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Am J Dermatopathol 2019 Jan 29. Epub 2019 Jan 29.

Geisel School of Medicine at Dartmouth, Hanover, NH.

Spontaneous hair repigmentation of physiologically white or gray hair is a rare occurrence that may be associated with melanoma in elderly individuals. We present the first case of this phenomenon in a man. A gray-haired, 80-year-old man presented to dermatology clinic with a 3-cm lock of black hair on his vertex scalp that developed over 1 year. Read More

Am J Dermatopathol 2019 Jan 29. Epub 2019 Jan 29.

Pathology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

Am J Dermatopathol 2019 Jan 29. Epub 2019 Jan 29.

Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.

Am J Dermatopathol 2019 Jan 29. Epub 2019 Jan 29.

Centro Médico Voth, Madrid, Spain.

We present a 41-year-old man with a hemionychodystrophy of the first toe, appearing as a longitudinal thickening of the nail plate, overcurved and with holes in its thickened free margin, thus leading to the clinical diagnosis of onychomatricoma. Complete excision showed typical nail plate of onychomatricoma and, underlying it, curvy disorganized neural-looking fascicles without atypia and with diffuse positivity for S100, interpreted as subungual neurofibroma (NF). Subungual NF is a very rare tumor, with only 12 previous cases reported. Read More

Am J Dermatopathol 2019 Jan 29. Epub 2019 Jan 29.

Department of Dermatology, National Skin Centre, Singapore.

We describe a rare and unique case of extramammary Paget disease in the genitals with concomitant histological features of herpes virus infection. This is a very rare and interesting association that has only been reported in 1 article in the literature so far. Read More

Am J Dermatopathol 2019 Jan 22. Epub 2019 Jan 22.

Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN.

Intraoral cutaneous hamartomas (ICHs) are uncommon mucosal lesions characterized microscopically by a combination of cutaneous structures, including various stages of follicular and sebaceous elements. Due to their rarity, the clinicopathologic and immunohistochemical attributes of ICHs have not been thoroughly delineated. Three cases of ICH were identified from our records, and formalin-fixed paraffin-embedded sections were immunohistochemically stained with antibodies against androgen receptor, estrogen receptor, and progesterone receptor, p63, factor XIIIα, and CD34. Read More

Am J Dermatopathol 2019 Jan 22. Epub 2019 Jan 22.

Departments of Dermatology, and.

Am J Dermatopathol 2019 Jan 22. Epub 2019 Jan 22.

Pathology, University of Virginia, Charlottesville, VA.

Peripheral gamma-delta T-cell proliferations are encountered in reaction to certain infections and in primary malignancies. Identifying sources of benign reactions is key in avoiding unnecessary workup and surveillance of these aggressive malignancies. Borrelia infections have been implicated in a number of lymphoproliferative disorders, but rarely, if ever, in this setting. Read More

Am J Dermatopathol 2019 Feb;41(2):161

Department of Dermatology, Stroger Hospital of Cook County, Chicago, IL.

Am J Dermatopathol 2019 Feb;41(2):159-160

Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX.

Am J Dermatopathol 2019 Feb;41(2):157-158

Departaments of *Dermatology, and †Dermatology and Pathology, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.

Am J Dermatopathol 2019 Feb;41(2):155-156

Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL.

Am J Dermatopathol 2019 Feb;41(2):85-117

Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.

After a review of the physiology in the formation and degradation of cutaneous elastic tissue, we describe the clinicopathologic disorders characterized by increased and decreased cutaneous elastic tissue. Cutaneous disorders characterized by increased and/or abnormal elastic tissue in the dermis include elastoma, also named nevus elasticus, dermatosis lenticularis disseminata, pseudoxanthoma elasticum, late-onset focal dermal elastosis, linear focal elastosis, elastoderma, elastofibroma dorsi, and elastosis perforans serpiginosa. In some of these conditions, the specific histopathologic diagnosis may be rendered with hematoxylin-eosin stain, whereas in other ones special elastic tissue stains are necessary to demonstrate the anomalies. Read More

Am J Dermatopathol 2019 Jan 14. Epub 2019 Jan 14.

Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC.

Am J Dermatopathol 2019 Jan 10. Epub 2019 Jan 10.

Center for Dermatopathology, Freiburg, Germany.

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Department of Pathology, Cork University Hospital, Cork, Ireland.

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic.

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Ackerman Academy of Dermatopathology, New York, NY.

Hailey-Hailey disease (familial benign chronic pemphigus) is a genodermatosis with a typical clinical presentation of macerated plaques involving intertriginous areas of the body and affects multiple family members. Epidermal acanthosis, incipient, and completed acantholysis of many of the spinous keratinocytes of the epidermis and foci of dyskeratosis are well-recognized histologic findings. We have observed solitary lesions on the "scalp" of patients having a Hailey-Hailey-like pattern, and not the suprabasilar clefting of pemphigus represents the first manifestation of pemphigus vulgaris, which was confirmed with direct immunofluorescence in all our patients. Read More

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Dermatology Clinic, University of Catania, Catania, Italy.

Reflectance confocal microscopy (RCM) displays horizontal, en face tissue sections of the epidermis and upper dermis, and interpretation of its features is classically based on the comparison with vertical conventional histopathological sections that, as known, do not reflect the same plane of observation. In 10 patients affected by psoriasis, we correlated RCM images with horizontal histopathological sections from skin biopsies, observing in all cases marked overlaps between the 2 techniques. Although vertical section examination remains the gold standard for the diagnosis of psoriasis, this novel comparative approach may contribute to a more precise definition of RCM findings and could represent the drive for further research as well as an innovative tool for educational purposes. Read More

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Ackerman Academy of Dermatopathology, New York, NY.

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Dermatology Associates of South Jersey, Mount Laurel Township, NJ.

Sclerosing perineuromas are rare, benign peripheral nerve sheath tumors classically reported on the fingers and palms of young men. We present the case of a 12-year-old boy with a slow-growing nodule on his right knee. Excision was performed, and pathology was consistent with a sclerosing perineuroma. Read More

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Dermatopathology Group, Department of Anatomical Pathology, PathWest Laboratory Medicine, Perth, Western Australia, Australia.

Flagellate erythema is a distinctive eruption characterized by "whip-like" linear or curvilinear streaks and plaques, occurring mainly on the trunk. It has classically been described in 2 disparate clinical settings: chemotherapy with bleomycin and ingestion of mushrooms (most commonly Shiitake mushrooms). Most of the literature comprises single case reports, often with minimal histological description of rather nonspecific features. Read More

Am J Dermatopathol 2019 Jan 11. Epub 2019 Jan 11.

Departments of Diagnostic Pathology, and.

High-risk human papillomavirus (HR-HPV) is known to play an oncogenic role in squamous cell carcinoma (SCC) at certain anatomical sites, namely the uterine cervix, oropharynx, and anogenital skin. However, the association between HR-HPV and nonanogenital cutaneous SCC (CSCC) remains controversial. In this study, we addressed this controversy by performing HR-HPV E6/E7 mRNA in situ hybridization (ISH) on 243 CSCC samples. Read More

Am J Dermatopathol 2019 Feb;41(2):122-127

Dermatology and Venereology and.

Background: Androgenetic alopecia (AGA) results from shortening of the anagen phase of the hair cycle and, subsequently, miniaturization of hair follicles. Alopecia areata (AA) is a disease of autoimmunity where T cells attack anagen hair follicles and shows multifactorial etiology. Dickkopf-1 (DKK-1) is a gene that is responsible for transformation of anagen to catagen, which suggests that it is involved in development of both diseases. Read More

Am J Dermatopathol 2019 Jan 3. Epub 2019 Jan 3.

Unit of Ocular Oncology, Department of Surgery and Translational Medicine, Careggi University Hospital, Florence, Italy.

