RESUMEN
A characteristic feature of neoplastic transformation is a perpetual activation of oncogenic proteins. Here, we studied signal transducers and activators of transcription (STAT) in patients with mycosis fungoides (MF)/cutaneous T-cell lymphoma (CTCL). Malignant lymphocytes in dermal infiltrates of CTCL tumors showed frequent and intense nuclear staining with anti-PY-STAT3 antibody, indicating a constitutive activation of STAT3 in vivo in tumor stages. In contrast, only sporadic and faint staining was observed in indolent lesions of patch and plaque stages of MF. Moreover, neoplastic lymphocytes in the epidermal Pautrier abscesses associated with early stages of MF did not express activated STAT3. To address the role of STAT3 in survival/apoptosis, CTCL tumor cells from an advanced skin tumor were transfected with either wild-type STAT3 (STAT3wt) or dominant-negative STAT3 (STAT3D). Forced inducible expression of STAT3D triggered a significant increase in tumor cells undergoing apoptosis, whereas forced expression of STAT3wt or empty vector had no effect. In conclusion, a profound in vivo activation of STAT3 is observed in MF tumors but not in the early stages of MF. Moreover, STAT3 protects tumor cells from apoptosis in vitro. Taken together, these findings suggest that STAT3 is a malignancy factor in CTCL.
Asunto(s)
Apoptosis , Proteínas de Unión al ADN/metabolismo , Linfoma Cutáneo de Células T/química , Transactivadores/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Proteínas de Unión al ADN/análisis , Proteínas de Unión al ADN/fisiología , Femenino , Humanos , Inmunohistoquímica , Linfocitos/química , Linfocitos/patología , Linfoma Cutáneo de Células T/etiología , Linfoma Cutáneo de Células T/patología , Masculino , Persona de Mediana Edad , Micosis Fungoide/química , Micosis Fungoide/patología , Invasividad Neoplásica/patología , Proteínas de Neoplasias/análisis , Proteínas de Neoplasias/metabolismo , Proteínas de Neoplasias/fisiología , Factor de Transcripción STAT3 , Neoplasias Cutáneas/química , Neoplasias Cutáneas/patología , Transactivadores/análisis , Transactivadores/fisiologíaRESUMEN
Comparative light microscopic studies have revealed subtle differences between allergic and irritant reactions in the skin. In the search for specific differences, we focussed on the early inflammatory response. This pilot study was conducted to test the hypothesis that follicular spongiosis can differentiate between early allergic and irritant patch test reactions. 8 patients with known contact allergy to either colophony or quarternium-15 participated in the study. In each patient, allergic and irritant patch tests reactions were elicited, and 4-mm punch biopsies were taken after 6 8 h from clinically equipotent reactions. Paired sets of slides were assessed blindly by 2 pathologists. 1 patient showing a pityrosporum folliculitis was excluded from the study. All biopsies from allergic patch tests were characterized by follicular spongiosis, while biopsies from irritant patch tests showed no recognizable changes except a slight follicular spongiosis in 1 patient. The 2 pathologists agreed independently on the correct classification in 6 out of 7 cases (p=0.0156). We tested an optimized model, selecting non-irritant allergens and a well-known irritant. Further investigations are needed to elucidate the diagnostic significance of the histological classification of allergic and irritant cutaneous reactions in punch biopsies.
Asunto(s)
Dermatitis Alérgica por Contacto/patología , Dermatitis Irritante/patología , Pruebas del Parche , Adulto , Biopsia , Dermatitis Alérgica por Contacto/etiología , Dermatitis Irritante/etiología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Resinas de Plantas/efectos adversos , Piel/efectos de los fármacos , Piel/patología , Factores de TiempoRESUMEN
Forty melanocytic lesions were examined in a pilot study, which was followed by a final series of 100 consecutive melanocytic lesions, in order to evaluate the inter-observer reproducibility of the histological criteria proposed for the dysplastic naevus. The specimens were examined in a blind fashion by four observers. Analysis by kappa statistics showed poor reproducibility of nuclear features, while reproducibility of architectural features was acceptable, improving in the final series. Consequently, we cannot apply the combined criteria of cytological and architectural features with any confidence in the diagnosis of dysplastic naevus, and, until further studies have documented that architectural criteria alone will suffice in the diagnosis of dysplastic naevus, we, as pathologists, shall avoid this term.
