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Dermatopathology
Volume 11
Issue 2
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Dermatopathology, Volume 11, Issue 2 (June 2024) – 4 articles

Cover Story (view full-size image): Poikilodermatous plaque-like hemangioma (PPH) is a recently identified clinical and pathological entity, with only 18 documented cases to date. It typically manifests as an atrophic, erythematous plaque-like lesion, primarily on the lower limbs of males over 50 years old. Histologically, PPH is characterized by a diffuse proliferation of thin-walled vessels in the dermis, accompanied by epidermal changes. The case and review study highlights the clinical and histological features of PPH. Despite its benign nature, PPH's indolent progression underscores the importance of accurate diagnosis to avoid unnecessary treatments. Differentiating PPH from more serious conditions, such as keratinocyte carcinoma and poikilodermic mycosis fungoides, is crucial. The study adds valuable insights to the limited literature on PPH and emphasizes the importance of recognizing its presentation and behavior. View this paper
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17 pages, 3825 KiB  
Article
The Prognostic Value of Histopathological Features in Early-Stage Mycosis Fungoides: Insights from a Retrospective–Prospective Cohort Study
by Sandra Jerkovic Gulin, Ivana Ilic and Romana Ceovic
Dermatopathology 2024, 11(2), 161-176; https://doi.org/10.3390/dermatopathology11020017 - 14 Jun 2024
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Abstract
Primary cutaneous lymphomas (PCLs), especially mycosis fungoides (MF), pose significant diagnostic and therapeutic challenges. This study aims to correlate initial histological features with the disease course and survival in MF patients. A retrospective–prospective cohort study was conducted on 83 patients diagnosed with early-stage [...] Read more.
Primary cutaneous lymphomas (PCLs), especially mycosis fungoides (MF), pose significant diagnostic and therapeutic challenges. This study aims to correlate initial histological features with the disease course and survival in MF patients. A retrospective–prospective cohort study was conducted on 83 patients diagnosed with early-stage MF at the Departments of Dermatovenerology and Pathology, UHC Zagreb, from January 2003 to December 2012. The analyzed histopathological parameters included lichenoid dermal lymphocyte infiltrate, Pautrier microabscesses, and lymphocyte atypia. Patients with more than 30 guardian lymphocytes per 100 keratinocytes exhibited worse overall and progression-free survival. Furthermore, those with over 50% atypical lymphocytes demonstrated a faster progression rate. A dense lichenoid dermal infiltrate and a high count of lymphocyte “keepers” significantly increased the mortality risk within five years of diagnosis. This study did not fully confirm the hypothesis regarding the prognostic value of large Pautrier microabscesses but highlighted the importance of dense lichenoid infiltrates. The study identified new potential histopathological prognostic factors in early-stage MF, suggesting the need for larger studies to confirm these findings. The identification of such predictors could enhance the prognostic stratification and guide more tailored therapeutic approaches for MF patients. Full article
(This article belongs to the Section Clinico-Pathological Correlation in Dermatopathology)
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7 pages, 14327 KiB  
Case Report
Giant Morpheaform Basal Cell Carcinoma Mimicking Scarring Alopecia: Exception Prone to Neglect
by Carlo Francesco Tomasini, Giacomo Fiandrino, Emanuele Mario Favale, Francesca Antoci and Stefania Barruscotti
Dermatopathology 2024, 11(2), 154-160; https://doi.org/10.3390/dermatopathology11020016 - 5 Jun 2024
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Abstract
A 74-year-old woman in good general health presented with a 5-year history of progressive hair loss over several years, interpreted as female androgenetic alopecia (AGA), and was treated with topical 5% Minoxidil without improvement. The patient’s relevant medical history revealed infiltrating, triple-negative apocrine [...] Read more.
