Dolores Ramón

Eccrine Angiomatous Hamartoma: Report of Three Patients

Abstract: Eccrine angiomatous hamartoma is a rare, benign entity. The histologic features include proliferation of eccrine sweat glands and angiomatous capillary channels. We report three children who each had a single lesion on a limb. These lesions were clinically angiomatous, and we obtained the diagnosis by histologic and immunohistochemical studies.

NEVOID HYPERKERATOSIS OF THE AREOLA

A 15-year-old woman presented with a painless change of color and texture of her right breast areola. The lesion had started some months previously. An examination of her right breast showed a hyperpigmentation of the areola, which appeared thickened and verrucous (Fig, 1), Her right nipple and left breast showed no alteration. She gave no personal or family history of ichthyosis, epidermal nevi, ot

FOLLICULAR MUCINOSIS AND HODGKIN'S DISEASE

A 21-year-old man had 10 to 12 scaling plaques witb hair loss, involving the chest (Eig. 1), back, and proximal extremities. Tbe plaques were approximately 5 to 6 cm in diameter. Tbe plaques were of 1 years duration, and the patient was asymptomatic. A few of the plaques had follicular hyperkeratosis. There were supraclavicular bilateral lymphadenopathies. Other examinations were normal. A skin biopsv specimen revealed a moderately intense inflammatory infiltrate that surrounded and invaded a spongiotic hair follicle (Eig. 2). Three was also exocytosis of lymphocytes into the surrounding epidermis. A blue Alcian stain showed abundant intrafollicular mucin. Immunophenotyping was done on the formalin-fixed tissue, and the cellular infiltrate was composed mainly of helper T-cells, CD4+; B cell marker was not negative. A biopsy specimen from the supraclavicular lymph node showed Hodgkins disease, nodular sclerosing type. A roentgenogram of the chest showed evidence of an enlarging bilateral mediastinum, and the scanner confirmed the anterior superior mediastinal lymphadenopathies. A computed tomographic scan of the abdomen showed a moderate enlargement of the spleen. The results of bone marrow examination were negative. A diagnosis of Hodgkins disease stage III was made. Policbemotherapv consisting of six cycles of MOPP (mechlorethamine, vincristine, procarbazine, prednisone) and ABVD (adriamicin, bleomycin, vinblastine, dacarbazine) alternating was given. After the fourth cvcle, the patient had a radiologic and clinical complete remission. The cutaneous lesions cleared only partially. He has remained in good health for 3.5 years since the diagnosis.

Linear rheumatoid nodule.

A 42-year-old man, witbout antecedents of interest, was admitted to tbe hospital with migratory artbralgias lasting several years and Raynauds phenomenon. Occasional nodules appeared on the interphalangic joints, followed by spontaneous disappearance. Exploration revealed a nodule on tbe elbow, 3 cm in diameter. Tbe nodule was mobile and painless and showed no signs of inflammatory lesions. A linear lesion (Fig. 1) was also observed extending some 15 cm from tbe posterior edge of the axilla along the ribcage. The linear lesion was approximately 4 mm thick; location was subcutaneous, witb a rope-like consistency and absence of inflamation or atrophy. Tbe overlying skin was slightly pigmented. Tbe nodule was painless and did not affect arm mobility. The rest of exploration was negative. No abnormalities were found in tbe bemogram chemistries, urinalysis, HBsAg, Mantoux test, immunoelectrophoresis, ANAs, complement level, rheumatoid factor, ASLO, joint and chest radiography, and electrocardiogram. Biopsies were performed on tbe elbow and axillary band lesions. The histologic findings were similar in both cases and revealed deep dermal and subcutaneous cell tissue lesions under an intact epidermis. Tbe inflammatory infiltrate consisted predominantly of histiocytes and was arranged around a more eosinopbilic zone, consisting of homogeneous and fragmented collagen together with collagen fibrinoid degeneration (Fig. 2). The in-depth infiltration showed a granulomatous pattern. The superficial dermis presented mononuclear cells and isolated fibroblasts infiltrating the collagen bands.

Mucinous Eccrine Nevus: An Unusual Lesion in a Child

Abstract: Mucinous eccrine nevus has been described as a variant of eccrine nevus. Only one instance of this variant, diagnosed in a 47‐year‐old woman, has been reported. We report a 2‐year‐old girl who had two 1 cm, asymptomatic, brownish nodules. Histologic analysis revealed a dermal lobulated proliferation of eccrine structures surrounded by a prominent mucinous stroma. This is thus, to the best of our knowledge, the first case of this extremely rare entity in a child.

