Dermatopathology
Naser Tayyebi Meibodi; Yalda Nahidi; Mostafa Izanlu; Negin Davoodi; Sima Davoodi
Abstract
Syringocystadenoma papilliferum is a rare benign adnexal tumor that originates from the apocrine and eccrine glands. It mainly manifests as a solitary lesion in the head and neck; however, rarely, it may involve the trunk and limbs, typically with a linear pattern. Here, we report an extremely rare case ...
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Syringocystadenoma papilliferum is a rare benign adnexal tumor that originates from the apocrine and eccrine glands. It mainly manifests as a solitary lesion in the head and neck; however, rarely, it may involve the trunk and limbs, typically with a linear pattern. Here, we report an extremely rare case of congenital linear syringocystadenoma papilliferum on the left buttock near the anus in a 6-year-old girl. This lesion should be considered in the list of differential diagnosis of linear lesions in order to prevent complications with proper diagnosis, treatment or follow-up.
Dermatopathology
Abinaya Sundari Amirthakatesan; Sharmila Devi Chandramohan; Uma Maheshwari Gurusamy
Abstract
Background & Objective: Fetal growth restriction (FGR) is one of the leading causes of perinatal morbidity and mortality. Our study aimed to analyze the gross and histopathological changes in the placentas of growth-restricted fetuses.Methods: Placentas of fifty growth-restricted fetuses received ...
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Background & Objective: Fetal growth restriction (FGR) is one of the leading causes of perinatal morbidity and mortality. Our study aimed to analyze the gross and histopathological changes in the placentas of growth-restricted fetuses.Methods: Placentas of fifty growth-restricted fetuses received in the Department of Pathology for 3 years were studied. Clinical data including ultra-sonographic findings were obtained. The received placentas were photographed and the details were documented in a prepared template. The relevant tissues were processed, analyzed, and correlated with the clinical findings.Results: The study demonstrates distinctive gross and histological abnormalities in the placentas of growth-restricted fetuses. More than two-thirds of the placentas had shorter gestational age (preterm), seen as commonly associated with maternal co-morbidities such as oligohydramnios and pregnancy induced hypertension (PIH). The predominant gross lesions observed were the umbilical cord abnormalities, infarcts, and intervillous thrombus. Maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM) were the two common histologic findings. Characteristic placental lesions with a significant risk of recurrence identified were distal villous immaturity (DVI), villitis of unknown etiology (VUE), and massive perivillous fibrin deposition (MPVFD). The unusual placental causes included villous capillary lesions and histological chorioamnionitis.Conclusion: Although a diverse etiology can cause FGR, the severity depends on the cumulative effects of multiple placental lesions. Hence, a meticulous placental examination is crucial for the effective management of growth-restricted fetuses in the current and subsequent pregnancies.
Dermatopathology
Fatemeh Montazer; Ali Zare Dehnavi; Abbas Dehghani; Arash Maboudi; Azadeh Goodarzi
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by a DNA repair defect caused by ultraviolet light and cutaneous manifestations, including solar lentigines, xerosis, actinic damage, and cutaneous neoplasms (e.g., basal cell carcinoma, squamous cell carcinoma, and melanoma). ...
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Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by a DNA repair defect caused by ultraviolet light and cutaneous manifestations, including solar lentigines, xerosis, actinic damage, and cutaneous neoplasms (e.g., basal cell carcinoma, squamous cell carcinoma, and melanoma). Cutaneous angiosarcoma (AS) is a rare group of aggressive skin tumors that infrequently occur in patients with XP, usually involving the scalp or face. The AS has three subtypes: idiopathic, complicating lymphedema, and post-irradiation. The AS has diverse histopathological types, and the uncommon variants are clear cell, epithelioid, granular cell, pseudo lymphomatous, verrucous, and signet-ring cell variants. Although the foamy cell variant of AS is the rarest type, its diagnosis would be really challenging due to the wide variety of differential diagnoses, especially for poorly differentiated ones. Therefore, definitive diagnosis and effective management in the early stages are crucial, and immunohistochemical (IHC) tests are essential. Here we report a 50-year-old Iranian man with AS complicating XP who presented with an ulcerative erythematous and progressive plaque. Histopathologic studies revealed foamy cells and vascular markers (i.e., CD 31 and CD 34) were positive, immunohistochemically which was found unusual features. In addition,, we review previously reported cases in the literature to provide some information on the diagnosis and management of such cases.
