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Dermatopathology (Basel, Switzerland) Oct 2022Clear cell acanthoma (CCA) is classically considered a benign epidermal tumor, although rare case reports have described CCA with malignant features. Here, we present a...
Clear cell acanthoma (CCA) is classically considered a benign epidermal tumor, although rare case reports have described CCA with malignant features. Here, we present a case of a patient with a biopsy proven CCA that regrew post-biopsy and was subsequently completely excised. Histologic examination of the tumor in the excision specimen revealed malignant cytologic features that were not present in the initial biopsy. A review of the literature identified five additional cases of CCA with similar malignant cytologic features. On analysis, common histopathologic characteristics included cellular pleomorphism, increased nuclear-to-cytoplasmic ratio, prominent nucleoli, and atypical mitotic figures. We support the designation of atypical clear cell acanthoma for these entities with features of both CCA and significant cytologic atypia. As none of these cases exhibited clinically aggressive behavior, further study is warranted.
PubMed: 36278542
DOI: 10.3390/dermatopathology9040041 -
Veterinary Dermatology Dec 2022Follicular cysts and infundibular keratinizing acanthomas are common benign cutaneous lesions in dogs. Current treatment options include surgical excision under general...
Follicular cysts and infundibular keratinizing acanthomas are common benign cutaneous lesions in dogs. Current treatment options include surgical excision under general anaesthesia, cryotherapy, carbon dioxide laser and retinoids, each with potential disadvantages. We describe a conscious, minimally invasive, surgical excision procedure with high success rate and no complications in five dogs.
Topics: Animals; Dogs; Acanthoma; Cryotherapy; Dog Diseases; Follicular Cyst; Skin Neoplasms; Minimally Invasive Surgical Procedures
PubMed: 36052581
DOI: 10.1111/vde.13119 -
Journal of Cutaneous Pathology Jan 2023Epidermodysplasia verruciformis (EDV) is a rare genodermatosis that predisposes individuals to persistent infection with β-human papillomavirus (HPV) genotypes. The...
Epidermodysplasia verruciformis (EDV) is a rare genodermatosis that predisposes individuals to persistent infection with β-human papillomavirus (HPV) genotypes. The term EDV acanthoma may be applied to lesions with incidental findings of EDV-defining histopathological features without clinical signs of EDV. We report a case of HPV-14- and -21-positive EDV acanthoma arising in association with condyloma in a female patient with a history of low-grade squamous intraepithelial lesion of the cervix positive for high-risk HPV (non-16/18), chronic kidney disease, and systemic lupus erythematosus. The patient had no family or personal history of EDV, but the patient was on immunosuppressive therapy with mycophenolate mofetil and prednisone. A biopsy specimen from one of the perianal lesions revealed histopathologic changes consistent with EDV in the setting of condyloma. Molecular testing showed HPV-14 and -21, which supported the coexistence of condyloma with EDV acanthoma.
Topics: Humans; Female; Acanthoma; Human Papillomavirus Viruses; Epidermodysplasia Verruciformis; Papillomavirus Infections; Condylomata Acuminata; Papillomaviridae; Skin Neoplasms
PubMed: 36039682
DOI: 10.1111/cup.14319 -
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 -
The Australasian Journal of Dermatology Nov 2022Since large cell acanthoma (LCA) has many overlapping clinical and histopathological features with other epidermal pigmented tumours, an additional method to...
Since large cell acanthoma (LCA) has many overlapping clinical and histopathological features with other epidermal pigmented tumours, an additional method to differentiate it would be of great clinical significance. A retrospective study was performed on 33 lesions (26 patients) to identify distinct dermoscopic findings of LCA and to describe dermoscopic-histopathological correlations. The results revealed that dermoscopy significantly aids in the distinction of LCA from other epidermal tumours included in the differential diagnosis. Yellow opaque homogeneous background, brown dots, and moth-eaten border are common findings, and prominent skin markings and short white streaks are additional distinguishing features. Several important findings that are common in other diseases are rare in LCA.