Úlceras vulvares agudas de Lipschütz

Resumen —Dos ninas virgenes de 14 y 12 anos, previamente sanas, consultaron por ulceras dolorosas genitales agudas que aparecieron en el contexto de un proceso febril. Las exploraciones complementarias descartaron tanto una enfermedad venerea como el resto de causas habituales de ulceraciones genitales. En ambos casos, las lesiones se resolvieron en menos de 2 semanas tras la administracion de antibioticoterapia oral y topica, sin secuelas ni recidivas posteriores.

Lymphoepitelioma-like carcinoma of the skin: report of three cases

Primary cutaneous lymphoepithelioma‐like carcinoma (LELC) is an extremely rare cutaneous neoplasm with histopathological features similar to those seen in the undifferentiated subtype of nasopharyngeal carcinoma. Microscopically, the tumor is well circumscribed and is composed of irregular nests of malignant epithelial cells in a background of reactive lymphoid cells including mature plasma cells. Its histogenesis remains unknown although an adnexal or epidermic origin has been proposed, and despite its poorly differentiated histology, the LELC prognosis is relatively good. We describe three new cases of this entity that support an epidermic origin.

Siringoma condroide: revisión clínica e histológica de ocho casos

Resumen Introduccion El siringoma condroide es un tumor cutaneo raro que se presenta como una lesion de lento crecimiento, indolente, mas frecuente en varones adultos y habitualmente benigna. Se trata quirurgicamente y su diagnostico es histologico. Se puede clasificar en ecrino y apocrino segun sus caracteristicas anatomopatologicas. Material y metodos Se reevaluan clinica e histologicamente 8 casos diagnosticados de siringoma condroide en nuestro Servicio en los ultimos 8 anos, asi como la microscopia de epiluminiscencia de uno de ellos. Resultados La mayoria de los casos se presentaron como lesions nodulares, bien delimitadas, cuyo diagnostico clinico de presuncion fue de patologia anexial o quistica. Todas fueron tratadas quirurgicamente. La microscopia de epiluminiscencia mostro un patron de coloracion blanquecino-azulado homogeneo. Todos los casos presentaban una matriz mixoide, y la mayoria tambien condroide. Cinco de los 8 casos fueron del tipo apocrino, uno de ellos con diferenciacion follicular y sebacea. Discusion El siringoma condroide habitualmente es un tumor cutaneo de pequeno tamano, con localizacion, frecuentemente, en cabeza y cuello. La dermatoscopia no parece aportar ningun rasgo especifico a esta lesion. El examen microscopico de estas lesiones revela estructuras tubuloalveolares y de tipo glandular dispuestas a modo de islas en el seno de un estroma fibroadiposo, condroide, mixoide o hialino. El tratamiento definitivo de estos tumores es quirurgico. Como regla general, se trata de un tumor benigno. Algunos autores han propuesto el termino de tumor mixto cutaneo atipico para aquellos siringomas condroides con rasgos histologicos de malignidad, pero sin evidencia de metastasis.

Eccrine squamous syringometaplasia mimicking a herpetic infection

A 69‐year‐old woman with a history of hypertension and essential tremor was diagnosed with a Burkitt‐like diffuse large‐cell lymphoma. She received chemotherapy with cyclophosphamide, vincristine and adriamycin (HyperCVAD). Ten days after starting the second cycle of chemotherapy (HyperCVAD), she presented with well‐defined, intense, erythematous macules which coalesced to form a symmetric diffuse erythema located on the upper back. Later, the lesions progressed and affected the lower back and perineal areas, extending to the groin. In a few days, a gradual diminution of the erythema was seen, with subsequent development of postinflammatory gray‐brownish hyperpigmentation. On the lower back, there were also superficial erosions. Some asymptomatic, closely grouped, gray papules, vesicles, and blisters were found in the groin, resembling the typical lesions of herpetic infection ( Fig. 1 ). Two biopsies of the groin and one of the upper back were performed, and were processed for histopathologic and microbiologic study.

Lupus eritematoso cutáneo subagudo inducido por fármacos

Resumen —Una mujer de 46 anos, sin antecedentes de enfermedades autoinmunes, desarrollo una erupcion cutanea clinica e histologicamente indicativa de un lupus eritematoso cutaneo subagudo. El exantema coincidio con la administracion reciente de tetrazepam, aunque tambien tomaba de forma prolongada anticonceptivos orales. Los estudios de autoinmunidad mostraron una elevacion de anticuerpos antinucleares, antihistonas y anti-Ro. La retirada de la medicacion se acompano de una rapida mejoria clinica y de los parametros de laboratorio, sin que presentara otros brotes con posterioridad, lo que permitio el diagnostico de lupus eritematoso cutaneo subagudo inducido por farmacos.