Chronic and Recurrent Sinusitis in Children, as Manifestation of Immune Dysfunction and Atopic Background.

Rhinosinusitis in children, as in adults, can be classified by duration (acute, recurrent, and chronic) and by cause (viral, bacterial, and inflammatory) and needs to be treated accordingly after careful investigation which include through clinical history, laboratory tests, and, if necessary, nasal endoscopy and imaging studies.

Once-daily application of calcipotriene 0.005%-betamethasone dipropionate 0.064% ointment for repigmentation of facial vitiligo.

Vitiligo vulgaris is an autoimmune pigmentary disorder with no universally efficacious therapeutic options. Separate applications of calcipotriene ointment 0.005% and topical corticosteroid ointments have been successful in the repigmentation of vitiligo.

Therapeutic considerations for severe nodular acne.

Severe nodular acne, defined as grade 4 or 5 acne on the Investigator's Static Global Assessment scale, is a skin condition characterized by intense erythema, inflammation, nodules, cysts, and scarring. Both the well known risk of physical scarring and the more recent recognition that acne can be a chronic, psychologically distressing disease with significant adverse effects on a patient's quality of life, have prompted earlier, more aggressive treatment with more effective medications, in the hope of preventing progression to more severe, nodular forms of the disease. Oral antibacterials, primarily tetracyclines, have long been the first-line therapy for severe nodular acne, which frequently remained refractory to therapy.

Histopathologic and immunohistochemical characterization of rash to human epidermal growth factor receptor 1 (HER1) and HER1/2 inhibitors in cancer patients.

Purpose: Human epidermal growth factor receptor (HER) 1 and HER 1/2 inhibitors have shown benefit against a wide range of solid tumors. However, their use is associated with rash in 40% to 90% of patients, which impacts quality of life and interrupts antineoplastic therapy. The pathologic characteristics of affected skin remain unclear, precluding development of rational therapies.

Sensitivity of fluorescence in situ hybridization for melanoma diagnosis using RREB1, MYB, Cep6, and 11q13 probes in melanoma subtypes.

Objective: To evaluate the diagnostic sensitivity of fluorescence in situ hybridization (FISH) using probes targeting 6p25, 6q23, 11q13, and Cep6 in melanoma subtypes.

Design: Blinded comparison of chromosomal copy number changes detected using FISH targeting 6p25, 6q23, 11q13, and Cep6 in benign nevi and melanoma subtypes.

Setting: Dermatopathology Laboratory, Department of Dermatology, Northwestern University, Chicago, Illinois.

The safety of nanosized particles in titanium dioxide- and zinc oxide-based sunscreens.

Given the increasing incidence and prevalence of skin cancer, dermatologists are more frequently recommending sunscreens to their patients. However, the safety of titanium dioxide and zinc oxide nanosized particles in the majority of sunscreens has come under scrutiny from governments and the general public. We sought to characterize the use, safety, and regulatory state of nanosized particles in titanium dioxide and zinc oxide in sunscreens based on studies and position statements from 1980 to 2008.

Distinguishing epithelioid blue nevus from blue nevus-like cutaneous melanoma metastasis using fluorescence in situ hybridization.

Blue nevus (BN)-like cutaneous melanoma metastasis is a well-recognized variant of melanoma metastasis. These lesions may clinically and histologically simulate benign blue nevi. The histologic changes may be indistinguishable from conventional blue nevi or epithelioid blue nevi (EBN), a benign dermal-based melanocytic neoplasm with epithelioid morphology and heavily pigmented cytoplasm.

Chromosomal copy number changes supporting the classification of lentiginous junctional melanoma of the elderly as a subtype of melanoma.

Recently the term lentiginous melanoma of the elderly has been suggested for a pattern of melanocytic neoplasia characterized by frequent occurrence in elderly patients, broad lentiginous growth pattern, with poorly cohesive nesting, suprabasilar extension of melanocytes and moderate cytological atypia. However, there are limited reported cases with follow-up information to confirm the malignant nature of these neoplasms. Using fluorescence in situ hybridization (FISH) targeting chromosomal loci that are frequently found to have copy number changes in melanoma, we evaluated cases of lentiginous junctional melanoma of the elderly in order to compare with the frequencies and patterns of chromosomal aberrations identified in other subtypes of melanoma.

Fluorescence in situ hybridization as a tool for microstaging in malignant melanoma.

Up to 30-50% of melanomas arise in association with a nevus. Accurately defining, the nevus from the melanoma can significantly affect microstaging. Recently, we showed that a targeted fluorescence in situ hybridization (FISH) assay could distinguish between benign nevi and melanoma with a sensitivity of 87% and specificity of 95%.

Palisaded encapsulated neuroma (PEN): an often misdiagnosed neural tumor.

We describe a unique case of a young man with concomitant Fragile X syndrome who presented with a dome-shaped pearly papule under the nose that had enlarged over 9 months. Histology demonstrated a smoothly contoured spindle cell neoplasm of the dermis with neuroid structures and foci of palisaded growth, consistent with a diagnosis of palisaded encapsulated neuroma (PEN). Palisaded encapsulated neuroma is a benign neural neoplasm of the skin or mucosa that displays histologic features of both a neurofibroma and a schwannoma.

Leukemia cutis masquerading as vitiligo.

Chronic myelomonocytic leukemia (CMML) is a hematologic stem cell disorder with myelodysplastic and myeloproliferative characteristics. Extramedullary leukemic infiltration of the skin, although uncommon in CMML, has prognostic relevance. We report a unique case of a patient with CMML who clinically presented with vitiligo that was histologically diagnosed as leukemia cutis.

The dermatologist's guide to hereditary syndromes with renal tumors.

Patients with hereditary syndromes with renal tumors initially may present to the dermatologist. It is essential that dermatologists recognize these syndromes because the early diagnosis of renal cancer may prove to be lifesaving. The 4 hereditary syndromes with cutaneous manifestations are von Hippel-Lindau (VHL) syndrome, Birt-Hogg-Dube (BHD) syndrome, tuberous sclerosis (TS), and hereditary leiomyoma renal cell carcinoma (HLRCC) syndrome.

Topical therapy in the treatment of actinic keratosis and basal cell carcinoma.

Actinic keratosis (AK) is an evolving malignant cutaneous neoplasm. AK also is known as solar keratosis and squamous cell carcinoma (SCC) in situ, either solar keratotic type or keratinocytic intraepidermal neoplasia. AKs can be treated with destructive or topical therapies.

Proteoglycan-collagen XV in human tissues is seen linking banded collagen fibers subjacent to the basement membrane.

Type XV is a large collagen-proteoglycan found in all human tissues examined. By light microscopy it was localized to most epithelial and all nerve, muscle, fat and endothelial basement membrane zones except for the glomerular capillaries or hepatic/splenic sinusoids. This widespread distribution suggested that type XV may be a discrete structural component that acts to adhere basement membrane to the underlying connective tissue.