Clinical and Serological Characterization of Orf-Induced Immunobullous Disease.

Importance: Ecthyma contagiosum, or orf, is a viral zoonotic infection caused by Poxviridae. Although human orf infection is considered to follow a self-limited course, various immunological reactions may be triggered, including immunobullous diseases. In the majority of the latter cases, the antigenic target remained enigmatic.

Desmoplastic cellular neurothekeoma: Clinicopathological analysis of twelve cases.

Background: Cellular neurothekeoma is a benign lesion most commonly found on the face and upper extremities in the first two decades of life.

Methods: Retrospective clinicopathologic review of 12 examples of cellular neurothekeoma typified by prominent stromal sclerosis, a distinctive variant that we refer to as desmoplastic cellular neurothekeoma.

Results: The mean age was 30 years (range, 3-55 years, 3 males, 9 females).

Orf-induced immunobullous disease: A distinct autoimmune blistering disorder.

Background: Many complications have been reported after orf infection, including lymphadenopathy, secondary bacterial infection, and erythema multiforme. Rare associations with papulovesicular eruptions, including a bullous pemphigoid-like eruption, have also been described.

Objectives: Our purpose was to clinically, histologically, and immunologically characterize two cases of orf-induced blistering disease, and to determine whether this condition represented a novel disease entity distinct from known immunobullous diseases.

Clear-cell acanthoma versus acanthosis: a psoriasiform reaction pattern lacking tricholemmal differentiation.

Clear-cell acanthoma (CCA) has been reported to be a benign epidermal neoplasm; however, several authors have suggested alternative differentiation as well as other nosologic categories, including a reactive dermatosis. Fourteen CCAs, ten tricholemmomas, and seven cases of psoriasis were reviewed with conventional microscopy, periodic acid-Schiff stains, and immunohistochemical stains. Twelve of fourteen (86%) CCAs were associated with underlying or adjacent conditions.

Cutaneous lupus erythematosus simulating squamous neoplasia: the clinicopathologic conundrum and histopathologic pitfalls.

Background: The clinical distribution and character of cutaneous lupus erythematosus lesions can simulate squamous neoplasms, leading physicians to submit a shave biopsy specimen with a differential diagnosis of squamous neoplasm.

Objective: Our aim was to describe histologic features of interface dermatitis that cause difficulty in distinguishing between cutaneous lupus erythematosus and squamous neoplasia in shave biopsy specimens and to identify distinguishing criteria.

Methods: Twenty-six biopsy specimens from 10 patients initially diagnosed with squamous neoplasia that ultimately proved to be cutaneous lupus erythematosus were identified.

Cutaneous clear-cell granular cell tumors: the histologic description of an unusual variant.

Background: Granular cell tumors (GCTs) are neoplasms showing nerve sheath differentiation that can arise in the skin but, to our knowledge, have not been associated with significant clear-cell morphology.

Methods: Two patients developed four separate GCTs with distinctive, diffuse clear-cell change, which completely camouflaged the primary differentiation. The morphology, histochemistry and immunohistochemistry of the lesions are described and are compared with the presence and extent of clear-cell change in 14 other cases of GCTs.

Self-healing juvenile cutaneous mucinosis: cases highlighting subcutaneous/fascial involvement.

Background: Self-healing juvenile cutaneous mucinosis is a rare disease affecting young people characterized by transient cutaneous lesions and sometimes mild inflammatory symptoms. The deep dermal and subcutaneous features of this disorder have not yet been well described.

Objective: The purpose of our study was to present 3 cases of self-healing juvenile cutaneous mucinosis in which the histopathologic features caused diagnostic confusion between this disorder and proliferative fasciitis.

The dark side of photomicrographs in pathology reports: liability and practical concerns hidden from view.

The rapid evolution of digital imaging has facilitated the ability to include photomicrographs in pathology reports. Although these pictures may seem to be an informative accompaniment to the written report, there are many problems raised by the images, which are not generally recognized. These include lack of quality standards, selection of representative images, and liability implications, which are addressed by well-established legal precedent.

Absence of HER2 overexpression in metastatic malignant melanoma.

Background And Objectives: Currently available systemic therapies for malignant melanoma produce low response rates in patients, and more effective treatment modalities are clearly needed. Trastuzumab (Herceptin), the antibody to the HER2 oncoprotein, has had a significant impact on therapy for patients with HER2-overexpressing metastatic breast cancer. This study examined the incidences of HER2 protein overexpression and HER2 gene amplification in metastatic malignant melanoma, which remain unclear in the literature.

Intraparenchymal nevus cell aggregates in lymph nodes: a possible diagnostic pitfall with malignant melanoma and carcinoma.

It is well documented that nevus cells can be found within the fibrous capsule and trabeculae of lymph nodes; however, it is less well known that nevus cells can also be found in the lymph node parenchyma. We report the findings in 13 cases of nevus cell aggregates located within the cortical and/or medullary parenchyma of lymph nodes. Seven of the 13 patients had a primary diagnosis of melanoma, three had no known malignancy, one had breast carcinoma, one had adnexal carcinoma of the skin, and one had squamous cell carcinoma of the tonsil.

Microtubule associated protein (MAP-2) expression defines the companion layer of the anagen hair follicle and an analogous zone in the nail unit.

Background: Microtubule associated protein 2 (MAP-2) is one of a group of polypeptides that are an integral component of the microtubular cytoskeletal structure of the central and peripheral nervous system. During the course of another investigation that utilized immunohistochemistry, MAP-2 expression was observed in the hair follicle, almost exclusively in the innermost layer of the outer root sheath of the anagen follicle. This innermost layer, the so-called companion layer, has unique properties that clearly distinguish it from the rest of the outer root sheath.

Histological characteristics of metastasizing thin melanomas: a case-control study of 43 cases.

Objective: To study clinical and histological features associated with metastasizing thin melanomas (MTMs).

Design: Case-control study of clinicopathological features of patients with MTMs by a panel of 10 dermatopathologists.

Setting: Members of the North American Melanoma Pathology Study Group selected the cases from the melanoma databases at 8 academic institutions.