Ángeles Revert

Diagnostic value of CD34 immunostaining in desmoplastic trichilemmoma

Desmoplastic trichilemmoma (DT) is a variant of trichilemmoma, characterized by a central prominent desmoplastic component which may simulate invasive carcinoma. We have studied the morphologic and immunohistochemical features of seven cases of DT. Immunohistochemistry was performed on paraffin sections using monoclonal antibodies to CD34 (QBEND/10), vimentin and GCDFP‐15. CD34 was also tested in seven cases of basal cell carcinoma (BCC), three with outer root sheath differentiation and four with morphea‐form features, and five squamous cell carcinomas. Histologically, features of conventional trichilemmoma were seen at the periphery of the seven lesions. In contrast, at the center, the epithelial cells tended to cluster in narrow irregular cords and nests entrapped in a dense collagenous stroma. One case of DT coexisted with a BCC. In all cases of DT, epithelial tumor cells showed CD34 immunostaining. All cases of BCC, including the one contiguous to a DT, were CD34 negative. CD34 immunodetection in the epithelial cells of the pseudoinvasive component of DT may be of great value in the differential diagnosis with other desmoplastic tumors of the skin, and particularly with BCC.

Eczema de contacto agudo a parafenilendiamina contenida en tatuajes transitorios con henna

Henna is a plant with coloring properties which is used as a dye for hair and skin, on occasion mixed with other substances. Paraphenylendiamine (PPD) is one of the additives used to accelerate drying, improve definition and darken its reddish color. There are several descriptions in literature of sensitization to the PPD contained in henna. We describe 3 new cases of allergic contact dermatitis to temporary tattoos, with skin tests positive for PPD in 2 of them. The lesions resolved in one of the patients, leaving persistent hypopigmentation. It is important for the population to be aware of this circumstance and the risk entailed by sensitization to PPD.

Granulomatous reactions to permanent cosmetic tattoos successfully treated with topical steroids and allopurinol

Two female patients presented nodular erythematous lesions overlying a permanent tattooed eyebrow and lip, respectively. Histologic examination showed in both cases epithelioid granulomas in close relation with scattered pigment. Complementary examinations and follow‐up disclosed a sarcoidosis. The lesions resolved after treatment with topical steroids and also oral allopurinol in one of the cases. Allopurinol may be an effective treatment for granulomatous reactions to foreign body particles.

Psoriasis of the lips

BACKGROUND Psoriasis is a frequently occurring disorder with a chronic and relapsing course. Common sites of involvement are the extremities, trunk, scalp and nails. The disease may occasionally involve genitalia and the anus. Although cutaneous lesions are generally sufficiently distinct to make a diagnosis, diagnostic difficulties can be found in cases of unusual involvement. MAIN OBSERVATIONS We report a 38-year-old man who presented scaling and cracking of the lips without intraoral involvement as a first manifestation of psoriasis. Three years later he developed erythematous plaques with desquamation on fingers, characteristic of psoriasis. CONCLUSION Psoriasis should be considered in the differential diagnosis of chronic or recurrent labial lesions.

Acral localized acquired cutis laxa

A 55-year-old woman had been asymptomatic until the age of 40 years, when she developed episodes of swelling of her hands, fingers, feet and, very rarely, her face. She also suffered from arthralgia. Shortly afterwards, she noticed the gradual onset of redundant skin and subcutaneous tissue on her fingers and toes. She had been treated for arthralgia with nonsteroidal anti-inflammatory drugs (NSAIDs) for many years. Family history was noncontributory. Physical examination showed loose, redundant skin on all fingers and both great toes (Figs. 1 and 2). The skin of the affected finger pads could be manipulated into shape as if it were chewing gum, and the induced deformity would persist for several minutes. There was no hyperextensibility of the joints or skin. The results of extensive laboratory investigation revealed only a slight increase in rheumatoid factor. Results of x-ray films of both hands and feet were normal. Skin biopsy specimens were taken from the fingertip of the left middle finger and from unaffected skin adjacent to the lesion. In the involved site, the elastic tissue was absent in the papillary and reticular dermis, and numerous acellular amorphous eosinophilic globular aggregates were present in the reticular dermis. No inflammatory infiltrate was found, and Congo red and crystal violet stains were negative (Figs. 3–5). Ultrastructural study of the paraffin-embedded tissue was performed. After standard procedures, ultrathin sections stained with uranyl acetate and lead citrate were examined with a 1010 Jeol electron microscope at 60 kV. Electron-dense aggregates of variable size, corresponding to the amorphous component of the elastic fibers, mostly devoid of the microfibrillary component, were found intermingled with collagen fibers in the reticular dermis. No amyloid fibers were present (Fig. 6). The skin from the uninvolved site showed no apparent abnormalities.

Multiple papules on the trunk and extremities

What is your diagnosis?

Multiple papules on the trunk and extremities: Multiple papules on the trunk and extremities

What is your diagnosis?