摘要:

Eighteen patients with pigmented longitudinal bands of the nail were evaluated. The following clinical data were obtained: age, gender, and race, duration of the pigmented bands, description and location of the lesion, history of any clinical changes; other nail changes; and family and past history. Nail matrix and/or nail bed biopsy were performed in all cases. The histopathologic findings of 18 patients with longitudinal melanonychia showed hyperpigmentation of the epidermis with no apparent increase in the number of melanocytes in 10 cases. One case showed melanoma in situ; another showed keratinocytic proliferation with focal atypia. Three cases showed subungual hemorrhage. The cause of solitary pigmented bands is often not readily apparent, making the clinical diagnosis challenging. Melanotic macule of the nail matrix, consisting of increased pigmentation of the epidermis with no apparent increased in the number of melanocytes, seems to be the most common cause. When the cause of longitudinal melanonychia is not clinically apparent, biopsy of the nail matrix and the nail bed should help to establish it.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

We studied the staining pattern of HMB-45 antibody in 29 compound Spitz nevi (SNs) of the epithelioid cell variety, 17 of which showed extension of nevus cells into the reticular dermis (i.e., “deep”); 20 ordinary compound nevi (CNs), all with a deep dermal component; and 22 primary cutaneous invasive malignant melanomas (MMs) (excluding the desmoplastic and spindle cell types), 12 of which extended into Clark level IV or V. Of the 29 SNs, eight (28%) stained negatively; five (17%), including two deep SNs, stained in the epidermal component only; and 16 (55%), including 10 deep SNs, stained in both the epidermal and dermal components. Of the latter 10 deep SNs, eight stained in the upper dermis only, and in the remaining two lesions, a smaller number of positively stained nevus cells were detectable in the lower dermis as well; these two SNs were not atypical histologically. Of the 20 CNs, four (20%) stained negatively, two (10%) stained in the epidermal component only, and 14 (70%) stained in the epidermal component and the upper dermis only. Of the 22 MMs, one stained negatively, and 21 (95%) stained positively in both the epidermal and dermal components. The pattern was variable in frequency of both staining and distribution, but showed no stratification. We conclude that the majority of our positively stained deep compound SNs showed a stratified pattern of HMB-45 staining, similar to ordinary CNs and different from MMs, and that this pattern might be used as an adjunct in the histopathologic differential diagnosis of compound SN and MM, in the proper clinicopathological context.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The accumuluation of p53 protein was studied immunohistochemically on paraffin-embedded sections of 26 Spitz nevi (SNs), 26 primary invasive cutaneous malignant melanomas (MMs), 20 metastases of MM, and 17 ordinary compound nevi (CNs), using monoclonal antibody BP53–12. Positive reactivity was detected in some of the tumor cells in seven (35%) metastatic MMs, all exhibiting strong nuclear staining; eight (31%) primary MMs, of which seven showed strong nuclear staining; two (7%) SNs, of which only one showed strong nuclear staining; and none of the CNs. The frequencies of the positively stained lesions in general, and the strongly positively stained lesions in particular, in the MM and metastatic MM groups were each statistically significantly higher than the respective frequencies in the SN and CN groups. We believe that the immunohistochemical detection of p53 protein with the use of monoclonal antibodies such as BP53–12 on paraffin sections, especially when strong nuclear reactivity is demonstrated, may prove to be an adjunctive tool in the histopathologic differentiation of MM from SN.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Of 291 immunosuppressed renal transplant recipients (RTRs) with surviving allografts attending the Royal London Hospital, 171 patients (59%) were found to have warty keratoses. On histological analysis, the lesions in 50 patients (17%) showed partial-thickness dysplasia, and 34 (12%) had one or more invasive squamous cell carcinoma (SCC) and/or one or more in situ SCC or fullthikness dysplasia. We examined the claim that squamoproliferative lesions in RTRs possess distinctive histopathological features that differ from those of similar lesions occurring sporadically in the nonimmunosuppressed population. We compared 40 squamoproliferative lesions from RTRs with 40 matched squamoproliferative lesions from nonimmunosuppressed patients; lesions were coded and their source was unknown to the assessors. Two dermatopathologists independently assessed the cases and gave scores for 11 histological features that have been reported to be characteristic of such lesions in the immunosuppressed population. These included a warty architecture, kiolocytes, and multinucleate giant cells. Using these criteria, it was not possible to distinguishe lesions of immunosuppressed patients from those of immunocompetent people.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The metastatic behavior of tumor cells largely depends on tumor-stroma interactions. In the present study, a particular morphological feature of tumor-stroma interaction was evaluated; hematoxylin-eosin-stained slides of 81 lesions of melanoma metastatic to the skin involving the subcutis were examined by automated image analysis for the presence of preexistent fat cells in the tumor. The area occupied by fat cells, expressed in micrometers squared per slide, was of prognostic significance; lesions with a fat cell area of <41,000 $mUm2showed a 2-year survival rate of 42%, versus 10% in lesions with a fat cell area of >41,000 $mUm2(log-rank test,z= 3.24; p ≤ 0.01). The adverse effect of fat cell area on prognosis still was seen when age, sex, and site of metastatic spread were concomitantly taken into account in a Cox proportional-hazard model. These data indicate that melanoma deposits involving the subcutis with presrevation of preexistent subcutaneous fat cells have high metastatic potential and a high risk for rapid internal dissemination.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Direct immunofluorescence is an immunopathological technique frequently utilized for diagnosis of vesiculobullous disease such as bullous pemphigoid. Fresh-frozen tissue is required for immunofluorescent esting, making retrospective analysis difficult. In this study, we compared two methods of antigen retrieval in formalin-fixed, paraffin-embedded skin tissue from patients with bullous pemphigoid to determine if archival tissue, after use of an unmasking antigen, can be substituted for fresh-frozen tissue in the immunopathological study of skin. Paraffin-embedded tissue blocks from patients with bullous pemphigoid and patients with eosinophilic spongiotic dermatitis as the prodromal stage of bullous pemphigoid were obtained. Sections were mounted on poly-L-lysine-coated slides and the slides were deparaffinized. The methods of antigen retrieval included incubation with trypsin (0.1%) and microwave irradiation in urea (6M). Antigen retrieval was followed by indirect immunofluorescence. Microwave irradiation was more effective in antigen retrieval than was incubation with trypsin (0.1%). Microwave irradiation in urea (6M) produced more intense immunofluorescent staining than did trypsinization. Overall, positive basement membrane zone immunofluorescent staining was found in 60% of patients with a diagnosis of classical bullous pemphigoid and in 50% of patients with eosinophilic spongiotic dermatitis as the prodromal stage of bullous pemphigoid. Although the frozen-tissue method appeared more effective than the antigen-retrieval method in immunofluorescent testing of skin, the antigen-retrieval method can certainly be considered an option in retrospective studies. Antigen retrieval may be particularly advantageous in patients with eosinophilic spongiotic dermatitis in whom the diagnosis of bullous pemphigoid may not be suspected initially.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

