Montserrat Gilaberte

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.

Review of 26 cases of classical pyoderma gangrenosum: clinical and therapeutic features

BACKGROUND: Classical pyoderma gangrenosum (CPG) is an uncommon, idiopathic, neutrophilic skin disease, generally associated with other skin conditions and systemic diseases, and with several treatment options. OBJECTIVE: The objective of this review was to know the clinical and therapeutic features of our cases of CPG. METHODS: Twenty‐six cases of CPG were included; 65 episodes of PG and 120 treatment courses were analysed; and the mean follow‐up was 4.6 years. RESULTS: 21 cases (80%) had lesions on the lower extremities, 16 (61%) had recurrences, 22 (84%) had some disease associated, and 13 (50%) had autoimmune inflammatory conditions. Ciclosporin A (CSA) was used in 22 (84%) patients and 51 (78%) episodes, and prednisone (PDN) was used in 15 (57%) patients and 26 (40%) episodes. CONCLUSIONS: CSA efficacy was excellent, with an early response and acceptable toxicity, although it did not seem to have any impact on the incidence of PG recurrences.

Epidermal growth factor receptor gene numerical aberrations are frequent events in actinic keratoses and invasive cutaneous squamous cell carcinomas

Please cite this paper as: Epidermal growth factor receptor gene numerical aberrations are frequent events in actinic keratoses and invasive cutaneous squamous cell carcinomas. Experimental Dermatology 2010; 19: 151–153.

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).

Merkel cell (primary neuroendocrine) carcinoma of the skin with nodal metastasis showing rhabdomyosarcomatous differentiation.

Background:  We describe a unique case of Merkel cell (primary neuroendocrine) carcinoma of the skin with a lymph node metastasis showing rhabdomyosarcomatous differentiation. Skeletal muscle differentiation has occasionally been described in primary small cell neuroendocrine carcinomas and considered a form of dual differentiation rather than a collision tumor. In the present case, capacity for divergent differentiation appeared late in the course of the tumor, which suggests a clonal origin for both components of the neoplasm.

Acantholytic dyskeratotic naevi following Blaschko's lines: a mosaic form of Darier's disease

Dariers disease (DD) is an autosomal‐dominant skin disorder characterized by loss of adhesion between epidermal cells and abnormal keratinization. Several patients with unilateral, linear, ‘zosteriform’ or localized lesions have been reported. We report three cases of DD in a localized pattern corresponding to mosaicism type 1 according to Happles classification and review the literature about the genetic cause of DD and DD in a ‘zosteriform’ pattern.

Bullous pemphigoid in a patient with psoriasis during the course of PUVA therapy: study by ELISA test

A 65‐year‐old woman had a history of deep vein thrombosis and depression. Psoriasis was diagnosed in 1986 and various topical and systemic therapies, singly or in combination, were prescribed: tar, topical corticosteroids, cyclosporine, etretinate, and methotrexate. Two courses of oral and one course of bath psoralen plus UVA (PUVA) therapy (cumulative dose, 467 J/cm2) and UVB (2.96 J/cm2) had been given.

Acquired Mucosal Indeterminate Cell Histiocytoma

Abstract:  Indeterminate cell histiocytosis is an exceptional and controversial entity with variable clinical, histopathologic or immunohistochemical findings, sharing morphologic and immunophenotypic features from both Langerhans and non‐Langerhans cell histiocytoses. Neoplastic cells express S‐100 and CD1a antigens, but lack Birbeck granules. It has been reported in both adults and children, as solitary or multiple cutaneous lesions with rare extracutaneous involvement. We describe a 12‐year‐old boy with an indeterminate cell histiocytosis manifesting as a solitary verrucous papule on the mucosa of the glans penis. The morphologic features and diagnostic criteria of cutaneous indeterminate cell histiocytic proliferations are reviewed. The possible relationship between indeterminate cell and Langerhans cell histiocytoses is discussed.

Merkel Cell Carcinoma Developing after Bone Marrow Transplantation

Merkel Cell Carcinoma Developing after Bone Marrow Transplantation Montserrat Gilabertea, Ramon M. Pujol g, Jordi Sierrab, Xavier Matias-Guiu c, Josep Isern d, Pere Serret e, Luis De Andrés f, Agustin Alomar a Departments of a Dermatology, bHematology, c Pathology, dRadiotherapy, e Plastic Surgery and f Medical Oncology, Hospital de la Santa Creu i Sant Pau, and g Hospital del Mar, IMAS, Barcelona, Spain

Cranial Fasciitis in an 8‐Year‐Old Boy: Clinical and Histopathologic Features

Abstract:  Cranial fasciitis is an uncommon benign disorder characterized by a fibroblast‐like cell proliferation, observed almost exclusively in children. Clinically, it manifests as a rapidly growing, solitary nodule in the head or neck area. Underlying bone involvement (cranial cortical erosion) is frequently detected. Histopathologic analysis allows differentiation between cranial fasciitis and fibrohistiocytic or even sarcomatous lesions observed in children. Cranial fasciitis is considered to be a reactive, non‐neoplastic disorder and is usually cured by a simple excision. An increased awareness of the clinical and histopathologic characteristics of this entity seems important to establish the diagnosis, to adopt an adequate, conservative treatment and to avoid unnecessarily aggressive procedures.