1/33. Proliferative actinic keratosis: three representative cases.OBJECTIVE: This article describes a new subtype of actinic keratosis that exhibits proliferative characteristics both histologically and clinically. We describe three representative cases occuring in the presence of infiltrative squamous cell carcinoma (SCC) and/or basal cell carcinoma (BCC). methods: Histories of each lesion in the three cases discussed were obtained. The lesions were removed by Mohs micrographic surgery. Permanent sections, stained with hematoxylin and eosin, were examined and studied under light microscopy. RESULTS: All three lesions had failed conventional treatment with liquid nitrogen and/or 5-fluorouracil (5-FU). Histologic examination of the lesions revealed sheets of dysplastic cells growing along the basal layer of the epidermis and migrating down hair follicles and sweat ducts. An associated infiltrative SCC and/or BCC was found in each case. CONCLUSIONS: Proliferative actinic keratosis is resistant to standard therapies because of deep migration of abnormal cells along hair follicles and sweat ducts. It has a strong propensity to develop infiltrative SCC and may occur concomitantly with BCC.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
2/33. Clinicopathological report Periocular tumour of the follicular infundibulum.Tumour of the follicular infundibulum (TFI) is an uncommon, benign lesion of the skin adnexae. Four cases are reported of periocular TFI. In all cases a clinical diagnosis of basal cell carcinoma was made before surgery; however, histopatholog ca examination revealed TFI. This is an epithelial tumour showing differentiation along the lines of the follicular infundibulum. Characteristic features are a shelf-like proliferat on of pale epithelia cells in the upper dermis, attachment to the epidermis and the upper portions of the pilosebaceous units, a dense border of elastic fibres, and palisading of the peripheral cell layer of the tumour plate. This benign tumour has not, to the authors' knowledge, been reported in the ophthalmic literature. It has a non-specific appearance and may be clinically misdiagnosed as naevus sebaceous, xanthoma, seborrhoeic keratosis, or basal cell carcinoma.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
3/33. Signet ring basal cell carcinoma. A case study emphasizing the differential diagnosis of neoplasms with signet ring cell formation.Signet ring cells are cells in which the nucleus is crescentically compressed to the cellular border so that the cells look like signet rings. Due to the pluripotential nature of the basal cells of the epidermis, basal cell carcinoma displays many histopathological variants. We herein report the rare case of a middle-aged woman who had a basal cell carcinoma on the skin of the upper lip. The neoplasm was predominantly composed of cells with signet ring configuration. Histochemically, the latter were mucin-negative. immunohistochemistry demonstrated intracytoplasmic reactivity for cytokeratin MNF116 with strong staining intensity, as well as for smooth muscle actin. The signet ring tumor cells were S100 protein-negative and carcinoembryonic antigen-negative. The lack of ploidy abnormality as well as of molecular alterations in K-ras and p53 genes may explain in part the non-aggressive biological behavior of the present tumor. Because of potential diagnostic difficulties, the pathologist should be aware of this unusual form of basal cell carcinoma. A brief review of the literature on the differential diagnosis of signet ring cell cutaneous tumors is presented.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
4/33. Ber-EP4 and MNF-116 in a previously undescribed morphologic pattern of granular basal cell carcinoma.Granular basal cell carcinoma (GBCC) is a rare subtype of basal cell carcinoma (BCC) with only seven previously described cases in the literature. A 65-year-old man presented with a papule on his cheek that was subsequently removed. Histopathologic examination revealed that the neoplasm had no connection to the overlying epidermis and that the neoplasm had two different morphologies; nodules composed solely of granular cells and other nodules with a rim of basaloid cells and central granular cells. The neoplasm stained for both Ber-EPF4 and MNF-116 thus confirming it as a subtype of BCC. GBCC should be considered in the differential diagnosis of nodular neoplasms containing granular cells.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
5/33. Topical 5-fluorouracil treatment of superficial basal cell epithelioma. A light and electron microscopic study.A 27-year-old patient developed superficial basal cell epitheliomas approximately 20 years after taking Fowler's solution. One of the lesions was successfully treated with topical 2% 5-fluorouracil soultion under occlusion. Sequential biopsies of the lesion before, during and after therapy were examined by light and electron microscopy, and the changes at various stages are described. Changes occurred only in tumor cells and adjacent epidermis, and only after occlusion of 5-FU. After one week of occlusive therapy, focal discontinuities in the basal lamina and intercellular spaces were wider with reduction and condensation of tonofilaments. Mitochondrial degeneration was seen along with irregularities in nucleoli. These changes were most prominent after two weeks of occlusive therapy, and many degenerating keratinocytes were seen detached from other cells. One month after cessation of therapy, the entire area was excised, and no evidence of tumor was seen.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
