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Dermatologie (Heidelberg, Germany) Apr 2023
Topics: Humans; Pseudolymphoma; Borrelia
PubMed: 36977839
DOI: 10.1007/s00105-023-05133-6 -
Alpha Psychiatry Jan 2023
PubMed: 36879993
DOI: 10.5152/alphapsychiatry.2023.221037 -
Acta Dermatovenerologica Croatica : ADC Nov 2022Dear Editor, Pilonidal cyst disease is a common, acquired, inflammatory disease predominantly affecting the natal clefts of the buttocks (1,2). The disease has a...
Dear Editor, Pilonidal cyst disease is a common, acquired, inflammatory disease predominantly affecting the natal clefts of the buttocks (1,2). The disease has a predilection for men, with a male-to-female ratio of 3-4:1. Patients are generally young, towards the end of second decade of life. Lesions are initially asymptomatic, while the development of complications such as abscess formation is associated with pain and discharge (1). Patients with pilonidal cyst disease may present to dermatology outpatient clinics, especially when the disease is asymptomatic. Herein we report the dermoscopic features of four cases of pilonidal cyst disease encountered in our dermatology outpatient clinic. Four patients who presented to our dermatology outpatient department for evaluation of a solitary lesion on buttocks were diagnosed with pilonidal cyst disease based on clinical and histopathological examination. All patients were young men and presented with solitary, firm, pink, nodular lesions in the region in proximity to the gluteal cleft (Figure 1, a, c, e). Dermoscopy of the first patient revealed a red structureless area in the central part of the lesion, consistent with ulceration. Additionally, white lines reticular as well as glomerular vessels were present at the periphery on the pink homogenous background (Figure 1, b). In the second patient, a yellow structureless central ulcerated area was surrounded by linearly arranged multiple dotted vessels at the periphery on a homogenous pink background (Figure 1, d). In the third patient, dermoscopy revealed a central yellowish structureless area with peripherally arranged hairpin and glomerular vessels (Figure 1, f). Lastly, similar to the third case, dermoscopic examination of the fourth patient showed a pink homogenous background with yellow and white structureless areas and peripherally arranged hairpin and glomerular vessels (Figure 2). Demographics and clinical features of the four patients are summarized in Table 1. Histopathology of all our cases revealed epidermal invagination and sinus formation, free hair shafts, and chronic inflammation with multinuclear giant cells. Histopathological slides of the first case can be seen in Figure 3 (a-b). All patients were referred to general surgery for treatment. The current knowledge pertaining to dermoscopy of pilonidal cyst disease is scarce in the dermatologic literature, and was previously evaluated in only two cases. Similar to our cases, the authors reported the presence of a pink-colored background, radial white lines, central ulceration, and multiple peripherally arranged dotted vessels (3). The dermoscopic features of pilonidal cysts differ from other epithelial cysts and sinuses. As for epidermal cysts, the presence of punctum and an ivory-white background color have been reported as characteristic dermoscopic findings (4,5). In addition, unruptured epidermal cysts reveal arborizing telangiectasia, while the ruptured epidermal cysts show peripheral linear branched vessels (4,5). A peripheral brown rim, linear vessels, and yellow homogenous background of the entire lesion have been reported as dermoscopic features of steatocystoma multiplex as well as milias (5). Of note, other cystic lesions mentioned above are typified by linear vessels, whereas pilonidal cysts present dotted, glomerular, and hairpin vessels. Pilonidal cyst disease must also be considered in the differential diagnosis of pink nodular lesions, along with amelanotic melanoma, basal cell carcinoma, squamous cell carcinoma, pyogenic granuloma, lymphoma, and pseudolymphoma (3). Based on our cases and the two cases in the literature, pink background, central ulceration, peripherally arranged dotted vessels, and white lines seem to be common dermoscopic features of pilonidal cyst disease. Our observations demonstrate that central yellowish structureless areas along with peripheral hairpin and glomerular vessels are also among the dermoscopic features of pilonidal cyst disease. In conclusion, pilonidal cysts can be easily differentiated from other skin tumors by the aforementioned dermoscopic features, and the diagnosis in patients clinically suspected of having pilonidal cyst can be supported by dermoscopy. However, there is need for further studies in order to better characterize typical dermoscopic features of this disease and their frequency.
Topics: Humans; Male; Female; Pilonidal Sinus; Epidermal Cyst; Dermoscopy; Skin Neoplasms; Skin Diseases
PubMed: 36812282
DOI: No ID Found -
The American Journal of Dermatopathology Apr 2023Primary cutaneous marginal zone lymphoma (PCMZL) is a low-grade malignant B-cell lymphoma that originates from the skin. It often presents as erythematous solitary or...
