MyMedR

Fulltext Images in clinical medicine. Nevus comedonicus

Bhullar A, Shamsudin N

N Engl J Med, 2015 Jun 25;372(26):2541.

PMID: 26107054 DOI: 10.1056/NEJMicm1406555

Matched MeSH terms: Skin Neoplasms/pathology*

Fulltext Acral melanoma of the extremities: a study of 33 cases Sarawakian patients

Zainal AI, Zulkarnaen M, Norlida DK, Syed Alwi SA

Med J Malaysia, 2012 Feb;67(1):60-5.

PMID: 22582550

Acral melanoma involve the non-pigmented palmoplantar and subungual areas and are commonly seen among Asians. Patients commonly display advanced stage of disease at presentation. It may appear unnoticed and mimic benign lesions.

Matched MeSH terms: Skin Neoplasms/pathology*

Congenital papulonodular eruption: presenting sign of congenital leukaemia cutis

Nanda A, El-Kamel MF, Al-Oneizi EM, Al-Ajmi M, Al-Enezi EM, Madda JP

Clin Exp Dermatol, 2012 Jul;37(5):509-11.

PMID: 22712859 DOI: 10.1111/j.1365-2230.2011.04270.x

Congenital leukaemia (CL) is a rare malignancy that accounts for < 1% of cases of childhood leukaemias. Leukaemia cutis (LC) refers to cutaneous infiltration with leukaemic cells, and is seen in 30-50% of CL cases. It may precede, follow or occur simultaneously with leukaemia. If left untreated, the prognosis is usually poor, but early diagnosis and treatment may result in a favourable prognosis. We report a case of congenital leukaemia cutis with a progressive, violaceous papulonodular eruption (a 'blueberry muffin' rash), which had been noted at birth, as a presenting sign of acute myeloid leukaemia (AML), which on investigation was classified as AML, FAB M2 type with a t(8; 21)(p11;q22) chromosomal defect. The patient had a favourable response to AML chemotherapy.

Matched MeSH terms: Skin Neoplasms/pathology

Fulltext Cyclin D1 expression in acral melanoma: a case control study in Sarawak

Ibrahim ZA, Narihan MZ, Ojep DN, Soosay AE, Pan KL

Malays J Pathol, 2012 Dec;34(2):89-95.

PMID: 23424770 MyJurnal

Acral melanoma has been reported to have distinctive clinical presentation and ethnic distribution compared to other histological types of malignant melanoma. Acral melanoma also exhibits distinctive focused gene amplifications, including cyclin D1 overexpression. We reviewed archived histological material of malignant melanoma in the Sarawak General Hospital from year 2004 to 2010. 43 tumours, comprising 28 acral melanoma and 15 non-acral melanoma, had sufficient material to be included in the study. The majority (36%) of acral melanoma tumours occurred in the heel. The tumours were analyzed for cyclin D1 expression by immunohistochemistry. 68% of acral melanoma were cyclin D1 positive compared to a positivity of 33% in non-acral tumours. This difference was statistically significant (p < 0.05). This finding may improve the histological diagnosis of acral melanoma and detection of positive resection margins.

Matched MeSH terms: Skin Neoplasms/pathology*

Fulltext Pilomatrixoma (calcifying epithelioma) in Sarawak

Kothare SN

Singapore Med J, 1981 Apr;22(2):96-8.

PMID: 7268457

This is a report of 9 cases of Pilomatrixoma (Calcifying Epithelioma) recorded in 188 benign tumours of the skin and adnexa in Sarawak during 1976 and 1977, with an incidence of 4.7 per cent. Out of the seven Chinese patients four were females. One more female was a Kayan and the race of another female patient was not recorded. Except one, all were below the age of 20 years; the youngest being only 6 months old. In one lesion ossification was also detected.

Matched MeSH terms: Skin Neoplasms/pathology

Clear cell variant of calcifying epithelial odontogenic tumor without calcification: a rarity

Mutalik VS, Nichat P, Carnelio S, Solomon M, Radhakrishnan R

J Contemp Dent Pract, 2014 Jan 1;15(1):119-21.

PMID: 24939279

Calcifying epithelial odontogenic tumor (CEOT) is a rare, benign, locally aggressive odontogenic epithelial tumor that affects the jaws. Although there are numerous reports on the variants of CEOT, occurrence of clear cells with complete absence of calcification has been a rarity. Histochemical analysis of tumor cells revealed glycogen granules with PAS staining, with absence of CD 1a staining in clear cells, while the amyloid-like deposit associated with clear cells showed green birefringence with Congo red. We report an unusual variant of CEOT occurring in a 27 years old male patient.

Matched MeSH terms: Skin Neoplasms/pathology

Fulltext Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization

Geok Chin T, Masir N, Noor Hussin H, Mohd Sidik S, Boon Cheok L, Yean T

Malays J Pathol, 2011 Jun;33(1):47-51.

PMID: 21874752 MyJurnal

Myeloid sarcoma (MS) is a rare extramedullary myeloid tumour. It has been reported in various sites, including lymph node, bone, skin, soft tissue, various organs and the CNS. It may precede or occur concurrently with acute myeloid leukemia. Urinary bladder involvement is extremely uncommon. We report a 70-year-old female who had MS of the urinary bladder, presented with frank and persistent hematuria associated with lower abdominal pain. She subsequently had tumour seeding in the abdominal skin via percutaneous suprapubic catheter. Tumours from both the urinary bladder and skin showed immature cells that were immunoreactive toward LCA (focal), MPO (strong), CD99 (weak) and CD117 (weak). Summary of cases in the literature is presented. The potential of its misdiagnosis and the useful markers for the diagnosis of MS are discussed.

Matched MeSH terms: Skin Neoplasms/pathology

Management of a cutaneous squamous cell carcinoma in an American flamingo (Phoenicopterus ruber)

Abu J, Wünschmann A, Redig PT, Feeney D

J. Avian Med. Surg., 2009 Mar;23(1):44-8.

PMID: 19530406

A 32-year-old female American flamingo (Phoenicopterus ruber) was presented with a squamous cell carcinoma of the middle digit of the right foot. No clinical, hematologic, or radiologic evidence of metastasis was present. Salvage amputation of the digit resulted in complete cure, whereas previous electrosurgery and radiation therapy were unsuccessful. Three years later, another squamous cell carcinoma was diagnosed in the middle digit of the left foot. The digit was also amputated. Seven months after the second amputation, the bird did not have any recurrence or signs of metastasis.

Matched MeSH terms: Skin Neoplasms/pathology

Pilomatrixoma as a diagnostic pitfall in fine needle aspiration cytology: a case report

Sivakumar S

Acta Cytol., 2007 Jul-Aug;51(4):583-5.

PMID: 17718128 DOI: 10.1159/000325801

BACKGROUND: Pilomatrixoma (pilomatrixoma, calcifying epithelioma of Malherbe) is a relatively uncommon, benign neoplasm arising from the skin adnexa. The tumor can cause diagnostic difficulty not only for the clinician but also for the cytologist.

CASE: A 62-year-old woman presented with a right submandibular swelling of 4 months' duration. The clinical findings were highly suspicious for malignancy. A fine needle aspiration biopsy was performed. Three preliminary differential diagnoses were offered: mucoepidermoid carcinoma of the submandibular salivary gland, squamous cell carcinomatous deposit in a submandibular lymph node and calcifying odontogenic tumor. Computed tomography demonstrated no bony lesion. No primary site of squamous cell carcinoma could be identified. An excisional biopsy of the swelling was performed, and the histologic diagnosis of pilomatrixoma was made.

CONCLUSION: The cytologic presentation of pilomatrixoma of the right submandibular region can masquerade as that of a malignant tumor, in this case mucoepidermoid carcinoma, squamous cell carcinoma or odontogenic tumor. This case delineates the cytomorphologic features of pilomatrixoma that may mimic carcinoma.

