1/7. Dissecting folliculitis of the scalp with marginal keratitis.We describe a young man with dissecting folliculitis of the scalp, who subsequently developed marginal keratitis. We are unaware of any previous reports of this association. The aetiology of dissecting folliculitis is thought to relate to abnormal follicular occlusion with subsequent suppuration, although an infective process has never been established. Marginal keratitis is postulated, but not proven, to be caused by an enhanced immune response to staphylococcus aureus antigens. We suggest that a similar abnormal response to infection may be important in these two conditions. This case also highlights ocular complications which may occur in patients with dissecting folliculitis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/7. Are cutaneous reactions to fly larvae mediated by CD4 , TIA NK1.1 T cells?BACKGROUND: Although there have been reports of fly larvae in wounds and as isolated primary infestations, there have been only rare reports documenting reactions to the larvae within the skin in humans and animals. There have been no reports documenting the histopathologic and immunohistochemical characteristics of the inflammatory infiltrate. OBJECTIVE: We present a patient who developed local pruritus, erythema, and swelling approximately three weeks after infestation by a fly larva within the scalp. Histopathologically the biopsy site showed a mixed infiltrate containing lymphoid cells and numerous eosinophils. Immunohistochemical stains showed predominantly CD4 T cells expressing an ab T-cell receptor (TCR) of which approximately 30% coexpressed T-cell intracellular antigen (TIA) and CD56. In addition, there were approximately 5% of these CD4 T cells which coexpressed CD30. CONCLUSIONS: Histopathologic and immunohistochemical findings are consistent with an effector cell population of cytotoxic CD4 T cells that produce a T-helper 2 cytokine pattern. The phenotype of this subset of T cells is unique and among its characteristics is that antigens--usually nonprotein antigens--are presented to these CD4 ,TIA natural killer (NK)1.1T cells by CD1d molecules.- - - - - - - - - - ranking = 3keywords = antigen (Clic here for more details about this article) |
3/7. Primary adenoid cystic carcinoma masquerading as syringoma of the scalp.We report a case of primary adenoid cystic carcinoma of the scalp in a 72-year-old man. It consisted of syringomalike papules scattered on an erythematous plaque that showed a loss of hair. Histologically, the papular lesion at first showed numerous tadpole-like tubular structures similar to those found in syringoma. Subsequent histologic studies over 2 years revealed the presence of numerous cribriform tumor masses penetrating into the subcutis, reaching the galea aponeurotica. Immunohistochemically, the neoplastic cells showed no staining with either polyclonal (P) or monoclonal (M) antibodies to carcinoembryonic antigen. M-cytokeratin, M-vimentin, and P-S-100 protein antibodies were positive only focally as were other antibodies, including anti-actin, anti-human lactalbumin, anti-beta 2 microglobulin, and breast cancer--associated antigens. The neoplastic cells showed no binding to lectins that characteristically react with the sweat apparatus, except for concanavalin a (con A) and peanut agglutinin (PNA), although the striking histopathologic resemblance to syringoma suggested its histogenic relation to eccrine glands initially.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
4/7. Localized cicatricial pemphigoid of the Brunsting-Perry type with transition into disseminated cicatricial pemphigoid. Report of a case proved by preembedding immunogold electron microscopy.BACKGROUND: In 1979, Provost described two patients with the clinical features of disseminated cicatricial pemphigoid for the first time. Until now, only four additional cases of disseminated cicatricial pemphigoid have been described. Existence of diagnosis of disseminated cicatricial pemphigoid has been discussed controversially because in four cases investigated by electron microscopy the blister formation was found below the lamina densa, which is indicative of an epidermolysis bullosa acquisita. observation: A 78-year-old woman is presented with a generalized eruption of blisters leaving behind scars that developed after a 7-year-long history of mild circumscribed recurrent blisters and scarring eruptions that had been diagnosed previously as Brunsting-Perry type of cicatricial pemphigoid. Immunofluorescence antigen mapping disclosed the blister formation above the lamina densa. Electron and immunoelectron microscopy using a preembedding immunogold technique revealed blister formation and antibody binding within the lamina lucida, predominantly below the subbasal dense plate. CONCLUSIONS: The clinical features of disseminated blistering followed by scarring, the immunofluorescence antigen mapping, and the electron and immunoelectron microscopic findings in our case for the first time clearly prove the existence of a disseminated cicatricial pemphigoid.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
5/7. Epidermoid cyst of the scalp containing human papillomavirus.We report an epidermoid cyst of the scalp with light microscopic and immunohistochemical evidence of human papillomavirus (HPV) infection. light microscopic features suggesting HPV infection included papillomatosis and hypergranulosis of the cyst lining with the presence of koilocytes. Much of the keratin within the cyst demonstrated parakeratosis. Immunoperoxidase labeling for HPV antigen was noted within koilocytes. Papillomavirus infection has been reported in plantar epidermoid cysts. To our knowledge, this is the first report of a papillomavirus-infected epidermoid cyst in a site other than plantar skin. light microscopic features of our cases differed from those of the plantar cysts. Epidermoid cysts may be induced by the papillomavirus or the virus may merely infect pre-existing cysts.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/7. La (SS-B)-positive neonatal lupus erythematosus: report of a case with unusual features.Neonatal lupus erythematosus is most often associated with autoantibodies against Ro and La antigens. Rarely, neonatal lupus erythematosus occurs in the absence of Ro antibody. We present a case of La antibody-positive neonatal lupus erythematosus with unusual features.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/7. Folliculotropic mycosis fungoides with large-cell transformation presenting as dissecting cellulitis of the scalp.Follicular mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma (CTCL) in which malignant lymphocytes preferentially infiltrate hair follicles. This report describes a patient with follicular mycosis fungoides presenting in a manner similar to dissecting cellulitis of the scalp with nonhealing, draining nodular lesions. Follicular mucinosis associated with folliculotropic mycosis fungoides resulted in follicular disruption and deep dissecting cellulitis. Large-cell transformation of CTCL was present in the initial diagnostic scalp and axillary lymph node specimens. The patient died from progressive CTCL 9 months following initial diagnosis despite electron beam radiation, topical mechlorethamine, interferon-alpha, and systemic chemotherapy. This case indicates that large-cell transformation of folliculotropic mycosis fungoides is an aggressive form of CTCL, and that folliculotropic mycosis fungoides can give rise to lesions which resemble dissecting cellulitis of the scalp. Upregulation of intercellular adhesion molecule-1 (ICAM-1) on follicular epithelium adjacent to lymphocyte function-associated antigen-1 (LFA-1)-positive folliculotropic lymphoma cells in this report provides insight into lymphocyte homing mechanisms in folliculotropic MF.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |