Dermatopathology Cases

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

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

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

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

Dermatitis Herpetiformis Visit: Dermatopathology site Abstract: Dermatitis herpetiformis. An update of the pathogenesis.Hautarzt. 2009 Aug;60(8):627-30, 632. The multifactorial pathogenesis of dermatitis herpetiformis is reviewed in light of current experimental data. Genetic background, gluten consumption, and abnormal immune and autoimmune reactions are the most important pathogenetic factors, but other agents also participate in the disease development. The predisposing and inducing factors are summarized, while the pathophysiological steps leading to the development of skin symptoms are detailed. Dermatitis herpetiformis. A clinical chameleon.Hautarzt. 2006 Nov;57(11):1021-8; quiz 1029. Celiac disease is a genetically determined bowel disease also influenced by exogenous factors in which exposure to grain components triggers a chronic immune response with intestinal symptoms. Dermatitis herpetiformis represents the cutaneous manifestation of celiac disease. While intense pruri