An 81-Year-Old Man With a Growth on the Areola: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

A Rare Soft-Tissue Tumor in a 15-Year-Old Boy With Tuberous Sclerosis Complex: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

Recurrent Pruritic Papules and Reticulated Hyperpigmentation in a Young Woman: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

Rubella Vaccine Persistence Within Cutaneous Granulomas in Common Variable Immunodeficiency Disorder
We present a case of treatment-refractory, disfiguring common variable immunodeficiency disorder–associated granulomatous dermatitis. Immunofluorescence microscopy of the biopsy specimen confirmed the presence of rubella vaccine capsid proteins in M2 macrophages within the granuloma, a newly recognized phenomenon in this patient population. This knowledge may serve to identify future therapeutic targets or preventative strategies for granulomatous dermatitis in patients with primary immunodeficiency disorder. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

Unilateral Periocular Intralymphatic Histiocytosis, Associated With Rosacea (Morbihan Disease)
We report a rare case of intralymphatic histiocytosis associated with rosacea and prominent periocular edema (Morbihan disease). The patient is a 56-year-old woman with a 12-year history of rosacea who suddenly developed edema of the right upper eyelid that persisted 6 months before she sought medical advice. Because of an unclear clinical diagnosis, surgical excision of the edematous upper eyelid was performed. The histologic slides showed interstitial edema of the dermis with dilated vascular channels and small epithelioid cell granulomas around hair follicles. In addition, there were aggregates of cells inside numerous ...
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

Panniculitis-Like Presentation of Extracavitary Primary Effusion Lymphoma
Abstract: Primary effusion lymphoma (PEL) is defined as a HHV-8-associated large B-cell lymphoma, which favors HIV-infected young adults, typically presenting as a serous (pleural, pericardial, or peritoneal) effusion with no identifiable tumor mass. Uncommon instances of lymphoid proliferations with the same morphology, immunophenotype, and molecular features as PEL, but occurring as a solid tumor mass without serous cavities involvement, have been termed extracavitary (or solid) variant of PEL. We hereby report the exceptional case of a HIV-associated extracavitary PEL primarily localized to the skin and exhibiting a p...
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

Spiradenoma With Adenoid Cystic Carcinoma–Like Features
We report the case of a 63-year-old male patient with a recurrent, painful hematoma-like cyst overlying the left lower extremity tibial tuberosity. A firm nodule was located at the base of the cyst, which was histologically consistent with spiradenoma. Interestingly, the lesion contained multifocal ACC-like components composed of epithelial basaloid cells surrounding pseudocystic structures filled with mucinous material. The ACC-like components did not demonstrate infiltration or perineural invasion. To the best of our knowledge, this is the second publication in the English literature regarding spiradenoma with an ACC-lik...
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Brief Report Source Type: research

Cutaneous Metastases From a Cribriform Adenocarcinoma of the Minor Salivary Glands
Abstract: Cutaneous metastases from solid tumor malignancies often emanate from breast, gastrointestinal, and lung tumors. Adenocarcinomas from minor salivary gland cancers may involve the skin contiguously but rarely as metastatic deposits. Furthermore, these metastases are usually locoregional and not distal. Recently, an uncommon neoplasm termed cribriform adenocarcinoma of the minor salivary glands has been described, and although it often spreads to cervical lymph nodes, metastatic involvement of the skin has not been reported. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Brief Report Source Type: research