Dermatopathology
Faezeh Taghavi; Sima Davoodi; Naser Tayyebi Meibodi; Yalda Nahidi; Mostafa Izanlu
Abstract
Nevus comedonicus (NC) is a rare developmental anomaly of the folliculosebaceous apparatus, which appears as numerous dilated papules containing firm, darkly pigmented, horny plugs. It appears shortly after birth and mostly before the age of 10; however, late-onset cases have been reported. There is ...
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Nevus comedonicus (NC) is a rare developmental anomaly of the folliculosebaceous apparatus, which appears as numerous dilated papules containing firm, darkly pigmented, horny plugs. It appears shortly after birth and mostly before the age of 10; however, late-onset cases have been reported. There is no gender or racial predilection. Moreover, NC can be a component of nevus comedonicus syndrome, a neurocutaneous disorder with skeletal, ocular, and central nervous system abnormalities. EHK properties in NC are not a common finding and are rarely seen in association with each other. This paper reports a healthy, 27-year-old young woman who has been developing numbers of asymptomatic unilateral linear skin lesions on her chest, waist, right thigh, and popliteal fossa in a unilateral linear pattern over ten years. Skin biopsy revealed dilated follicular ostia with orthokeratotic hyperkeratosis, columns of parakeratosis, cornoid flagellation, epidermolytic hyperkeratosis, and mild acanthosis on its wall.
Dermatopathology
Shramika Mahadev Naik; Swapnil Arun More; Sneha Ramdas Joshi
Abstract
Background & Objective: Leprosy is characterized by various clinicopathological forms depending on the host's body. Therefore, the correlation of histopathological findings with bacteriological index is helpful in diagnosing, classifying, and monitoring the treatment. We aimed to analyze the histomorphological ...
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Background & Objective: Leprosy is characterized by various clinicopathological forms depending on the host's body. Therefore, the correlation of histopathological findings with bacteriological index is helpful in diagnosing, classifying, and monitoring the treatment. We aimed to analyze the histomorphological correlation with the bacteriological index in different types of leprosy. Then, study the histopathological spectrum of leprosy.Methods: We carried out a histomorphological study of skin biopsies obtained from 100 new patients tested clinically in OPD (Out Patients Department) on the basis and calculation of bacteriological index on a slit-skin smear. The histomorphological correlation with the bacteriological index was to be found in different types of leprosy.Results: In the histopathological studies, 52% of the patients were diagnosed with borderline tuberculoid (BT) followed by 20% with borderline lepromatous (BL), 13% with lepromatous leprosy (LL), 8% with tuberculoid (TT), 4% with histoid Hansen's disease, and 3% with mid-borderline (BB). On the clinical and histopathological examinations, correlation was found for 80% of the cases. Considering the histopathological correlation with the bacteriological index, 63% of the cases showed good correlation which was comparable with that of other studies.Conclusion: Because of the underlying symptoms of leprosy, there is a difference between different types of leprosy and the clinical and environmental perceptions. Thus, the correlation of clinical, histopathological, and bacteriological index could be more helpful in the diagnosis of leprosy rather than considering only one parameter.
Dermatopathology
Fatemeh Sari Aslani; Akbar Safaee; Mozhgan Akbarzadeh Jahromi; Leila Karami
Abstract
Background & Objective: Acral melanoma (AM) is a common type of cutaneous melanoma that occurs in the skin of the palms, soles, and nail beds. This malignancy, like other types of cancer, has different genetic alterations. To date, despite decades of research the roles of oncogenic BRAF mutations ...
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Background & Objective: Acral melanoma (AM) is a common type of cutaneous melanoma that occurs in the skin of the palms, soles, and nail beds. This malignancy, like other types of cancer, has different genetic alterations. To date, despite decades of research the roles of oncogenic BRAF mutations in the pathogenesis of AM has not been fully clarified. The present study was designed to identify V600E mutation in patients with AM from the south of Iran. Methods: The samples were collected from the pathology lab archive of Shiraz University of Medical Sciences (2015-2020). A total of 41 patients with primary invasive AM underwent excisional biopsy or amputation were collected to evaluate BRAF V600E mutation using Polymerase Chain Reaction (PCR) and Sanger sequencing.Results: Total number of 41cases (21 male and 20 female) and age range of 34-87 years were enrolled. The histological subtypes were 24 acral lentiginous melanomas (ALM), 10 cases of nodular melanoma (NM), and 7 cases of superficial spreading melanoma (SSM). In our study, only one case (a 44-year-old male with nail bed AM and the histological subtype of acral lentigenous melanoma) showed BRAF-V600E mutation. Conclusion: These findings suggest that the population of our interest showed a very low prevalence of this mutation providing novel insights into the pathobiology of AM and its related treatment.