Synovial sarcoma (SS) is a high-grade soft-tissue sarcoma occurring predominantly in older children and young adults. Only approximately 7% occur in the head and neck region, with SS representing less than 0.1% of all head and neck cancers. Read More

Am J Dermatopathol 2019 Jan 3. Epub 2019 Jan 3.

Oncologia Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland.

Large B-cell lymphomas include several subtypes. Recently, anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma has been delineated as a distinct entity involving mostly lymph nodes and rarely affecting extranodal sites. We describe the first case of a primary cutaneous ALK-positive large B-cell lymphoma in a 48-year-old man with a solitary nodule on the back, and describe the histologic and phenotypic features. Read More

Am J Dermatopathol 2019 Jan 3. Epub 2019 Jan 3.

Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL.

Background: Frontal fibrosing alopecia (FFA) is an irreversible scarring alopecia, and its incidence has reached epidemic size. Immune privilege collapse of the bulge and epithelial mesenchymal transition play a role in the pathogenesis. We have noted adipose tissue in the dermis in several specimens from FFA. Read More

Am J Dermatopathol 2019 Jan;41(1):80-82

Departments of Dermatology.

Am J Dermatopathol 2019 Jan;41(1):75-76

Department of Dermatology, Complejo Asistencial Universitario de León, León, Spain.

Am J Dermatopathol 2019 Jan;41(1):73-74

Department of Dermatology, Dell Medical School, The University of Texas, Austin, TX.

Am J Dermatopathol 2019 Jan;41(1):70

Department of Dermatology, Boston University School of Medicine, Boston, MA.

Am J Dermatopathol 2019 Jan;41(1):1-6

Dermatopathologist, Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA.

TLE1 immunohistochemistry is widely used as a biomarker for synovial sarcoma. Recently, we identified TLE1 expression in a subset of melanomas and noted staining in sebaceous glands and follicular epithelium. TLE1 immunohistochemistry has not been well studied in cutaneous tumors. Read More

Am J Dermatopathol 2018 Dec 26. Epub 2018 Dec 26.

Department of Pathology, Florida Hospital Orlando, Orlando, FL.

RAS-associated autoimmune leukoproliferative disease (RALD) is a recently described noninfectious and nonmalignant clinical syndrome characterized by autoimmune disorders, massive splenomegaly, modest lymphadenopathy, and monocytosis. On the molecular level, RALD is defined by somatic mutations of either NRAS or KRAS gene in a subset of hematopoietic cells. To date, there is a dearth of well-documented histopathologic description of cutaneous involvement by RALD in the literature. Read More

Am J Dermatopathol 2018 Dec 21. Epub 2018 Dec 21.

Dermatology Department, Chelsea and Westminster, London, United Kingdom.

Cutaneous toxicities associated with BRAF inhibitor treatment in patients with metastatic melanoma have been well described. We present a rare association of granulomatous dermatitis in association with the BRAF inhibitor vemurafenib. Three patients with metastatic melanoma all presented with asymptomatic papular eruptions 8-21 months into vemurafenib therapy. Read More

Am J Dermatopathol 2018 Dec 20. Epub 2018 Dec 20.

Ackerman Academy of Dermatopathology, New York, NY.

Intralesional Kenalog (triamcinolone) injection is a useful treatment for several skin conditions. Although dermal deposition of triamcinolone has been described in the literature, histopathologic findings of foreign body reactions to it have seldom been reported. Here, we describe a case of a granulomatous reaction to the intralesional injection of triamcinolone acetonide in the treatment of nodulocystic acne. Read More

Am J Dermatopathol 2018 Dec 20. Epub 2018 Dec 20.

Departments of Dermatology and Cutaneous Biology.

B-cell lymphoblastic lymphoma (B-LBL) is a malignant neoplasm of immature B cells that accounts for only 10% of all cases of lymphoblastic lymphoma. Most commonly, B-LBL presents as bony lesions, but in rare cases, the disease manifests cutaneously. We present a case of simultaneous cutaneous and systemic presentation of B-LBL in an otherwise healthy 28-year-old man in which the lymphoblastic infiltrate stained positive for CD79a, Tdt, CD10, and CD20. Read More

Am J Dermatopathol 2018 Dec 20. Epub 2018 Dec 20.