The Prognostic Value of Podoplanin Expression in Nonmelanoma Skin Cancers: Correlation With Lymphatic Vessel Density
Conclusions: Podoplanin plays an evident role in the development and progression of both benign and malignant skin neoplasms and may serve as a potential predictor of their clinical course and prognosis. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Histiocytoid Melanoma
We report 5 cases of melanoma characterised by a subtle microscopic appearance reminiscent of a benign dermal histiocytic infiltrate, which we refer to as “histiocytoid melanoma.” These lesions are characterised clinically by ill-defined areas of cutaneous pigmentation, which in several cases reached large proportions. Microscopically, there is a subtle interstitial pattern of infiltration by predominantly single cells with a histiocytoid morphology, often resembling melanophages. Immunohistochemical confirmation was typically required, with the cells showing positive labelling for Sox-10 as well as Melan-A. In...
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Clinicopathological Analysis of Acquired Melanocytic Nevi and a Preliminary Study on the Possible Origin of Nevus Cells
Conclusion: AMN may have a multicellular origin that commonly follows the mode of Abtropfung. Furthermore, DSCs may partly or independently participate in the formation of nevus cells. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Distinct Salivary Gland Features in Sjögren's Syndrome and Lupus Erythematosus Sialadenite
Conclusions: These results indicated that in each disorder, MSG have their specific morphological changes, which lead to xerostomia, and the impairment of MSG in LE is probably due to a lupus sialadenitis. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Dermal C4d Deposition and Neutrophil Alignment Along the Dermal–Epidermal Junction as a Diagnostic Adjunct for Hypocomplementemic Urticarial Vasculitis (Anti-C1q Vasculitis) and Underlying Systemic Disease
This study shows that both the alignment of neutrophils along the DEJ and dermal C4d deposition are strongly associated with HUV and SLE. Therefore, these (immuno)histopathological features can be used as an easy diagnostic adjunct for early detection of underlying systemic disease in UV. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Original Study Source Type: research

In Memoriam: Daniel (Danny) Santa Cruz, MD
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: Editorial Source Type: research

A Long-Term Study of Persistent Sézary Syndrome: Evidence for Antigen Shift by Multiparameter Flow Cytometry and Its Significance in Overall Survival
Abstract: Sézary syndrome (SS) is a peripheral T-cell lymphoma characterized by erythroderma, diffuse lymphadenopathy, and circulating neoplastic T cells, which classically show a helper T-cell immunophenotype with loss of CD7 and CD26. Flow cytometry is often used to identify and enumerate populations of Sézary cells in the peripheral blood; however, the significance and frequency of antigen shift over time is unclear. In this article, we follow the immunophenotype of the neoplastic T-cell population from 28 patients with SS across 415 flow cytometry studies. Antigen shift for each patient was assigned as ...
Source: The American Journal of Dermatopathology - May 21, 2020 Category: Pathology Tags: CME Article Source Type: research

Incidental Acantholysis in Hailey–Hailey Disease (Microscopic Nikolsky Sign): An Underappreciated Histologic Sign
We report the recurrent presence of incidental foci of variably extensive, subclinical acantholysis in multiple bioptic specimens taken from a patient with known HHD for dermatologic conditions other than HHD. Such histologic finding has gone underappreciated in the literature, despite being a likely frequent occurrence in skin biopsies from HHD patients; recognition of this finding might represent a valuable diagnostic clue in selected cases of HHD. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

Retiform Purpura After Percutaneous Angioplasty: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

Brownish and Indurated Plaques With Yellowish Papules: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

Skin-Colored Nodule on the Cutaneous Lip: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

A Fatal Infection With Subtle and Nonspecific Signs and Symptoms in a Neonate: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

TTF-1 Positivity in Merkel Cell Carcinoma: The Chosen Clone Matters
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Letters to the Editor Source Type: research

Primary Subcutaneous Spindle Cell Synovial Sarcoma: First Reported Case
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Letters to the Editor Source Type: research

Adnexotropism as a Histopathological Clue for the Diagnosis of Primary Cutaneous CD4+ Small/Medium-Sized T-Cell Lymphoproliferative Disorder
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Letters to the Editor Source Type: research

Retiform Purpura After Percutaneous Angioplasty: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

Brownish and Indurated Plaques With Yellowish Papules: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

Skin-Colored Nodule on the Cutaneous Lip: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

A Fatal Infection With Subtle and Nonspecific Signs and Symptoms: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

Multifocal Epithelioid Hemangioma of the Penis in a 4-Year-Old Child: A Case Report
In this study, we report a case of a 4-year-old boy who presented with 2 red-raised skin lesions on the penis. Histopathologic examination revealed a dermal lesion composed of vascular spaces lined by epithelioid endothelial cells. The cells are bland with hobnail protrusions into the lumen. There is no cytological atypia or mitotic activity. The stroma is fibrotic with scant inflammatory cells. By immunoperoxidase stains, the tumor cells are positive with the vascular markers CD31 and CD34 but negative with the epithelial marker cytokeratin AE1/AE3. The diagnosis of multifocal EH was rendered. To the best of our knowledge...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