Dermatopathology
Nikolaos D. Goutas; Emmanouil I. Sakelliadis; Eleftheria Lakiotaki; Konstantinos D. Katsos; Kalliroi Spanou; Pinelopi Korkolopoulou; Dimitrios G. Vlachodimitropoulos
Abstract
Cardiac tumors range from benign to high grade malignancies. The incidence of cardiac involvement either by primary, or secondary tumors during autopsy is reported to be extremely low. Extranodal NK/T-cell lymphoma (ENKTL), nasal type is an unusual type of lymphoma. The skin is the second most common ...
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Cardiac tumors range from benign to high grade malignancies. The incidence of cardiac involvement either by primary, or secondary tumors during autopsy is reported to be extremely low. Extranodal NK/T-cell lymphoma (ENKTL), nasal type is an unusual type of lymphoma. The skin is the second most common site of involvement after the respiratory tract. We present a case of a 63-year-old male, who was recently diagnosed with ENKTL, nasal type, who received chemotherapy, and died without any evident cause. The corpse was referred for routine medicolegal examination. Macroscopical determination of the cause of death was not feasible and subsequent histopathological examination revealed heart infiltration by ENKTL that was found in vivo in cutaneous lesions. Similar infiltrations existed in the pancreatic tissue. To the best of our knowledge, myocardial infiltration of ENKTL, inducing severe myocardial lesions that eventually caused death, is rare, with limited cases reported in the literature.
Dermatopathology
Parvin Rajabi; Syed Mehdi Eftekhari; Azadeh Kadkhodaii; Amirhosein Kefayat
Abstract
Background and Objective: CD137 is a member of the TNF-Receptor family. TNF-alpha antagonists have therapeutic effect in active psoriasis. In this study, the relative frequency of CD137 expression was investigated in the inflammatory cells of psoriasis lesions for the first time. Methods: The specimens ...
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Background and Objective: CD137 is a member of the TNF-Receptor family. TNF-alpha antagonists have therapeutic effect in active psoriasis. In this study, the relative frequency of CD137 expression was investigated in the inflammatory cells of psoriasis lesions for the first time. Methods: The specimens were obtained from pathology department of Al-Zahra hospital from 2007 to 2016, from paraffin-embedded skin biopsies. A number of 64 psoriasis skin lesions specimens and 34 normal skin specimens were rechecked for the diagnosis. Then, the immunohistochemical staining for CD137, CD4, and CD8 was performed. Results: CD137 expression of dermal inflammatory cells in psoriasis lesion was 11.19±5.5%. Although, in normal skin biopsied, CD137 expression was observed in 1.3±3.03% of the inflammatory cells. (p =0.001). The relative frequency of the CD137 positive inflammatory cells was significantly more in epidermis versus dermis (epidermis: 31.1%±12.8, dermis 11.1%±5.5). There was no remarkable relation between the CD137 expression rate and the CD4: CD8 ratio. Conclusion: CD137 as a TNF-alpha receptor has a significant role in pathogenesis of the psoriasis lesions. Therefore, CD137 antagonists can be considered as a novel target for the treatment of incurable psoriasis patients.
Dermatopathology
Maryam Nasimi; alireza Ghanadan; Kambiz Kamyab; vahidesadat Azhari; Tahereh Yousefi
Abstract
Background & Objective: Predicting the transformation of dysplastic or congenital nevi into malignant lesions results in a significant increase in the survival of patients. Some specific gene mutations have been reported to be very helpful in this regard. Therefore, this study aimed to evaluate the ...
