Dermatopathology Cases

Focal Mucinosis Visit: Dermatopathology Site Abstract: Discrete papular dermal mucinosis with Hashimoto thyroiditis: a case report. Cutis. 2011 Mar;87(3):143-5. The cutaneous focal mucinoses are a group of connective tissue disorders characterized by deposition of mucin found either focally or diffusely in the dermis. A 47-year-old woman presented with asymptomatic flesh-colored papules on the neck, inguinal area, intergluteal area, vulvar area, and extremities of 5 months' duration. There was no history of preceding trauma or insect bites. The patient had undergone a subtotal thyroidectomy 21 years prior but had not used any thyroid medication before she was referred to our clinic. Thyroid ultrasonography was consistent with Hashimoto thyroiditis. During dermatologic examination, flesh-colored, well-defined, smooth papules that measured approximately 1.5 x 1 cm in size on the genital region, fingers, face, and scalp were seen. Histopathologic examination of a lesional biopsy reve

Image1 Image2 Image3 Case 115 A solitary, asymptomatic, flesh coloured papule on the face of a 45 yr old male. Diagnosis

Deep Penetrating Nevus Visit: Dermatopathology Site Visit: Deep Penetrating Nevus Abstract: Deep penetrating nevus: a review.Arch Pathol Lab Med. 2011 Mar;135(3):321-6. CONTEXT: Deep penetrating nevus is a distinctive melanocytic lesion that may simulate melanoma both clinically and histologically. OBJECTIVE: To review clinical and histologic features of deep penetrating nevi and discuss their differential diagnosis, especially regarding melanoma. DATA SOURCES: The literature on deep penetrating nevi is reviewed and supplemented by our experiences with deep penetrating nevi. CONCLUSIONS: One or more disturbing histologic features may frequently be found in deep penetrating nevi, including asymmetry, plump but fairly regular nests of melanocytes in the dermis, cytologic atypia with some nuclear pleomorphism, a small to medium-sized eosinophilic nucleolus, absence of maturation, occasional presence of normal dermal mitoses, and a patchy mononuclear inflammatory cell infiltrate. Although

Image1 Image2 Image3 Image4 Image5 Case 114 A dark pigmented papule on the neck of a 25 year old female. Diagnosis

Extramammary Paget's Disease Visit: Dermatopathology Site Visit: Pathology of Extramammary Paget's Disease Abstract: Extramammary Paget's disease: Evaluation of the histopathological patterns of Paget cell proliferation in the epidermis.J Dermatol. 2011 Nov;38(11):1054-7. doi: 10.1111/j.1346-8138.2011.01268.x. Epub 2011 Sep 23. Extramammary Paget's disease (EMPD) is a rare malignant skin neoplasm. The prototypical pattern of tumor cell proliferation in the epidermis includes single cells and/or nest arrangements, mainly in the lower epidermis. Although other patterns have been recognized, they have not previously been investigated in detail. We aimed to examine the patterns of tumor cell proliferation in the epidermis. Surgical specimens were obtained from 38 patients with primary EMPD. We defined six patterns, in addition to the prototypical one: (i) glandular; (ii) acantholysis-like; (iii) upper nest; (iv) tall nest; (v) budding; and (vi) sheet-like. There were 26 mal