Matched MeSH terms: Skin Neoplasms/pathology*

Extramammary Paget's disease: a report of 2 cases and a review of the literature

Khoo JJ, Choon SE

Malays J Pathol, 2003 Jun;25(1):73-8.

PMID: 16196382

Extramammary Paget's disease (EMPD) is a rare disorder and may be found in the vulva, scrotum, penile area, perianal region and the groin. Frequently, it is associated with an underlying regional neoplasm or internal malignancy. We report 2 cases of EMPD; one involving the scrotal area and the other the vulva. Both were elderly patients who presented to the dermatologists with chronic eczematous lesions in the perineum that did not respond to topical treatment. Skin biopsies confirmed extramammary Paget's disease. Investigations for internal malignancies were negative. However, one of the patients defaulted treatment before surgery. The other patient had two excision surgeries with skin grafting to try to achieve tumour free margins. A long term follow-up was planned for him to look for recurrences. These cases emphasise that EMPD can mimic exudative dermatitis and present as a chronic non-healing lesion in the perineum for many years. Clinicians should have a high index of suspicion to pick up the disease early by biopsy. Various immunohistochemical markers not only can help differentiate other histological diagnoses but also help predict the presence of underlying malignancies. Management of EMPD included thorough search for occult or underlying malignancy followed by complete excision surgery with intraoperative frozen sections. Even then, recurrences are high for this disease and long term follow-up is advocated.

Matched MeSH terms: Skin Neoplasms/pathology*

Malignant proliferating trichilemmal tumour: a case report

Fernandez SH

Malays J Pathol, 1999 Dec;21(2):117-21.

PMID: 11068417

An 86-year-old man presented with a painless, pea-sized growth over the left angle of his jaw, which had been gradually enlarging over two years. A clinical diagnosis of pilar cyst was made. Histopathological examination of the mass revealed a malignant proliferating trichilemmal tumour. During follow-up 4 months later, a palpable small upper jugular lymph node was noted at the left side of the neck. Biopsy revealed a metastatic malignant trichilemmal tumour. This case illustrates a rare malignant tumour which is a challenge to clinical diagnosis.

Matched MeSH terms: Skin Neoplasms/pathology*

Localized amyloidosis in basal cell carcinoma. A pathologic study

Looi LM

Cancer, 1983 Nov 15;52(10):1833-6.

PMID: 6627203

Congo-red screening demonstrated intratumor deposits of amyloid in 35 of 53 unselected cases of basal cell carcinoma. Male subjects had a higher amyloid positivity rate than female subjects. The amyloid deposits were permanganate-resistant and located in the stroma between clumps of tumor cells, as well as abutting the advancing front of the neoplasm. Solar elastosis was often observed in the overlying and adjacent subepidermis. The relationship between amyloid positivity and the different histological subtypes of basal cell carcinoma, tumor ulceration, and density of the lymphoplasmacytic stromal infiltrate were also studied. The possibility that amyloid originates from the tumor cells and is a result of tumor apoptosis (degeneration) is discussed.

Matched MeSH terms: Skin Neoplasms/pathology*

p16 gene expression in basal cell carcinoma

Eshkoor SA, Ismail P, Rahman SA, Oshkour SA

Arch Med Res, 2008 Oct;39(7):668-73.

PMID: 18760195 DOI: 10.1016/j.arcmed.2008.06.003

Basal cell carcinoma (BCC) develops predominantly in sun-exposed skin in fair-skinned individuals prone to sunburn. BCC typically occurs in adults. High exposure to ultraviolet (UV) radiation increases rate of developing BCC, a slowly growing tumor that occurs in hair-growing squamous epithelium and rarely metastasizes. In genetic studies, BCC patients have cell-cycle abnormalities of different parts of the signaling pathway. Retinoblastoma regulatory pathway is important in cell cycle arrest. In this pathway, p16INK4a, an inhibitor of Rb pathway, binds to CDK4 and CDK6 competitively with cyclin D1 to prevent phosphorylation of tumor suppressor pRB gene. Alteration of this pathway contributes to development of human cancers and also is effective in skin cancers. In this study, we analyzed mRNA expression using in situ RT-PCR and the role of immunohistochemical expression of p16INK4a in BCC.