Global Pathology Laboratory, Aurora Diagnostics, Miami Lakes, FL.

Lichen myxedematosus is a chronic cutaneous mucinosis that can present on a spectrum from localized cutaneous lesions to systemic disease of scleromyxedema. The clinical presentation of localized cutaneous lichen myxedematosus is waxy lichenoid papules, nodules, and/or plaques that have histopathologic findings of mucin deposition and a variable degree of fibroblast proliferation. There is an absence of serum paraproteins, and there are no other systemic causes of cutaneous mucinosis such as thyroid disease. Read More

Am J Dermatopathol 2018 Dec 19. Epub 2018 Dec 19.

Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China.

Am J Dermatopathol 2018 Dec 19. Epub 2018 Dec 19.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.

Background: Tumoral melanosis (TM) is a histologic diagnosis characterized by abundant pigment-laden macrophages in the dermis. It is generally thought to represent a regressed melanoma, although it has also been reported after benign pigmented lesions as well. Determining the antecedent lesion in cases of TM is of clinical importance to accurately guide therapy and prognostication. Read More

Am J Dermatopathol 2018 Dec 10. Epub 2018 Dec 10.

Dermatology Division, Department of Internal Medicine, Carilion Clinic, Virginia Tech Carilion School of Medicine, Roanoke, VA.

Am J Dermatopathol 2018 Dec 10. Epub 2018 Dec 10.

Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Background: Premature desquamation of the inner root sheath (PDIRS) is considered one of the distinctive features in central centrifugal cicatricial alopecia (CCCA). However, PDIRS can be seen in other alopecia subtypes, and its utility in the diagnosis of CCCA has been debated. We aimed to examine a large cohort of alopecia cases for the presence of PDIRS in association with and without inflammation to determine whether PDIRS in noninflamed follicles can be used as a specific marker of CCCA. Read More

Am J Dermatopathol 2018 Dec 7. Epub 2018 Dec 7.

Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL.

Am J Dermatopathol 2018 Dec 7. Epub 2018 Dec 7.

Department of Pathology, UPMC Shadyside, Pittsburgh, PA.

Melanoma is one of the great mimickers in pathology because it has diverse morphologies and can be mistaken for carcinoma or sarcoma. In most cases, immunochemistry is helpful in supporting the diagnosis and excluding other differentials. However, metastatic melanoma may lose immunohistochemical melanocytic markers and express nonmelanocytic lineage markers, which often poses a diagnostic dilemma and may be misdiagnosed as a poorly differentiated carcinoma or sarcoma. Read More

Am J Dermatopathol 2018 Dec 7. Epub 2018 Dec 7.

Department of Dermatology, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt.

Am J Dermatopathol 2018 Dec 7. Epub 2018 Dec 7.

Departments of Dermatology and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.

Am J Dermatopathol 2018 Nov 30. Epub 2018 Nov 30.

Division of Dermatology, Dell Medical School, The University of Texas-Austin, Austin, TX.

Am J Dermatopathol 2018 Nov 27. Epub 2018 Nov 27.

Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA.

Am J Dermatopathol 2018 Nov 27. Epub 2018 Nov 27.

Unidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades, Centro Médico Nacional SXXI, IMSS, Mexico City, México.

The role of Mycobacterium tuberculosis in the etiology and pathogenesis of cutaneous tuberculosis is controversial because of the difficulties associated with demonstrating the presence of these mycobacteria in tuberculid cutaneous lesions by routinely available microbiological and histological techniques. In this study, we aimed to demonstrate the presence of M. tuberculosis in cutaneous tuberculosis. Read More

Am J Dermatopathol 2018 Nov 27. Epub 2018 Nov 27.

Pathology, Royal Liverpool and Broadgreen University Hospitals NHS trust, Liverpool, United Kingdom.

Am J Dermatopathol 2018 Nov 22. Epub 2018 Nov 22.

Department of Dermatology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.