Asunto(s)
Síndrome del Nevo Displásico/diagnóstico , Piel/patología , Biopsia , Interpretación Estadística de Datos , Síndrome del Nevo Displásico/patología , Humanos , Melanoma/diagnóstico , Melanoma/patología , Nevo/diagnóstico , Nevo/patología , Variaciones Dependientes del Observador , Proyectos Piloto , Reproducibilidad de los ResultadosRESUMEN
Cholesterol microemboli are caused by cholesterol crystals released from arteriosclerotic plaques in the major arteries. The clinical picture is illustrated by two case histories with symptoms in the form of myalgia, livedo reticularis and gangrene. The diagnoses were verified by demonstration of cholesterol crystals in the affected tissue. The pathogenesis is illustrated and, on the basis of the literature, it is emphasized that cholesterol microemboli are probably often overlooked clinically and that an increasing incidence must be anticipated on account of the increasing frequency of invasive procedures and treatments of arteriosclerotic vascular disease.
Asunto(s)
Colesterol , Embolia/patología , Anciano , Arteriosclerosis/complicaciones , Arteriosclerosis/patología , Cristalización , Embolia/etiología , Femenino , Gangrena , Humanos , Dedos del Pie/patologíaRESUMEN
Actinomyces-like granules showing the Splendore-Hoeppli phenomenon have been demonstrated in histologic material, e.g. uterine curettings, in various conditions unrelated to genuine actinomycotic infection. The exact nature of the granules and the mechanism of their formation is open to speculation. We report two patients with a follicular skin eruption (Pityrosporum folliculitis) where pseudoactinomycotic granules were found in the skin biopsies. To the best of our knowledge, such findings have not previously been reported, but supposedly they are not rare. In order to avoid an incorrect diagnosis of actinomycosis, and unnecessary therapy, it is important to be familiar with the phenomenon.
Asunto(s)
Actinomicosis/diagnóstico , Dermatomicosis/patología , Foliculitis/diagnóstico , Malassezia/aislamiento & purificación , Actinomicosis/patología , Biopsia , Gránulos Citoplasmáticos/microbiología , Gránulos Citoplasmáticos/ultraestructura , Dermatomicosis/microbiología , Femenino , Foliculitis/microbiología , Foliculitis/patología , Humanos , Masculino , Microscopía Electrónica , Persona de Mediana Edad , Piel/microbiología , Piel/patología , Piel/ultraestructuraRESUMEN
We studied biopsy specimens taken from the scalp of four normal volunteers by transmission electron microscopy (TEM). At the suprabulbous level of the follicle, where the cells of Henle's layer are fully keratinized but the cells of Huxley's layer are not, the cytoplasmic processes of Huxley's layer ("Flügelzellen") reach the cells of the outer root sheath through the keratinized cylinder of Henle's layer. This junction between the outer root sheath cells and the "Flügelzellen" has not been previously characterized ultrastructurally. It is peculiar in its total lack of desmosomes, and it may have the features of a gap junction. The function of this structure and its possible role in hair growth is unknown. It may be related to nutrition, differentiation, or both.
Asunto(s)
Cabello/ultraestructura , Adulto , Diferenciación Celular , Desmosomas/ultraestructura , Femenino , Humanos , Queratinas/ultraestructura , Masculino , Microscopía ElectrónicaRESUMEN
We studied the presence of melanocytes in the various epithelial zones of the anal canal, using a recently introduced melanocyte-specific antibody (HMB-45) together with antibody to S-100 protein. In normal and canals and in haemorrhoids, melanocytes, defined as intraepithelial HMB-45/S-100 positive cells, were frequently demonstrated in the anal squamous zone, only sporadically in the anal transitional zone, and not at all in the colorectal zone. In the epithelium surrounding, but clearly separated from, resected primary anal malignant melanomas, increased numbers of benign melanocytes were demonstrated in the squamous zone and transitional zone, but also in the colorectal zone. We interpret this finding as a tumour-induced proliferation of benign melanocytes normally present, but in very small numbers or in some way 'masked', in the epithelium of the upper anal canal. The demonstration of melanocytes in all three zones of the anal canal substantially supports the observation that malignant melanoma of the anal canal may originate not only below but also above the dentate line.
