Mirella Giangiacomi

Cutaneous carcinomas and preinvasive neoplastic lesions. Role of MMP-2 and MMP-9 metalloproteinases in neoplastic invasion and their relationship with proliferative activity and p53 expression.

Background: Metalloproteinases (MMPs) are thought to be involved in the process of destruction of basement membranes and stromal invasion by neoplastic epithelial cells.

Lichen striatus in adults and pimecrolimus: open, off‐label clinical study

Background  Lichen striatus is a well‐known, acquired, self‐healing, linear inflammatory dermatosis. Lichen striatus occurring in adults tends to be more extensive and itchy than in children, sometimes requiring symptomatic treatment. The therapeutic approach usually adopted is topical steroids, even though prolonged use may lead to several side‐effects, particularly cutaneous atrophy.

Immunohistochemical study of apoptosis markers and involvement of chemokine CXCR4 in skin Merkel cell carcinoma

Background  Merkel cell carcinoma (MCC) is a rare, aggressive cancer of the skin that mainly affects elderly patients. Because of its rarity, there is no established treatment or proven markers to guide therapy or prognosis. Immunohistochemical expression of apoptosis proteins is considered a useful marker of both malignancy and tumour progression. Apoptosis plays a fundamental role in skin homeostasis, and apoptotic cells have been detected in normal and diseased skin. Chemokines posses a wide range of biological activities and CXCR4 is expressed in some cancer cells, where it plays an efficient role in metastasis formation.

A case of hypertrophic lichen ruber planus of the leg complicated by a squamous cell carcinoma.

A case of hypertrophic lichen ruber planus of the leg complicated by a squamous cell carcinoma In November 2000, a 58-year-old man suffering from longstanding (20 years) and histologically documented hypertrophic lichen planus (LP) of the legs (Fig. 1), with no other additional cutaneous or mucosal involvement, was referred for the evaluation of the development of an exophytic neoformation within the context of an LP skin lesion. After a physical examination, a 3 × 2-cm, well-outlined, easily bleeding verrucous nodule was evident over a plaque of hypertrophic LP located in the pretibial area of the right leg (Fig. 2). No history of arsenicals, ionizing radiation treatment, topical application of coal tar, or systemic administration of immunosuppressive drugs was found; the patient had stopped topical application of corticosteroids 12 months before the tumor appeared. Wide surgical excision of the cutaneous lesion was performed. Within the context of the LP plaque, a cutaneous neoplastic proliferation of large, polygonal, keratinizing, welldifferentiated, abnormally oriented squamous cells, with deep dermis invasion, was evident. The tumor presented rare atypical mitoses and areas of maturation forming parakeratotic horny pearls. On immunohistochemical evaluation, proliferating markers showed a variable grade of staining: monoclonal antibodies against monoclonal mouse antiproliferating cell nuclear antigen (PCNA) stained more than 70% of deeper invading neoplastic cells. High proliferating malignant cells of the nodular component reacted strongly with monoclonal mouse anti-human ki67 antigen (Mib-1), whose expression dramatically decreased between the tumor and LP lesion. Rare atypical mitoses, located in the deep, more aggressive part of the neoplasm, were labeled by p53 with strong expression. A diagnosis of well-differentiated squamous cell carcinoma (SCC) associated with hypertrophic LP was made.

Bullous-vesicular variant of mycosis fungoides presenting as erythema annulare centrifugum: a case report

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Adult rhabdomyoma: report of two cases of rhabdomyoma of the lip and of the eyelid.

We describe two cases of adult rhabdomyoma. One was located in the lip of a 66-year-old woman and was removed because it was clinically suspicious for infiltrating carcinoma. The other arose in the eyelid of a 60-year-old woman with a glass eye and was initially interpreted as a reactive process due to the prosthesis. Both lesions were composed of cells with oval nuclei and deeply eosinophilic cytoplasms with occasional cross striations. Immunoreactivity for desmin and myoglobin excluded the diagnosis of other tumors with similar morphology. The unusual association of the eyelid tumor with the prosthesis suggests a role for chronic irritation in the pathogenesis of rhabdomyoma.

A case of follicular mycosis fungoides with follicular mucinosis: a rare association.

Follicular mycosis fungoides (FMF) is a rare cutaneous T cell lymphoma characterized by an atypical lymphoid infiltrate spreading within and around hair follicles without epidermotropism or follicular mucin deposits. Its occasional presentation with minimal epidermal involvement and/or follicular mucinosis suggests the need for uniform histologic criteria. We describe a new case of FMF associated with follicular mucinosis and discuss its morphologic spectrum of presentation.

Recurrent epithelioid angiosarcoma of the scalp simulating melanoma. A 10-year follow-up.

We present a case of an intriguing mesenchymal neoplasm of the scalp that recurred several times over 10 years before a final diagnosis was possible. The case was sent for expert opinions to various international dermatopathological authorities and was, for a long time, unanimously interpreted as malignant melanoma. This diagnosis was supported by immunohistochemical examinations demonstrating S‐100 positivity. Nevertheless, the clinical behaviour, as well as some histopathological features raised doubt regarding the diagnosis. Only after the last recurrence, followed by a repeat extensive immunohistochemical study, the diagnosis of epithelioid angiosarcoma was made. Histologically malignant melanoma can be highly misleading and in literature, reports of misinterpreted cases of melanoma are published. In contrast, tumours that can simulate melanoma are also not infrequent and it is essential to perform immunohistochemistry to confirm diagnosis and exclude a melanocytic lesion.

The successful off-label use of photodynamic therapy for classic porokeratosis of Mibelli: case report.

Porokeratosis of Mibelli is an uncommon chronic disorder of epidermal keratinization that should be treated because it can undergo malignant change into epithelial tumors on the lesions. At the moment, it represents a therapeutic challenge for dermatologists because of the lack of standardized guidelines about the treatment. Herein, we report a case of classic porokeratosis of Mibelli treated with photodynamic therapy successfully.