Pattern of Cross-Reactivity Between Mycobacterial Immunohistochemical Stain and Normal Human Eosinophils: A Potential Pitfall in the Diagnosis of Cutaneous Mycobacterial Infections
In this study, we document 4 cases of previously unreported cross-reactivity between the mycobacterium tuberculosis IHC polyclonal antibody and normal eosinophil granules in patients without other evidence of CTB infection. Such cross-reactivity represents a potential pitfall for the use of IHC in the diagnosis of CTB. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

A Skin Plaque Preceding Systemic Relapse of Gamma-Delta Hepatosplenic T-Cell Lymphoma
We report the second instance in the literature of a solitary skin nodule heralding recurrence of HSTL. The patient was a 40-year-old man in apparent remission from HSTL, 4 years after chemotherapy and autologous bone marrow transplant. Biopsy of a flank lesion showed atypical lymphoid cells involving the dermis with a perivascular and periadnexal pattern, and fat lobules of the subcutaneous tissue. Their phenotype mirrored that of previous biopsies, with expression of CD2, CD3, CD7, CD56, and T-cell receptor-gamma, and lack of T-cell receptor-beta, CD4, CD5, and CD8. Cutaneous involvement by HSTL has rarely been reported ...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

Inflammatory Cells in Atypical Eruption of Lymphocyte Recovery Carry the Same Mutations as Neoplastic Myeloid Cells
Abstract: Cutaneous eruption of lymphocyte recovery (ELR) during bone marrow (BM) aplasia recovery after intensive chemotherapy has been reported in very few patients. The presence of skin rashes in patients with acute leukemia who are undergoing intensive chemotherapy and BM transplantation is a diagnostic challenge because of the clinical similarity between drug eruptions, infiltrates related to the relapse of the underlying disease, cutaneous graft-versus-host disease, and ELR. IDH1 mutations have been identified as a recurrent genetic anomaly in acute myeloid leukemia and myelodysplastic syndromes. However, until now...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

Localized Acral Sclerosing Langerhans Cell Histiocytosis: A New Form of Presentation of Cutaneous Langerhans Cell Histiocytosis
We report the first case of a localized acral sclerosing LCH, a new form of LCH. This case highlights the broad and surprising form of presentation of LCH which may be overlooked and can significantly delay its diagnosis. The development of systemic disease may occur months to years after the initial skin presentation. Prompt diagnosis and treatment may prevent progression to systemic disease, as documented in some cases. (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Brief Report Source Type: research

Diffuse Dermal Angiomatosis: Report of a Classic Case With a Comment on the Pathophysiology Based on the Histologic Findings
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Brief Report Source Type: research

Validation of Image Quality and Diagnostic Accuracy Using a Mobile Phone Camera Microscope Adaptor Compared With Glass Slide Review in Teledermatopathology
This study aims to validate the use of a commercially available adaptor in the diagnosis of inflammatory and infectious conditions in dermatopathology. Representative images were taken of slides for fifty-four cases using the adaptor and shared through a cloud-based platform with five dermatopathologists who rendered diagnoses and judged the quality of the images. After a washout period of 8 weeks, the same cases were assessed by the same dermatopathologists using the original glass slides. The intraobserver concordance rate was 93.3%, and the quality of the mobile phone images was rated as “excellent” or &ldqu...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Rapid BRAF Mutation Testing in Pigmented Melanomas
In this study, we evaluated the performance of Idylla BRAF mutation detection in 23 melanomas including resections, small biopsies, and cytology cell blocks. Pathologists assigned each case a pigment score from 0 to 2 based on extent of melanin content. Samples with a pigment score of 2 were successfully resulted, thus demonstrating that high melanin content did not inhibit the assay. Sensitivity and specificity of BRAF mutation detection were 100% compared with reference laboratory testing. Tissue input requirements were low, with the Idylla successfully detecting a BRAF mutation in cell block material containing only &si...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Measurement of Tumor Thickness in Cutaneous Squamous Cell Carcinomas: Do the Different Methods Provide Better Prognostic Data?
This study evaluated the clinical significance on patient outcome by measuring tumor thickness using 4 common, currently available methods (measurement from: A. uninvolved dermoepidermal junction; B. top of granular cell layer of the epidermis overlying the tumor, that is, similar to Breslow thickness; C. dermoepidermal junction with in situ cSCC; D. top of granular layer of uninvolved skin) in 85 specimens from nongenital areas of 78 patients with cSCC. Thirty-five percent of them were from the head and neck area. Measurements were performed in millimeters using the digital ruler of image analysis software (Olympus cellSe...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Erythema Nodosum, Early Stage—A Subcutaneous Variant of Leukocytoclastic Vasculitis? Clinicopathological Correlation in a Series of 13 Patients
Abstract: Erythema nodosum (EN) is considered to represent a septal panniculitis. In a period from January 2000 until June 2018, we clinically and histopathologically investigated 124 patients with EN, 13 (10.5%) of them in an early stage demonstrating features of a leukocytoclastic vasculitis (LCV) around postcapillary venules of the subcutaneous fat. Three of these patients presented with EN on the lower legs and Sweet syndrome on the head/neck, arms, or trunk. 19.3% and 70.2% of patients demonstrated “classic” features of subacute and chronic forms of EN, respectively. Histopathologically, in cases of earl...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Original Study Source Type: research

