein by neoplastic cells. Important differential diagnostic considerations include atypical fibroxanthoma (AFX) and spindle cell squamous carcinoma. Spindle cell squamous cell carcinoma is characterized by positivity for cytokeratin, whereas the diagnosis of AFX has been one of exclusion. Procollagen 1 (PC1) has been identified as a relatively sensitive marker of AFX. In this study, we sought to analyze the expression of PC1, S100 protein, and Melan-A in a series of 37 DMs (27 males and 10 females; ages 36-92 years, mean age 74 years). All lesions displayed a spindle cell morphology with varying degrees of desmoplasia. The

Dermatopathology Case 39

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Image1 Image2 Image3 Image4 Case 39 An indurated nodule on the forehead of a 70 year old male. Answer

Answer of Dermatopathology Case 38

Trichoblastoma Visit: Pathology of Trichoblastoma Visit: Dermatopathology site Abstract: Cytologic features of trichoblastoma in fine needle aspiration biopsies.Acta Cytol. 2009 Nov-Dec;53(6):679-82. OBJECTIVE: To review the cytologic features of trichoblastoma in order to define criteria that may aid in identification of these tumors at the time of aspirationand allow a definitive diagnosis. STUDY DESIGN: A 58-year-old male presented witha mass lesion on the thigh. On fine needle aspiration, the patient was diagnosed as having a benign skin adnexal tumor. Histology showed the presence of atrichoblastic fibroma, and a retrospective analysis of the cytology wasperformed. RESULTS: The cytologic features of trichoblastoma resembled a cellular fibroadenoma/phyllodes tumor on aspiration, not previously described in theliterature. If the cytomorphology of a skin or subcutaneous aspirate appears to resemble that of a fibroadenoma, the diagnosis of a trichoblastoma should be entertained. Perip

Dermatopathology Case 38

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Image1 Image2 Image3 Case 38 A well cicumscribed solitary lesion (1.5cm in diameter) on the scalp of a 35 year old male. Answer