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Dermatology Online Journal Jul 2018Clear cell acanthoma (CCA) is a rare, benign cutaneous condition most often seen on the lower extremities. Lesions are of variable morphology and have been described as...
Clear cell acanthoma (CCA) is a rare, benign cutaneous condition most often seen on the lower extremities. Lesions are of variable morphology and have been described as polypoid, pigmented, giant, and cystic lesions. Although no racial or gender predilection has been reported, CCA on the breast is a very rare finding that has been observed mainly in young Korean women. Herein, we describe a case of CCA of the areola in an elderly woman with metastatic renal cell carcinoma. Physical exam revealed a pink plaque with central erosions on the left areola. Given the concern for cutaneous metastasis, excisional biopsy was performed, which showed pale glycogenated epithelium consistent with CCA. No evidence of recurrence or new lesions was observed after 6 months of follow-up. Our case exemplifies that clinicians should consider CCA in the differential diagnosis for a new eczematous lesion involving the breast, even in the setting of malignancy.
Topics: Acanthoma; Aged, 80 and over; Carcinoma, Renal Cell; Female; Humans; Kidney Neoplasms; Neoplasms, Second Primary; Nipples; Skin Neoplasms
PubMed: 30261576
DOI: No ID Found -
Journal Der Deutschen Dermatologischen... Feb 2024Tumor of follicular infundibulum (TFI) has been described as a neoplasm - isolated and multiple - and in association with other lesions. Its histopathologic definition... (Review)
Review
BACKGROUND AND OBJECTIVES
Tumor of follicular infundibulum (TFI) has been described as a neoplasm - isolated and multiple - and in association with other lesions. Its histopathologic definition is controversial.
PATIENTS AND METHODS
We present a histopathologically analyzed series of 28 patients with TFI features. This has been supplemented by a search in MEDLINE on the literature on this subject. The corresponding figures given in these articles have been discussed and analyzed.
RESULTS
Patients comprised 16 women and twelve men. TFI features were seen in five patients with nevus sebaceous, two trichofolliculomas, one dilated pore Winer, eight viral warts, one dermatofibroma, six seborrheic keratoses, three actinic keratoses, one invasive squamous cell carcinoma, and one basal cell carcinoma in association with a squamous cell carcinoma/actinic keratosis. After study of the literature especially of solitary cases of TFI, we interpret such cases mostly as variants of seborrheic keratoses with variable degree of infundibular, isthmic and/or sebaceous differentiation with or without regression.
CONCLUSIONS
We regard TFI as an epithelial growth pattern which may occur in hamartomatous, inflammatory, infectious, reactive, or neoplastic conditions, in most solitary forms likely best classified within the histopathological spectrum of seborrheic keratoses.
Topics: Male; Humans; Female; Keratosis, Seborrheic; Skin Neoplasms; Hair Diseases; Carcinoma, Squamous Cell; Acanthoma; Pituitary Gland; Follicular Cyst; Neoplasms, Basal Cell
PubMed: 38332423
DOI: 10.1111/ddg.15296 -
The American Journal of Dermatopathology Dec 2015Initial investigations reported GATA3 to be a sensitive and relatively specific marker for mammary and urothelial carcinomas. Recently, GATA3 expression has been...
Initial investigations reported GATA3 to be a sensitive and relatively specific marker for mammary and urothelial carcinomas. Recently, GATA3 expression has been described in several other epithelial tumors. However, there has been only limited investigation of GATA3 expression in cutaneous epithelial tumors. The objective of this study was to examine the immunohistochemical expression of GATA3 in a wide variety of cutaneous epithelial neoplasms. GATA3 expression was evaluated in 99 benign and 63 malignant cutaneous epithelial tumors. GATA3 was consistently and usually strongly expressed in clear cell acanthoma, trichofolliculoma, trichoepithelioma, trichilemmoma, sebaceous adenoma, sebaceoma, apocrine hidrocystoma, apocrine tubular papillary adenoma, hidradenoma papilliferum, and syringocystadenoma papilliferum. Hidradenomas exhibited variable positive staining. Most poromas, syringomas, chondroid syringomas, cylindromas, and spiradenomas were negative or only focally and weakly positive. Focal staining was present in all pilomatrixomas. Thirteen of 14 basal cell carcinomas, 21 of 24 squamous carcinomas, and all 6 sebaceous carcinomas exhibited positive staining. The 1 apocrine carcinoma, both mucinous carcinomas, and 2 of 3 microcystic adnexal carcinomas also exhibited positive staining, whereas the 1 eccrine porocarcinoma and the 1 adenoid cystic carcinoma were negative. One of 11 Merkel cell carcinomas exhibited focal weak staining. Our findings demonstrate that GATA3 is expressed in a wide variety of benign and malignant cutaneous epithelial neoplasms. In addition to carcinomas of breast and urothelial origin and other more recently described GATA3-positive tumors, the differential diagnosis of a metastatic tumor of unknown primary origin that expresses GATA3 should also include a carcinoma of cutaneous epithelial origin.
