Jesús Cuevas

Syphilis in an HIV infected patient misdiagnosed as leprosy

A 42‐year‐old man with uveitis and a widespread cutaneous eruption, histopathologically characterized by dermal granulomatous infiltrates with perineurial invasion, was incorrectly diagnosed and treated as having borderline leprosy. Further studies demonstrated secondary syphilis and human immunodeficiency virus (HIV) inlection. Standard penicillin therapy resolved his cutaneous and ocular lesions. Reports on clinical and pathological findings of active syphilis in HIV infected patients are scarce but this case and isolated previous case reports suggest that granulomatous infiltrates might be a common feature in secondary syphilis with short evolution in HIV infected palients.

Two Cases of Segmental Multiple Glomangiomas in a Family: Type 1 or Type 2 Segmental Manifestation?

Several autosomal dominant skin diseases may manifest cutaneous mosaicism. Two types of segmental arrangement can be distinguished: type 1 is characterized by segmental lesions with similar severity to that observed in the diffuse phenotype, the remaining skin being normal; type 2 is characterized by segmental lesions showing a major degree of severity and milder lesions diffusely arranged. Multiple glomus tumours have recently been included in the group of genodermatoses showing type 2 segmental involvement. A family with 2 cases of multiple glomangiomas arranged in a segmental fashion is reported. A 12-year-old girl presented multiple nodular glomangiomas on her right buttock and thigh, in a band-like distribution. A sister of her paternal grandfather showed plaque-like multiple glomangiomas on her left thigh and various glomangiomas on her right buttock and arm. No other family members were known to be affected. Two new cases of familial segmental multiple glomangiomas are reported, with the particularity that one of these exhibited type 2 segmental manifestation and the other type 1 from a clinical point of view.

Papular xanthoma in children ; Report and immunohistochemical study

Abstract: Papular xanthoma was diagnosed in a 14‐month‐old boy. The eruption cleared spontaneously within four years, immunohistopathologic study revealed that the predominant foamy histiocytic cells had the phenotypic features of the dermal dendrocyte. Giant multinucleated cells, which showed characteristics of monocyte‐derived macrophages, were also present. We suggest classifying diseases derived from dermal dendrocytes into a separate group of histiocytoses.

Mucinous carcinoma of the skin: evaluation of lymphatic invasion with D2-40.

Primary cutaneous mucinous carcinoma is a rare adnexal sweat gland neoplasm that mainly affects elderly people. Differential diagnosis includes mammary and gastrointestinal metastatic mucinous carcinoma (MC) and secondary cutaneous involvement by underlying neoplasms. An 83-year-old woman presented with an 8-year history of slow-growing infiltrate plaque in her right hemithorax, with ulceration on supraclavicular area, right upper limb edema and palpable axillary lymphadenopathies. She underwent partial excision of the tumor and local radiotherapy. Imaging studies showed widespread cutaneous dissemination with enlargement of ipsilateral axillary lymph nodes but without evidence of underlying breast cancer. Histopathological examination showed large amounts of mucin in the dermis including small islands of epithelial cells. They stained positive for cytokeratin 7, carcinoembryonic antigen, epithelial membrane antigen, gross cystic disease fluid protein-15, and c-erbB-2. Lymphatic invasion was demonstrated by D2-40-immunostained sections. A diagnosis of primary cutaneous mucinous carcinoma was made. Our aim was to reevaluate the differential clinical, histopathological, and immunohistochemical criteria for distinguishing primary cutaneous mucinous carcinoma from skin metastases of visceral mucinous carcinoma, especially those arising in breast. We also propose D2-40 as a reliable marker to detect lymphatic invasion that indicates a strong aggressive trend with shorter recurrence-free and predicts nodal metastases.

Cirugía de Mohs: Aplicación de la técnica a neoplasias del pene

MOHS MICROGRAPHIC SURGERY: APLICATION OF THIS TECHNIQUE TO PENILE NEOPLASMS Mohs micrographic surgery is a surgical technique that allows the excision in successive layers of cutaneous malignancies with the higher cure rates. At the same time, this surgical technique offers the maximal preservation of normal tissue. That is possible because Mohs surgery provides the advantage of microscopically controlled tumor-free borders in each stage guiding the surgeon in the tumor persistence until the complete surgical excision. Mohs micrographic surgery is a precise treatment for penile neoplasms and its utility is justified because the removal of a substantial surgical margin of normal tissue is obviated. Mohs micrographic surgery is indicated in the treatment of penile verrucous carcinoma due to the significant risk of loco-regional recurrence after conventional surgery. Although infrequent, other penile neoplasms that can benefit from Mohs micrographic surgery are: basal cell carcinoma, extrammamary Paget’s disease, in situ melanoma and granular cell tumor.