Ricardo F. de Misa

Low-dose intralesional interferon alfa for discoid lupus erythematosus

The hyperpigmentations that occur during pregnancy may result from hormonal changes, a greater population of melanocytes in affected areas or greater sensitivity of the melanocytes to hormonal stimulation.4 Melanocyte-stimulating hormone (MSH), estrogen, and progesterone have each been implicated as causes. However, if these pigmentary changes are classified into two groups based on abnormalities of either MSH or estrogen/progesterone levels, there are specific clinical findings associated with each of these abnormalities as well as an area of overlap. The formation of new lentigines and nevi or darkening and enlargement of preexisting lesions may also result from increased levels of MSH and estrogen/progesterone.4,5 Ellis and Wheeland4 showed that melanocytic nevi excised from pregnant women, women who had delivered within I month, and women who were taking oral contraceptives had increased estrogen and progesterone binding compared with control subjects. Journal of the American Academy of Dermatology

Cutaneous Metastases from Prostatic Cancer

The skin is involved in metastases from 2–9% of malignant tumors. These usually tend to spread to the skin relatively late in the course of the disease. Skin metastases of prostatic origin are quite uncommon and preferentially localized to the lower abdomen and genital area. We present a case of cutaneous metastasis from prostatic adenocarcinoma that preceded diagnosis of the primary tumor and was located on the neck.

PAPULAR MUCINOSIS ASSOCIATED WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

1. Harrist TJ, Eine JD, Berman RS, et al. Neutropbilic eccrine bidradenitis: a distinctive type of neutrophilic dermatosis associated witb myelogenous leukemia and chemotherapy. Arch Dermatol 1982; 118:263-266. 2. Moisson YE, Aractingi S, Pinquier L, et al. Hidradenite eccrine neutropbilique. Ann Dermatoi Venereol 1992; 119:605-611. 3. Smith KJ, Skelton HG, James WD, et al. Neutrophilic eccrine bidradenitis in HIV-infected patients. J Am Acad Dermatol 1990; 23:945-947. 4. Pierson ]C, Helm TN, Taylor JS. Neutrophilic eccrine hidradenitis heralding tbe onset of acute myelogenous leukemia. Arch Dermatol 1993; 129:791-792.

Infrequent Expression of Protein p53 in Epidermotropic Variants of Cutaneous T-Cell Lymphoma

Although diverse types of lymphomas have been examined for immunohistochemical detection of p53 protein, little information is available with regard to p53 protein expression in CTCL. We analyzed cutaneous biopsy specimens of 22 patients with the diagnoses of mycosis fungoides or Sézary syndrome with polyclonal rabbit anti‐p53 antiserum CM‐1. Staining of neoplastic cells was observed only in two patients with advanced disease. Overexpression of p53 protein does not seem to be a major feature of either mycosis fungoides or Sézary syndrome.

MYCOSIS FUNGOIDES WITH SIGNET-RING CELLS AND MONOCLONAL GAMMOPATHY

A 73‐year‐old white woman was admitted to our hospital for evaluation of a chronic dermatitis. Personal history was remarkable only for arterial hypertension and noninsulin‐dependent6 diabetes mellitus. Clinical and histopathologic findings were consistent with a diagnosis of mycosis fundoides (mf and staging procedures including bolld cell counts, serum biochemistry, urinalysis, bone marrow biopsy, Sé zary cell counts in peripheral bolld, computerized tomography (ct scans, abdominal ultrasonography, chest roentgenograms, serum protein electrophoresis, and immunoelectrophoresis disclosed normal or negative results (T2 N0 M0 B0).

Amelanotic bone marrow infiltration secondary to pigmented malignant melanoma.

Amelanotic melanomas account for aproximately 2 to 3% of malignant melanomas. Some authors suggest an increased aggressiveness and a higher rate of metastases for these clinical variants (l). In autopsy series, bone marrow involvement is observed in 45% of patients with malignant melanoma (MM) (2). However, in vivo staging procedures disclose neoplastic infiltration only in 7% of the cases (2). As far as we can determine, bone marrow infiltration by amelanotic cells of malignant melanoma has not been previously described. We report the case of a woman with a personal history of inelanotic MM who developed involvement of bone marrow by amelanotic cells presenting as primary fibrinolysis.