A 74-year-old woman in good general health presented with a 5-year history of progressive hair loss over several years, interpreted as female androgenetic alopecia (AGA), and was treated with topical 5% Minoxidil without improvement. The patient’s relevant medical history revealed infiltrating, triple-negative apocrine carcinoma of the right breast four years before, treated by quadrantectomy, radiation, lymphadenectomy and chemotherapy, with no recurrence at the last follow-up. On examination, there was an asymptomatic 15 × 15 cm firm and whitish area of scarring alopecia on the central scalp. Dermoscopy revealed multiple arborizing vessels and many telangiectasia. The clinical considerations included mainly cutaneous metastasis of breast carcinoma (alopecia neoplastica), pseudopelade of Broque and morpheaform basal cell carcinoma (BCC). A histopathologic examination revealed characteristic changes of morpheaform BCC with basaloid islands and cords of atypical basaloid cells diffusely infiltrating the dermis, embedded in a sclerotic and hypervascularized stroma. Secondary alopecia neoplastica due to morpheaform BCC on the scalp is an exceedingly rare entity, possessing subtle clinical features that may mimic both scarring and non-scarring alopecia. Delayed recognition may contribute to aggressive behavior and extensive local destruction. Treatment with hedgehog inhibitors in locally advanced BCC of the scalp, both in adjuvant and neoadjuvant modalities, is promising. Full article
(This article belongs to the Section Clinico-Pathological Correlation in Dermatopathology)
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7 pages, 4250 KiB  
Case Report
Poikilodermatous Plaque-like Hemangioma: Case Presentation and Literature Review
by Pablo Díaz-Calvillo, Francisco Vílchez-Márquez, Francisco Manuel Ramos-Pleguezuelos and Salvador Arias-Santiago
Dermatopathology 2024, 11(2), 147-153; https://doi.org/10.3390/dermatopathology11020015 - 21 May 2024
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Abstract
Poikilodermatous plaque-like hemangioma (PPH) is a recently described clinical and pathological entity, with only 18 cases reported in the literature. Although uncommon, this benign condition presents consistent clinical and histological findings. We present a new case of PPH in an 81-year-old male and [...] Read more.
Poikilodermatous plaque-like hemangioma (PPH) is a recently described clinical and pathological entity, with only 18 cases reported in the literature. Although uncommon, this benign condition presents consistent clinical and histological findings. We present a new case of PPH in an 81-year-old male and review the existing literature. The persistence over time and the need to distinguish PPH from more significant lesions underscore the importance of its clinical and pathological recognition. Full article
(This article belongs to the Section Clinico-Pathological Correlation in Dermatopathology)
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5 pages, 1695 KiB  
Case Report
Intratarsal Keratinous Cyst Clinically Misdiagnosed as a Chalazion
by John Lennon Silva Cunha, Clenia E. S. Andrade, Fernando A. P. da Cunha Filho, Alexandre R. da Paz, Manuel A. Gordón-Núñez, Pollianna M. Alves and Cassiano F. W. Nonaka
Dermatopathology 2024, 11(2), 142-146; https://doi.org/10.3390/dermatopathology11020014 - 19 Apr 2024
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Abstract
The intratarsal keratinous cyst (IKC) is a recently described entity, often clinically misdiagnosed as a chalazion. We report a case of a 61-year-old male patient with a chief complaint of a small lesion on the upper eyelid that evolved over six months. On [...] Read more.
The intratarsal keratinous cyst (IKC) is a recently described entity, often clinically misdiagnosed as a chalazion. We report a case of a 61-year-old male patient with a chief complaint of a small lesion on the upper eyelid that evolved over six months. On physical examination, an asymptomatic, firm nodule was identified on the left upper eyelid. The patient reported no history of trauma. A provisional diagnosis of chalazion was established, and an excisional biopsy was performed. Histopathologically, the lesion was lined with a stratified squamous epithelium, with a corrugated epithelial surface showing abrupt keratinization without keratohyalin granules, and compact keratinous-appearing material in the cystic lumen. The diagnosis was IKC. No signs of recurrence were observed after one year of follow-up. It is essential to accurately diagnose IKC and distinguish it from chalazion and epidermal inclusion cysts, because IKC requires complete surgical excision and can exhibit multiple recurrences if not properly removed. Full article
(This article belongs to the Special Issue Educational Case Reports in Dermatopathology)
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