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Background & Objective: Predicting the transformation of dysplastic or congenital nevi into malignant lesions results in a significant increase in the survival of patients. Some specific gene mutations have been reported to be very helpful in this regard. Therefore, this study aimed to evaluate the prevalence of BRAF V600E mutation in dysplastic and congenital nevi.Methods: This cross-sectional study was conducted on patients with congenital (n=30) or dysplastic (n=30) nevi. For genomic analysis, the BRAF gene mutation (V600E) was evaluated using the real-time polymerase chain reaction.Results: The prevalence of BRAF gene (V600E) mutation was found as 1 case (3.3%) in congenital and 8 cases (26.7%) in dysplastic nevi indicating the higher prevalence of this mutation in patients with dysplastic nevi (p =0.026). Moreover, in the dysplastic nevi group, the presence of BRAF gene mutation (V600E) showed a significant relationship with the severity of dysplasia as the mutation rate was 25% in mild cases, in comparison with 54.5% in moderate dysplasia cases (p =0.009).Conclusion: According to the results, 3.3% of the patients with congenital nevi and 26.7% of the subjects with dysplastic nevi were positive for BRAF V600E mutation. Furthermore, the severity of dysplasia could have a positive relationship with the presence of the mutation.
Dermatopathology
Fatmagul Kusku; Damlanur Sakiz
Abstract
Coronavirus is a single-stranded RNA virus that causes acute respiratory syndrome and various skin lesions. In addition, ischemic acral lesions have been reported in patients with severe coronavirus disease 2019 (COVID-19) due to coagulation disorders. We here present a case with ischemic acral lesions ...
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Coronavirus is a single-stranded RNA virus that causes acute respiratory syndrome and various skin lesions. In addition, ischemic acral lesions have been reported in patients with severe coronavirus disease 2019 (COVID-19) due to coagulation disorders. We here present a case with ischemic acral lesions caused by COVID-19. The patient was 51-year old male who was hospitalized with COVID-19 pneumonia. After 28 days in the Intensive Care Unit, patient developed acroischemic lesions in the fingers and toes. In the histopathologic examination, vasculitis was observed as the infiltration of mixed-type inflammatory cells in the mid-sized muscular arteries wall. Moreover, microthrombosis was detected in small capillaries. It is clear that thrombotic lesions have occurred as a result of COVID-19 or administered treatment. Further studies are required to confirm and better characterize the skin reactions in COVID-19.
Dermatopathology
Maral Mokhtari; Farzaneh Mostanbet; Saideh Nekooee Fard; Golsa Shekarkhar; Mozhdeh Sepaskhah; Maryam Sadat Sadati
Abstract
Background & Objective: Thiopurine drugs are considered as a treatment modality in various autoimmune disorders including pemphigus vulgaris (PV). These drugs are metabolized by an enzyme “Thiopurine S-methyl transferase” (TPMT). Various variants of this enzyme may have decreased ...
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Background & Objective: Thiopurine drugs are considered as a treatment modality in various autoimmune disorders including pemphigus vulgaris (PV). These drugs are metabolized by an enzyme “Thiopurine S-methyl transferase” (TPMT). Various variants of this enzyme may have decreased activity leading to serious drug side effects. To investigate the phenotype and genotype of TPMT in PV patients receiving thiopurine drugs. Methods: 50 patients (29 women and 21 men) with pemphigus vulgaris treating with standard dose of Thiopurine drugs were selected. Sex, age, result of liver function test and complete blood count were recorded. Genotyping of two common non-functional allele (TPMT*2 and TPMT*3C) by Allele-specific and RFLP-PCR was performed. TPMT enzymatic level was determined by an ELISA based method. Results: Of patients, 36 (72%) were found to have normal TPMT level; and 12, (24%) had higher level of enzyme and 2, 4% had low TPMT enzyme, but none of the patients showed mutant TPMT*2 and TPMT*3C alleles. None of the patients showed hepatotoxicity and bone marrow suppression. Conclusion: The phenotypic assay based on ELISA method may have false positive and misleading results but genotyping using PCR-RFLP and allele specific PCR is accurate, simple and cost-effective and can be used in patients decided to undergo thiopurine treatment.
Dermatopathology
Pouri Salehi; Farzaneh Tafvizi; Kambiz Kamyab Hesari
Abstract
Background & Objective: Malignant melanoma is the fatal cutaneous neoplasm which is curable by the early diagnosis. The expression of occludin protein which is an integral membrane protein is altered in an epithelial-to-mesenchymal transition. Although, recent studies provide sufficient evidence ...
