The American Journal of dermatopathology
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Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a superficial benign skin tumor that arises from hair follicle matrix cells. Although pilomatrixomas are well-recognized lesions, clinically they are frequently misdiagnosed as other skin conditions. By reviewing all the literature over the past 10 years, the aims of this article are to analyze the cause, clinical presentation, management, and outcome of pilomatrixoma among children and adults to gain a more complete understanding of this lesion in today's clinical context. ⋯ Pilomatrixomas are thought to arise from mutation in the Wnt pathway and has been linked to several genetic conditions. It is commonly misdiagnosed preoperatively; however, with better awareness of the lesion, it can be appropriately treated while avoiding unnecessary diagnostic tests. Complete surgical excision with clear margins is almost always curative.
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Review Case Reports
Neutrophilic sebaceous adenitis with intralobular Demodex mites: a case report and review of the literature.
A 61-year-old white man presented with a 1-week history of an asymptomatic erythematous, annular plaque with minimal scale limited to the nasal bridge. Histological examination showed a mixed infiltrate of lymphocytes and neutrophils within sebaceous glands. ⋯ Demodex brevis mites are uncommon inhabitants of sebaceous glands of the nose, presenting more commonly on other body sites. The cause of neutrophilic sebaceous adenitis is unknown, but the presence of D. brevis in affected sebaceous glands in this case suggests a possible association.
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This second part of the review categorizes the site-specific nail tumors, as proposed in the first part, according to their clinical presentations. Acquired localized longitudinal pachyonychia allows for the specific recognition of onychogenic nail tumor, which can be classified into 2 groups according to the predominant compartment of origin within the nail unit as follows: epithelial tumors encompassing onychocytic matricoma and onychocytic carcinoma, and fibroepithelial tumors: the so-called onychomatricoma. As onychomatricoma is neither an epithelial matrical tumor nor a tumor with a limited differentiation toward the matrix, the author proposes instead the descriptive term of panonychoma fibropapilliferum (POP). ⋯ The author proposes to categorize subungual tumors into 2 types: subungual skin tumors (including subungual skin metastasis from internal malignancies) and nail tumors. Nail tumors can be accurately classified using a combined clinical and histogenetic approach. This new and expanding group of appendageal tumors is important for both dermatologists and dermatopathologists for the potential early detection of a malignant lesion or for the avoidance of overtreatment of a benign lesion.
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Review Case Reports
A case of sweet syndrome with spleen and lymph node involvement preceded by parvovirus B19 infection, and a review of the literature on extracutaneous sweet syndrome.
A 45-year-old white woman presented with fever, arthalgias, and widespread erythematous papules after a recent Parvovirus B19 infection. Biopsy findings were consistent with classic Sweet syndrome. A splenectomy, which was performed due to radiographic evidence of multiple splenic lesions, revealed a diffuse neutrophil-predominant infiltrate with formation of numerous "abcesses." Her skin lesions recurred several times over the next 6 years, with repeat biopsies showing evidence of recurrent Sweet neutrophilic dermatosis. ⋯ This clinical-pathologic presentation was consistent with Sweet syndrome involving both cutaneous and lymphoreticular (spleen and lymph nodes) sites. This case illustrates the importance of recognizing extracutaneous involvement in Sweet syndrome and differentiating this from infectious, malignant, and other processes. The literature on extracutaneous involvement of Sweet syndrome is reviewed.
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A reappraisal of histoid leprosy in the contemporary postglobal leprosy elimination era, a fallout of the World Health Organization leprosy elimination program, is succinctly outlined. The cardinal clinical expression, differential clinical diagnosis, the cytodiagnosis, and diagnostic salient histopathological features are highlighted.