Matched MeSH terms: Skin Neoplasms/pathology

Multiple clustered dermatofibroma presenting in a segmental distribution

Bhabha FK, Magee J, Ng SY, Grills CE, Su J, Orchard D

Australas J Dermatol, 2016 Feb;57(1):e20-2.

PMID: 25557526 DOI: 10.1111/ajd.12257

Multiple dermatofibromas is a rare entity consisting of more than fifteen lesions. Multiple clustered dermatofibroma is a distinct variant of multiple dermatofibromas and is defined as a well-demarcated plaque composed of individual dermatofibromas. We report a 16-year-old boy with multiple clustered dermatofibroma in a segmental distribution, which has previously not been reported in the literature.

Matched MeSH terms: Skin Neoplasms/pathology*

Immunohistochemical determination of the P15 protein expression in cutaneous squamous cell carcinoma

Moad AI, Lan TM, Kaur G, Hashim H, Mabruk MJ

J Cutan Pathol, 2009 Feb;36(2):183-9.

PMID: 18564286 DOI: 10.1111/j.1600-0560.2008.00989.x

The tumor suppressor gene p15(INK4b) is a cyclin-dependent kinase inhibitor, in which its inactivation has been determined in primary tumors and in several tumor-derived cell lines. The precise role of p15(INK4b) protein expression in cutaneous squamous cell carcinoma (SCC) is currently not known. In a previous study, we have shown the frequent occurrence of allelic imbalance/loss of heterozygosity in cutaneous SCC using two microsatellite markers flanking the p15(INK4b) gene. This study is a continuation of our previous study and aims to determine the possible role of p15(INK4b) protein expression in the genesis of cutaneous SCC. P15(INK4b) protein expression was determined using immunohistochemical approach in 107 cases of cutaneous SCC tissue arrays and 19 cases of normal human skin tissues. The expression of p15(INK4b) was significantly reduced in the cutaneous SCC cases as compared with normal human skin (p = 0.017 and p < 0.05). However, there were no significant relationship between clinicopathologic variables of the patients (age, sex and tumor grade) and p15(INK4b) protein expression. The absence of p15(INK4b) expression in the majority of tissue microarray cores of cutaneous SCC indicated that p15(INK4b) could possibly be involved in the pathogenesis of cutaneous SCC.

Matched MeSH terms: Skin Neoplasms/pathology

Merkel cell carcinoma: Preparing to go the distance

Arumugam M, Jamil A, Amiseno RA, Rosli N, Abdul Shukor N

Malays J Pathol, 2020 Aug;42(2):277-281.

PMID: 32860382

INTRODUCTION: Merkel cell carcinoma (MCC) is a rare and aggressive malignancy of the skin, with poor clinical outcomes. Typical conditions include a rapidly growing, solitary dome-shaped, violaceous nodule. Several root causes have been identified - sun exposure, age, lighter skin, immunocompromised state, and polyomavirus infection. Wide local excision is the best treatment. The tumour is radiotherapy-responsive. However, the success rate of the treatment with chemotherapy is rather limited. Immunotherapy has shown promising results. Early detection is important to prevent morbidity and mortality.

CASE REPORT: In this literature work, we reported on a particular case of MCC, as exhibited by an 84-year-old Chinese woman, and discussed the clinical features and management of MCC.

DISCUSSION: We highlighted that MCC cases have a link to the polyomavirus 5. Patients who were identified with the Polyomavirus 5, and underwent immunotherapy, were seen to depict much better prognosis.

Matched MeSH terms: Skin Neoplasms/pathology

Fulltext Germline variants are associated with increased primary melanoma tumor thickness at diagnosis

Mangantig E, MacGregor S, Iles MM, Scolyer RA, Cust AE, Hayward NK, et al.