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Background & Objective: Malignant melanoma is the fatal cutaneous neoplasm which is curable by the early diagnosis. The expression of occludin protein which is an integral membrane protein is altered in an epithelial-to-mesenchymal transition. Although, recent studies provide sufficient evidence supporting the functional importance of occludin in cancer, the prognostic significance of occludin expression levels in melanoma remains obscure. The aim of this study was to determine occludin expression level and itscorrelation with clinicopathological features of the patients with melanoma. Methods: The occludin mRNA level was compared between paraffin-embedded tissues of 40 patients with melanoma and 10 subjects with normal skin. The quality and quantity of the RNA was determined and occludin expression level was measured using Real-time PCR and ∆∆CT computational technique. Result: Theoccludin mRNA level reduced five-fold in the melanoma patients compared to the control group (P=0.000). No significant difference was observed between male and female cases (P=0.533). No significant correlation was observed between occludin mRNA level, mitotic count (P=0.252), and Breslow levels (P=0.171) Conclusion: We can conclude that down-regulation of occludin expression in the patients with melanoma is a hallmark of cancer progression and it might be used as a prognostic factor. No significant correlation was found between occludin gene expression and clinicopathological characteristics including Clark level, Breslow staging, mitotic count, age and gender (P<0.05).
Dermatopathology
Simin Shamsi meymandi; Shahriar Dabiri; Alireza ZeynadiniMeymand; Maryam Iranpour; Maryam Khalili; Sorour Alijani; Mahin Aflatoonian
Abstract
Background & Objective:Basal cell carcinoma (BCC) is classified into BCC1 or low risk (nodular, superficial type) and BCC2 or high risk (micronodular, morpheaform, infiltrative, and basosquamous types) based on clinical behavior. This study attempts to evaluate immunohistochemical (IHC) findings ...
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Background & Objective:Basal cell carcinoma (BCC) is classified into BCC1 or low risk (nodular, superficial type) and BCC2 or high risk (micronodular, morpheaform, infiltrative, and basosquamous types) based on clinical behavior. This study attempts to evaluate immunohistochemical (IHC) findings and clinical features associated with local aggressiveness and recurrence in BCC lesions.Methods:This is a cross-sectional descriptive study conducted on 42 paraffin blocks (22 BCC1, 20 in BCC2) at Pathology Department of Afzalipour Teaching Hospital. First, demographic features of the patients were recorded and pathology blocks were classified by two dermatopathologists based on histopathological types of BCC1 and BCC2. Then, primary monoclonal antibodies including CD10, CD1a, SMA, Ki67, CD34, and P53 were utilized for IHC study. We compared BCC1 and BCC2 according to IHC markers, demographic features of patients, and tumoral features.Results:The mean number of Langerhans cells (LCs) within epidermis above tumor mass was 14+1.92 and 4.7±1.23 in BCC1 and BCC2, respectively; these results show a significant difference between the two groups (P=0.001). P53 was positive in 41.13±6.39% and 74.5 ±6.26% of the tumor cells in BCC1 and BCC2 groups, which was statistically significant (P=0.001). Also, the mean number of blood vessels was 14.40±1.30 and 21.40±1.97 in BCC1 and BCC2, that was statistically significant (P=0.005).Conclusion: Higher numbers of angiogenesis (SMA positive) and positive P53 were observed in BCC2 than BCC1. Also, more active positive CD1a cells were observed in BCC1 compared to BCC2.
Dermatopathology
Parvin Rajabi; Mitra Hydarpoor; Ahmadreza Maghsoudi; Fatemeh Mohaghegh; Maryam Dehghani Mobarakeh
Abstract
Background & Objective: Basal cell carcinoma (BCC) is a common skin cancer arising from the basal layer of the epidermis and its appendages. They are locally invasive, aggressive, and destructive of skin and the surrounding structures. β-Catenin is a multifunctional protein located to the ...
