RESUMEN
The authors report a case of a Latin American woman who developed progressive pigmentation primarily involving two digits of her right hand. She was scheduled for amputation based on a presumptive histologic diagnosis of melanoma with regression. Dermatology consultation with repeat biopsies disclosed a lichenoid tissue reaction with marked pigment incontinence and no evidence of melanoma. This report should prompt physicians to include lichen planus pigmentosus in the differential diagnosis of acral lentiginous melanoma.
Asunto(s)
Hiperpigmentación/diagnóstico , Liquen Plano/diagnóstico , Melanoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Diagnóstico Diferencial , Eritema/diagnóstico , Femenino , Humanos , Hiperpigmentación/patología , Liquen Plano/patología , Melanoma/patología , Persona de Mediana Edad , Neoplasias Cutáneas/patologíaRESUMEN
The subepidermal blistering disorders are comprised of a number of unrelated disorders with a diverse clinical presentation and pathogenic basis that share in common the presence of blister formation beneath the epidermis. Many of the disorders are both debilitating and potentially fatal. Timely and accurate diagnosis facilitates their appropriate management. The etiologic, clinical, and pathologic attributes as well as the treatment of these disorders including bullous pemphigoid, epidermolysis bullosa acquisita, dermatitis herpetiformis, linear IgA dermatosis, cicatricial pemphigold, herpes gestationis,and porphyria cutanea tarda are described.
Asunto(s)
Enfermedades Cutáneas Vesiculoampollosas/patología , Humanos , Enfermedades Cutáneas Vesiculoampollosas/diagnóstico , Enfermedades Cutáneas Vesiculoampollosas/etiología , Enfermedades Cutáneas Vesiculoampollosas/terapiaRESUMEN
Merkel cell carcinoma is a rare aggressive neoplasm, with about 400 cases diagnosed in the United States each year. Among the cutaneous-derived neoplasms, it is the most deadliest, with a higher mortality rate than melanoma. Although the classic clinical presentation as a rapidly growing papule in a sun-exposed site of an elderly patient is not specific, certain histopathologic and ancillary pathologic features allow for its discrimination in most cases. Herein, we review the etiology, pathogenesis, clinical, and pathologic attributes as well as the staging treatment and prognosis of this important public health menace.
Asunto(s)
Carcinoma de Células de Merkel/diagnóstico , Neoplasias Cutáneas/diagnóstico , Carcinoma de Células de Merkel/epidemiología , Carcinoma de Células de Merkel/etiología , Carcinoma de Células de Merkel/terapia , Humanos , Estadificación de Neoplasias , Pronóstico , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/terapiaRESUMEN
BACKGROUND: Insulin-like growth factor-I (IGF-I) is the principal mediator of growth hormone, exerting its effects through binding of the insulin-like growth factor-I receptor (IGF-IR). Post-receptor activation leads to the production of transcription factors involved in cell proliferation, differentiation, transformation, and survival. Data indicate that IGF-IR is involved in tumorigenesis. To our knowledge, this receptor has not been previously studied in primary cutaneous carcinomas. METHODS: Twenty-five cases of primary cutaneous carcinomas consisting of three keratoacanthoma-type squamous cell carcinomas (KAs), two squamous cell carcinomas in situ (SCCs in situ), eight squamous cell carcinomas (SCCs), three conventional basal cell carcinomas (BCCs), two morpheaform basal cell carcinomas (M-BCCs), and seven Merkel cell carcinomas (MCCs) were analyzed for IGF-IR immunohistochemical expression using IGF-IR mouse monoclonal antibody (dilution 1 : 50) using the avidin-biotin-peroxidase complex method. RESULTS: Normal epidermis was negative for IGF-IR expression. Normal eccrine glands and outer root sheath strongly expressed IGF-IR. All KAs, SCCs in situ, SCCs, and BCCs were negative for IGF-IR expression. Six of seven (86%) of the MCCs stained with IGF-IR strongly, showing cell membrane accentuation and a perinuclear dot-like pattern. CONCLUSION: The data suggest that IGF-IR immunopositivity in MCCs might constitute a diagnostic tool in discriminating between SCCs and BCCs. Although the possible pathogenic significance of the perinuclear dot-like staining pattern observed in these neoplasms is unknown, its pattern is similar to what has been previously described with cytokeratin-20 immunostaining.
Asunto(s)
Carcinoma Basocelular/química , Carcinoma de Células de Merkel/química , Carcinoma de Células Escamosas/química , Receptor IGF Tipo 1/análisis , Neoplasias Cutáneas/química , Anticuerpos Monoclonales , Humanos , Inmunohistoquímica/métodosRESUMEN
Bullous dermatoses can be debilitating and possibly fatal. A selection of autoimmune blistering diseases, including pemphigus vulgaris, paraneoplastic pemphigus, bullous pemphigoid, cicatricial pemphigoid, dermatitis herpetiformis and linear IgA dermatosis are reviewed. Pemphigus vulgaris usually starts in the oral mucosa followed by blistering of the skin, which is often painful. Paraneoplastic pemphigus is associated with neoplasms, most commonly of lymphoid tissue, but also Waldenström's macroglobulinemia, sarcomas, thymomas and Castleman's disease. Bullous pemphigoid is characterized by large, tense bullae, but may begin as an urticarial eruption. Cicatricial (scarring) pemphigoid presents with severe, erosive lesions of the mucous membranes with skin involvement in one third of patients focused around the head and upper trunk. Dermatitis herpetiformis is intensely pruritic and chronic, characterized by papulovesicles and urticarial wheals on the extensor surfaces in a grouped or herpetiform, symmetric distribution. Linear IgA dermatosis is clinically similar to dermatitis herpetiformis, but it is not associated with gluten-sensitive enteropathy as is dermatitis herpetiformis.