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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 -
European Journal of Dermatology : EJD Aug 2021
PubMed: 34405809
DOI: 10.1684/ejd.2021.4088 -
Skin Appendage Disorders Jun 2021
PubMed: 34307486
DOI: 10.1159/000516306 -
The American Journal of Dermatopathology Jan 2022Histopathologically both hidroacanthoma simplex (HS) and clonal seborrheic keratosis (CSK) are characterized by intraepidermal nests of tumor cells. Although they show... (Comparative Study)
Comparative Study
Histopathologically both hidroacanthoma simplex (HS) and clonal seborrheic keratosis (CSK) are characterized by intraepidermal nests of tumor cells. Although they show subtle microscopic differences, they can be difficult to accurately differentiate. Previous immunohistochemical studies have been inconclusive. We conducted an immunohistochemical study with GATA3 and p63 on cases of HS and CSK tentatively identified by their microscopic appearances and cases of eccrine poroma and seborrheic keratosis as their respective controls. The clinical, histopathological, and dermoscopic findings of these cases were also reviewed. All cases of HS and poroma were negative for GATA3, whereas all cases of CSK and seborrheic keratosis were positive for GATA3. HS, CSK, and their controls were all positive for p63. Microscopic, clinical, and dermoscopic differences were also found between HS and CSK. Our study demonstrated that GATA3 is useful for differentiating HS from CSK. Our initial microscopic observations also proved to be reliable, but immunostaining with GATA3 is helpful for confirming the diagnosis or establishing the diagnosis of uncertain cases. Awareness of the clinical and dermoscopic features of these 2 entities could also avoid misdiagnosis based solely on pathological observation.
Topics: Acanthoma; Adult; Aged; Female; GATA3 Transcription Factor; Humans; Keratosis, Seborrheic; Male; Middle Aged; Skin Neoplasms; Sweat Gland Neoplasms; Transcription Factors; Tumor Suppressor Proteins
PubMed: 34132661
DOI: 10.1097/DAD.0000000000001998 -
Annals of Dermatology Jun 2021Clear cell acanthoma (CCA) is an uncommon, benign epithelial tumor presenting as a well-defined, slow-growing solitary nodule. The diagnosis of CCA is usually based on...
Clear cell acanthoma (CCA) is an uncommon, benign epithelial tumor presenting as a well-defined, slow-growing solitary nodule. The diagnosis of CCA is usually based on clinical and histopathological evaluation of the tumor. However, when such type of benign tumor occurs on an exposed area, a biopsy is not always the best diagnostic option since it may leave scar. The recent advent of dermoscopy has offered an accurate and non-invasive method to diagnose CCA without resorting to skin biopsy. A 40-year-old male presented with a shiny, erythematous-to-brown, flattened nodule on the left cheek. Dermoscopic examination revealed a 'string of pearls' vascular pattern, a characteristic dermoscopic feature of CCA. Under the clinical and dermoscopic impression of CCA, a 595 nm pulsed dye laser (PDL) therapy targeting the vascular tissue in the superficial dermis of the lesion was chosen for a minimally invasive treatment. After repeated sessions of PDL, an optimal cosmetic outcome was achieved and no recurrence was recorded during the follow-up period. Herein, we report a case of presumed CCA which was successfully diagnosed and treated by utilizing non-invasive modalities.
PubMed: 34079188
DOI: 10.5021/ad.2021.33.3.275 -
Italian Journal of Dermatology and... Aug 2022
Topics: Acanthoma; Humans; Hyperplasia; Papilloma; Sebaceous Gland Diseases; Skin Neoplasms
PubMed: 34044515
DOI: 10.23736/S2784-8671.21.07032-8 -
Anais Brasileiros de Dermatologia 2021
Topics: Acanthoma; Dermoscopy; Humans; Skin Neoplasms
PubMed: 34006397
DOI: 10.1016/j.abd.2020.06.027 -
The American Journal of Dermatopathology Dec 2021Various acanthomas have been named based on their distinctive histopathologic patterns. Hypergranulotic dyskeratotic acanthoma represents another acanthoma with a...
