摘要:

There is accumulating evidence that the expression of certain adhesion molecules has important consequences for understanding patterns of evil movement in normal and pathologically altered skin. This paper reviews recent work regarding the role of integrins and other adhesion molecules (ICAM‐1, YCAM‐1, PKCAM‐1, PECAM‐1, and ELAM‐1) in cutaneous inflammation and neoplasia, and presents a unifying hypothesis which outlines how sequential expression of cytokines and adhesion molecules in evolving inflammation may alter the nature of the cellular

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01654.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This report describes 41 patients with lesions similar to those previously termed “deep penetrating” or “plexiform spindle cell” nevus (DPN). DPN occurs primarily during the first four decades, is somewhat more common in females, and has a predilection for the face, trunk, and proximal extremities. It is usually less than 1 cm in diameter and often shows variegation in color, including shades of brown, blue, and black, that create clinical concern regarding malignant melanoma. None of the present tumors nor those from the literature recurred following excision. Microscopically, DPN usually has a wedge shape, invariably involves reticular dermis, and may penetrate subcutis. Involvement of neurovascular structures and adnexae and spread between fibers of the reticular dermis create a lascicular‐plexiform architecture. The melanocytes are fusiform or epithelioid, lightly to moderately pigmented, and exhibit mild to locally prominent nuclear alypia. Sparse to abundant melanophages are characteristic. Milolic figures are few and present in only a small minority of lesions. The present study of a consecutive series also indicates that DPN is a frequent participant in combined nevus, as it was associated with ordinary nevus in two‐thirds of

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01655.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Drug‐induced pemphigus has been recognized for 20 years, hui the mechanisms leading to acantholysis are still unclear. It has recently been demonstrated that penicillamine, captopril, and thiopronin may produce acantholytic lesions, cither by direct toxic or biochemical died, in human skin explains. Our work confirms that penicillamine and captopril may induce acantholysis on the model of keralinocyte culture on dead, de‐epidermized dermis. Moreover, it demonstrates that piroxicam, a new non‐steroidal anti‐inflammatory drug, of which one side effect is a pemphigus vulgaris‐like eruption, is also able to producein vitroaca

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01656.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Depletion of Langerhans colls (LC) is known lo follow bone marrow transplantation (BMT) and is thought to be mainly related lo prelransplanl radiation and chemotherapy conditioning regimens. We studied sequential biopsies of clinically normal skin of 22 thalasscmic and leukemie palienls undergoing allogeneic BMT who had received only chemotherapy (busulfan and cyclophosphamide) as conditioning regimen. LC were identified immunohistochemically using antibodies against CD1a and HLA‐DR antigens, and their number expressed per square mm of epidermal vertical section, the latter measured by computerized image analysis. Afler the preparatory regimen, the number of LC decreased progressively in both leukemie and thalassemic patients. CD1a+and HLA‐DR+epidermal cells were reduced, respectively, to 68.5% and 64.5% of their original number around Day 2, and to 23.1% and to 18.2% around Day 17. By this time, electron microscopic examination of selected biopsies confirmed the depletion of LC. Variable depopulation was observed between Days 40 and 60. Our results indicate that a conditioning regimen based exclusively on high dose chemotherapy depletes epidermal LC early after BMT, and that such depletion is not related to the development of acute graft‐versus‐host

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01657.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A grave prognosis is usually associated with leukemic skin infiltrates (leukemia culis). However, some leukemia skin infiltrates are clinically similar to reactive non‐leukemic infiltrates in paetients with leukemia; thus it is of great importance to distinguish them. Fifty‐four cases which were thought clinically to be leukemia cutis underwent immunophenotyping with a panel of nine T, B, monocytic, and macrophagc markers using paraffin sections. Immunohistochemistry helped identify 44 cases with leukemia cutis and 10 with reactive infiltrates. In all cases of leukemia culis, the staining patterns of skin infiltrates were concordant with cell type in the bone marrow. Furthermore, the panel of markers was usually helpful in distinguishing reactive from leukemic infiltrates, especially in cases with chronic lymphatic leukemia. Immunohistochemistry is a valuable adjunct in histopathologic differentiation of skin infiltrates in most cases of leukemia. With formalin‐fixed, paraffin‐embedded biopsies, we recommend that CD45 (LCA), CD45RO (UCHL‐1), CDS, CD20 (L‐26), CD43 (Leu‐22), CD68 (KIM), lysozyme, and chloroacetate estcrase be considered in cases of systemic leukemia with cutaneous papules and nodules that prove difficult to interpret with ro