Asunto(s)
Canal Anal/citología , Mucosa Intestinal/citología , Melanocitos/patología , Canal Anal/química , Canal Anal/patología , Anticuerpos Monoclonales , Neoplasias del Ano/patología , Hemorroides/patología , Humanos , Inmunohistoquímica , Mucosa Intestinal/química , Mucosa Intestinal/patología , Melanocitos/química , Melanoma/patología , Proteínas S100/análisisRESUMEN
We describe a Danish family of four generations suffering from hypotrichosis of the scalp. Age at onset was 6-17 years and almost total scalp alopecia was reached by the age of 14-21 years. No associated ectodermal defects were present. Nine of 22 persons covering four generations were affected. Growth of the scalp hair slowly decreased and was accompanied by a gradual, diffuse hair loss without regional variation. A scalp biopsy was performed, revealing a non-scarring alopecia with features of androgenetic alopecia. The pedigree was compatible with autosomal dominant inheritance.
Asunto(s)
Hipotricosis/genética , Cuero Cabelludo/patología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Biopsia , Niño , Femenino , Genes Dominantes/genética , Cabello/patología , Humanos , Hipotricosis/patología , Masculino , LinajeRESUMEN
A retrospective survey during a 2-year period disclosed 18 patients with acute febrile neutrophilic dermatosis (Sweet's syndrome). An associated lympho- or myeloproliferative malignancy was found in 6 patients. Attacks of Sweet's syndrome preceded the diagnosis of neoplasia in 4 patients (3 months to 6 years). Some differences in symptoms and signs were found in the group of patients with associated malignancy compared with the group without, that is, male predominance, mucosal symptoms, anemia, and frequent recurrence of skin symptoms. The onset of Sweet's syndrome indicates an acute infectious disease, and the patients are frequently referred to departments of internal medicine and infectious diseases. In addition, the skin lesions may mimic those which often accompany a generalized infection (erythema multiforme, erythema nodosum, vasculitis, pustular eruptions and urticaria). Since Sweet's syndrome may precede the possibly associated malignant disease, the initial diagnosis of the syndrome is important and should be made with confidence with increasing awareness of the characteristic symptoms.
Asunto(s)
Neoplasias/complicaciones , Enfermedades de la Piel/complicaciones , Enfermedad Aguda , Anciano , Femenino , Fiebre , Humanos , Masculino , Persona de Mediana Edad , Neutrófilos/patología , Estudios Retrospectivos , Piel/patología , Enfermedades de la Piel/patología , SíndromeRESUMEN
To test the specificity of certain histologic features claimed to be frequent in congenital melanocytic nevi, 66 of 313 consecutive newborn infants without congenital nevi (verified by perinatal examination) were addressed in a questionnaire 2 1/2 years after birth. Fifty children with acquired melanocytic nevi were reexamined clinically and biopsies were performed in 15. Congenital features were found in seven biopsy specimens from the indubitably acquired melanocytic nevi. These nevi were larger and more speckled in color than melanocytic nevi without "congenital features." It is concluded that the histologic features said to be specific for congenital nevi are, in fact, not specific. The possible relationship between these features and an increased melanoma risk cannot be refuted by the present study, but the risk of misinterpretation based on congenital features as the sole criterion in the prediction of the potential malignancy of melanocytic nevi is real.
Asunto(s)
Nevo Pigmentado/congénito , Neoplasias Cutáneas/congénito , Preescolar , Colágeno , Glándulas Ecrinas/patología , Cabello/patología , Humanos , Recién Nacido , Melanocitos/patología , Nevo Pigmentado/patología , Neoplasias Cutáneas/patologíaRESUMEN
Eight of 11 patients with interstitial cystitis had positive skin reactions to patch tests with urine (delayed type IV or irritant reactions). The positive reactions were seen to tests with the patients' own urine, but also, although less frequently, to tests with foreign urine as well. Immediate reactions (type I reactions; prick tests, scratch patch tests, and 20-minute patch tests) were not observed. The clinical morphology and the histology of the positive patch tests suggest a toxic rather than an allergic reaction, although the latter could not be totally excluded. The positive skin reactions may be relevant in the pathogenesis of interstitial cystitis suggesting a mucosal hyperreactivity to some component of urine.
Asunto(s)
Cistitis/orina , Pruebas del Parche , Ribonucleasas , Pruebas Cutáneas , Anciano , Proteínas Sanguíneas/metabolismo , Cistitis/inmunología , Proteínas en los Gránulos del Eosinófilo , Femenino , Humanos , Hipersensibilidad/complicaciones , Hipersensibilidad Tardía/inmunología , Persona de Mediana EdadRESUMEN
Histologic examination of the prepuces removed from 78 consecutive patients with phimosis was performed during a 2-year period. In 15 cases (14.2%), the typical changes of lichen sclerosus et atrophicus (LSA) were found. A different, distinct histologic pattern of fibrosis was noticed in six patients (7.7%). Clinically, the two conditions were indistinguishable and presented as severe, nonretractable phimosis. The largest group of the patients (46.2%) had histologically normal prepuces, but clinically they too had severe phimosis. Since phimosis especially in young boys may regress spontaneously, and since on the other hand LSA may evolve into squamous cell carcinoma, we conclude that treatment of phimosis should be planned according to its histologic pattern and not according to its monotonous clinical appearance.
Asunto(s)
Pene/patología , Fimosis/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Circuncisión Masculina , Fibrosis , Humanos , Masculino , Persona de Mediana Edad , Pene/cirugía , Fimosis/etiología , Fimosis/cirugía , Distribución Aleatoria , Estudios Retrospectivos , Enfermedades de la Piel/complicaciones , Enfermedades de la Piel/patología , Enfermedades de la Piel/cirugíaRESUMEN
Black rubber chemicals are capable of causing an allergic contact dermatitis, in some cases associated with a purpuric capillaritis. A typical case of such a purpuric reaction is described in a man sensitive to black rubber chemicals.
Asunto(s)
Dermatitis por Contacto/etiología , Púrpura/etiología , Goma/efectos adversos , Anciano , Dermatitis por Contacto/patología , Humanos , Masculino , Pruebas del ParcheRESUMEN
Three hundred fourteen unselected babies were examined within 96 hours of delivery. Three (1%) of the infants had clinically recognizable pigmented lesions. Two of the lesions (mean, 0.6%; range, 0.1%-2.3%; 95% confidence limits) proved histologically to be compound melanocytic nevi. The histology displayed almost identical patterns, with large nests of melanocytes at the dermoepidermal junction and only few nevus cells in the papillary dermis. A 0.6% incidence rate corresponds to 330 congenital melanocytic nevi in Denmark each year (range, 55-1265; 95% confidence limits). Because histology does not seem to be an accurate diagnostic tool to sort out the malignant potential of the small congenital melanocytic nevi, prospective studies are needed to characterize the premalignant melanocytic nevi, whether congenital or acquired.
Asunto(s)
Nevo Pigmentado/epidemiología , Neoplasias Cutáneas/epidemiología , Dinamarca , Femenino , Humanos , Recién Nacido , Masculino , Melanocitos/patología , Nevo Pigmentado/congénito , Nevo Pigmentado/patología , Piel/patología , Neoplasias Cutáneas/congénito , Neoplasias Cutáneas/patologíaRESUMEN
The excretion of pseudouridine in the urine of 17 patients with psoriasis was significantly increased. The largest increase was found in patients with psoriatic arthritis. No correlation between the extent of psoriasis and pseudouridine excretion was found. The excretion of pseudouridine was followed in 10 of the 17 patients during treatment with anthralin or PUVA. Pseudouridine excretion decreased significantly during therapy. The possible application of pseudouridine excretion in monitoring the disease activity in psoriasis is discussed.
Asunto(s)
Seudouridina/orina , Psoriasis/orina , Uridina/análogos & derivados , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Terapia PUVA , Psoriasis/tratamiento farmacológicoRESUMEN
Among 5 500 seborrheic keratoses 3 were found with marked squamous cell atypia. Clinically they were seborrheic keratoses. Even though they were incompletely removed, no recurrences were observed. In contrast to some reports in the literature we regard these lesions as biologically benign, and suggest that they be treated accordingly.