Primary cutaneous marginal zone lymphoma (PCMZL) is a low-grade malignant B-cell lymphoma that originates from the skin. It often presents as erythematous solitary or multiple papules, nodules, and/or plaques. It is one of the 3 main subtypes of primary cutaneous B-cell lymphomas. PCMZLs are believed to develop from chronic antigenic stimulation such as from tick-borne bacteria, vaccines, tattoo pigment, or other foreign body. In addition, cutaneous lymphoid hyperplasia, a documented precursor to malignant PCMZL, often presents in response to areas of chronic inflammation. Cutaneous lymphoid hyperplasia and PCMZL share several clinical and histological similarities that require clinicopathologic suspicion, immunohistochemical ancillary studies, and histopathologic analysis to accurately differentiate the 2 entities. Although gene rearrangement studies have historically been of limited value in the diagnosis of PCMZL, recent studies investigating molecular markers have identified the presence of multiple genetic abnormalities that have helped to better characterize the disease and aid in diagnosis. In addition, newer studies have found associations between PCMZL and gastrointestinal disorders, including Helicobacter pylori and inflammatory bowel disorders. In this article, we describe a case of a 56-year-old patient with a history of ulcerative colitis presenting with chronic reactive lymphoid hyperplasia that transformed to primary cutaneous marginal zone lymphoma.
Topics: Humans; Middle Aged; Pseudolymphoma; Skin Neoplasms; Hyperplasia; Lymphoma; Lymphoma, B-Cell; Lymphoma, B-Cell, Marginal Zone
PubMed: 36806052
DOI: 10.1097/DAD.0000000000002399 -
RoFo : Fortschritte Auf Dem Gebiete Der... May 2023
Topics: Humans; Pseudolymphoma; Diagnosis, Differential; Hypothalamus, Posterior; Neoplasms
PubMed: 36791770
DOI: 10.1055/a-1997-9041 -
Skin Health and Disease Feb 2023
PubMed: 36751317
DOI: 10.1002/ski2.135 -
Contact Dermatitis May 2023
Topics: Humans; Dermatitis, Allergic Contact; Pseudolymphoma
PubMed: 36718054
DOI: 10.1111/cod.14285 -
Pharmaceutics Dec 2022Topical photodynamic therapy (PDT) is a non-invasive treatment modality frequently used in dermatology to treat superficial skin cancers but also some inflammatory or... (Review)
Review
Topical photodynamic therapy (PDT) is a non-invasive treatment modality frequently used in dermatology to treat superficial skin cancers but also some inflammatory or infectious dermatoses. PDT appears a more and more promising therapeutic option also for cutaneous lymphomas, either of T- or B-cell origin. It is a well-tolerated treatment and has excellent cosmetic outcomes, less side effects compared to other therapies (steroids, surgery, radiotherapy, and so on), no particular contraindications, and is easily repeatable in case of relapses. However, how PDT works in the treatment of cutaneous lymphoproliferative diseases is poorly understood and the literature data are still controversial. Further randomized, controlled clinical trials involving a greater number of patients and centers with a long follow-up are necessary to assess the efficacy of PDT and establish a unique standardized treatment protocol in relation to the lymphomatous disease and the type, thickness, and location of the lesions.
PubMed: 36678676
DOI: 10.3390/pharmaceutics15010047 -
Medicine Dec 2022The diagnosis of lymphoma in routine diagnostics can be challenging due to clinical, morphological and immunphenotypical overlap with unusual reactive processes termed...
RATIONALE
The diagnosis of lymphoma in routine diagnostics can be challenging due to clinical, morphological and immunphenotypical overlap with unusual reactive processes termed "pseudolymphomas."
PATIENT CONCERNS
45-year-old male that underwent surgical debridement for a necrotizing fasciitis of the thigh with concomitant excision of a regional lymph node.
DIAGNOSES
The lymph node demonstrated an architecture-effacing activation and proliferation of lymphoblasts and was initially misdiagnosed as an aggressive lymphoma. Only in consideration of the clinical context and with the help of additional immunohistochemical and molecular analyses the final diagnosis of a reactive lymphadenopathy could be made.
INTERVENTIONS
No further therapy was required after the final diagnosis of a reactive lymphadenopathy was made.
OUTCOMES
The clinical follow-up was unremarkable, with no evidence of residual disease after 6 months.
LESSONS
This case report adds the parafollicular activation and proliferation of blasts and plasmablasts in the drainage area of an active infection to the spectrum of "pseudolymphomas" and reiterizes the importance of placing histopathological findings in the proper context.
Topics: Male; Humans; Middle Aged; Fasciitis, Necrotizing; Pseudolymphoma; Lymphoma; Drainage; Debridement; Lymphadenopathy
PubMed: 36595811
DOI: 10.1097/MD.0000000000032457 -
JAAD Case Reports Jan 2023
PubMed: 36583144
DOI: 10.1016/j.jdcr.2022.11.020