Topics: Humans; Acanthoma; Dermoscopy; Skin Neoplasms; Retrospective Studies; Skin; Diagnosis, Differential
PubMed: 36005944
DOI: 10.1111/ajd.13912 -
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 -
Annals of Dermatology Jun 2022Epidermolytic acanthomas (EA) are uncommon benign tumors clinically presenting as single to multiple papules. Histologically, EA display hyperkeratosis, hypergranulosis,...
Epidermolytic acanthomas (EA) are uncommon benign tumors clinically presenting as single to multiple papules. Histologically, EA display hyperkeratosis, hypergranulosis, acanthosis, and epidermal degeneration-also known as epidermolytic hyperkeratosis (EH). EA may be misdiagnosed as condyloma both clinically and histopathologically when located on the genitalia. Thus, this diagnosis carries a significant psychological burden and must remain in the differential when initially considering genital warts. We utilize the case of a 62-year old female referred to dermatology for a 5-year history of multiple pruritic and hypopigmented vulvar papules-misdiagnosed as genital warts-to highlight the impact of differentiating EA from genital warts. This patient was initially misdiagnosed with common genital warts at her gynecologist's office and treated unsuccessfully for years. A shave biopsy was performed and histology revealed EH, consistent with EA.
PubMed: 35721331
DOI: 10.5021/ad.2022.34.3.221 -
Head and Neck Pathology Mar 2022The fifth chapter of the upcoming fifth edition of the 2022 World Health Organization Classification of Tumours of the Head and Neck titled Tumours of the oral cavity... (Review)
Review
The fifth chapter of the upcoming fifth edition of the 2022 World Health Organization Classification of Tumours of the Head and Neck titled Tumours of the oral cavity and mobile tongue, has had some modifications from the 2017 fourth edition. A new section "Non-neoplastic Lesions", introduces two new entries: necrotizing sialometaplasia and melanoacanthoma. The combined Oral potentially malignant disorders and Oral epithelial dysplasia section in the 2015 WHO has now been separated and submucous fibrosis and HPV-associated dysplasia are also discussed in separate sections. Carcinoma cuniculatum and verrucous carcinoma are described in dedicated sections, reflecting that the oral cavity is the most common location in the head and neck for both these entities which have distinct clinical and histologic features from conventional squamous cell carcinoma. This review summarizes the changes in Chapter 5 with special reference to new additions, deletions, and sections that reflect current clinical, histological, and molecular advances.
Topics: Acanthoma; Carcinoma, Verrucous; Humans; Mouth Neoplasms; Oral Submucous Fibrosis; Sialometaplasia, Necrotizing; Tongue; Tongue Neoplasms; World Health Organization
PubMed: 35312982
DOI: 10.1007/s12105-021-01402-9 -
Dermatologic Therapy May 2022Benign lichenoid keratosis is one of the most common skin lesions that develop on the faces of middle-aged women. This study aimed to find an effective treatment method...
Benign lichenoid keratosis is one of the most common skin lesions that develop on the faces of middle-aged women. This study aimed to find an effective treatment method for benign lichenoid keratosis. A total of 49 patients, who had a positive diagnosis during 2010-2018, were enrolled in the study. An Investigator's Global Assessment of the lesion was done using the 5-point visual analog scale to evaluate treatment efficacy. After excluding subjects who did not have a follow-up photograph, 38 subjects were given an Investigator's Global Assessment score. Combination therapy using laser and a topical agent was useful in the management of benign lichenoid keratosis on the face. Ablative laser was effective for immediate improvement of the lesion, whereas non-ablative laser was also useful and showed several benefits over ablative laser. Optimal treatment should be decided after considering the patient's preference, compliance with treatment regimen, and skin type.
Topics: Acanthoma; Combined Modality Therapy; Female; Humans; Keratosis, Actinic; Light; Middle Aged; Skin Neoplasms
PubMed: 35246904
DOI: 10.1111/dth.15419 -
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