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The Journal of Dermatology Jul 2020Porokeratoma is a recently described solitary or multiple tumor-like acanthoma, sharing the histological feature of cornoid lamellae with porokeratosis. Whether...
Multiple porokeratomas (porokeratotic acanthoma) coexisting with disseminated superficial porokeratosis: Clinical, dermoscopic and pathological observations, and review of published work.
Porokeratoma is a recently described solitary or multiple tumor-like acanthoma, sharing the histological feature of cornoid lamellae with porokeratosis. Whether porokeratoma is a variant of porokeratosis is controversial. We report a rare case of a 53-year-old Chinese woman who presented with multiple, symmetrical, hemispherical and verrucous plaques on her lower extremities that had been present for 20 years. The clinical manifestation resembled the fungal disease of chromoblastomycosis. The diagnosis of multiple porokeratoma coexisting with disseminated superficial porokeratosis was rendered according to the clinical, dermoscopic and pathological features. Oral acitretin (30 mg/day) and laser therapy were administrated. After 6 months of treatment, the number of plaques on her limbs was significantly reduced without recurrence. From this case, we speculate that porokeratoma is a rare and special variant of porokeratosis. In complex cases with multiple lesions, oral acitretin can be combined with surgery, cryotherapy and laser therapy.
Topics: Acanthoma; Cryotherapy; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Porokeratosis; Skin Neoplasms
PubMed: 32415691
DOI: 10.1111/1346-8138.15376 -
The Journal of Dermatology Jun 2020Clear cell acanthoma (CCA) is a rare benign epidermal tumor that is difficult to diagnose by visual inspection. Conversely, its diagnosis by dermoscopy is relatively...
Clear cell acanthoma (CCA) is a rare benign epidermal tumor that is difficult to diagnose by visual inspection. Conversely, its diagnosis by dermoscopy is relatively easy owing to the characteristic serpiginous arrangement of coiled vessels, sometimes described as the "string-of-pearls" formation. However, in few published reports, the dermoscopic diagnosis of mature CCA has been reported. Here, we report the histopathological and detailed dermoscopic findings of two CCA cases. Between these, one case was of early (~6 months) CCA exhibiting the characteristic vascular string-of-pearls formation, whereas the other was of a more mature (~10 years) CCA; although the latter case showed combined thick and thin white intersecting lines with large coiled vessels and/or red clods, it had the string-of-pearls formation. Thus, regardless of CCA maturity, the string-of-pearls formation was present. We propose that the combination of combined thick and thin white intersecting lines along with the vascular string-of-pearls formation reflecting large coiled vessels and/or red clods on dermoscopy is a diagnostic clue to mature CCA.
Topics: Acanthoma; Aged; Biopsy; Dermoscopy; Diagnosis, Differential; Epidermis; Female; Humans; Male; Middle Aged; Neoplasm Staging; Skin Neoplasms; Treatment Outcome
PubMed: 32180264
DOI: 10.1111/1346-8138.15311 -
Anais Brasileiros de Dermatologia 2020The Borst-Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic...
The Borst-Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic epidermis. One of the neoplasms where this phenomenon is found is hidroacanthoma simplex. This neoplasm is considered the intraepidermal form of the eccrine poroma. Despite its benign nature, malignant transformations are reported. The present article reports a case of hidroacanthoma simplex and discusses the dermoscopy of this phenomenon.
Topics: Acanthoma; Aged, 80 and over; Biopsy; Dermoscopy; Epidermis; Female; Humans; Skin Neoplasms
PubMed: 31932162
DOI: 10.1016/j.abd.2019.03.004 -
Annals of Dermatology Dec 2020Epidermolytic acanthoma (EA) is a rare benign tumor, which usually appears as a solitary small papule. However, there are a few case reports of multiple EA, most of...
Epidermolytic acanthoma (EA) is a rare benign tumor, which usually appears as a solitary small papule. However, there are a few case reports of multiple EA, most of which occurs on the genital area. Cases of multiple EA may mimic verruca vulgaris, condyloma accuminatum, seborrheic keratosis, and bowenoid papulosis, and therefore, can be easily misdiagnosed. A 78-year-old male presented with a 2-week history of discrete, small skin-colored papules around the anus. The other case involved a 47-year-old male with a 5-year history of skin-colored papules on the scrotum. Skin biopsy of both cases revealed a well-demarcated papular lesion characterized by compact hyperkeratosis, perinuclear vacuolization, and reticular degeneration in the granular and upper spinous layer with coarse basophilic keratohyalin granules. Epidermal invagination was consistent with a cup-shaped type of EA. Both cases tested negative for human papillomavirus. We report typical cases of multiple EA, which should be considered as the differential diagnosis of small skin-colored papules in the anogenital area, to prevent the misdiagnosis.
PubMed: 33911795
DOI: 10.5021/ad.2020.32.6.512 -
Experimental Dermatology Jun 2022An 82-year-old female patient presented with a recent onset of painful skin lesions in unilateral distribution on the abdominal area following the lines of Blaschko; the...
Whole-transcriptome sequencing identifies postzygotic ATP2A2 mutations in a patient misdiagnosed with herpes zoster, confirming the diagnosis of very late-onset segmental Darier disease.