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Background & Objective: Basal cell carcinoma (BCC) is a common skin cancer arising from the basal layer of the epidermis and its appendages. They are locally invasive, aggressive, and destructive of skin and the surrounding structures. β-Catenin is a multifunctional protein located to the intracellular side of the cytoplasmic membrane coded by the CTNNB1 gene, which maps to chromosome 3p22.1. It has a critical role in cell-to-cell adhesion by linking cadherins to the actin cytoskeleton and has a central role in transcriptional regulation in the Wnt signaling pathway. We evaluated the diagnostic value of the Beta catenin immunohistochemistry marker in distinction of aggressive and non-aggressive Basal cell carcinoma.Methods: This cross sectional and descriptive-analytical study was done on archived formalin fixed, paraffin embedded tissue blocks in pathology library of Al-Zahra hospital in Isfahan city. We used immunochemistry to determinate the role of β-Catenin in aggressiveness in BCC with higher rate of relapse.Results: A total of 76 samples were evaluated in two groups (aggressive &none aggressive). The mean percentage of cytoplasmic β-Catenin staining in aggressive group was more significant than the other group (sensitivity: 86.8% specificity: 81.6%, PPV: 81.5% and NPV: 86.1%) and the mean percentage of membranous β-Catenin staining in non-aggressive group were significant more than the aggressive group. Intensity of membranous staining in both groups significant less than normal epithelium.Conclusion: Cytoplasmic β-Catenin staining in aggressive BCC is more significant than non-aggressive subtypes, so this indicates that the use of β-Catenin IHC marker maybe helpful in the diagnosis of aggressive BCC.
Dermatopathology
Fatemeh Sari Aslani; Mina Heidari Esfahani; Mozhdeh Sepaskhah
Volume 13, Issue 3 , July 2018, , Pages 317-324
Abstract
Background and Objective: Non-scarring alopecia is a challenge in the diagnosis and treatment, rarely studied in Asian countries. The current study aimed at evaluating histopathological features including hair count of different subtypes of non-scarring alopecia in Iranian patients.Methods: The current ...
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Background and Objective: Non-scarring alopecia is a challenge in the diagnosis and treatment, rarely studied in Asian countries. The current study aimed at evaluating histopathological features including hair count of different subtypes of non-scarring alopecia in Iranian patients.Methods: The current study was conducted on 114 cases diagnosed with non-scarring alopecia in Molecular Dermatology Research Center and Pathology Department of Shiraz University of Medical Sciences, Shiraz, Iran. Cases with two 4-mm scalp punch biopsies were selected. Patients’ clinical data were compared with histological findings.Results: Androgenetic alopecia (AGA) was the most common subtype Followed by alopecia areata (AA) and combined AGA/telogen effluvium (TE). Perifollicular inflammation was observed in 21% of AGA with a significant difference in males and females (66.7% vs. 33.3%; P-value <0.05). Clinical and histopathologic diagnoses were correlated in 55% of cases. Maximum correlation was observed in combined AGA and chronic TE (88%). For vertical sections, the diagnostic rate was 33.6%, while 88% for transverse sections.Conclusion: Transverse together with vertical sectioning provides most of the information in non-scarring alopecias, while transverse sectioning is enough to diagnose the majority of non-scarring alopecias. Perifollicular inflammation was observed in a significant number of cases with AGA, more common in males. It is suggested to report such cases as possibly curable.
Dermatopathology
Soheila Nasiri; Zahra Asadi- kani; Fatemeh Nabavi; Marjan Saeedi
Volume 13, Issue 3 , July 2018, , Pages 377-378
Abstract
Dear Editor-in-ChiefMalignant melanoma is a tumor arising from melanocyte; this tumor rarely occurs before puberty, with higher mortality rate in males and better survival rate in female patients affected by metastatic melanoma (1, 2). These facts propose that a relationship and association may exist ...
