Norma Saxe

Benign and malignant cellular blue nevus. A clinicopathological study of 30 cases

The clinical and pathological features of 29 cellular blue nevi (CBN) and one malignant cellular blue nevus from our hospital files were reviewed. Although the sacrococ-cygeal region/buttock was the commonest single site, the majority of CBN occurred on the limb peripheries. Two-thirds of patients were under the age of 40 years. Follow-up of a mean of 7 years did not reveal any evidence of malignancy. Four histological subtypes were recognized: mixed biphasic, alveolar, fascicular or neuronevoid, and atypical varieties. One case developed a benign nodal metastasis. In one case, malignancy arose within a CBN. The importance of recognizing the variety of patterns, the benign behavior of the atypical variety, and the criteria for malignancy are herein discussed.

Dermal and intravascular fasciitis : unusual variants of nodular fasciitis

Three cases with characteristic features of nodular (pseudosarcomatous) fasciitis arising in the dermis are described. This is only the second report documenting a dermal location for this condition. One of the three cases also showed features of intravascular fasciitis. A fourth case of intravascular fasciitis arising in periocular tissue is included. The differential diagnosis of dermal fasciitis includes benign fibrous histiocytoma, pyogenic granuloma, peripheral nerve tumors, cutaneous smooth muscle tumours, spindle cell carcinoma, spindle cell melanoma, dermatofibrosarcoma protuberans and atypical fibroxanthoma.

Cutaneous manifestations of the Proteus syndrome.

Abstract: The Proteus syndrome is a rare disorder in which the major manifestations are skeletal overgrowth, digital hypertrophy, exostoses of the skull, and hamartomatous tumors. Numerous skin lesions also occur. We treated six individuals, all of whom had the features unique to this syndrome of marked hypertrophy of the skin of the soles. The palms were similarly involved in two Patients. Light microscopy of biopsy material from thickened areas of the soles showed elongation of the cytoplasm of the basal cells. Large epidermal nevi Were present in three persons, as were linear macular lesions with areas of depigmentation and hyperpigmentation.

Tinea Capitis in Adults

ABSTRACT: Tinea capitis is regarded as rare in healthy adults. A study of 46 adults presenting with scalp problems with no other identifiable cause and 26 asymptomatic adult contacts of children with tinea capitis was undertaken. The confirmation of tinea capitis in 9 of 46 patients and 5 carriers among 26 adult contacts suggests that tinea capitis may affect healthy adults more often than was supposed. Further epidemiologic studies may be of interest.

The cutaneous manifestations of the Klippel‐Trenaunay‐Weber syndrome

The Klippel‐Trenaunay‐Weber syndrome (KTWS) is the widely accepted eponym for the condition of angioosteohypertrophy. The clinical features of limb overgrowth and various vascular malformations have been previously well‐described, but the spectrum of dermatological manifestations of the KTWS is less well‐documented. For this reason we have evaluated the natural history of the cutaneous lesions in 20 affected individuals. It has emerged that the hitherto unreported problem of aseptic cellulilis is a frequent and potentially severe complication in the KTWS.

Lymphoma of the Skin. A Comparative Clinico-Pathologic Study of 50 Cases Including Mycosis Fungoides and Primary and Secondary Cutaneous Lymphoma

A clinico‐pathologic study of lymphomas of the skin included 14 cases of mycosis fungoides, 14 of primary lymphoma and 22 of secondary lymphoma. Mycosis fungoides has clinical and histopathologic features which allow for separation from the other groups. In this study, patients with mycosis fungoides had a longer duration of history and presented with papules, plaques, erythroderma or generalized dermatitis but not with tumor nodules ab initio. A confident histologic diagnosis required the presence of the mycosis cell, which was usually present in association with a mixed inflammatory cell infiltrate. Another important histologic feature was the presence of invasion of the epidermis by the mycosis cells singly and/or in nests (Pautrier microabscesses). Primary and secondary lymphomas of the skin presented clinically as multiple tumor nodules and histologically as a monomorphic infiltrate of neoplastic cells confined to the dermis and subcutis. A feature which has not been adequately documented in a large series was the presence of an associated prominent epithelioid cell reaction in several cases from all three groups.

Primary oxalosis—an unusual cause of livedo reticularis

A young woman presented with renal failure and skin lesions of livedo reticularis (LR) due to primary oxalosis. Primary oxalosis is a rare autosomal‐recessive error of metabolism characterized by accumulation of calcium‐oxalate crystals in the kidneys, eyes, heart and skin. This unusual cause of intravascular obstruction resulting in livedo reticularis should be considered in patients with renal impairment. An approach to the diagnosis of LR is presented.

Leg ulcers in hereditary spherocytosis

Refractory leg ulcers in two patients healed following splenectomy. Neither patient had the ethnic background or family history of haematological abnormalities to suggest a haemoglobinopathy.

Macromelanosomes in the early diagnosis of neurofibromatosis.

Skin biopsies of café-au-lait macules from 34 patients with a clinical diagnosis of classical neurofibromatosis were examined histologically and ultrastructurally to determine the presence or absence of macromelanosomes in the epidermal melanocytes and keratinocytes. Sixteen of the 34 patients had macromelanosomes. The presence of macromelanosomes varied with age and ethnic background; they were detected in nine of 12 Whites, six of 10 persons of mixed ancestry, and one of two Blacks. In these populations skin biopsy is useful in early diagnosis of neurofibromatosis. However, none of 10 persons of Indian stock had macromelanosomes. Their total absence in this group may be indicative of genetic heterogeneity.

Mycobacterial skin infections

Procedures for classifying mycobaeteria (1,2) provide a clinical approach, while not reflecting biological relatedness (3). Epidemiological differences exist between disease due to the obligate pathogen mycobacteria tuberculosis and the environmental bacteria, whose demonstration in lesions does not necessarily signify responsibility for the disease. Non-tuberculous mycobacteria rarely spread personto-pcrson, infection depending on the organisms distribution in the environment, as well as opportunities such as skin trauma, surgery, or patient immuno-suppression. Classification