María-Teresa Fernández-Figueras

A prospective study of the incidence of skin cancer and its risk factors in a Spanish Mediterranean population of kidney transplant recipients

Background  Skin cancer is the most common malignancy occurring in kidney transplant recipients (KTRs).

Actinic keratosis with atypical basal cells (AK I) is the most common lesion associated with invasive squamous cell carcinoma of the skin

Progression from actinic keratosis (AK) to invasive squamous cell carcinoma (iSCC) of the skin is thought to occur after the development of full thickness epidermal neoplasia, as in the classic pathway of cervical cancer. Nevertheless, cutaneous iSCC may also directly arise from a proliferation of atypical basaloid cells limited mostly to the epidermal basal layer (AK I), akin to what happens in the ‘differentiated pathway’ of iSCC of the vulva, oral cavity and other locations.

Expression profiles associated with aggressive behavior in Merkel cell carcinoma

Primary neuroendocrine carcinoma of the skin, or Merkel cell carcinoma, is the most aggressive cutaneous neoplasm. In spite of its similarities to small cell carcinomas from other locations, Merkel cell carcinoma shows many peculiarities probably related to its epidermal origin and the etiologic role of UV radiation. We have immunohistochemically investigated 43 markers on a tissue microarray in which 31 surgically resected Merkel cell carcinomas were represented. Of these, 15 patients remained free of disease after removal, whereas 16 developed metastases. Immunoreactivity was scored according to staining intensity and the percentage of positive cells. We found statistically significant correlations between metastatic tumor spread and overexpression of matrix metalloproteinase (MMP) 7, MMP10/2, tissue inhibitor of metalloproteinase 3, vascular endothelial growth factor (VEGF), P38, stromal NF-kappaB, and synaptophysin. Also detected were statistically significant correlations between the expression levels of MMP7 and VEGF, MMP7 and P21, MMP7 and P38, MMP10/2 and VEGF, P38 and synaptophysin, P38 and P53, and P21 and stromal NF-kappaB. These findings may be helpful in predicting the clinical course of Merkel cell carcinoma and are potentially useful for the development of targeted therapies.

Pityriasis lichenoides in children : Clinicopathologic review of 22 patients

Abstract: Pityriasis lichenoides (PL) is a cutaneous disease of unknown origin, with an autoinvolutive course, that can occur in pediatric patients. Traditionally, acute and chronic variants have been described, but other special forms of presentation have been reported. We reviewed the clinical records and histopathologic specimens of all pediatric patients diagnosed with PL in our hospital from 1980 to 1995 to assess the clinicopathologic features of this disorder in our environment. Twenty‐two of the 118 cases reviewed were pediatric patients less than 15 years old (12 males and 10 females, 18.6% of all patients). Their ages ranged from 3 to 15 years, with a mean of 9.3 years. Most of the patients (72%) had the chronic variant of the disease, while the remainder had an acute course. One patient suffered from acute ulceronecrotic PL. Systemic treatments prescribed were erythromycin in eight patients, PUVA in five patients, and methotrexate in one patient. Three patients had a prolonged course with more than two episodes. Acute and chronic PL are polar extremes, but individual cases cannot be classified only on the basis of histopathologic data, since coexistence of lesions in different stages of evolution can lead to sampling bias. Acute ulceronecrotic forms and the presence of a variable degree of cellular atypia in the infiltrate are liable to cause differential diagnostic problems with lymphomatoid papulosis (LP), which cannot be completely resolved on the basis of T‐cell receptor clonal rearrangement detection.

Multinucleate cell angiohistiocytoma: a fibrohistiocytic proliferation with increased mast cell numbers and vascular hyperplasia.

Background: Multinucleate cell angiohistiocytoma (MCAH) is an uncommon lesion clinically characterized by multiple papules usually located on the face and acral regions of elderly women. Histopathologically, MCAH is characterized by dermal vascular hyperplasia associated with increased number of factor XIIIa‐positive fibrohistiocytic cells and multinucleate cells with scalloped borders.

Clinical spectrum and histological analysis of 32 cases of specific cutaneous sarcoidosis

Background:  Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology in which skin involvement is frequent.

Benign myoepithelioma of the skin.

A case of cutaneous myoepithelioma is reported. The tumor was composed of spindle-shaped, epithelioid, and plasmacytoid (hyaline) cells. It exhibited a widespread immunoreactivity for low molecular weight keratins and protein S-100, being irregularly positive for smooth muscle actin. Ultrastructural studies of tumor cells showed a variable content of intermediate filaments, with focal densities resembling smooth muscle dense bodies. A well-developed basal lamina, pinocytotic vesicles, and some desmosomes were also observed. In spite of being accepted as an individual entity, myoepitheliomas probably belong to a family of lesions that include mixed tumors. Therefore, this case can be considered as a salivary-gland-type tumor, probably originating from myoepithelial cells of sweat glands. The existence of this unique neoplasm provides further support to the debated role of myoepithelial cells in the development of mixed tumors.

Adverse cutaneous reactions to anakinra in patients with rheumatoid arthritis: clinicopathological study of five patients

Background  Anakinra, a recombinant human form of interleukin‐1 receptor antagonist, is used to treat patients with active rheumatoid arthritis (RA).

Prognostic significance of p27Kip1, p45Skp2 and Ki67 expression profiles in Merkel cell carcinoma, extracutaneous small cell carcinoma, and cutaneous squamous cell carcinoma

Aims:  To compare the immunohistochemical expression of prognostic markers p27Kip1, p45Skp2 and Ki67 in Merkel cell carcinoma (primary neuroendocrine carcinoma of the skin, MCC), small cell neuroendocrine carcinoma of lung and urinary bladder (SNC), and cutaneous squamous cell carcinoma (SCC).

Imatinib-associated lichenoid eruption : acitretin treatment allows maintained antineoplastic effect

the nail plate. It is thought to be due to a defect in keratinization with persistence of keratohyaline granules and air trapping within the nail. Our patient presents with true transverse leuconychia of her thumbnails and fingernails which resolved spontaneously during the third trimester of both her pregnancies. The leuconychia decreased in intensity from the thumb to the little finger on both hands and was also associated with transverse yellow bands, most prominent on her thumbnails. Neither phenomenon is readily explained. The menstrual cycle has previously been reported as a cause of transverse leuconychia. The onset of our patient’s leuconychia with the commencement of her menses and its ‘disappearance’ and subsequent ‘reappearance’ during and following each pregnancy also implies a hormonal influence. The exact aetiology of her leuconychia remains unknown. No similar cases have been reported to date.