Generalized Multinucleate Cell Angiohistiocytoma: Histopathological and Immunohistochemical Analyses of 10 Lesions.

ABSTRACT: Multinucleate cell angiohistiocytoma (MCAH) is an uncommon fibrohistiocytic disorder that usually presents as a localized solitary papule or multiple grouped papules. Generalized presentation is very rare with less than 20 cases reported in the literature. In this article, we present histopathological and immunohistochemical studies of 10 lesions from a patient with generalized MCAH. In all lesions, the histopathological changes were confined to a discrete zone of the superficial dermis that consisted of (1) an increase in the number of capillary-sized vessels with thickened walls, (2) presence of oval to dendritic spindle cells and stellate hyperchromatic multinucleated cells, (3) fibrosis marked by compact collagen, (4) hypertrophy and hyperplasia of small nerve fibers, and (5) a moderately dense lymphocytic infiltrate. The entire population of the cellular component including the multinucleated cells stained for CD10, whereas a subpopulation of the mononuclear spindle cells stained for factor XIIIa and CD68. CD34 highlighted only the blood vessels. The results confirm that the multinucleated cells lack expression of CD68 and factor XIIIa and that CD10 may be used to highlight the entire cellular component. The rarely reported hypertrophy and hyperplasia of nerve fibers in MCAH may be a common finding as it was observed in all 10 lesions.

MicroRNAs in cutaneous melanoma: Role as diagnostic and prognostic biomarkers.

Melanoma is the leading cause of skin cancer deaths in the United States, and its incidence has been rising steadily for the past 30 years (Aftab, Dinger, & Perera, 2014). A more complete understanding of the molecular mechanisms that drive melanomagenesis is crucial to improve diagnosis, prognostication, and treatment of this disease. Given that melanoma survival rates are better when the disease is detected early, precise diagnostic tests for early melanoma detection would be extremely useful. In addition, as survival rates decrease drastically when the disease becomes metastatic, improved tools to more precisely identify high-risk patients as well as to predict treatment response are necessary. The role of microRNAs (miRNAs) in melanoma biology could be the key. miRNA expression profiling has identified several miRNAs that play a crucial role in melanoma cell proliferation, migration, and invasion, as well as miRNAs involved in apoptosis and in the immune response. Here we review the most current data on the miRNAs involved in melanoma as well as their potential roles as diagnostic and prognostic biomarkers of this disease.

Acute generalized exanthematous pustulosis due to terbinafine.

Acute generalized exanthematous pustulosis is a rare adverse cutaneous reaction characterized by the rapid appearance of numerous pustules arising on edematous, erythematous skin. It is commonly accompanied by fever and leukocytosis and usually resolves with discontinuation of the offending agent. Herein, acute generalized exanthematous pustulosis induced by terbinafine is described, followed by a brief review of the literature.

Lichen Sclerosus in Perspective.

Lichen sclerosus (LS) was first described in women by a researcher in 1887.1 It was recognized in men by another investigator in 1928.2 Lichen sclerosus is a chronic, inflammatory lymphocytic dermatosis that occurs in anywhere from 1:30 to 1:1,000 adults.3,4 There is a slight predominance of women, with a bimodal age distribution in pre-pubertal individuals and again in life's sixth-seventh decades. Studies have established that the majority with pre-pubertal onset continue to have adulthood disease.5 Psychosocial implications of this disease, specifically self-image, anxiety, and sexual function, can be debilitating for patients.6-9 As no cure has been described for lichen sclerosus. Treatment is aimed at symptomatic relief and preventing additional effacement. Unfortunately, the scarring that occurs is usually permanent.10,11 As it is unclear whether treatment alters the theoretic risk of malignant degeneration, estimated at 4%-5%,12,13 frequent clinical examinations are indicated.14-17.

Beware of Home Remedies for Mole Removal.

The use of at-home remedies for many dermatologic issues is common, as some patients do not seek professional care either for lack of access, excessive cost of prescription medication, or desire for a more "natural" solution. As these over-the-counter compounds become more prevalent, it is important for dermatologists to be aware not only of the chemicals that they contain but also of their potential adverse effects. It is important to educate and warn patients that not only will these compounds probably not achieve the desired endpoint but they may lead to unwanted cosmetic results and even permanent scarring.