An 82-year-old female patient presented with a recent onset of painful skin lesions in unilateral distribution on the abdominal area following the lines of Blaschko; the initial diagnosis of Varicella-Zoster infection was made. However, because the individual lesions appeared as hyperkeratotic papules and were unresponsive to antiviral therapy, a skin biopsy was performed, which revealed hyperkeratosis, suprabasal acantholysis and dyskeratosis with corps ronds and grains, consistent with acantholytic dyskeratotic acanthoma. Since this entity has been associated with Darier disease, whole-transcriptome sequencing by RNA-Seq was performed on RNA isolated from a lesion and from adjacent normal appearing skin, and a recently developed bioinformatics pipeline that can identify both genomic sequence variants and the presence of any of 926 viruses was applied. Two pathogenic missense mutations in the ATP2A2 gene were identified in the lesional but not in normal appearing skin, and no evidence of Varicella-Zoster infection was obtained. These findings confirm the diagnosis of segmental Darier disease due to postzygotic mutations in the ATP2A2 gene, and attest to the power of a novel single-step application of RNA-Seq in providing correct diagnosis in this rare genodermatosis.
Topics: Aged, 80 and over; Chickenpox; Darier Disease; Diagnostic Errors; Female; Herpes Zoster; Humans; Mutation; Sarcoplasmic Reticulum Calcium-Transporting ATPases; Transcriptome
PubMed: 35246884
DOI: 10.1111/exd.14559 -
Journal of Cutaneous Pathology Jan 2023Benign lichenoid keratosis (BLK) is a cutaneous lesion that can clinically mimic malignancy and may represent regression of a pre-existing lesion. BLK may show epidermal...
BACKGROUND
Benign lichenoid keratosis (BLK) is a cutaneous lesion that can clinically mimic malignancy and may represent regression of a pre-existing lesion. BLK may show epidermal pseudo-nests prompting evaluation for a melanocytic lesion. False positivity of MART-1/Melan-A immunostaining in pseudonests has been showed; however, the value of SRY-related HMG-box 10 (SOX10) staining in BLK with features suspicious for a melanocytic proliferation has not been previously reported.
METHODS
Twenty-one cases of BLK from 2015 to 2020 were identified. Slides were reviewed and SOX10 immunohistochemistry was performed on each case. Subsequently, Melan-A immunohistochemical staining was performed on all cases.
RESULTS
In 10 cases (47.6%), unexpected SOX10 staining was seen in rare to numerous small, single cells in the epidermis above the basal cell layer. No malignancy was identified. Of the 10 cases, 8 (80%) showed suprabasal SOX10 staining did not show similar suprabasal Melan-A staining; 2 (20%) cases showed scattered suprabasal cells positive for Melan-A.
CONCLUSION
SOX10 immunostaining in BLK can highlight scattered cells in the epidermis (not easily noticeable on routine stain). Performing SOX10 immunostain alone on BLK can prompt a misdiagnosis of a melanocytic lesion and should be done with caution.
Topics: Humans; MART-1 Antigen; Keratosis, Actinic; Melanocytes; Skin Diseases; Acanthoma; Skin Neoplasms; Biomarkers, Tumor; SOXE Transcription Factors
PubMed: 36030406
DOI: 10.1111/cup.14318 -
Journal Der Deutschen Dermatologischen... Apr 2022
Topics: Acanthoma; Antiviral Agents; Humans; Interferon alpha-2; Interferon-alpha; Polyethylene Glycols; Recombinant Proteins; Skin Neoplasms
PubMed: 35188707
DOI: 10.1111/ddg.14719 -
Italian Journal of Dermatology and... Apr 2023
Topics: Humans; Acanthoma; Skin Neoplasms; Skin; Colonic Neoplasms
PubMed: 37153955
DOI: 10.23736/S2784-8671.23.07493-5 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Dec 2020The patient, a 70-year-old woman, presented with a mass in the right nasal cavity accompanied by recurrent nosebleeds for 3 months. Physical examination revealed a mass...
The patient, a 70-year-old woman, presented with a mass in the right nasal cavity accompanied by recurrent nosebleeds for 3 months. Physical examination revealed a mass in the right nasal vestibule, with a diameter of about 1.5 cm. The surface of the mass was not smooth and nasal CT showed a mass in the right nasal vestibule, which could be surgically removed. Immunohistochemical results of the tumor showed CKpan(3+), CK5/6(3+), p40(3+), p53(+), CD10(-), AR(-), Bcl-2(-), ki-67(+20%). Pathological diagnosis was acantholytic dyskeratotic acanthoma. This disease is rare and easy to be misdiagnosed, so it is necessary to pay attention to identification.
Topics: Acanthoma; Aged; Epistaxis; Female; Humans; Immunohistochemistry; Nasal Cavity; Nose Neoplasms; Skin Neoplasms
PubMed: 33254352
DOI: 10.13201/j.issn.2096-7993.2020.12.019 -
International Journal of Gynecological... Jan 2020Epidermolytic acanthoma is a rare benign lesion that most often presents as a solitary or multiple small papular lesions on the trunk, face, limbs or external male...
Epidermolytic acanthoma is a rare benign lesion that most often presents as a solitary or multiple small papular lesions on the trunk, face, limbs or external male genitalia. Only a small number of cases have been reported occurring on the vulva and clinically and histologically they may mimic and be misdiagnosed as viral warts. We report 2 cases of multiple epidermolytic acanthomas localized to the vulva. Molecular tests (in situ hybridization and polymerase chain reaction) showed no evidence of human papillomavirus infection and p16 staining was negative. We stress the need for pathologists to consider epidermolytic acanthoma in the differential diagnosis of multiple vulval lesions resembling viral warts.
Topics: Acanthoma; Diagnosis, Differential; Female; Genotype; Humans; Hyperkeratosis, Epidermolytic; Middle Aged; Papillomavirus Infections; Skin Neoplasms; Vulvar Neoplasms; Warts
PubMed: 30480645
DOI: 10.1097/PGP.0000000000000570