Various acanthomas have been named based on their distinctive histopathologic patterns. Hypergranulotic dyskeratotic acanthoma represents another acanthoma with a distinctive histopathologic pattern that has been rarely reported. In this article, clinical and histological features of hypergranulotic dyskeratotic acanthoma are delineated. A retrospective analysis was performed of cases with diagnosis or suggested diagnosis of hypergranulotic dyskeratotic acanthoma between 2012 and 2017 from 2 dermatopathology laboratories. Forty-eight potentials were identified, of which 18 cases met the inclusion histologic criteria. Most cases came from women (78%) with a mean age of 53 years, and the thigh was the most common site involved. All cases had the following histopathological findings: (1) verrucous or digitated epidermal hyperplasia, (2) hyperkeratosis dominated by basketweave or compact orthokeratosis, (3) hypergranulosis involving the breadth of the lesion, and (4) presence of enlarged, often indistinctly bordered, keratinocytes with cytoplasm characterized by a blue-gray granular peripheral zone sometimes showing outstretched desmosomes and central perinuclear eosinophilic zones, a combination of findings representing slowly evolving dyskeratosis. Retrospective nature and a small sample size are the major limitations of the study. In sum, hypergranulotic dyskeratotic acanthoma can be easily distinguished from other acanthomas based on their repeatable histopathological findings.
Topics: Acanthoma; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Retrospective Studies; Skin Neoplasms
PubMed: 33958516
DOI: 10.1097/DAD.0000000000001966 -
Dermatology (Basel, Switzerland) 2022Optical coherence tomography (OCT) has been shown to provide non-invasive diagnosis of common skin neoplasms, especially basal cell carcinoma. OCT produces a... (Comparative Study)
Comparative Study
BACKGROUND
Optical coherence tomography (OCT) has been shown to provide non-invasive diagnosis of common skin neoplasms, especially basal cell carcinoma. OCT produces a cross-sectional view of the tissue, similar to a traditionally sectioned histopathological view, but the resolution of conventional OCT is low and thus limits clinical application.
OBJECTIVES
This study aimed to investigate the application ability of a full-field (FF)OCT system which was newly developed to scan the skin at the cellular level.
METHODS
Patients with skin tumours or inflammatory lesions warranting biopsy were consecutively enrolled. All lesions underwent clinical, dermoscopic, and OCT assessment, followed by routine biopsy. The adjacent normal skin was scanned for comparison. OCT images were interpreted (blinded to the biopsy results) and then compared with the histopathological diagnosis.
RESULTS
A total of 111 patients with 115 lesions completed the protocol, including 80 skin tumours, 28 inflammatory diseases, and 7 other diseases. Of the OCT images, 43.5% were of good quality and show expected features. Identifiable features of actinic keratosis, Bowen's disease, basal cell carcinoma, extramammary Paget's disease, seborrheic keratosis, large cell acanthoma, bullous pemphigoid, interface dermatitis, lichenoid tissue reaction, and psoriasis were demonstrated. Lesions are located deeply, and so some features were out of the field of view, accounting for 40.0% (46/115).
CONCLUSIONS
This study expanded the ability of FFOCT for the clinical diagnosis of various skin conditions. This new optical technique can clearly visualise skin lesions located in the epidermis and upper dermis. It provided an effective way to perform digital skin biopsy in superficial skin diseases.
Topics: Adult; Carcinoma, Basal Cell; Dermatitis; Dermis; Diagnosis, Differential; Epidermis; Female; Humans; Male; Middle Aged; Pilot Projects; Reproducibility of Results; Skin; Skin Neoplasms; Tomography, Optical Coherence
PubMed: 33946063
DOI: 10.1159/000514686 -
JAAD Case Reports May 2021
PubMed: 33912638
DOI: 10.1016/j.jdcr.2021.03.018