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01658.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Sinus histiocytosis with massive lymphadenopathy (Rosai‐Dorfnian disease) is a systemic proliferation of cells that resemble‐ the sinus histiocytes of lymph nodes. Whereas initial reports high‐lighted the often striking cervical adenopathy, more than 40% of patients have extranodal involvement. Cutaneous lesions are (Inmost common form of extranodal disease, but cases that present as cutaneous disease without lymph node involvement are rare. We examined biopsies from three patients with cutaneous lesions of sinus histocytosis, none of whom had detectable systemic involvement, and compared them to those of two patients whose lymph nodes were involved by the disease. The histology of skin lesions in all live cases showed dense nodular or diffuse infiltrates of “hisliocytes,” emperipolesis of lymphocytes, neutro‐phils, and plasma cells. “Histiocytes” were present in lumens of dilated lymphatics. At the peripheries of the lesions were lymphoid aggregates and thick‐walled vessels surrounded by plasma cells. Staining with anti‐S‐100 protein antibody showed marked cytoplasmic positively in the “hisliocytes” in each case. The only features that differed among the two groups were the presence ol pseudoepitheliomalous hyperplasia and infiltrates of eosinophils in one case in which the disease was limited to the skin. We believe that cutaneous sinus histiocytosis can be specifically diagnosed by skin biopsy. Because cutaneous sinus histiocytosis may be unfamiliar to general palhologists, dermatopathologists, and dermatologists, cases limited to the ski

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01659.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The eosinophilia‐myalgia syndrome (EMS) associated with the ingestion of L‐tryptophan (IT) containing products has recently been recognized in the United States. We report the histologic features of the cutaneous scleroclerma‐like changes in four patients. All of the patients met the Center for Disease Control criteria for EMS and had a history of LT ingestion. Skin biopsies showed increased dermal mucin and dermal sclerosis, with trapping of adnexal structures. There are clinical and histologic similarities between EMS, seleroderma, the toxic oil syndrome, and fascilitis with eosino

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01660.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We report three patients with pemphigoid nodularis. Patients were females aged 76, 71 and 50 years, and all had features of billions pemphigoid together with prurigo‐like lesions at some stage of their illness. In two eases, nodular lesions preceded the onset of blistering by some months. Blisters arose on normal skin and in one patient also at sites of prurigo lesions. Routine histology of bullous lesions revealed the presence of subepidermal blisters. Electron microscopy perlormed in two eases confirmed the level of split to be through the lamina lucicla. Direct immunoflourenscence in all eases was positive, with linear basement membrane zone deposition of IgG and G3. Circulating IgG anti‐basement membrane antibody was also detected in all patients, and in two, immunoblotting revealed a single antigen of 220

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01661.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Cutaneous papillomavirus infection is common in patients who are immunosupprcsscd. We describe swollen keratinocytes in the granular layer in lesions from four patients who had human immunodeficiency virus infection. These cells were similar to those described in skin lesions of epidermodysplasia verruciformis. Amplification of DNA from the lesions revealed an amplimer for human papillomavirus using a consensus primer for a highly conserved region of the LI open reading frame: however, specific binding was not noted when radiolabelled probes for human papillomavirus types 6, 11, 16, 18, and 33 were used. We conclude that the presence of these distinctive swollen cells strongly suggests immunosuppression and quite possibly infection by a less common papillomavirus type.

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01662.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Cutaneous extramedullary hematopoiesis is rare, usually occurring in ueonates following intrauterine viral infections, hereditary spherocytosis or the twin transfusion syndrome. Only 20 cases of cutaneous extramedullary hematopoiesis have been reported in adults, all with myelofibrosis. The cutaneous inliltrates may be atypical and difficult to distinguish from leukemia cutis. We have studied a 65‐year‐old woman with myelofibrosis and approximately 40 violaceous, firm, non‐tender cutaneous nodules measuring 1 to 4 cm in diameter, located on her abdomen near a splenectomy scar. Histologically, the lesions had a dense infiltrate of myeloid cells in all stages of maturation, atypical large cells with multilobate nuclei or multiple nuclei, resembling atypical megakaryocytes, and fibroblasts. Although the patient received erythropoietin therapy prior to the development of the nodules, erythroid progenitors were not seen. Reticulin was increased particularly surrounding the atypical megakaryocytes. The myeloid cells stained for chloracetate esterase and with the polyclonal antibody MAC 387. Atypical megakaryocytes stained for Factor Xllla and Factor Vlll‐related antigen. Dendritic Factor XIIla positive cells were also increased. The skin lesions remain unchanged grossly one year after their development.Hoss DM, McNutt NS. Cutaneous myelof

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01663.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY