Dramatic response of scarring scalp discoid lupus erythematosus (DLE) to intravenous methylprednisolone, oral corticosteroids, and hydroxychloroquine in a 5-year-old child.

Discoid lupus erythematosus (DLE) is rare in childhood. We report the case of a 5-year-old girl who presented with erythematous scaly plaques, with scarring alopecia, involving approximately 40% of her scalp. Histopathology confirmed the diagnosis of DLE.

Overexpression of p27KIP1 in seborrheic keratosis.

Background: The pathogenesis of seborrheic keratosis (SK) is not well understood. SKs are slow growing, but the details of cell cycle control in these lesions are not known. We hypothesized that cyclin-dependent kinase inhibitors would be strongly expressed in SKs and that the proliferation rate would be low.

Histologic spectrum of melanocytic nevi removed from patients > 60 years of age.

Background: The histology of melanocytic nevi removed from older patients often differs from that of nevi from younger adults. According to the literature, the most common nevus in older individuals is the intradermal nevus, and purely junctional nevi are rare and should alert the pathologist to a possible melanoma precursor.

Objective: To evaluate the histologic features of melanocytic nevi removed from patients > 60 year of age.

Prospective step sections for small skin biopsies.

Context: In our laboratory, for small skin biopsies or curetted specimens, 3 slides are prepared before the case is reviewed by the dermatopathologist.

Objective: To examine the utility of these "prospective" step sections in improving diagnostic accuracy and turnaround time.

Design: Five hundred consecutive cases, in which step sections had been cut prior to slide review, were studied.

Interpretation of skin biopsies by general pathologists: diagnostic discrepancy rate measured by blinded review.

Context: Slide review has been advocated as a means to reduce diagnostic error in surgical pathology and is considered an important component of a total quality assurance program. Blinded review is an unbiased method of error detection, and this approach may be used to determine the diagnostic discrepancy rates in surgical pathology.

Objective: To determine the diagnostic discrepancy rate for skin biopsies reported by general pathologists.

Atypical fibroxanthoma with prominent sclerosis.

Background: Malignant cutaneous spindle cell lesions with marked sclerosis are uncommon. Only a few cases of cutaneous leiomyosarcoma and dermatofibrosarcoma protuberans with sclerosis have been published.

Methods: We report a case of atypical fibroxanthoma (AFX) with prominent sclerosis and hyalinization occurring on the scalp of an 81-year-old male.

Expression of desmin and smooth muscle myosin heavy chain in dermatofibromas.

Background: The histopathologic features of dermatofibroma vary remarkably, and this diversity may occasionally cause problems in differentiating between benign and malignant mesenchymal lesions, including smooth muscle neoplasms. Immunohistochemical stains are sometimes necessary to clarify the histogenesis of a lesion.

Objective: To evaluate dermatofibromas for expression of desmin and smooth muscle myosin heavy chain (SM-MHC) antigens, which are commonly used as evidence of smooth muscle differentiation.