6/33. Familial basaloid follicular hamartoma: lesional characterization and review of the literature.Basaloid follicular hamartoma (BFH) is a rare cutaneous lesion associated with the acquisition of small papules that remain stable for many years. Basaloid follicular hamartoma lesions can present sporadically or as part of an inherited syndrome. Occasionally, biopsies of BFH lesions are interpreted as basal cell carcinoma (BCC), which necessitates complete removal of the lesion. In this report, we characterize a case of a familial BFH syndrome and discuss the clinical, histologic, and molecular features of BFH lesions that help to distinguish it from BCC. The BFH lesions in our patients remained stable for many years. Histologically, BFH lesions exhibit fewer mitoses and decreased single cell necrosis when compared with BCC. Immunohistochemical staining for the proliferation markers proliferating cell nuclear antigen and Ki-67 demonstrated less staining in BFH than in BCC. In addition, levels of PTCH (patched) mRNA were increased relative to unremarkable epidermis in familial BFH lesions but to a lesser degree and in a different pattern than that seen in BCC. In summary, familial BFH can be distinguished from BCC based on clinical, histologic, and molecular features and is associated with deregulation of the PTCH pathway. Basaloid follicular hamartoma may represent an indolent lesion within the spectrum of basaloid epithelial neoplasms associated with deregulation of the PTCH signaling pathway. We discuss this case in parallel with a growing body of literature that supports the nosologic designation of BFH.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
7/33. Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid: a case report.BACKGROUND: Syringocystadenoma papilliferum is an unusual benign tumor most commonly located on the scalp or face, which frequently arises from a nevus sebaceous. Transition of SP to basal cell carcinoma and, rarely, to metastatic adenocarcinoma may occur. CASE REPORT: A 28-year-old female patient had been suffering from a pinkish, painless nodule for 25 years. physical examination revealed a pinkish, non-tender, painless nodule, 5mm in diameter, on the lower eyelid. The nodular lesion was excised, and the lower eyelid was reconstructed with V-Y advancement flap. Histopathologic examination revealed hyperkeratosis with papillomatosis of epidermis. The dermis showed several cystic invaginations extending downwards from the epidermis. One year later, the postoperative result was cosmetically and functionally acceptable. CONCLUSON: Syringocystadenoma papilliferum mimicking basal cell carcinoma on the lower eyelid is of interest, since there were scanty skin appendages. Our paper considers the issue of differentiating between SP and BCC, since SP is asymptomatic and may have similar appearance. We believe that SP may be a transitional step from nevus sebaceous to basal cell carcinoma, since molecular studies show PTCH gene in all three lesions, the origins of SP are still debatable, and both SP and BCC can arise in nevus sebaceous of Jadassohn.- - - - - - - - - - ranking = 2keywords = epidermis (Clic here for more details about this article) |
8/33. A case of superficial epithelioma with sebaceous differentiation.Superficial epithelioma with sebaceous differentiation (SESD) is a rare benign neoplasm with peculiar histopathologic characteristics, which occurs in aged skin. We report upon a case of SESD occurring on the left upper back, which histopathologically is a superficial, multilobular tumor with numerous basaloid cells mixed with sebaceous cells attached to the overlying epidermis. This case represents a solitary benign neoplasm without any associated malignancy.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
9/33. Treatment of bowen's disease and basal cell carcinoma of the nose with imiquimod 5% cream.We report the successful use of topical imiquimod 5% cream for extensive multifocal, recurrent (post cryotherapy), biopsy-proven bowen's disease of the nose. Treatment was applied on a once-a-day regimen, and a total of 32 applications over 9 weeks were used. A florid local skin reaction occurred early in the treatment, necessitating a rest period and decreasing the frequency of application. The bowen's disease was coexistent with a multifocal superficial basal cell carcinoma (BCC) that had a partial response. Persistent BCC at 4 weeks post treatment was surgically excised. This tumour showed an unusual histological picture, with normal epidermis overlying residual BCC in the papillary dermis. The bowen's disease remains clinically clear at 12-months follow up.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
10/33. Basal cell carcinoma showing connections with epidermal cysts.Basal cell carcinomas arising from epidermal cysts are rare. A 76-year-old Japanese man had had a blackish nodule on his right knee for 15 years, under which he later noticed the development of a subcutaneous nodule. On histological examination masses of tumour cells showed the feature of adenoid and solid patterns of basal cell carcinoma that were connected to the wall of epidermal cysts in many places as well as with the overlying epidermis.- - - - - - - - - - ranking = 1keywords = epidermis (Clic here for more details about this article) |
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