Aikaterini Zioga

Primary cutaneous leiomyosarcoma: clinicopathological analysis of 36 cases

Massi D, Franchi A, Alos L, Cook M, Di Palma S, Enguita A B, Ferrara G, Kazakov D V, Mentzel T, Michal M, Panelos J, Rodriguez‐Peralto J L, Santucci M, Tragni G, Zioga A & Tos A P D
(2010) Histopathology56, 251–262

Cryosurgery during topical imiquimod: a successful combination modality for lentigo maligna

Background  Either cryosurgery or topical imiquimod have been used to treat patients with lentigo maligna in cases where surgery is not feasible.

Immunohistochemical Expression of Vascular Endothelial Growth Factor (VEGF) and C-KIT in Cutaneous Melanocytic Lesions

Vascular endothelial growth factor (VEGF) and C-KIT are involved in tumor progression in several human neoplasms. The aim of the present study has been to investigate their immunohistochemical expression in melanocytic lesions. We examined 11 compound nevi, 12 dysplastic nevi, and 18 melanomas. Immunostaining for VEGF was observed only in melanomas; c-kit expression was detected in melanomas (higher in radial than in vertical growth phase) and in nevi (predominantly in the junctional component). Our data indicate that assessment of VEGF expression might aid in the differential diagnosis between dysplastic nevi and melanomas. Moreover, VEGF might be a candidate for targeted therapy. The loss of c-kit expression might contribute to melanoma progression.

Expression of Notch-1 and alteration of the E-cadherin/β-catenin cell adhesion complex are observed in primary cutaneous neuroendocrine carcinoma (Merkel cell carcinoma)

Increasing evidence indicates that Notch signaling contributes to physiological processes, including development and differentiation, as well as tumorigenesis, either as a tumor promoter or suppressor, depending on cellular context, expression levels and cross talk with other signaling systems. Recent studies reported absent or minimal Notch-1 expression in neuroendocrine tumors of the lung and gastrointestinal tract, suggesting a tumor-suppressor function of Notch-1. Merkel cell carcinoma is a rare and highly aggressive primary cutaneous neuroendocrine carcinoma. Because no information is available on Notch-1 expression in this tumor, we have investigated a series of 31 Merkel cell carcinoma for Notch-1 immunoreactivity. Immunoreactivities for E-cadherin and β-catenin were also analyzed. All but 1 Merkel cell carcinoma (30 of 31) retained cytoplasmic and membrane Notch-1 expression in more than 50% of cells. β-Catenin displayed a prevalent membrane-associated staining in 30 of 31 cases, and 22 cases showed more than 50% of immunoreactive cells whereas nuclear β-catenin was seen only in 2 of 31 cases. E-cadherin membranous expression was remarkably low, as only 1 of 26 cases was found positive in more than 50% of cells. In contrast with neuroendocrine tumors in other tissues, evident Notch-1 expression was found in Merkel cell carcinoma. This finding does not support a tumor-suppressor function of Notch-1 in Merkel cell carcinoma. Downregulation of E-cadherin and diffuse membranous β-catenin expression suggest a dysregulation of the E-cadherin/β-catenin complex in Merkel cell carcinoma. This may contribute to local invasion and distant metastasis.

Ectopic modified sebaceous glands in human penis.

The balanopreputial sulcus is believed to be the most frequent site of the so-called Tyson’s glands. The intriguing feature of these anatomical structures is their mere existence, which has been doubted. Herein, the authors present a case of a 24-year-old man who underwent surgical treatment of his phimosis. On microscopic examination of the specimen, glands with morphological features similar to those described by Tyson were noted.

Eruptive Pseudoangiomatosis: Report of an Adult Case and Unifying Hypothesis of the Pathogenesis of Paediatric and Adult Cases

One month after the onset of immunosuppressive treatment with corticosteroids and mycophenolate mofetil for a newly diagnosed pemphigus vulgaris, a 50-year-old female patient developed a new eruption clinically and histomorphologically consistent with eruptive pseudoangiomatosis (EP). Its self-limited course further confirmed this diagnosis. Although initially described as a paediatric eruption, meanwhile more adult cases of EP (30 out of a total of 53 cases identified by a Medline search) are reported in the literature. The review of adult cases of EP disclosed some common clinical and epidemiological characteristics: adult EP cases tend to cluster in the Mediterranean region of Europe, develop during the summer months, sometimes in the form of limited micro-epidemics, affect immunocompromised individuals and have lesions confined to the exposed skin sites. These characteristics, together with the exanthematic nature of the disease in children, point to some vector-transmitted infectious agent as the cause of this probably underdiagnosed disease.

Severe Rosacea in a Patient on Infliximab for Ulcerative Colitis: Pathophysiological Considerations

© 2009 The Authors. doi: 10.2340/00015555-0681 Journal Compilation

Persistent Erythema Multiforme in a Patient with Extrahepatic Cholangiocarcinoma

Presented in this report is a 66-year-old male with a widespread persistent erythema multiforme mostly atypical in appearance, which was detected well before the diagnosis of underlying extrahepatic cholangiocarcinoma. The lesions regressed in response to chemotherapy, but they appeared again in connection with tumor relapse. Clinicians should recognize persistent erythema multiforme as one of the paraneoplastic dermatoses and efforts should be made to detect internal malignancies in patients with these skin lesions.

Linear-agminated juvenile xanthogranulomas

An 8‐month‐old girl presented with an asymptomatic skin lesion on the right popliteal fossa, which had been present for approximately 6 months. The child had a past medical history of a urinary tract infection at the age of 1 month and had been on daily cotrimoxazole since. There was no history of trauma to the site. Examination revealed a solitary, well‐demarcated, plaque‐like lesion on the right popliteal fossa, with multiple agminated papules in an almost linear distribution ( Fig. 1a ). The lesion did not follow Blaschkos lines, but was vertical to them. The plaque was slightly indurated, measuring approximately 4 × 1.5 cm, fixed to the overlying skin but movable over the deeper tissue. The papules were yellowish in color and firm to palpation, showing a positive Dariers sign ( Fig. 1b,c ). There was no regional adenopathy and no other skin lesions were observed. The physical examination and laboratory investigations were otherwise unremarkable. There was no hepatosplenomegaly, and an ocular examination and chest X‐ray were normal.

Acute febrile neutrophilic dermatosis (Sweet's syndrome) in a child, associated with a rotavirus infection: a case report

IntroductionSweets syndrome characterized by fever, blood neutrophilia and inflammatory skin lesions, is rarely diagnosed in children. It presents in three clinical settings: classical Sweets syndrome, usually after a respiratory tract infection; malignancy-associated, frequently related to acute myelogeneous leukemia; and drug-induced. We present, to the best of our knowledge, the first case of a rotavirus -infection-related Sweets syndrome.Case presentationAn 18-month-old boy of Hellenic origin was referred to us with diarrhea, fever, neutrophilia, typical skin lesions, asymmetrical hip arthritis and oropharyngeal involvement. A skin biopsy confirmed the diagnosis. Thorough screening did not reveal any underlying systemic illness, except for the confirmation of an overt rotavirus infection. The syndrome responded promptly upon corticosteroid administration; no recurrence was observed.ConclusionBesides describing the connection of Sweets syndrome to a rotavirus infection, this case report is also a reminder that in a child presenting with a febrile papulo-nodular rash with neutrophilia Sweets syndrome should be included in the differential.