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Dear Editor-in-ChiefMalignant melanoma is a tumor arising from melanocyte; this tumor rarely occurs before puberty, with higher mortality rate in males and better survival rate in female patients affected by metastatic melanoma (1, 2). These facts propose that a relationship and association may exist between estrogens and melanoma. The effects of estrogens are mediated by estrogen receptor alpha and beta (3) that are members of the nuclear hormone receptor family. Estrogen receptors act by ligand-dependent binding to the estrogen-response element, leading to transcriptional regulation of target genes (4). Although these receptors have a high degree of homology in the DNA-binding domain, they are different in their N-terminal and ligand-binding domain (E-domain) (5). Moreover; the effects of these two receptors are also different, while estrogen receptor alpha is associated with stimulation of growth. Estrogen receptor beta (ERbeta) is associated with suppression of stimulation or inhibition of cells from multiplying (2). A number of reports show either a decreased expression of ERbeta messenger RNA and ERbeta protein or an increased estrogen receptor alpha/beta mRNA ratio in tumor versus normal tissue in several cancers such as breast, ovary, colon, and prostate (6, 7). As the expression of ERbeta in melanocytic lesions is controversial and finding new diagnostic methods to differentiate between benign and malignant melanocytic lesions is essential, the current study was conducted using immunohistochemical staining to characterize the expression of ERbeta in dysplastic nevi and melanoma. The expression of ERbeta was investigated in 10 patients with melanoma (five male and five female) and 10 patients with dysplastic nevi (seven male and three female) at the Department of Dermatology, Shahid Beheshti University of Medical Science, Tehran, Iran. All cases underwent immunohistochemical analysis according to the method described by de Giorgi et al. (2, 8). Only one of the patients with melanoma had ERbeta expression of grade III and the other nine patients had grade I, but all the dysplastic nevi had grade III staining. Comparison of melanocytes staining levels in the two mentioned groups with the Mann-Whitney U-test revealed a significant difference between estrogen receptor beta staining samples (P-value=0.0002). Results of the current study suggested a probable role for estrogen receptors in melanoma; in addition, it proposed ERbeta as a valuable diagnostic marker to differentiate between benign and malignant melanocytic lesions; however, according to the relatively small number of patients, further comprehensive studies should be conducted to confirm the current studyresults.
Dermatopathology
Ruchita Tyagi; Dilpreet Kaur; Gursheen Kaur; Bhavna Garg; Neena Sood; Sunil Gupta
Abstract
Basal cell carcinoma (BCC) commonly affects the elderly and is mostly confined to the head and neck region. Only 10% of all cases occur on the trunk. We presented a case of bullous lesion on the abdomen in a young male, initially diagnosed by clinicians as a vascular nevus. Histopathological examination ...
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Basal cell carcinoma (BCC) commonly affects the elderly and is mostly confined to the head and neck region. Only 10% of all cases occur on the trunk. We presented a case of bullous lesion on the abdomen in a young male, initially diagnosed by clinicians as a vascular nevus. Histopathological examination and immunohistochemistry (IHC) revealed it to be Nodular cystic variant of BCC. This rare variant of BCC morphologically resembles benign skin adnexal tumor of Eccrine syringofibroadenoma. Ber Ep4 positivity on IHC established the correct diagnosis. This case highlights that nodular cystic variant of BCC can be a diagnostic dilemma for clinicians and pathologists.
Dermatopathology
Nayere Askari; Tooba Ghazanfari; Mohammad Mehdi Naghizadeh; Athar Moin; Ali Khamesipour; Shahryar Pourfarzam; Zuhair Mohammad Hassan
Abstract
Background & objective: Pruritus is the most frequent chronic dermal complication of sulfur mustard (SM), which negatively influences the quality of life. Exact pathophysiology of SM-induced itching is unknown. The current study aimed at evaluating the possible association between SM-induced ...
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Background & objective: Pruritus is the most frequent chronic dermal complication of sulfur mustard (SM), which negatively influences the quality of life. Exact pathophysiology of SM-induced itching is unknown. The current study aimed at evaluating the possible association between SM-induced itching and the serum levels of matrix metalloproteinase (MMP)-9 and their endogenous inhibitors, and serum levels of soluble forms of selectins (sL-, sP-, and sE-selectins) as adhesion molecules involved in the development of different inflammatory reactions. Methods: Serum levels of MMP-9, MMP-9/ tissue inhibitors of metalloproteinases (TIMPs), and selectins were measured by the enzyme-linked immunosorbent assay (ELISA), and compared between the groups (n=368) with and without itching, and matched control groups (n=126). Results: Serum levels of MMP-9 were significantly higher in the SM exposed group with itching, compared with that of the group without itching (medians: 894 and 624 pg/mL respectively; P-value =0.034). There was no relationship between the serum levels of MMP-9/TIMP-1, MMP-9/TIMP-2, MMP-9/TIMP-4, and itching in the patients exposed to SM. Median serum levels of sE- and sL-selectins in the exposed group with itching were higher than those of the exposed group without itching. These differences were statistically insignificant (P-values =0.084 and 0.095, respectively). Conclusion: According to the results of the current study, the increased serum levels of MMP-9 and selectins 20 years after exposure may play role in the pathogenesis and persistence of SM-induced itching in the exposed individuals.