Topics: Biomarkers, Tumor; GATA3 Transcription Factor; Humans; Immunohistochemistry; Neoplasms, Adnexal and Skin Appendage; Retrospective Studies; Skin; Skin Neoplasms
PubMed: 26595821
DOI: 10.1097/DAD.0000000000000306 -
Head and Neck Pathology Jun 2019Laugier-Hunziker syndrome (LHS, also termed idiopathic lenticular mucocutaneous hyperpigmentation) is an unusual condition characterized by progressive pigmentation of...
Laugier-Hunziker syndrome (LHS, also termed idiopathic lenticular mucocutaneous hyperpigmentation) is an unusual condition characterized by progressive pigmentation of the mucous membranes. LHS displays a benign course and is not associated with malignancy. Here we present a case of LHS with a 7-year follow-up. We document metachronous oral melanoacanthomas in this individual. In addition, we found that the oral melanotic macules in this patient waxed and waned in a cyclical manner. To our knowledge, this is the first report of these findings in the context of LHS. Finally, we provide an overview of other conditions that can present with mucosal hyperpigmentation. It is critical to distinguish LHS from other conditions characterized by mucosal pigmentation in order to facilitate optimal patient care.
Topics: Acanthoma; Female; Humans; Hyperpigmentation; Middle Aged; Mouth Neoplasms; Skin Neoplasms
PubMed: 29450847
DOI: 10.1007/s12105-018-0897-3 -
Dermatopathology (Basel, Switzerland) 2019Epidermolytic acanthoma is a rare benign tumor that appears as a solitary papule or, rarely, multiple small papules on the trunk and extremities, or on genitalia. They...
Epidermolytic acanthoma is a rare benign tumor that appears as a solitary papule or, rarely, multiple small papules on the trunk and extremities, or on genitalia. They are generally asymptomatic, although they can be pruritic. The clinical presentation is often misleading, and the lesions are often misdiagnosed histologically and frequently confused with condyloma acuminatum. Here, we report a case of an epidermolytic acanthoma on the penis of a 57-year-old male, whose final diagnosis was made after several years.
PubMed: 31700841
DOI: 10.1159/000499366 -
Veterinary Clinical Pathology Mar 2017Follicular tumors and cysts are common skin lesions in dogs. Both are distinguished based on their cellular origin (matrical, isthmus, or infundibular cells) and the...
BACKGROUND
Follicular tumors and cysts are common skin lesions in dogs. Both are distinguished based on their cellular origin (matrical, isthmus, or infundibular cells) and the type of keratin they produce. Typically, differentiation requires histopathology, as all these lesions often have similar cytologic features.
OBJECTIVES
The goal of this retrospective study was to identify unique cytologic features that may assist differentiation of canine benign follicular tumors and cysts at cytology, using histopathology as gold standard.
METHODS
Electronic medical records of the University of California-Davis Veterinary Medical Teaching Hospital were searched for diagnoses of follicular tumors and cysts in dogs that had both histopathologic and cytologic diagnoses between January 2000 and December 2013. Cytologic specimens were reassessed in a blinded manner for the presence and type of background, cells, noncellular elements, and inflammation.
RESULTS
Forty-six samples were included in the study. Follicular cysts (n = 25) and infundibular keratinizing acanthomas (n = 5) contained sheets of keratinized anucleate to nucleated squamous cells. Trichoepitheliomas (n = 8) had 2 primary cytologic presentations: those with primarily basaloid cells that appeared to be undergoing keratinization (3/8; 38%) and those with keratinizing anucleate to nucleated squamous cells (5/8; 63%). Trichoblastomas (n = 8) had pink matrix with spindle cells and contained cohesive clusters of basaloid cells.
CONCLUSION
Trichoblastomas, and to a lesser extent, trichoepitheliomas, have unique cytologic features with the potential to distinguish them from other benign follicular tumors and cysts. These results are an important first step toward improving the diagnostic specificity of cytologic examination of cutaneous follicular lesions.
Topics: Animals; Cysts; Dog Diseases; Dogs; Electronic Health Records; Hospitals, Teaching; Retrospective Studies; Skin Neoplasms
PubMed: 28249100
DOI: 10.1111/vcp.12458 -
The British Journal of Dermatology Dec 2017A variety of genodermatoses with multiple cutaneous tumours and germline genetic alterations, such as PTCH1 mutations, have been described. Other cutaneous syndromes... (Review)
Review
BACKGROUND
A variety of genodermatoses with multiple cutaneous tumours and germline genetic alterations, such as PTCH1 mutations, have been described. Other cutaneous syndromes have been associated with somatic gene mutations, such as FGFR3 in familial seborrhoeic keratosis.
OBJECTIVES
To describe the clinical, dermoscopic and histopathological features of multiple cutaneous lesions, mostly infundibulocystic basal cell carcinomas (ICBCCs) and pure reticulated acanthomas, present in a family affected by familial seborrhoeic keratosis. In addition, we tested for possible germline alterations in FGFR3 and PTCH1.
METHODS
Ten members of one family were clinically examined and 92 skin biopsy specimens were evaluated. Blood samples from six individuals were analysed for FGFR3 and PTCH1 germline alterations. We reviewed the literature concerning genetic FGFR3 alterations in seborrhoeic keratosis.