CD is an early T-cell marker that has been used in the diagnosis of stem cell leukemias. Loss of expression of CD7 with a battery of other mature T-cell markers has also been used as one criteria in the diagnosis cutaneous T-cell lymphomas. More recently. CD7-negative T cells have been shown to be a normal population of T cells in the peripheral blood and the skin, and may represent a mature T-cell population with a different pattern of maturation and activation. In addition, in HIV-1 disease expansion of CD7-negative T cells has been found in the peripheral blood. We evaluated the number of CD7-negative T cells in skin infiltrates to determine whether there was an increase of CD7-negative T cells. We studied T-cell markers including CD3, CD4, CD7, CD8, CD20, CD29, and CD29, and HLA-DR on cutaneous biopsy material from inflammatory dermatoses in 57 patients with HIV-1 disease in Walter Reed stages (WR) 1–6, and in 14 HIV-1-negative patients WR0. The inflammatory infiltrates showed a moderate to marked decrease in CD7 expression on CD3+ T cells in benign inflammatory infiltrates of the majority of HIV-1+ patients. The majority of HIV-1-negative patients showed no decrease in CD7 expression, although 5 of 14 showed a moderate decrease and 1 of 14 showed a marked decrease. Although the nature of CD7—T cells has not been clearly defined, this population of mature T cells appears to have distinct immunologic properties as well as a trophism for skin. Better characterization of these T cells, as well as factors that promote their maturation and activation, may give clues to the high incidence as well as the pathogenesis of skin disease in HIV-1+ patients.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Nevus sebaceus, considered to be a hamartoma, is known to develop several secondary hyperplastic and neoplastic proliferations. By the use of immunohistochemical studies, we were able to describe a sometimes very striking increase of Merkel cells in nine of 19 nevi sebaccei. Only nevi sebacei that formed follicular germ structures and trichoblastomas showed a Merkel cell hyperplasia. In the hyperplastic epidermis of some cases a slight hyperplasia of singular Merkel cells was observed. In foci with follicular germs and trichoblastomas, however, the Merkel cells were much more abundant and sometimes arranged in cluster. Merkel cell hyperplasia is likely to reprsent another facet of hamartomatous hyperplasia in nevi sebacei. Our observation that trichoblastomas in nevus sebaceus possess, as a rule, hyperplasia of Merkel cells, might be an additional aid to distinguish these tumors from basal cell carcinomas, which are usually devoid of Merkel cells. Furthermore, our findings are a hint that development of follicular germs and trichoblastomas in nevi sebacei may be promoted by Merkel cells.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A simple and rapid procedure to diagnose major variants of congenital epidermolysis bullosa (EB) by means of immunohistochemical staining of collagen IV (CIV) in formalin-fixed and paraffin-embedded samples is described. Sixteen cases were stained with a monoclonal antibody (clone CIV 22) against collagen IV present in the lamina densa layer of the basement membrane. Electron microscopy was performed simultaneously. Twelve cases showed one of two staining patterns: an EB simplex pattern (seven cases) consisting of linear and continuous staining on the “floor” of the blister and an EB dystrophica pattern (five cases) showing a linear and discontinuous staining on the “roof” of the blister. In four cases, collagen IV staining was not reactive because of irreversible antigen loss due to inadequate fixation and/or embedding. In those cases with positive staining, an excellent correlation with electron microscopie diagnosis was achieved. This procedure allows a rapid diagnosis of major EB variants, especially where electron microscopy is not available, and also facilitates diagnosis by optimally orienting specimens for ultrastructural examination when available.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Juvenile hyaline fibromatosis (JHF) is a rare hereditary disorder named by Drescher et al. in 1969. As recently as 1985, only 30 cases had been reported worldwide. We report the case of a 9-year-old girl who was diagnosed with JHF at age 3 and has been closely followed since. She initially had slowly gorowing multiple soft tumors over her entire body as well as hypertrophic gingiva and mild bone deformities. She was originally misdiagnosed with infantile myofibromatosis at age 3. However, at age 6, because of the light and electron microscopic findings of the tumors, she was diagnosed as having JHF. Currently, at age 9, she has nodular lesions developing over her body as well as bone changes that are progressing with no evidence of regression.

ISSN:0193-1091    

出版商:OVID    

年代:1995

数据来源: OVID