Role of BIOCHIP Indirect Immunofluorescence Test in Cutaneous Vesiculobullous Diseases
Abstract: BIOCHIP mosaics for indirect immunofluorescence in cutaneous vesiculobullous diseases provide antibody profiles in a single run and can be an alternative to performing multistep assays. There is scanty data regarding their utility. BIOCHIP tests performed over 4 years were compared with biopsy and/or direct immunofluorescence (DIF). Of 209 BIOCHIP tests, 108 were positive. Pemphigus vulgaris and Bullous pemphigoid were the commonest. Dsg3 was the commonest positive substrate in pemphigus group (86%) with 100% sensitivity. Intercellular space pattern on BIOCHIP primate esophagus was seen only in 49%. BP 180 was ...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: Original Study Source Type: research

BAP-1 Expression Status by Immunohistochemistry in Cellular Blue Nevus and Blue Nevus–like Melanoma
In this study, we applied anti–BAP-1 antibodies to a series of CBN/BN (n = 11) and MABN/MMCBN (n = 4). Nuclear BAP-1 expression was detected in the majority of CBN/BN (n = 10/11) but was lost in 1 case. Most cases of MABN/MMCBN showed loss of nuclear BAP-1 expression (n = 3/4), with one case of MMCBN showing preserved BAP-1 expression. Demonstration of BAP-1 loss in a single case of CBN and preservation of BAP-1 expression in 1 case of MMCBN may indicate that detection of alterations in BAP-1 protein expression by immunohistochemistry may not be a completely reliable biomarker for the distinction of BN/CBN from MABN/...
Source: The American Journal of Dermatopathology - April 21, 2020 Category: Pathology Tags: CME Article Source Type: research

Epstein–Barr Virus-Positive Mucocutaneous Ulcer in a Pediatric Patient—Case Report
Abstract: The Epstein–Barr virus (EBV)-positive mucocutaneous ulcer is a rare entity in the spectrum of lymphoproliferative diseases associated with the EBV. It occurs typically in patients with immunosuppression associated with immunosenescence, as well as due to iatrogenic causes, posttransplant patients and primary immunodeficiency disorders. It is often a benign and self-limited disease that recedes by stopping or reducing the immunosuppressive agents in most of the cases. Histologically, it is characterized by a population of EBV-positive atypical lymphoid cells. Here, we present a rare case of a 5-month-old p...
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Extraordinary Case Report Source Type: research

A Perianal Mass Associated With Eosinophilic Granulomatosis With Polyangiitis: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

Severe Infection and Loss of Leg Function From an Unusual Cutaneous Disease: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

Multiple Papules on an Elderly Man: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

Violaceous Papules Presenting on the Foot and Lower Limb: Challenge
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research

Sarcoidosis With Cutaneous Manifestations of Necrobiosis Lipoidica
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Letters to the Editor Source Type: research

Granulomatous Phlebitis in Necrobiosis Lipoidica
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Letters to the Editor Source Type: research

Atypical Herpes Simplex Presenting Necrotizing Granulomas in an Immunocompromised Patient
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Letters to the Editor Source Type: research

A Perianal Mass Associated With Eosinophilic Granulomatosis With Polyangiitis: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

Severe Infection and Loss of Leg Function From an Unusual Cutaneous Disease: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research

Multiple Papules on an Elderly Man: Answer
No abstract available (Source: The American Journal of Dermatopathology)
Source: The American Journal of Dermatopathology - March 24, 2020 Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research