RESULTS
Individuals of all generations affected by familial seborrhoeic keratosis also presented other skin tumours that corresponded histologically to reticulated acanthomas without apocrine or sebaceous differentiation, as well as ICBCCs. In addition, two novel germline variants, p.Pro449Ser (c.1345C>T) in FGFR3 and p.Pro725Ser (c.2173C>T) in exon 14 of PTCH1 were identified in five participants.
CONCLUSIONS
We characterize for the first time the clinical, dermoscopic and histopathological features of multiple reticulated acanthomas without apocrine or sebaceous differentiation, for which we propose the term 'pure reticulated acanthoma', and ICBCCs associated with familial seborrhoeic keratosis. We identified FGFR3 and PTCH1 germline polymorphisms whose influence in the development of reticulated acanthomas is unknown.
Topics: Acanthoma; Aged; Carcinoma, Basal Cell; Dermoscopy; Female; Germ-Line Mutation; Humans; Keratosis, Seborrheic; Male; Middle Aged; Patched-1 Receptor; Pedigree; Polymorphism, Genetic; Receptor, Fibroblast Growth Factor, Type 3; Skin Neoplasms
PubMed: 28627087
DOI: 10.1111/bjd.15736 -
The American Journal of Dermatopathology Sep 2021Cutaneous clear cell proliferations encompass a heterogenous group of several primary cutaneous neoplasms and metastatic tumors with different histogenesis. Many of...
Cutaneous clear cell proliferations encompass a heterogenous group of several primary cutaneous neoplasms and metastatic tumors with different histogenesis. Many of these clear cell proliferations may seem strikingly similar under the microscope resulting in challenging diagnosis. In many of these clear cell lesions, the reason for the clear or pale appearance of proliferating cells is unknown, whereas in other ones, this clear cell appearance is due to intracytoplasmic accumulation of glycogen, mucin, or lipid. Artifacts of tissue processing and degenerative phenomenon may also be responsible for the clear cell appearance of proliferating cells. Awareness of the histopathologic findings as well as histochemical and immunohistochemical techniques are crucial to the accurate diagnosis. This review details the histopathologic features of clear cell cutaneous proliferations, classifying them according their type of differentiation and paying special attention to the histopathologic differential diagnosis among them.
Topics: Acanthoma; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Epidermis; Granular Cell Tumor; Hair Follicle; Hemangiosarcoma; Histiocytoma, Benign Fibrous; Humans; Immunohistochemistry; Keratosis, Seborrheic; Liposarcoma; Melanoma; Neurofibroma; Perivascular Epithelioid Cell Neoplasms; Sebaceous Gland Neoplasms; Skin Neoplasms; Sweat Gland Neoplasms; Xanthomatosis
PubMed: 34411018
DOI: 10.1097/DAD.0000000000001881 -
The American Journal of Dermatopathology Oct 2022Porokeratoma is a rare type of epidermal acanthoma, of which 22 cases have been published in the literature. It is characterized by the presence of multiple cornoid... (Review)
Review
Porokeratoma is a rare type of epidermal acanthoma, of which 22 cases have been published in the literature. It is characterized by the presence of multiple cornoid lamellae embedded within a single verrucous or keratotic nodule. Despite this histologic feature being shared with porokeratosis, the etiopathogenesis of porokeratoma and its relationship with porokeratosis remain unclear. We report a new case of porokeratoma involving hair follicles, a finding that has been reported in only one of the previously published cases. Analogous to follicular porokeratosis, a form of porokeratosis involving hair follicles, we have termed this lesion "follicular porokeratoma." A review of all 23 published cases (including the present case) is also provided.
Topics: Acanthoma; Epidermis; Hair Follicle; Humans; Porokeratosis; Skin Neoplasms
PubMed: 35925572
DOI: 10.1097/DAD.0000000000002271 -
Dermatopathology (Basel, Switzerland) Feb 2023Post-pemphigus acanthomas have been rarely discussed in the literature. A prior case series identified 47 cases of pemphigus vulgaris and 5 cases of pemphigus foliaceus,...
Post-pemphigus acanthomas have been rarely discussed in the literature. A prior case series identified 47 cases of pemphigus vulgaris and 5 cases of pemphigus foliaceus, out of which 13 developed acanthomata as a part of the healing process. Additionally, a case report by Ohashi et al. reported similar recalcitrant lesions on the trunk of a patient with pemphigus foliaceus being treated with prednisolone, IVIG, plasma exchange, and cyclosporine. Some view post-pemphigus acanthomas as variants of hypertrophic pemphigus vulgaris, being difficult to diagnose when they present as only single lesions, with a clinical differential of an inflamed seborrheic keratosis or squamous cell carcinoma. Here, we present a case of a 52-year-old female with a history of pemphigus vulgaris and four months of only topical therapy (fluocinonide 0.05%) who presented with a painful, hyperkeratotic plaque on the right mid-back that was found to be a post-pemphigus acanthoma.
PubMed: 36810570
DOI: 10.3390/dermatopathology10010012