Dermatopathology
Farahnaz Bidari Zerehpoosh; Soheila Nasiri; Sara Zahedifard; Shahram Sabeti
Abstract
Background:Non-Melanoma Skin Cancer (NMSC), the most prevalent types being Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC), is the most common type of malignancy in human beings. These neoplasms are more frequent in the elderly and fair skinned people and mainly occur on sun-exposed sites ...
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Background:Non-Melanoma Skin Cancer (NMSC), the most prevalent types being Squamous Cell Carcinoma (SCC) and Basal Cell Carcinoma (BCC), is the most common type of malignancy in human beings. These neoplasms are more frequent in the elderly and fair skinned people and mainly occur on sun-exposed sites of the body. Ultraviolet B (UVB) has a well-known effect in induction and promotion of growth of these cancers. The p53 tumor suppressor gene is believed to be an early target in UV-induced skin carcinogenesis. Aggregates of keratinocytes with p53 protein overexpression are frequently identified in normal human skin and are more prevalent in chronically sun-exposed skin, and have been proposed to play a role in skin cancer pathogenesis. The aim of this study was to clarify the potential role of P53 in the development of NMSC. Methods: Immunohistochemical evaluation of p53 expression in peri-lesional skin of 90 cases of SCC, BCC and melanocytic nevi was performed. Results: The well-delineated compact type of p53 clone, but not the strong dispersed type, was significantly more predominant in SCCs in comparison with BCCs and melanocytic nevi (P value=0.001). The size of p53 clones was also significantly greater in SCCs compared to the BCCs (P=0.003) and melanocytic nevi (P=0.001). There was no significant difference between these neoplasms regarding the frequency of P53 clones (P=0.86). Conclusion: This study suggests the possible relationship of epidermal p53 clones with the pathogenesis of SCC.
Dermatopathology
Antonio An Tung Chuh; Vijay Zawar; Gayatri Karad
Volume 11, Issue 4 , October 2016, , Pages 416-417
Abstract
Dear Editor-in-Chief Lesional histopathological features in pityriasis rosea (PR) are non-specific (1). Our aim here is to investigate whether a histopathological take-off sign (TOS) is associated with PR.
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Dear Editor-in-Chief Lesional histopathological features in pityriasis rosea (PR) are non-specific (1). Our aim here is to investigate whether a histopathological take-off sign (TOS) is associated with PR.
Dermatopathology
Srabani Chakrabarti; Subrata Pal; Biplab Biswas; Kingshuk Bose; Saswati Pal; Swapan Pathak
Volume 11, Issue 1 , January 2016, , Pages 54-60
Abstract
Background: Granulomatous dermatoses are common skin pathology, often need histopathological confirmation for diagnosis. Histologically six sub-types of granulomas found in granulomatous skin diseases- tuberculoid, sarcoidal, necrobiotic, suppurative, foreign body & histoid type. The aims of the ...
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Background: Granulomatous dermatoses are common skin pathology, often need histopathological confirmation for diagnosis. Histologically six sub-types of granulomas found in granulomatous skin diseases- tuberculoid, sarcoidal, necrobiotic, suppurative, foreign body & histoid type. The aims of the present study were clinico-pathological evaluation of granulomatous skin lesions and their etiological classification based on histopathological examination. Methods: It was a five years (Jan 2009- Dec 2013) retrospective study involving all the skin biopsies. Detailed clinical and histopathological features were analyzed and granulomatous skin lesions were categorized according to type of granuloma & etiology. Special stains were used in few cases for diagnostic purpose. Results: Among 1280 skin biopsies, 186 cases (14.53%) were granulomatous skin lesions with a ratio 1:24. In histopathological sub-typing, tuberculoid granuloma was most common type (126 cases, 67.74%). Most common etiology of granuloma in the study was leprosy (107 cases, 57.52%). Other etiologies were cutaneous tuberculosis, foreign body granulomas, fungal lesions, cutaneous leishmaniasis, sarcoidosis and granuloma annulare. Conclusion: Histopathology is established as gold standard investigation for diagnosis, categorization and clinico-pathological correlation of granulomatous skin lesions.