Hum Mol Genet, 2021 01 06;29(21):3578-3587.

PMID: 33410475 DOI: 10.1093/hmg/ddaa222

Germline genetic variants have been identified, which predispose individuals and families to develop melanoma. Tumor thickness is the strongest predictor of outcome for clinically localized primary melanoma patients. We sought to determine whether there is a heritable genetic contribution to variation in tumor thickness. If confirmed, this will justify the search for specific genetic variants influencing tumor thickness. To address this, we estimated the proportion of variation in tumor thickness attributable to genome-wide genetic variation (variant-based heritability) using unrelated patients with measured primary cutaneous melanoma thickness. As a secondary analysis, we conducted a genome-wide association study (GWAS) of tumor thickness. The analyses utilized 10 604 individuals with primary cutaneous melanoma drawn from nine GWAS datasets from eight cohorts recruited from the general population, primary care and melanoma treatment centers. Following quality control and filtering to unrelated individuals with study phenotypes, 8125 patients were used in the primary analysis to test whether tumor thickness is heritable. An expanded set of 8505 individuals (47.6% female) were analyzed for the secondary GWAS meta-analysis. Analyses were adjusted for participant age, sex, cohort and ancestry. We found that 26.6% (SE 11.9%, P = 0.0128) of variation in tumor thickness is attributable to genome-wide genetic variation. While requiring replication, a chromosome 11 locus was associated (P

Matched MeSH terms: Skin Neoplasms/pathology*

Lymphomatoid papulosis presenting as a rash in a patient with HIV infection

Warren S, Li V, Drayton R, May K

Int J STD AIDS, 2018 11;29(11):1120-1122.

PMID: 29665741 DOI: 10.1177/0956462418767183

A 43-year-old Malaysian man with well-controlled HIV infection on combination antiretroviral therapy presented with a six-week history of a widespread rash. The patient was otherwise well but was developing new lesions on a daily basis. Referral to Dermatology instigated punch biopsies, which revealed a diagnosis of lymphomatoid papulosis type A. This case highlights the importance of swift referral, especially in cases of spontaneous regression of symptoms, in order to obtain the correct diagnosis. In most patients, this condition tends to be chronic, with its chronicity and benign clinical course setting it apart from cutaneous anaplastic T-cell lymphoma and Hodgkin's disease, which are major entities in the histological differential diagnosis.

Matched MeSH terms: Skin Neoplasms/pathology*

Fulltext Nevus lipomatosus superficialis

Yap FB

Singapore Med J, 2009 May;50(5):e161-2.

PMID: 19495497

Nevus lipomatosus superficialis is a rare benign skin malformation characterised by ectopic adipocytes in the upper dermis. It is classified into two types: a classical Hoffman-Zurhelle type and the solitary type. A case of the classical type with multiple soft, non-tender, pedunculated, cerebriform, skin-coloured papules and nodules over the right lower back is presented in a 21-year-old Malay woman. She had a rare occurrence of ulceration and necrosis of the lesions.

Matched MeSH terms: Skin Neoplasms/pathology

Amelanotic spitzoid melanoma in a prepubescent boy

Goh EH, Zarina AL, Thambidorai CR, Maizaton AA, Siti AM, Somasundram S

Pediatr Surg Int, 2008 Apr;24(4):447-9.

PMID: 17437116

The diagnosis of malignant melanoma (MM) in children is difficult due to its uncommon occurrence as well histological similarities to Spitz nevus. A case of MM of the foot in an 11-year-old boy is reported illustrating the histological overlap between Spitz nevus and MM. In our patient, both the primary foot lesion and the regional inguinal metastases were amelanotic, further increasing the diagnostic difficulty. The literature on MM in children is limited and the documentation of such unusual cases is necessary to improve the knowledge on this disease.

Matched MeSH terms: Skin Neoplasms/pathology*

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