Prapand Apisarnthanarax

Granular cell tumor: An analysis of 16 cases and review of the literature

Sixteen patients with granular cell tumors were seen between 1964 and 1979. The medical data of these patients showed an average age incidence of 39 years and a greater frequency among Negroes (69%) and in female patients (62.5%). The most common sign (in 12 of 16 patients) was the presence of an asymptomatic mass. There was a total of 88 tumors in 16 patients; 74 arose in the skin, 6 in the oral cavity, 2 each in the breast and perineum, and 1 each in the larynx, parotid gland, eyelid, and appendix. Multiple tumors were noted in 4 patients (25%), all of whom were Negroes. The histogenesis of this tumor is still controversial but appears to favor the theory of multipotential undifferentiated mesenchymal cell origin.

Spreading pigmented actinic keratosis

We present four cases of spreading pigmented actinic keratoses, an only recently described pigmented lesion of sun-exposed areas, in which the histologic appearance is that of actinic keratosis with the additional feature of excessive melanin deposition in the lower epidermis and in the upper dermis. Clinically, it is a brown patch or plaque with a smooth surface, usually larger than 1 cm, that tends to spread centrifugally. Clinical differential diagnoses include seborrheic keratosis, melanocytic nevus, senile lentigo, lentigo maligna, and lentigo maligna melanoma. This pigmented lesion is probably much more common than the existing literature would indicate.

Histamine-triggered localized vasculitis in patients with seropositive rheumatoid arthritis

To gain some insight into the pathogenesis of vasculitis in rheumatoid arthritis, and to investigate its relation to circulating immunoreactants, we injected 50 microliters of histamine intradermally in four seropositive and four seronegative patients with rheumatoid arthritis. Skin biopsies obtained before histamine and at 4 hours after histamine were studied by immunofluorescence microscopy, and skin biopsies 24 hours after histamine were studied by light microscopy. At 4 hours after histamine, all seropositive patients demonstrated deposits of IgM and complement components in dermal vessels; by 24 hours, various degrees of leukocytoclastic vasculitis were noted. Circulating material reactive with Raji cells, C1q, or both, was present in 3/3 seropositive patients. In contrast, none of the seronegative patients exhibited vascular deposits of immunoreactants or vasculitis. The results indicate that patients with rheumatoid arthritis who are seropositive may have circulating complexes with appropriate characteristics to induce vasculitis and that vasoactive substances may be used to trigger their local deposition in vessels.

MULTIPLE CUTANEOUS GRANULAR CELL TUMORS SIMULATING PRURIGO NODULARIS

ABSTRACT: A 37‐year‐old black man with 64 pruritic cutaneous granular cell tumors represents the highest number of such lesions ever reported. The clinical resemblance to prurigo nodularis are the unique features. Partial response to intralesional corticosteroid injection is noted.

Clinical Manifestations of Primary Cutaneous Malignant Melanoma

Cutaneous malignant melanoma is the most aggressively malignant of all skin tumors, although it is a relatively uncommon neoplasm. In the United States, an estimated 13,600 new cases of malignant melanoma were diagnosed in 1980, about 4.5% of the 300,000 total cases of skin cancer [1]. Malignant melanoma causes about 1% of all cancer deaths [2].